Waterpipe smoking and dependence are associated with chronic bronchitis: a case-control study in Lebanon

Waterpipe smoking and its association with chronic bronchitis has not been assessed in Lebanon. This case-control study in Beirut in 2009/2010 evaluated this relationship: 274 cases of chronic bronchitis and 559 controls without the condition aged >/=40 years were enrolled. Data were collected by questionnaire on: sociodemographic characteristics, respiratory symptoms, smoking [waterpipe and cigarette] and nicotine dependence. ANOVA, Student, Kruskal-Wallis, chi-squared and Fisher exact tests were used when applicable and logistic regression analysis was carried out. Previous waterpipe smoking [OR = 6.4], previous mixed smoking [OR = 38.03] and current mixed smoking [OR = 7.68] were significantly associated with chronic bronchitis [P < 0.001 for all] but current exclusive waterpipe smoking was not [OR = 1.87, 95% CI: 0.74-4.72]. Current waterpipe dependence was significantly associated with chronic bronchitis [OR = 3.74, P < 0.001]. After adjustment for covariates/confounders, ever waterpipe smoking > 20 WP-years [P < 0.001] was significantly associated with chronic bronchitis

Exposure to outdoor air pollution and chronic bronchitis in adults: a case-control study

Although Lebanon is a highly polluted country, so far no study has specifically been designed to assess the association between outdoor air pollution and chronic bronchitis in this country. To assess the association between exposure to outdoor air pollution and chronic bronchitis in Lebanon. A pilot case-control study was conducted in two tertiary care hospitals. Cases consisted of patients diagnosed with chronic bronchitis by a pulmonologist and those epidemiologically confirmed. Controls included individuals free of any respiratory signs or symptoms. After obtaining informed consent, a standardized questionnaire was administered. Bivariate, stratified [over smoking status and gender] and multivariate analyses revealed that passive smoking at home [ORa: 2.56, 95% CI: 1.73-3.80] and at work [ORa: 1.89, 95% CI: 1.13-3.17]; older age [ORa: 1.75, 95% CI: 1.55-2.39]; lower education [ORa: 1.44, 95% CI: 1.21-1.72]; living close to a busy road [ORa: 1.95, 95% CI: 1.31-2.89] and to a local power plant [ORa: 1.62, 95% CI: 1.07-2.45]; and heating home by hot air conditioning [ORa: 1.85, 95% CI: 1.00-3.43] were moderately associated with chronic bronchitis; an inverse association was found with heating home electrically [ORa: 0.58, 95% CI: 0.39-0.85]. A positive dose-effect relationship was observed in those living close to a busy road and to a local diesel exhaust source. Chronic bronchitis is associated with outdoor air pollution