This is the 3591st article of Da Yi Xiao Nursing
Seeing the CT image of my friend Xiao Zhao's lung physical examination really surprised me a little. In the upper lobe of his right lung, there was a mixed ground glass nodule 12 mm in diameter, which was almost certainly an early lung cancer. Soon Xiao Zhao underwent surgery, and the result of the operation was in line with my judgment, which was a slightly invasive lung adenocarcinoma. To tell you the truth, every year similar patients will encounter a lot, but Xiao Zhao suffers from this disease, I really have some doubts. Xiao Zhao is the head of security at a sales company. I have been doing it for more than ten years, and I am familiar with the road with light work and no pressure. He is also a good man who takes care of his family, and he works from nine to five every day. Belonging to the kind of people who usually live a very regular life, watching his circle of friends often be a healthy and upward activity such as morning running and playing badminton. Half a month after the operation, he came to my outpatient clinic to visit him, and I carefully talked to him about some causes, asked his parents, grandparents, grandparents, including an uncle who had no history of tumors. The family house has also been renovated for many years, and there is no radioactive stone. Usually, I pay attention to everything when cooking, and I almost don't touch the fumes. It is also important to note that he never smokes. Patients like him, who have neither a family history nor a history of environmental exposure, are still relatively rare. Just when I was talking to him about my doubts, Xiao Zhao suddenly came to this sentence: "I have been smoking almost every day for more than ten years." It's strange: "Aren't you non-smoking?" Why do you smoke every day again? Xiao Zhao said: "Although I don't smoke myself, I smoke second-hand smoke every day." It turned out that Xiao Zhao belonged to the company's security department, and their office was in the corner of the company. Usually, there are few people in this place, and the people in the same office as him are senior old smokers, and many old smokers in the company often sneak to their offices to smoke. This time and so, his office, almost every day is full of smoke. In the past few years, he has a colleague who also suffered from lung cancer, and a colleague with emphysema, all of whom retired early, but the remaining ones are still obsessed and continue to swallow clouds. On weekdays and weekends, these colleagues often play a few laps of mahjong together, and they also smoke constantly when playing cards. It seems that Xiao Zhao is smoking second-hand smoke almost every day.
The official name for secondhand smoke is environmental tobacco smoke (ETS) or "other people's smoke." Refers to a mixture of tobacco smoke emitted by smokers during smoking and the measured tobacco smoke emitted when a cigarette or other combustible smoking herbal product is burned. Inhalation or exposure to second-hand smoke by non-smokers is formally known as second-handsmoke exposure, also known as passive smoking.
Second-hand smoke also contains many toxic and harmful substances, and a United States National Toxicology Program conducted in 2000 estimated that second-hand smoke contained at least 250 toxic substances. These include 69 carcinogens such as benzoanthracene, N-nitrosamines, etc., of course, there are many harmful components such as carbon monoxide and nicotine. As early as 1981, Professor Trichopoulos et al. did the first study on the risk of lung cancer after second-hand smoke exposure of non-smokers, and a number of related studies in this regard were launched successively, such as InternationalAgency for Research on Cancer 2004; US Department ofHealth and Human Services 2006; Kim et al. Studies such as 2014 have clearly confirmed that exposure to secondhand smoke increases the risk of lung cancer. There are even studies that have found that exposure to secondhand smoke in early childhood increases the chances of developing lung cancer in adulthood. Early-stage lung cancer patients will shorten their survival even if they are exposed to second-hand smoke after surgery, which means that lung cancer patients will continue to be exposed to second-hand smoke even after surgery, which will also lead to the recurrence of lung cancer. In this way, Xiao Zhao's lung cancer is also a cause that can be checked. In fact, the author has been writing all these years. Many lung cancer patients diagnosed without smoking, carefully asked for medical history, almost all have a history of exposure to secondhand smoke. While some lung cancer patients will tell me that their families smoke under the exhaust fan in the kitchen every time, there is very little smoke smelling at home. But secondhand smoke, like hand smoke, has no so-called level of safety. The 2010 U.S. Surgeon General's Report on Tobacco clearly states that even short-term exposure to secondhand smoke can be harmful to human health. The role of the kitchen exhaust fan is to remove some of the oil smoke, for example, we usually make chili oil, although the exhaust fan is opened to the maximum, it will still smell a strong chili smell. So when smoking, although the exhaust fan is turned on, only a part of the smoke is eliminated, and many smokes will drift in the kitchen. Foreign countries have done experiments in this regard, and the power of the currently commonly used exhaust fan cannot achieve the effect of completely removing tobacco smoke. To completely absorb the smoke, it is necessary to install an ultra-powerful exhaust filtration device, which is obviously impossible for the family.
Although second-hand smoke is harmful to health is an old problem, in today's high incidence of lung cancer, the problem of second-hand smoke should still be paid attention to. For each of us: "For the sake of our own health, we must reject second-hand smoke".
Author: Shanghai Fengxian District Central Hospital
Liu Hongwei Chief Physician