RESEARCH PAPER
Systemic inflammation in 222.841 healthy employed smokers and nonsmokers: white blood cell count and relationship to spirometry
 
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1
Hospital Universitari Germans Trias i Pujol, Servicio de Neumología, Badalona, Barcelona, Spain
 
2
Sociedad de Prevención de Ibermutuamur, Madrid, Spain
 
3
Servei d’statística Aplicada, Universitat Autónoma de Barcelona, Barcelona, Spain
 
 
Submission date: 2011-12-05
 
 
Acceptance date: 2012-03-29
 
 
Publication date: 2012-05-21
 
 
Corresponding author
José Antonio Fiz Fernández   

Hospital Universitari Germans Trias i Pujol, Servicio de Neumología, Planta 8. Carretera del Canyet s/n, Badalona, Barcelona 08916, Spain
 
 
Tobacco Induced Diseases 2012;10(May):7
 
KEYWORDS
ABSTRACT
Background:
Smoking has been linked to low-grade systemic inflammation, a known risk factor for disease. This state is reflected in elevated white blood cell (WBC) count.

Objective:
We analyzed the relationship between WBC count and smoking in healthy men and women across several age ranges who underwent preventive medical check-ups in the workplace. We also analysed the relationship between smoking and lung function

Methods:
Cross-sectional descriptive study in 163 459 men and 59 382 women aged between 16 and 70 years. Data analysed were smoking status, WBC count, and spirometry readings.

Results:
Total WBC showed higher counts in both male and female smokers, around 1000 to 1300 cell/ml (t test, P < 0.001). Forced expiratory volume in 1 second (FEV1%) was higher in nonsmokers for both sexes between 25 to 54 years (t test, P < 0.001). Analysis of covariance showed a multiple variable effect of age, sex, smoking status, body mass index on WBC count. The relationship between WBC blood count and smoking status was confirmed after the sample was stratified for these variables. Smokers with airway obstruction measured by FEV1% were found to have higher WBC counts, in comparison to smokers with a normal FEV1% among similar age and BMI groups.

Conclusions:
Smoking increases WBC count and affects lung function. The effects are evident across a wide age range, underlining the importance of initiating preventive measures as soon as an individual begins to smoke.

 
REFERENCES (31)
1.
Yeung MC, Buncio AD: Leukocyte count, smoking, and lung function. Am J Med. 1984, 76: 31-37. 10.1016/0002-9343(84)90741-1.
 
2.
Friedman GD, Siegelaub AB, Seltzer CC, Feldman R, Collen MF: Smoking habits and the leukocyte count. Arch Environ Health. 1974, 29: 26-137.
 
3.
Tell GS, Grimm RH, Vellar OD, Theodorsen L: The relationship of white cell count, platelet count, and hematocrit to cigarette smoking in adolescents: the Oslo Youth Study. Circulation. 1985, 72: 971-974. 10.1161/01.CIR.72.5.971.
 
4.
Zalokar JB, Richard JL, Claude JR, Pharm D: Leukocyte count, smoking, and myocardial infarction. N Engl J Med. 1981, 304: 465-468. 10.1056/NEJM198102193040806.
 
5.
Lampe JW, Stepnaniants SB, Mao M, Radich JP, Dai H, Linsley PS, Friend SH, Potter JD: Signatures of environmental exposures using peripheral leukocyte gene expression: Tobacco smoke. Cancer Epidemiol Biomarkers Prev. 2004, 13: 445-453.
 
6.
Cosio MG, Saetta M, Agusti A: Immunologic aspects of chronic obstructive pulmonary disease. N Engl J Med. 2009, 360: 2445-2454. 10.1056/NEJMra0804752.
 
7.
Terashima T, Klut ME, English D, Hards J, Hogg JC, van Eeden St F: Cigarette smoking causes sequestration of polymorphonuclear leukocytes released from the bone marrow in lung microvessels. Am J Respir Cell Mol Biol. 1999, 20: 171-177.
 
8.
Adams DH, Lloyd AR: Chemokines: leucocyte recruitment and activation cytokines. Lancet. 1997, 349: 490-495. 10.1016/S0140-6736(96)07524-1.
 
9.
Arcavi L, Benowitz NL: Cigarette smoking and infection. Arch Intern Med. 2004, 164: 2206-2216. 10.1001/archinte.164.20.2206.
 
10.
Casan P, Burgos F, Barberá JA, Giner J: Espirometría. Manual de procedimientos SEPAR. Sociedad Española de Neumología y Cirugía Torácica. 2002, S.A de Ediciones, Madrid, 4-15.
 
11.
Castellsagué J, Burgos F, Sunyer J, Barberà JA, Roca J, for the Barcelona Collaborative Group on Reference, for the Barcelona Collaborative Group on Reference: Values for Pulmonary Function testing and the Spanish Group of the European Community Respiratory health Survey. Respir Med. 1998, 92: 401-407. 10.1016/S0954-6111(98)90282-7.
 
12.
Smith MR, Kinmonth AL, Lubel RN, Bingham S, Day NE, Wareham NJ, Welch A, Khaw KT: Smoking status and differential white cell count in men and women in the EPIC-Norfolk population. Atherosclerosis. 2003, 169: 331-337. 10.1016/S0021-9150(03)00200-4.
 
13.
Ruggiero C, Metter EJ, Cherubini A, Maggio M, Sen R, Najjar SS, Windham GB, Ble A, Senin U, Ferrucci L: White blood cell count and mortality in the Baltimore longitudinal study of aging. J Am Coll Cardiol. 2007, 49: 1842-1850.
 
14.
Friedman GD, Klatsky AL, Siegelaub AB: The leukocyte count as a predictor of myocardial infarction. N Engl J Med. 1974, 290: 1275-1278. 10.1056/NEJM197406062902302.
 
15.
Friedman GD, Siegelaub AB, Seltzer CC, Feldman R, Collen MF: Smoking habits and the leukocyte count. Arch Environ Health. 1973, 26: 137-143.
 
16.
Roethig HJ, Feng S, Liang Q, Liu J, Rees WA, Zedler BK: A 12-month, randomized, controlled study to evaluate exposure and cardiovascular risk factors in adult smokers switching from conventional cigarettes to a second generation electrically heated cigarette smoking system. J Clin Pharmacol. 2008, 48: 580-591. 10.1177/0091270008315316.
 
17.
Phillips AN, Neaton JD, Cook DG, Grimm RH, Shaper AG: Leukocyte count and risk of major coronary heart disease events. Am J Epidemiol. 1992, 136: 376-380.
 
18.
Schwartz J, Weiss ST: Host and environmental factors influencing the peripheral blood leukocyte count. Am J Epidemiol. 1991, 134: 1402-1409.
 
19.
Nieto FJ, Szklo M, Folsom AR, Rock R, Mercuri M: Leukocyte count correlates in midle-aged adults: the atherosclerosis risk in communities (ARIC) study. Am J Epidemiol. 1992, 136: 525-537.
 
20.
Yarnell JW, Sweetnam PM, Rogers S, Elwood PC, Bainton D, Baker IA, et al: Some long term effects of smoking on the haemostatic system: a report from the Caerphilly and Speedwell collaborative surveys. J Clin Pathol. 1987, 40: 909-913. 10.1136/jcp.40.8.909.
 
21.
Hansen LK, Grimm RH, Neaton JD: The relationship of white blood cell count to other cardiovascular risk factors. Int J Epidemiol. 1990, 19: 881-888. 10.1093/ije/19.4.881.
 
22.
Petitti DB, Kipp H: The leukocyte count: associations with intensity of smoking and persistence of effect after quitting. Am J Epidemiol. 1986, 123: 89-95.
 
23.
Roethig AJ, Koval T, Muhammad-Kah R, Jin Y, Mendes P, Unverdorben M: Short term effects of reduced exposure to cigarette smoke on white blood cells, platelets and red blood cells in adult cigarette smokers. Regul Toxicol Pharmacol. 2010, 57: 333-337. 10.1016/j.yrtph.2010.04.005.
 
24.
Al-Awadhi AM, Alfadhli SM, Mustafa NY, Sharma PN: Effects of cigarette smoking on hematological parameters and von Willebrand factor functional activity levels in asymptomatic male and female Arab smokers. Med Princ Pract. 2008, 17: 149-153. 10.1159/000112970.
 
25.
Tanigawa H, Iso K, Yamagishi I, Muraki N, Kawamura A, Nakata S, Sakurai T, Ohira T, Shimamoto T: Association of lymphocyte sub-populations with clustered features of metabolic syndrome in middle-aged Japanese men. Atherosclerosis. 2004, 173: 295-300. 10.1016/j.atherosclerosis.2003.12.019.
 
26.
Bastard JP, Maachi M, Lagathu C, et al: Recent advances in the relationship between obesity, inflammation, and insulin resistance. Eur Cytokine Netw. 2006, 17: 4-12.
 
27.
Huang Z-S, Chien KL, Yang CY, Tsai KS, Wang CH: Peripheral differential leukocyte counts in humans vary with hyperlipidemia, smoking and body mass index. Lipids. 2001, 36: 237-245. 10.1007/s11745-001-0713-9.
 
28.
Albanes D, Jones YD, Micozzi MS, Mattson ME: Associations between smoking and body weight in the US population: analysis of NHANES II. Am J Public Health. 1987, 77: 439-444. 10.2105/AJPH.77.4.439.
 
29.
Kauffman A, Augustson EM, Patrick H: Unraveling the relationship between smoking and weight: The role of sedentary behavior. J Obes. in press.
 
30.
Qi Gan W, Man P, Sin DD: The interactions between cigarette smoking and reduced lung function on systemic inflammation. Chest. 2005, 127: 558-564. 10.1378/chest.127.2.558.
 
31.
Qi Gan W, Man P, Senthilselvan A, Sin D: Association between chronic obstructive pulmonary disease and systemic inflammation: a systematic review and a meta-analysis. Thorax. 2004, 59: 574-580. 10.1136/thx.2003.019588.
 
 
CITATIONS (22):
1.
Low-grade inflammation is associated with lower haemoglobin levels in healthy individuals: results from the Danish blood donor study
S. R. Kotzé, O. B. Pedersen, M. S. Petersen, E. Sørensen, L. W. Thørner, C. J. Sørensen, A. S. Rigas, H. Hjalgrim, K. Rostgaard, H. Ullum, C. Erikstrup
Vox Sanguinis
 
2.
Profil inflammatoire systémique des fumeurs atteints de BPCO comparés aux fumeurs indemnes de BPCO
Y. Mosrane, M. Bougrida, A.S. Alloui, M. Martani, L. Rouabah, M.K. Bourahli, H. Mehdioui, H. Ben Saad
Revue de Pneumologie Clinique
 
3.
Are healthy smokers really healthy?
Zijing Zhou, Ping Chen, Hong Peng
Tobacco Induced Diseases
 
4.
Identification of gene expression signature for cigarette smoke exposure response—from man to mouse
F Martin, M Talikka, J Hoeng, MC Peitsch
Human & Experimental Toxicology
 
5.
Review of biomarkers to assess the effects of switching from cigarettes to modified risk tobacco products
Michael John Peck, Edward B. Sanders, Gerhard Scherer, Frank Lüdicke, Rolf Weitkunat
Biomarkers
 
6.
Serum white blood cell count and pulmonary function test are negatively associated
H.-F. Yang, T.-W. Kao, C.-C. Wang, T.-C. Peng, Y.-W. Chang, W.-L. Chen
Acta Clinica Belgica
 
7.
Smoking: A risk factor for vascular disease
Phyllis Gordon, Patty Flanagan
Journal of Vascular Nursing
 
8.
Longitudinal effects of systemic inflammation markers on periodontitis
Christiane Pink, Thomas Kocher, Peter Meisel, Marcus Dörr, Marcello R. P. Markus, Lukasz Jablonowski, Anne Grotevendt, Matthias Nauck, Birte Holtfreter
Journal of Clinical Periodontology
 
9.
Transient changes in inflammatory and oxidative stress markers with total sleep deprivation
Rugül Köse Çınar, Yasemin Görgülü, Okan Çalıyurt, Bülent Sönmez
Sleep and Biological Rhythms
 
10.
The acute effect of cigarette smoking on the respiratory function and FENO production among young smokers
Marios Kougias, Constantine I. Vardavas, Nektarios Anagnostopoulos, Yuko Matsunaga, Anna Tzwrtzi, Maria Lymberi, Gregory N. Connolly, Panagiotis K. Behrakis
Experimental Lung Research
 
11.
Relation of inflammatory markers with symptoms of psychotic disorders: a large cohort study
E.J. Liemburg, I.M. Nolte, H.C. Klein, H. Knegtering
Progress in Neuro-Psychopharmacology and Biological Psychiatry
 
12.
Smoking and Increased White and Red Blood Cells
Kasper Mønsted Pedersen, Yunus Çolak, Christina Ellervik, Hans Carl Hasselbalch, Stig Egil Bojesen, Børge Grønne Nordestgaard
Arteriosclerosis, Thrombosis, and Vascular Biology
 
13.
A transcript-wide association study in physical activity intervention implicates molecular pathways in chronic disease
Kajal Claypool, Chirag Patel
 
14.
Tobacco Smoke and Endothelial Dysfunction: Role of Aldehydes?
Jordan Lynch, Lexiao Jin, Andre Richardson, Daniel Conklin
Current Hypertension Reports
 
15.
Serum white blood cell count and pulmonary function test are negatively associated
H.-F. Yang, T.-W. Kao, C.-C. Wang, T.-C. Peng, Y.-W. Chang, W.-L. Chen
Acta Clinica Belgica
 
16.
Purple corn extract (PCE) alleviates cigarette smoke (CS)-induced DNA damage in rodent blood cells by activation of AMPK/Foxo3a/MnSOD pathway
Wan-Sik Kim, Chea-Ha Kim, Jung-Min Lee, Jeong-Ho Jeon, Beom-Goo Kang, Madhuri Warkad, Gozde Inci, Hong-Won Suh, Soon Lim, Sung-Chan Kim, Jaebong Kim, Jae-Yong Lee
Animal Cells and Systems
 
17.
Supplements for Smoking-Related Lung Diseases
Naser Alsharairi
Encyclopedia
 
18.
Evolutionary Gerontology and Geriatrics
Giacinto Libertini, Graziamaria Corbi, Valeria Conti, Olga Shubernetskaya, Nicola Ferrara
 
19.
GMEPS: a fast and efficient likelihood approach for genome-wide mediation analysis under extreme phenotype sequencing
Janaka Liyanage, Jeremie Estepp, Kumar Srivastava, Yun Li, Motomi Mori, Guolian Kang
Statistical Applications in Genetics and Molecular Biology
 
20.
Clearing the Haze: How Does Nicotine Affect Hematopoiesis before and after Birth?
Taylor Cool, Alessandra Baena, E. Forsberg
Cancers
 
21.
Aqueous humor perturbations in chronic smokers: a proteomic study
Radgonde Amer, Adi Koriat
Scientific Reports
 
22.
Construction, characterization and gastrointestinal digestion and absorption kinetics of the nanoparticles loaded with Malus baccata (Linn.) polyphenols
Huipeng Zhu, Qianyu Jiang, Dawei Gao, Lu Wang, Xiaoyu Li
Food Bioscience
 
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