24 Cent Eur J Public Health 2012; 20 (1): 24–28 SUMMARY Exposure to environmental tobacco smoke leads to very serious health effects, especially on the respiratory system. The objective of this paper was to estimate the infuence of passive smoking on absence from work because of respiratory problems in women. The study sample consisted of 497 women aged 40–56 who live in an area with identical outdoor air pollution. Environmental tobacco smoke exposure was recorded in 346 women. Data about respiratory symptoms in women were entered into a structured questionnaire. Statistics tests showed no signifcant difference of living conditions, keeping pets, hereditary predisposition among women. The occurrence of congested nose (OR=3.47; 95% CI=1.38–9.01), nasal secretion (OR=3.48; 95% CI=1.38–9.02) and sinusitis (OR=2.88; 95% CI=1.22–6.89) was signifcantly higher in women who were exposed to environmental tobacco smoke. Primary health care need for respiratory symptoms due to the effect of passive smoking is higher in the exposed women. Passive smoking can be a risk factor for the appearance of respiratory symptoms and illness in women that causes absence from work. Key words: indoor air pollution, passive smoking, women’s health, absence from work, respiratory illness Address for correspondence: A. Stanković, Vojvode Tankosica 9/61, 18000 Niš, Serbia. E-mail: aleksandra@exe-mail.net EXPOSURE TO ENVIRONMENTAL TOBACCO SMOKE AND ABSENCE FROM WORK IN WOMEN IN NIŠ, SERBIA Aleksandra Stanković, Maja Nikolić, Mirjana Aranđelović Medical faculty, University in Niš, Serbia INTRODUCTION The consequences of passive smoking have been for decades the subject of numerous modern studies, which go back even to the level of cells and genetic material. Today, many effects of this activity are well-known, and most worked out in the area of respiratory organs as the primary place of entry of tobacco smoke into the body. The harmful ingredients of tobacco smoke impact via the blood many organs and tissues causing changes manifested by various symptoms and illnesses. Indoor tobacco smoke originates from two sources: 25% are exhaled by smokers from their lungs while 85% are released from the tip of burning cigarettes. Non-smokers, i.e., passive smokers, are exposed to lateral flow of air in which the level of bad ingredients of cigarettes is much higher than in the main stream. This is particularly true for inhaling not filtered smoke out of cigarettes. Not filtered smoke is one that stems from the burning cigarette and is released directly from the cigarette into the air (1). According to the Environment Protection Agency, tobacco smoke is classified as a group A carcinogen since it has been proved that about 60 components of tobacco smoke have car- cinogenic characteristics. Cigarette smoke irritates especially the mucous membranes of the eye, nose, and upper respiratory organs causing inflammation of the sinuses, throat, vocal cords, bronchi, and contributes to the development of emphysema and lung cancer (2, 3, 4). Because of the long-term swelling and changes in the mucosa of the nose, the sense of smell can gradu- ally weaken due to the damage of the olfactory nerve. Harmful ingredients of tobacco smoke disrupt the normal function of bronchial epithelium and stimulate the secretion of bronchial mucus (5, 6). Exposure to tobacco smoke leads to more frequent use of health care, absence from work, and in most cases hospitaliza- tion for respiratory diseases. The female population is a special category that needs attention because exposure to tobacco smoke can also seriously affect fertility and may lead to complications in pregnancy and childbirth (7). Furthermore, prenatal exposure to cigarette smoke affects health of the newborn infant and his/her subsequent school performance (8). Some studies demostrated that women married to smokers are at higher risk of lung cancer, ovarian, and endometrial cancer (9). The problem of passive smoking is complex and represents a serious health hazard that can be prevented by health education campaigns aimed at purveying the evidence about the risk of passive inhalation of tobacco smoke. The aim of this study is to examine the prevalence and inci- dence of respiratory symptoms and absence from work in the female population in Niš depending on their exposure to tobacco smoke in their homes. MATERIALS AND METHODS The participants in the study were selected from the area of the city of Niš. It has been established by measurements performed by the Public Health Institute in Niš that in the respective area the concentration levels of air pollutants are below the permis- sible values according to Regulations of the Republic of Serbia for the last few decades.