INTRODUCTION The global disease burden may be exacerbated by exposure to passive smoking (SHS), with the workplace being a primary location for such exposure. Numerous epidemiological studies have identified SHS as a risk factor for diseases affecting various systems, including cardiovascular, respiratory, immune, endocrine, and nervous systems. The conventional observational study has certain methodological constraints which can be circumvented through a Mendelian randomization (MR) study. Our MR study intends to investigate the causal link between workplace exposure to SHS and the potential associated diseases. METHODS Summary statistics data involving European participants was sourced from three databases: the UK Biobank, the FinnGen study, and the European Bioinformatics Institute. Genetic variants linked with exposure to SHS in the workplace were identified as instrumental variables. The MR was carried out using inverse variance weighted (IVW), MR-Egger, and weighted median methods. Sensitivity tests were also undertaken within the MR to evaluate the validity of the causality. RESULTS According to the IVW model, genetically determined atrial fibrillation (AF) and stroke [P= 6.64E-04 and 5.68E-07, odds ratio = 2.030 and 2.494, 95% confidence interval = 1.350,3.051 and 1.743,3.569] were robustly associated with exposure to SHS in the workplace. Suggestive associations were found between workplace SHS and myocardial infarction (MI), asthma, and depression. CONCLUSIONS The MR study demonstrates that exposure to SHS in the workplace is a significant risk factor for AF and stroke in European individuals. Whether workplace exposure to SHS influences other diseases and the causality between them requires further exploration. IMPLICATIONS This study explored the causality between exposure to SHS in the workplace and potential associated diseases in multiple systems, including MI, AF, stroke, lung cancer, asthma, allergic disease, type 2 diabetes, and depression, using a MR study. The MR study can circumvent the methodological constraints of observational studies and establish a causal relationship. The two-sample MR analysis provides evidence supporting the causal association of frequent workplace SHS with AF and stroke. Individuals exposed to SHS in the workplace may also have a heightened risk of MI, asthma, and depression. However, whether SHS affects other diseases and the causality between them requires further investigation. To our knowledge, this is the first two-sample MR study to determine the causal relationship between SHS and potential diseases. As exposure to SHS in the workplace is a prevalent issue and may contribute to a global disease burden. The reduction of exposure following the introduction of smoke-free laws has led to a decrease in the admission rate for cardiac events and an improvement in health indicators. It is crucial to further advance smoke-free policies and their implementation.

中文翻译：

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评估多个系统中二手烟与潜在相关疾病之间的因果关系：双样本孟德尔随机研究。

简介 接触被动吸烟 (SHS) 可能会加剧全球疾病负担，而工作场所是此类接触的主要场所。大量流行病学研究已确定二手烟是影响多种系统疾病的危险因素，包括心血管、呼吸、免疫、内分泌和神经系统。传统的观察性研究具有某些方法学限制，可以通过孟德尔随机化（MR）研究来规避。我们的 MR 研究旨在调查工作场所接触二手烟与潜在相关疾病之间的因果关系。方法涉及欧洲参与者的汇总统计数据来自三个数据库：英国生物银行、FinnGen 研究和欧洲生物信息学研究所。与工作场所二手烟暴露相关的遗传变异被确定为工具变量。使用逆方差加权 (IVW)、MR-Egger 和加权中值方法进行 MR。MR 内还进行了敏感性测试，以评估因果关系的有效性。结果 根据 IVW 模型，遗传决定的心房颤动 (AF) 和卒中 [P= 6.64E-04 和 5.68E-07，比值比 = 2.030 和 2.494，95% 置信区间 = 1.350,3.051 和 1.743,3.569]与工作场所接触二手烟密切相关。研究发现，工作场所二手烟与心肌梗死 (MI)、哮喘和抑郁症之间存在暗示性关联。结论 MR 研究表明，在工作场所接触二手烟是欧洲人发生 AF 和中风的重要危险因素。工作场所接触二手烟是否会影响其他疾病以及它们之间的因果关系需要进一步探讨。意义 本研究利用 MR 研究探讨了工作场所接触二手烟与多种系统潜在相关疾病之间的因果关系，包括心肌梗死、房颤、中风、肺癌、哮喘、过敏性疾病、2 型糖尿病和抑郁症。MR研究可以规避观察性研究的方法论限制并建立因果关系。两个样本的 MR 分析提供了支持频繁工作场所 SHS 与 AF 和中风之间因果关系的证据。在工作场所接触二手烟的人患心肌梗死、哮喘和抑郁症的风险也可能更高。然而，SHS是否影响其他疾病以及它们之间的因果关系还需要进一步研究。据我们所知，这是第一个确定 SHS 与潜在疾病之间因果关系的双样本 MR 研究。由于工作场所接触二手烟是一个普遍存在的问题，可能会增加全球疾病负担。无烟法出台后暴露的减少导致了心脏事件入院率的下降和健康指标的改善。进一步推进无烟政策及其实施至关重要。