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Gatzke-Kopp LM, Riis JL, Ahmadi H, Piccerillo HL, Granger DA, Blair CB, Thomas EA. Environmental tobacco smoke exposure is associated with increased levels of metals in children's saliva. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2023; 33:903-910. [PMID: 37147431 PMCID: PMC10733142 DOI: 10.1038/s41370-023-00554-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 05/07/2023]
Abstract
BACKGROUND Exposure to environmental tobacco smoke (ETS) has been associated with detectable levels of cotinine (a nicotine metabolite) in children's saliva. However, tobacco smoke also contains toxic and essential trace metals, including chromium (Cr), copper (Cu), lead (Pb), manganese (Mn), nickel (Ni) and zinc (Zn). OBJECTIVE The current study examines whether there is a relationship between ETS exposure, as gauged by salivary cotinine, and salivary levels of these metals in a subset (n = 238) of children from the Family Life Project. METHODS Using inductively-coupled-plasma optical emission spectrophotometry, we measured levels of metals in saliva from children at ~90 months of age. Salivary cotinine was measured using a commercial immunoassay. RESULTS We found that Cr, Cu, Mn, and Zn were detected in most samples (85-99%) with lower levels of detection for Pb and Ni (9.3% and 13.9% respectively). There were no significant differences in any of the metal concentrations between males and females, nor were levels associated with body mass index, although significant differences in salivary Cr and Mn by race, state and income-to-needs ratio were observed. Children with cotinine levels >1 ng/ml had higher levels of Zn (b = 0.401, 95% CI: 0.183 to 0.619; p = 0.0003) and Cu (b = 0.655, 95% CI: 0.206 to 1.104; p = 0.004) compared to children with levels <1 ng/ml, after controlling for multiple confounders, including sex, race, BMI and income-to-needs ratio. Further, we show that children whose cotinine levels were >1 μg/L were more likely to have detectable levels of Pb in their saliva (b = 1.40, 95% CI: 0.424 to 2.459; p = 0.006) compared to children with cotinine levels <1 ng/ml, also considering confounders. IMPACT STATEMENT This is the first study to demonstrate significant associations between salivary cotinine and salivary levels of Cu, Zn and Pb, suggesting that environmental tobacco smoke exposure my be one source of increased children's exposure to heavy metals. This study also demonstrates that saliva samples can be used to measure heavy metal exposure, and thus serve as a non-invasive tool for assessing a broader range of risk indicators.
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Affiliation(s)
- Lisa M Gatzke-Kopp
- Department of Human Development and Family Studies, Penn State University, University Park, PA, 16802, USA
| | - Jenna L Riis
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
| | - Hedyeh Ahmadi
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
- University Statistical Consulting, LLC, Irvine, CA, USA
| | - Hillary L Piccerillo
- Department of Psychological Sciences, University of California Irvine, Irvine, CA, USA
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
| | - Douglas A Granger
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA
- Johns Hopkins University, Bloomberg School of Public Health, and School of Medicine, Baltimore, MD, USA
| | - Clancy B Blair
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
| | - Elizabeth A Thomas
- Institute for Interdisciplinary Salivary Bioscience Research, University of California Irvine, Irvine, CA, USA.
- Department of Epidemiology, University of California Irvine, Irvine, CA, USA.
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Molecularly imprinted polymers as a selective sorbent for forensic applications in biological samples-a review. Anal Bioanal Chem 2021; 413:6013-6036. [PMID: 34430982 DOI: 10.1007/s00216-021-03596-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/14/2021] [Accepted: 08/02/2021] [Indexed: 01/09/2023]
Abstract
Molecularly imprinted polymers (MIP) consist of a molecular recognition technology with applicability in different areas, including forensic chemistry. Among the forensic applications, the use of MIP in biological fluid analysis has gained prominence. Biological fluids are complex samples that generally require a pre-treatment to eliminate interfering agents to improve the results of the analyses. In this review, we address the development of this molecular imprinting technology over the years, highlighting the forensic applications of molecularly imprinted polymers in biological sample preparation for analysis of stimulant drugs such as cocaine, amphetamines, and nicotine.
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Mahabee-Gittens EM, Mazzella MJ, Doucette JT, Merianos AL, Stone L, Wullenweber CA, A. Busgang S, Matt GE. Comparison of Liquid Chromatography Mass Spectrometry and Enzyme-Linked Immunosorbent Assay Methods to Measure Salivary Cotinine Levels in Ill Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1157. [PMID: 32059566 PMCID: PMC7068296 DOI: 10.3390/ijerph17041157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Revised: 02/04/2020] [Accepted: 02/07/2020] [Indexed: 12/26/2022]
Abstract
Objective: Cotinine is the preferred biomarker to validate levels of tobacco smoke exposure (TSE) in children. Compared to enzyme-linked immunosorbent assay methods (ELISA) for quantifying cotinine in saliva, the use of liquid chromatography tandem mass spectrometry (LC-MS/MS) has higher sensitivity and specificity to measure very low levels of TSE. We sought to compare LC-MS/MS and ELISA measures of cotinine in saliva samples from children overall and the associations of these measures with demographics and TSE patterns. Method: Participants were nonsmoking children (N = 218; age mean (SD) = 6.1 (5.1) years) presenting to a pediatric emergency department. Saliva samples were analyzed for cotinine using both LC-MS/MS and ELISA. Limit of quantitation (LOQ) for LC-MS/MS and ELISA was 0.1 ng/ml and 0.15 ng/ml, respectively. Results: Intraclass correlations (ICC) across methods = 0.884 and was consistent in sex and age subgroups. The geometric mean (GeoM) of LC-MS/MS = 4.1 (range: < LOQ - 382 ng/mL; 3% < LOQ) which was lower (p < 0.0001) than the ELISA GeoM = 5.7 (range: < LOQ - 364 ng/mL; 5% < LOQ). Similar associations of cotinine concentrations with age ( < -0.10, p < 0.0001), demographic characteristics (e.g., income), and number of cigarettes smoked by caregiver ( > 0.07, p < 0.0001) were found regardless of cotinine detection method; however, cotinine associations with sex and race/ethnicity were only found to be significant in models using LC-MS/MS-derived cotinine. Conclusions: Utilizing LC-MS/MS-based cotinine, associations of cotinine with sex and race/ethnicity of child were revealed that were not detectable using ELISA-based cotinine, demonstrating the benefits of utilizing the more sensitive LC-MS/MS assay for cotinine measurement when detecting low levels of TSE in children.
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Affiliation(s)
- E. Melinda Mahabee-Gittens
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (L.S.); (C.A.W.)
| | - Matthew J. Mazzella
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.J.M.); (J.T.D.); (S.A.B.)
| | - John T. Doucette
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.J.M.); (J.T.D.); (S.A.B.)
| | - Ashley L. Merianos
- School of Human Services, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Lara Stone
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (L.S.); (C.A.W.)
| | - Chase A. Wullenweber
- Division of Emergency Medicine, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA; (L.S.); (C.A.W.)
| | - Stefanie A. Busgang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA; (M.J.M.); (J.T.D.); (S.A.B.)
| | - Georg E. Matt
- Department of Psychology, San Diego State University, San Diego, CA 92123, USA;
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Gehricke JG, Gevorkian J, Stehli A, Alejo SD, Dawson M, Kopelevich A. Discrepancies in the Validity of Self-Reported Cigarette Smoking in Adults With and Without ADHD. J Dual Diagn 2019; 15:177-183. [PMID: 31156069 PMCID: PMC6711780 DOI: 10.1080/15504263.2019.1620399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Attention-deficit/hyperactivity disorder (ADHD) is associated with an increased smoking prevalence and impairments in executive function, which may negatively affect the validity of self-reported smoking rates. This study compares the utility of self-reported smoking with salivary cotinine in adult smokers and nonsmokers with and without ADHD. Methods: Participants (N = 82) were adult smokers and nonsmokers with and without ADHD (n = 35 ADHD and n = 47 controls) from an observational study. Odds ratios (ORs) for accuracy of self-reported smoking compared to salivary cotinine were calculated using diagnosis (ADHD vs. control), gender, age, education, employment, and number of cigarettes per day as predictors. Post-hoc analysis stratified sensitivity, specificity, and accuracy of self-reported smoking in individuals with ADHD and without ADHD. Results: The initial analysis identified education as a significant independent predictor of odds of accuracy, OR = 6.22, p = .013, after adjusting for diagnosis, gender, age, employment, and cigarettes per day. Post-hoc analysis revealed that sensitivity, specificity, and accuracy of self-reported smoking was 100% for individuals with ADHD who had more than high school education compared to those with high school or less, which was 83.3%, 45.5%, and 65.2%, respectively. Self-reported smoking of control participants with greater than a high school education had a sensitivity of 85.7%, a specificity of 91.7%, and an accuracy of 88.5%. Control participants with a high school or lower education had a sensitivity of 54.6%, a specificity of 90%, and an accuracy of 71.4% for their self-reported smoking. Conclusions: Individuals with ADHD and high school or lower education showed the lowest specificity and accuracy in their self-reported smoking, which may affect documented smoking prevalence rates. This is a secondary analysis of data collected as part of a clinical trial registered as NCT00915798 at www.clinicaltrials.gov .
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Affiliation(s)
- Jean-G Gehricke
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Jonathan Gevorkian
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Annamarie Stehli
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Sharina Dyan Alejo
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Meghan Dawson
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
| | - Alexei Kopelevich
- Department of Pediatrics, The Center for Autism & Neurodevelopmental Disorders, University of California, Irvine , Santa Ana , CA , USA
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Nurse-initiated intervention programs: future directions for cessation and prevention of adolescent smoking. J Addict Nurs 2014; 25:4-8. [PMID: 24613944 DOI: 10.1097/jan.0000000000000016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Tobacco use in adolescence remains at unacceptable levels. Increasing teen knowledge about the dangers of smoking appears to be insufficient in changing adolescent attitudes regarding the use of tobacco. To incite change and increase their effectiveness, adult smoking cessation programs need to be tailored to adolescents. Ultimately, intrapersonal, interpersonal, and environmental factors that underlie tobacco use and smoking behaviors in adolescents must be identified. The nurse's role is both in identification of the adolescent smoker and assessment of the smoking behavior. Future directions in nursing practice, nursing education, and research surrounding tobacco use in youth are discussed.
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Yuki D, Kikuchi A, Miura N, Kakehi A, Onozawa M. Good relationship between saliva cotinine kinetics and plasma cotinine kinetics after smoking one cigarette. Regul Toxicol Pharmacol 2013; 67:240-5. [DOI: 10.1016/j.yrtph.2013.08.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Revised: 07/31/2013] [Accepted: 08/01/2013] [Indexed: 11/17/2022]
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Vitor RV, Martins MCG, Figueiredo EC, Martins I. Application of molecularly imprinted polymer solid-phase extraction for salivary cotinine. Anal Bioanal Chem 2011; 400:2109-17. [DOI: 10.1007/s00216-011-4870-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2011] [Revised: 03/01/2011] [Accepted: 03/02/2011] [Indexed: 01/01/2023]
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Kataoka H, Inoue R, Yagi K, Saito K. Determination of nicotine, cotinine, and related alkaloids in human urine and saliva by automated in-tube solid-phase microextraction coupled with liquid chromatography–mass spectrometry. J Pharm Biomed Anal 2009; 49:108-14. [DOI: 10.1016/j.jpba.2008.09.044] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 09/20/2008] [Accepted: 09/25/2008] [Indexed: 10/21/2022]
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