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Park MB, Sim B. Evaluation of Thirdhand Smoke Exposure after Short Visits to Public Facilities (Noraebang and Internet Cafés): A Prospective Cohort Study. TOXICS 2022; 10:toxics10060307. [PMID: 35736915 PMCID: PMC9227155 DOI: 10.3390/toxics10060307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/20/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
We aimed to evaluate the degree of thirdhand smoke (THS) caused by short-term exposure to smoking-related substances. To this end, we evaluated the change in concentration of a smoking-related urine biomarker in volunteers before and after visiting public spaces where there is likely THS exposure. We hypothesized that a visit to such public spaces would result in an increase in such biomarkers. Participants visited one of the predetermined facilities (noraebang, PC café) and revisited the same facility after 24 h, spending around 2 h per visit. We selected creatinine-corrected urine cotinine (CUC) as a biomarker to evaluate THS. In addition, we collected nicotine-derived nitrosamine ketone (NNK) from surface dust at each site with cotton swabs (diameter of 2.5 cm). We examined whether CUC concentration significantly changed across three time points (baseline, first visit, and second visit) via repeated-measures analysis of variance (RM-ANOVA). Moreover, we analyzed the interaction to determine whether cigarette smell affects the CUC concentration. Finally, CUC and dust NNK were analyzed with Pearson’s correlation. The CUC concentration did not increase from baseline to the first visit, but increased from the baseline to the second visit (Diff = Ln [0.565] ng/mg, P < 0.01). Further, the CUC concentration increased from the first to the second visit (Diff = Ln [0.393] ng/mg, p < 0.01). In the case of the interaction effect, there were statistically significant differences in CUC concentration depending on the smell of smoke in the facility (Diff = Ln [0.325], F value = 4.438, p value = 0.041). The change in CUC concentration from baseline to the second visit (r = 0.562, p < 0.001) and from the first to the second visit (r = 0.544, p < 0.001) were correlated with NNK concentration. We evaluated whether a short stay in a facility with smoke-related substances that adhere to the surrounding environment would expose individuals to THS even if they do not smell or are directly exposed to cigarette smoke. We confirmed that even two relatively short stays (approximately 2 h each) in a facility in which people had previously smoked can lead to THS exposure.
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Affiliation(s)
- Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon 35345, Korea;
| | - Boram Sim
- HIRA Research Institute, Health Insurance Review and Assessment Service (HIRA), Wonju 26465, Korea
- Correspondence:
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Kim J, Shim IK, Won SR, Ryu J, Lee J, Chung HM. Characterization of urinary cotinine concentrations among non-smoking adults in smoking and smoke-free homes in the Korean national environmental health survey (KoNEHS) cycle 3 (2015-2017). BMC Public Health 2021; 21:1324. [PMID: 34229648 PMCID: PMC8259109 DOI: 10.1186/s12889-021-11265-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 06/04/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Although many indoor public places have implemented smoke-free regulations, private homes have remained sources of tobacco smoke pollutants. This study examined differences in urinary cotinine concentrations in the Korean non-smoking adult population between living in smoking and smoke-free homes, and the relationship of urinary cotinine concentrations with socio-demographic factors in smoke-free homes. METHODS Samples from 2575 non-smoking adults (≥19 years old) in the Korean National Environmental Health Survey cycle 3 (2015-2017), a representative Korean study, were used. Smoking and smoke-free homes were defined based on whether there were smokers at homes. Weighted linear regression models were used to determine urinary cotinine concentrations and identify factors associated with urinary cotinine. RESULTS The geometric mean of urinary cotinine concentrations for non-smoking adults living in smoking homes was 2.1 μg/L (95% confidence interval [CI] = 1.8-2.4), which was significantly higher than the mean of 1.3 μg/L (95% CI = 1.2-1.4) for those living in smoke-free homes. Urinary cotinine concentrations were different significantly by home smoking status in most socio-demographic subgroups. Data from smoke-free home showed urinary cotinine concentration in adults was significantly higher in those who lived in homes with ventilation duration < 30 min/day, those who spent more time indoors at home, those who spent less time outdoors, and those who worked in non-manual or manual occupations. CONCLUSIONS The urinary cotinine concentration in Korean non-smoking adults living in smoking homes was higher than that in adults living in smoke-free homes. Even in smoke-free homes, home-related factors, such as ventilation duration and time spent indoors, were associated with urinary cotinine concentration. Further study is warranted to examine potential sources of tobacco smoke pollution in smoke-free homes.
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Affiliation(s)
- Jeonghoon Kim
- Department, Indoor Environment and Noise Research Division, Environmental Infrastructure Research National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea.
| | - In-Keun Shim
- Department, Indoor Environment and Noise Research Division, Environmental Infrastructure Research National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea
| | - Soo Ran Won
- Department, Indoor Environment and Noise Research Division, Environmental Infrastructure Research National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea
| | - Jungmin Ryu
- Department, Indoor Environment and Noise Research Division, Environmental Infrastructure Research National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea
| | - Jongchun Lee
- Department, Indoor Environment and Noise Research Division, Environmental Infrastructure Research National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea
| | - Hyen-Mi Chung
- Department, Indoor Environment and Noise Research Division, Environmental Infrastructure Research National Institute of Environmental Research, Seo-gu, Incheon, 22689, Republic of Korea
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Nazaroff WW, Weschler CJ. Indoor acids and bases. INDOOR AIR 2020; 30:559-644. [PMID: 32233033 DOI: 10.1111/ina.12670] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 05/15/2023]
Abstract
Numerous acids and bases influence indoor air quality. The most abundant of these species are CO2 (acidic) and NH3 (basic), both emitted by building occupants. Other prominent inorganic acids are HNO3 , HONO, SO2 , H2 SO4 , HCl, and HOCl. Prominent organic acids include formic, acetic, and lactic; nicotine is a noteworthy organic base. Sources of N-, S-, and Cl-containing acids can include ventilation from outdoors, indoor combustion, consumer product use, and chemical reactions. Organic acids are commonly more abundant indoors than outdoors, with indoor sources including occupants, wood, and cooking. Beyond NH3 and nicotine, other noteworthy bases include inorganic and organic amines. Acids and bases partition indoors among the gas-phase, airborne particles, bulk water, and surfaces; relevant thermodynamic parameters governing the partitioning are the acid-dissociation constant (Ka ), Henry's law constant (KH ), and the octanol-air partition coefficient (Koa ). Condensed-phase water strongly influences the fate of indoor acids and bases and is also a medium for chemical interactions. Indoor surfaces can be large reservoirs of acids and bases. This extensive review of the state of knowledge establishes a foundation for future inquiry to better understand how acids and bases influence the suitability of indoor environments for occupants, cultural artifacts, and sensitive equipment.
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Affiliation(s)
- William W Nazaroff
- Department of Civil and Environmental Engineering, University of California, Berkeley, CA, USA
| | - Charles J Weschler
- Environmental and Occupational Health Sciences Institute, Rutgers University, Piscataway, NJ, USA
- International Centre for Indoor Environment and Energy, Technical University of Denmark, Lyngby, Denmark
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Pinheiro GP, Souza-Machado CD, Fernandes AGO, Mota RCL, Lima LL, Vasconcellos DDS, Luz Júnior IPD, Silva YRDS, Lima VB, Oliva STD, Mello LMD, Couto RD, Chatkin JM, Cruz CMS, Cruz ÁA. Self-reported smoking status and urinary cotinine levels in patients with asthma. ACTA ACUST UNITED AC 2018; 44:477-485. [PMID: 30304204 PMCID: PMC6459745 DOI: 10.1590/s1806-37562017000000018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 03/26/2018] [Indexed: 11/21/2022]
Abstract
Objective: To determine the frequency of active smoking among patients with asthma and individuals without asthma by self-report and urinary cotinine measurement. Methods: This was a cross-sectional study conducted in the city of Salvador, Brazil, and involving 1,341 individuals: 498 patients with severe asthma, 417 patients with mild-to-moderate asthma, and 426 individuals without asthma. Smoking status was determined by self-report (with the use of standardized questionnaires) and urinary cotinine measurement. The study variables were compared with the chi-square test and the Kruskal-Wallis test. Results: Of the sample as a whole, 55 (4.1%) reported being current smokers. Of those, 5 had severe asthma, 17 had mild-to-moderate asthma, and 33 had no asthma diagnosis. Of the 55 smokers, 32 (58.2%) were daily smokers and 23 (41.8%) were occasional smokers. Urinary cotinine levels were found to be high in self-reported nonsmokers and former smokers, especially among severe asthma patients, a finding that suggests patient nondisclosure of smoking status. Among smokers, a longer smoking history was found in patients with severe asthma when compared with those with mild-to-moderate asthma. In addition, the proportion of former smokers was higher among patients with severe asthma than among those with mild-to-moderate asthma. Conclusions: Former smoking is associated with severe asthma. Current smoking is observed in patients with severe asthma, and patient nondisclosure of smoking status occurs in some cases. Patients with severe asthma should be thoroughly screened for smoking, and findings should be complemented by objective testing.
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Affiliation(s)
- Gabriela Pimentel Pinheiro
- . Programa para o Controle da Asma na Bahia - ProAR - Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil.,. Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | - Carolina de Souza-Machado
- . Programa para o Controle da Asma na Bahia - ProAR - Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil.,. Escola de Enfermagem, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | | | | | - Liranei Limoeiro Lima
- . Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | | | - Ives Pereira da Luz Júnior
- . Laboratório de Química Analítica e Ambiental, Instituto de Química, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | | | - Valmar Bião Lima
- . Programa para o Controle da Asma na Bahia - ProAR - Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil.,. Programa de Pós-Graduação em Medicina em Saúde, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | - Sérgio Telles de Oliva
- . Departamento de Química Analítica, Instituto de Química, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | - Luane Marques de Mello
- . Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto (SP) Brasil
| | - Ricardo David Couto
- . Laboratório de Bioquímica Clínica, Departamento de Análises Clínicas e Toxicológicas, Faculdade de Farmácia, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
| | - José Miguel Chatkin
- . Escola de Medicina, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre (RS) Brasil
| | - Constança Margarida Sampaio Cruz
- . Programa de Pós-Graduação em Medicina e Saúde Humana, Escola Bahiana de Medicina e Saúde Pública, Salvador (BA) Brasil.,. Obras Sociais Irmã Dulce, Hospital Santo Antônio, Salvador (BA) Brasil
| | - Álvaro Augusto Cruz
- . Programa para o Controle da Asma na Bahia - ProAR - Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil.,. Faculdade de Medicina da Bahia, Universidade Federal da Bahia - UFBA - Salvador (BA) Brasil
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Campo L, Polledri E, Bechtold P, Gatti G, Quattrini G, Olgiati L, Romolo M, Ranzi A, Lauriola P, Carrozzi G, Fustinoni S. ETS Exposure and PAH Body Burden in Nonsmoking Italian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1156. [PMID: 29865209 PMCID: PMC6025440 DOI: 10.3390/ijerph15061156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 05/28/2018] [Accepted: 05/29/2018] [Indexed: 11/17/2022]
Abstract
Active smoking is associated with increased body burden of polycyclic aromatic hydrocarbons (PAHs); the aim of this study was to assess whether environmental tobacco smoking (ETS) increases the internal dose of PAHs. In 344 nonsmoking Italian adults, out of 497 individuals selected as representative of the population of the town of Modena, ETS exposure was evaluated by a self-administered questionnaire and by the measurement of urinary cotinine (COT-U). PAH exposure was assessed by the measurement of urinary 1-hydroxypyrene (1-OHPYR) and of ten urinary PAHs. In all subjects, median (5th⁻95th percentile) COT-U was 0.47 (.
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Affiliation(s)
- Laura Campo
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Petra Bechtold
- Department of Public Health, Local Health Unit, 41121 Modena, Italy.
| | - Giulia Gatti
- Department of Public Health, Local Health Unit, 41121 Modena, Italy.
| | - Giulia Quattrini
- Department of Public Health, Local Health Unit, 41121 Modena, Italy.
| | - Luca Olgiati
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
| | - Michael Romolo
- Department of Public Health, Local Health Unit, 41121 Modena, Italy.
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, 41121 Modena, Italy.
| | - Paolo Lauriola
- Italian National Research Council, Institute of Clinical Physiology, Unit of Environmental Epidemiology and Disease Registries, 56124 Pisa, Italy.
| | - Giuliano Carrozzi
- Department of Public Health, Local Health Unit, 41121 Modena, Italy.
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milano, Italy.
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Campo L, Polledri E, Bechtold P, Gatti G, Ranzi A, Lauriola P, Goldoni CA, Bertazzi PA, Fustinoni S. Determinants of active and environmental exposure to tobacco smoke and upper reference value of urinary cotinine in not exposed individuals. ENVIRONMENTAL RESEARCH 2016; 148:154-163. [PMID: 27060750 DOI: 10.1016/j.envres.2016.03.029] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 03/02/2016] [Accepted: 03/22/2016] [Indexed: 06/05/2023]
Abstract
The aims of this study were (1) to explore the behavioral and sociodemographic factors influencing urinary cotinine (COT-U) levels in active smokers and in environmental tobacco smoke (ETS)-exposed individuals, (2) to assess the specificity and sensitivity of the questionnaire for identifying active smokers and nonsmokers, and (3) to derive the upper reference value of COT-U in non-ETS exposed individuals. The COT-U levels of 495 adults (age range 18-69 years) who classified themselves as active smokers (29%) or as nonsmokers with (17%) or without (83%) ETS exposure were quantified by LC-MS-MS (quantification limit: 0.1µg/L, range of linearity: 0.1-4000µg/L). Median COT-U levels in these groups were 883, 1.38, and 0.39µg/L, respectively. Significant determinants of COT-U levels in active smokers were the number of cigarettes per day, type of smoking product, smoking environment, as well as time between the last cigarette and urine collection. Among ETS-exposed nonsmokers, significant determinants were living with smokers, being exposed to smoke at home, ETS exposure duration, as well as time between the last exposure and urine collection. When a 30-µg/L COT-U cut-off value was used to identify active daily smoking, the sensitivity and specificity of the questionnaire were 94% and 98%, respectively. For ETS exposure, the COT-U value of 1.78 (0.90 confidence interval 1.75-1.78) µg/L, corresponding to the 95th percentiles of the COT-U distribution in non-ETS-exposed participants, is proposed as upper reference value to identify environmental exposure.
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Affiliation(s)
- Laura Campo
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
| | - Elisa Polledri
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Petra Bechtold
- Department of Public Health, Local Health Unit, Modena, Italy
| | - Giulia Gatti
- Department of Public Health, Local Health Unit, Modena, Italy
| | - Andrea Ranzi
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy
| | - Paolo Lauriola
- Environmental Health Reference Centre, Regional Agency for Environmental Prevention of Emilia Romagna, Modena, Italy
| | | | - Pier Alberto Bertazzi
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Silvia Fustinoni
- Department of Clinical Sciences and Community Health, University of Milan and Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
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Desouky DES, Elnemr G, Alnawawy A, Taha AA. The Relation between Exposure to Environmental Tobacco Smoke and the Quantity of Cotinine in the Urine of School Children in Taif City, Saudi Arabia. Asian Pac J Cancer Prev 2016; 17:139-45. [PMID: 26838199 DOI: 10.7314/apjcp.2016.17.1.139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Environmental tobacco smoke (ETS) is a major public health problem for all ages. Despite the high prevalence of smoking among the Saudi population, there is limited information about levels of urinary cotinine in Saudi children exposed to SHS. The aim of the study was to assess the exposure of schoolchildren to ETS, and measure their urinary cotinine levels. Multistage cluster sampling was carried out, where schoolchildren from 4 schools were randomly chosen from primary schools in Taif city. A questionnaire including questions on SHS exposure and smoking rules in the residence were sent to students parents/guardians. Urine samples were taken and analyzed for total cotinine using chemiluminescent immunoassay. Of the studied children, 38.4% had a smoking father, 61.8%, 41.2% and 49.3% of them were exposed to ETS indoors, outdoors and both indoors and outdoors respectively. The mean urinary cotinine was significantly higher among children exposed to ETS compared to unexposed children. Urinary cotinine levels in children with both indoor and outdoor exposure was significantly higher compared with its level in children with single exposure. A significant positive correlation was found between urinary cotinine concentrations and the number of cigarette packs smoked by parents, and the number of smokers in the residence. The mean urinary cotinine level was significantly higher in children who reported no smoking rules at the residence.. The study revealed a high exposure of Saudi children to ETS. An antismoking media awareness campaign on the harmful effects of ETS should be carried out, in addition to family counseling programs targeted to parents to protect their children from ETS.
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Affiliation(s)
- Dalia El Sayed Desouky
- Departments of Public Health and Community Medicine, College of Medicine and Applied Medical Sciences, Taif University, Saudi Arabia E-mail :
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Martínez-Sánchez JM, Sureda X, Fu M, Pérez-Ortuño R, Ballbè M, López MJ, Saltó E, Pascual JA, Fernández E. Secondhand smoke exposure at home: assessment by biomarkers and airborne markers. ENVIRONMENTAL RESEARCH 2014; 133:111-6. [PMID: 24912142 DOI: 10.1016/j.envres.2014.05.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Revised: 05/05/2014] [Accepted: 05/07/2014] [Indexed: 05/13/2023]
Abstract
OBJECTIVE We assessed and characterized the relationship among biomarkers of secondhand smoke (SHS) exposure in non-smokers according to their exposure at home as measured by airborne markers. METHODS We conducted an observational study on exposure to SHS at home using airborne markers (nicotine and benzene) and biomarkers from the non-smokers living in these homes. We selected 49 non-smoking volunteers from different homes: 25 non-smokers living with at least one smoker and 24 non-smokers living in smoke-free homes. We installed two passive devices to measure nicotine and benzene concentrations in the main room of the house (i.e., the living room). One week later, the researcher returned to the volunteer's home to collect the two devices, obtain saliva and urine samples, and administer a SHS questionnaire. RESULTS Salivary and urinary cotinine concentrations highly correlated with air nicotine concentrations measured at the volunteers'homes (rsp=0.738 and rsp=0.679, respectively). The concentrations of airborne markers of SHS and biomarkers in non-smokers increased with increasing self-reported intensity and duration of SHS exposure at home during the previous week (p<0.05). The multivariable regression model showed a significant association with nicotine in air at home (β=0.126, p=0.002 for saliva and β=0.115, p=0.010 for urine). CONCLUSIONS Our findings suggest that, even in countries with comprehensive smoke-free legislation, exposure to SHS at home continues to be the main source of exposure for non-smokers who live in non-smoke-free homes. Therefore, public health policies should promote smoke-free homes.
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Affiliation(s)
- Jose M Martínez-Sánchez
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet, 08908 L'Hospitalet de Llobregat, 199-203 Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Biostatistics Unit, Department of Basic Sciences, Universitat Internacional de Catalunya, Sant Cugat del Vallès, Spain.
| | - Xisca Sureda
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet, 08908 L'Hospitalet de Llobregat, 199-203 Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Marcela Fu
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet, 08908 L'Hospitalet de Llobregat, 199-203 Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Raúl Pérez-Ortuño
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Montse Ballbè
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet, 08908 L'Hospitalet de Llobregat, 199-203 Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain; Addictions Unit, Institute of Neurosciences, Hospital Clínic de Barcelona, Barcelona, Spain
| | - María J López
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Institut d'Investigació Biomèdica-IBB Sant Pau, Barcelona, Spain
| | - Esteve Saltó
- Health Plan Directorate, Ministry of Health, Generalitat de Catalunya, Spain; Department of Public Health, Universitat de Barcelona, Barcelona, Spain
| | - José A Pascual
- IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain; Department of Experimental and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
| | - Esteve Fernández
- Tobacco Control Unit, Cancer Prevention and Control Program, Institut Català d'Oncologia, Av. Granvia de l'Hospitalet, 08908 L'Hospitalet de Llobregat, 199-203 Barcelona, Spain; Cancer Prevention and Control Group, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, Universitat de Barcelona, Barcelona, Spain
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Schvartsman C, Farhat SCL, Schvartsman S, Saldiva PHN. Parental smoking patterns and their association with wheezing in children. Clinics (Sao Paulo) 2013; 68:934-9. [PMID: 23917656 PMCID: PMC3714778 DOI: 10.6061/clinics/2013(07)08] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2013] [Accepted: 03/10/2013] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To investigate parental smoking patterns and their association with wheezing in children. METHODS We performed a case-control study that included 105 children between 6 and 23 months of age who were divided into two groups: cases (children with 3 previous episodes of wheezing) and controls (healthy children without wheezing). The children's exposure to cigarette smoking was estimated using a questionnaire completed by the mothers and by the children's urinary cotinine levels. RESULTS Based on both the questionnaire results and cotinine levels, exposure to cigarette smoking was higher in the households of cases in which the incidence of maternal smoking was significantly higher than that of paternal smoking. Children in this group were more affected by maternal smoking and by the total number of cigarettes smoked inside the house. Additionally, the questionnaire results indicated that the risk of wheezing was dose dependent. The presence of allergic components, such as atopic dermatitis and siblings with allergic rhinitis and asthma, greatly increased the odds ratio when wheezing was associated with cotinine levels. CONCLUSION Children exposed to tobacco smoke have an increased risk of developing wheezing syndrome. This risk increases in association with the number of cigarettes smoked inside the house and the presence of other allergic components in the family.
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Affiliation(s)
- Claudio Schvartsman
- Universidade de São Paulo, Hospital das Clínicas, Instituto da Criança, Faculdade de Medicina, São Paulo, SP, Brazil.
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Murray EL, Brondi L, Kleinbaum D, McGowan JE, Van Mels C, Brooks WA, Goswami D, Ryan PB, Klein M, Bridges CB. Cooking fuel type, household ventilation, and the risk of acute lower respiratory illness in urban Bangladeshi children: a longitudinal study. INDOOR AIR 2012; 22:132-9. [PMID: 22007670 DOI: 10.1111/j.1600-0668.2011.00754.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
UNLABELLED Acute lower respiratory illnesses (ALRI) are the leading cause of death among children <5 years. Studies have found that biomass cooking fuels are an important risk factor for ALRI. However, few studies have evaluated the influence of natural household ventilation indicators on ALRI. The purpose of this study was to assess the association between cooking fuel, natural household ventilation, and ALRI. During October 17, 2004-September 30, 2005, children <5 years living in a low-income neighborhood of Dhaka, Bangladesh, were assessed weekly for ALRI and surveyed quarterly about biomass fuel use, electric fan ownership, and natural household ventilation (windows, ventilation grates, and presence of a gap between the wall and ceiling). Bivariate and multivariate analyses were performed using generalized estimating equations. Six thousand and seventy-nine children <5 years enrolled during the study period (99% participation) experienced 1291 ALRI. In the multivariate model, ≥2 windows [OR = 0.75, 95% CI = (0.58, 0.96)], ventilation grates [OR = 0.80, 95% CI = (0.65, 0.98)], and not owning an electric fan [OR = 1.50, 95% CI = (1.21, 1.88)] were associated with ALRI; gap presence and using biomass fuels were not associated with ALRI. Structural factors that might improve household air circulation and exchange were associated with decreased ALRI risk. Improved natural ventilation might reduce ALRI among children in low-income families. PRACTICAL IMPLICATIONS The World Health Organization has stated that controlling pneumonia is a priority for achieving the fourth Millennium Development Goal, which calls for a two-third reduction in mortality of children <5 years old compared to the 1990 baseline. Our study represents an important finding of a modifiable risk factor that might decrease the burden of respiratory illness among children living in Bangladesh and other low-income settings similar to our study site. We found that the existence of at least two windows in the child's sleeping room was associated with a 25% decreased ALRI risk. Increasing available natural ventilation within the household in similar settings has the potential to reduce childhood mortality because of acute lower respiratory illnesses.
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Affiliation(s)
- E L Murray
- Department of Epidemiology, Rollins School of Public Health of Emory University, Atlanta, GA, USA.
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El-Hodhod MA, Hamdy AM, Ahmed MB, Youssef SR, Aly SMH. Effect of passive smoking on blood lymphocyte apoptosis in children. Eur J Clin Invest 2011; 41:387-92. [PMID: 21114490 DOI: 10.1111/j.1365-2362.2010.02420.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Passive smoking is a well-known risk factor for both recurrent respiratory infections and disturbed lipid profile. Whether passive smoking problems are related to altered lymphocyte survival and its relation to altered lipid profile are the points of concern in this work. MATERIALS AND METHODS Urinary cotinine and creatinine levels as well as lipid profile and flow cytometric assessment of apoptosis of peripheral blood lymphocytes (PBL) were assessed in 26 children with history of indoor exposure to cigarette smokers in comparison with 14 matched children with no such history. RESULTS Lipid profile showed significantly higher mean levels of triglycerides, cholesterol and low-density lipoprotein (LDL) and significantly lower mean levels of high-density lipoprotein (HDL) in passive smoking children compared to nonpassive-smoking ones. Furthermore, cotinine parameters were positively correlated with triglycerides and LDL and negatively correlated with HDL. Early apoptosis of PBL was significantly higher in exposed vs nonexposed ones. CONCLUSIONS Passive smoking in children could be a risk factor for enhanced lymphocytic apoptosis. It is possible that altered lipid profile may play a role in the increased risk. The impact of this lymphocytic derangement on increased frequency of infections is noticeable.
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Affiliation(s)
- Moustafa A El-Hodhod
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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13
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Swamy GK, Reddick KLB, Brouwer RJN, Pollak KI, Myers ER. Smoking prevalence in early pregnancy: comparison of self-report and anonymous urine cotinine testing. J Matern Fetal Neonatal Med 2010; 24:86-90. [PMID: 20384470 DOI: 10.3109/14767051003758887] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Societal pressures against smoking during pregnancy may lead to a reduction in disclosure of smoking status. The objective of this study was to compare prevalence of smoking at prenatal intake by self-report with anonymous biochemical validation. METHODS Women receiving care at the Duke Obstetrics Clinic from February 2005 through January 2006 were eligible for evaluation. Self-reported smoking and urine samples were obtained anonymously at prenatal intake. The NicCheck™ I semi-quantitative dipstick was used to detect urinary nicotine, cotinine, and 3-hydroxycotinine. The difference, with 95% confidence interval, between the proportions of smokers by self-report and urine testing was calculated for (1) high-positive vs. low-positive and negative results combined and (2) any positive vs. negative results. RESULTS Among 297 subjects, self-reported smoking was 18.2 vs. 14.8% for low-positive and negative results combined with an absolute difference of 3.4%, [-2.9%, 9.6%]. When comparing self-report with any positive result (43.1%), the absolute difference was 24.9%, [17.4%, 32.1%]. CONCLUSIONS Our findings suggest that most pregnant women disclose their smoking and many nonsmokers may have significant second-hand exposure. Universal urinary cotinine screening of pregnant women could aid in appropriately counseling women about second-hand exposure as well as monitoring women at high risk for adverse pregnancy outcomes.
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Affiliation(s)
- Geeta K Swamy
- Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, USA
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Pate Capps N, Stewart A, Burns C. The interplay between secondhand cigarette smoke, genetics, and cervical cancer: a review of the literature. Biol Res Nurs 2009; 10:392-9. [PMID: 19251719 DOI: 10.1177/1099800408330849] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023]
Abstract
Research has suggested a link between smoking and cervical cancer; however, little data are available on secondhand smoke (SHS) exposure and cervical cancer risk. This article reviews the literature on the links among smoking, SHS exposure and cervical cancer. The review was based on a search of electronic databases. The research reviewed clearly showed that smoking increases cervical cancer risk through myriad mechanisms that interact with genetics and the pathologic processes leading to cervical cancer. However, less is understood about the role of SHS in cervical cancer. With new technology enabling scientists to examine how genomic structure responds to environmental stimuli, more information should be forthcoming on links between SHS exposure, biomarkers, and genetic changes involved in the development of cervical cancer.
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Affiliation(s)
- Natalie Pate Capps
- University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205, USA.
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Bartsch RH, Weiss G, Kästenbauer T, Patocka K, Deutinger M, Krapohl BD, Benditte-Klepetko HC. Crucial aspects of smoking in wound healing after breast reduction surgery. J Plast Reconstr Aesthet Surg 2007; 60:1045-9. [PMID: 17662466 DOI: 10.1016/j.bjps.2006.08.001] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 07/24/2006] [Accepted: 08/28/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to investigate the influence of cigarette smoking on wound-healing in patients undergoing breast reduction. METHODS In our prospective study, 50 patients (25 smokers, 25 nonsmokers) scheduled for breast reduction have been evaluated. Urine cotinine levels were measured to analyse perioperative smoking habits. Urine samples were taken preoperatively and on the fourth postoperative day. Cotinine as a metabolite of nicotine allows precise evaluation of nicotine exposure. To assess the progress of woundhealing we classified secreting, instable, inflamed or necrotic wound conditions, which required a dressing after the tenth postoperative day as impaired wound healing. For statistical analysis non-parametrical tests for independent and dependent data were used. RESULTS Ten of 25 smokers presented impaired wound healing compared to 4 of 25 nonsmokers. The median cotinine level of smokers was 1964 (783/3963)ng/cc preoperatively and 432 (148/1695)ng/cc postoperatively. Nonsmokers had a preoperative cotinine level of 18 (7/37)ng/cc and 15 (4/34)ng/cc postoperatively. Smokers who developed impaired wound-healing showed higher levels of cotinine pre- (2117 ng/cc) and especially postoperatively (485 ng/cc) compared to smokers with regular woundhealing (1614 ng/cc and 389 ng/cc). Both differences in cotinine levels were statistically significant (p=0.03 and p=0.02). CONCLUSIONS The data of the present study confirm the negative effect of smoking on wound healing in patients undergoing breast reduction.
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Affiliation(s)
- Rudolf Heinrich Bartsch
- Hospital Rudolfstiftung, Department of Plastic and Reconstructive Surgery, Juchgasse 25, 1010 Vienna, Vienna, Austria.
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Gehring U, Leaderer BP, Heinrich J, Oldenwening M, Giovannangelo MECA, Nordling E, Merkel G, Hoek G, Bellander T, Brunekreef B. Comparison of parental reports of smoking and residential air nicotine concentrations in children. Occup Environ Med 2006; 63:766-72. [PMID: 16912089 PMCID: PMC2077986 DOI: 10.1136/oem.2006.027151] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Using questionnaires to assess children's residential exposure to environmental tobacco smoke (ETS) may result in misclassification from recall and response bias. Questionnaire data have frequently been validated against urinary cotinine measurements, but rarely against actual measurements of residential air nicotine. OBJECTIVE To compare questionnaire reported smoking with air nicotine concentrations in a large population of children and with urinary cotinine levels in a subpopulation; and to assess the potential impact of the symptom status of the children on the agreement between different measures of exposure. METHODS The authors assessed residential exposure to ETS in 347 German, 335 Dutch, and 354 Swedish preschool and schoolchildren by questionnaire and air nicotine measurements, and in a subset of 307 German children by urinary cotinine measurements. They then compared the different measures of ETS exposure. RESULTS In all countries, air nicotine concentrations increased with increasing questionnaire reported smoking in a dose-response fashion. Specificity and negative predictive values of questionnaire reports for nicotine concentrations were excellent. Sensitivity and positive predictive values were moderate to good. Excluding occasional smokers, the overall percentage of homes misclassified was 6.9%, 6.7%, and 5.1% in Germany, the Netherlands, and Sweden, respectively. Similar results were found for the agreement of urinary cotinine concentrations with questionnaire reports and air nicotine levels. There was no indication of underreporting by parents of symptomatic children. CONCLUSION Despite some misclassification, questionnaire reports are an inexpensive and valid estimate of residential ETS exposure among preschool and school children.
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Affiliation(s)
- U Gehring
- Utrecht University, Institute for Risk Assessment Sciences, Utrecht, The Netherlands.
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Yang M, Pyo MY. Molecular epidemiology of lung cancer in female passive smokers. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2005; 23:75-97. [PMID: 16291523 DOI: 10.1081/gnc-200052205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
To clarify etiology of lung cancer in nonsmoker females, various studies have been done. Particularly, host factors and environmental tobacco smoking (ETS) of females have been emphasized. However, traditional epidemiological data showed controversial results of sex or gender differences in lung cancer susceptibility and suggest presence of some confounders. One of them is that most of epidemiology studies are based on self-reports for ETS. To prevent misestimate effects of ETS via the self-report, exposure monitoring of ETS is required. On the other hand, focusing on genetic polymorphisms in metabolic enzymes and DNA repair, molecular epidemiological studies have been done in nonsmoker females. Therefore, this review considered: 1. gender differences in lung cancer; 2. effects of passive smoking on lung cancer; 3. exposure monitoring of ETS including genetic risks of lung cancer to clarify etiology of lung cancer in the nonsmoker females with molecular epidemiological discussion.
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Affiliation(s)
- Mihi Yang
- College of Pharmacy, Sookmyung Women's University, Seoul, Republic of Korea.
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