Changes and stability of hand nicotine levels in children of smokers: Associations with urinary biomarkers, reported child tobacco smoke exposure, and home smoking bans

BACKGROUND

Exposure to thirdhand smoke (THS) residue takes place through inhalation, ingestion, and dermal transfer. Hand nicotine levels have been proposed to measure THS pollution in the environment of children, but little is known about its variability and stability over time and correlates of change.

OBJECTIVES

The goal was to determine the stability of hand nicotine in comparison to urinary biomarkers and to explore factors that influence changes in hand nicotine.

METHODS

Data were collected from 0 to 11-year-old children (Mean age = 5.9) who lived with ≥1 tobacco smokers (N = 129). At a 6-week interval, we collected repeated measures of hand nicotine, four urinary biomarkers (cotinine, trans-3'-hydroxycotinine, nicotelline N-oxides, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol), and parent-reported child tobacco smoke exposure (TSE). Dependent sample t-tests, correlations, and multivariable regression analyses were conducted to examine the changes in child TSE.

RESULTS

Hand nicotine levels (r = 0.63, p < 0.001) showed similar correlations between repeated measures to urinary biomarkers (r = 0.58-0.71; p < 0.001). Different from urinary biomarkers, mean hand nicotine levels increased over time (t(113) = 3.37, p < 0.001) being significantly higher in children from homes without smoking bans at Time 2 (p = 0.016) compared to Time 1 (p = 0.003). Changes in hand nicotine correlated with changes in cotinine and trans-3'-hydroxycotinine (r = 0.30 and r = 0.19, respectively, p < 0.05). Children with home smoking bans at Time 1 and 2 showed significantly lower hand nicotine levels compared to children without home smoking bans.

DISCUSSION

Findings indicate that hand nicotine levels provide additional insights into children's exposure to tobacco smoke pollutants than reported child TSE and urinary biomarkers. Changes in hand nicotine levels show that consistent home smoking bans in homes of children of smokers can lower THS exposure. Hand nicotine levels may be influenced by the environmental settings in which they are collected.

Hand nicotine as an independent marker of thirdhand smoke pollution in children's environments

BACKGROUND

Hand nicotine (HN) levels measure children's exposure to tobacco smoke pollutants from thirdhand and secondhand smoke. HN is associated with urinary and salivary cotinine, but the associations of HN with other tobacco smoke exposure (TSE) markers remain unknown.

OBJECTIVES

We compared levels of HN and four urinary TSE biomarkers: cotinine, trans-3'-hydroxycotinine (3HC), nicotelline N-oxides, and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and children's sociodemographic and TSE patterns. We also examined if HN is a plausible pathway for children's exposure to active smoking.

METHODS

Data were collected from 175 non-smoking patients (Mean (SD) age = 5.4 (3.4) years) who lived with ≥1 cigarette smoker(s). HN and TSE biomarker levels were determined using LC-MS/MS. Multivariate and multivariable regression analyses were conducted to examine associations between TSE markers and parent-reported measures, controlling for sociodemographics.

RESULTS

Of the five markers of TSE, cotinine (R² = 0.221; p = 0.003) and HN (R² = 0.247; p = 0.001) showed the strongest overall associations. Of the five markers, only cotinine showed significantly higher levels among Black children (β^=0.307,p<0.05) independent of age, reported exposure, and home smoking bans. Cotinine (β^=0.010,p<0.05), NNAL (β^=0.012,p<0.05), and HN (β^=0.011,p<0.05) showed significant positive associations with reported exposure independent of race, age, and home smoking bans. NNAL (β^=-0.285,p<0.05) and HN (β^=-0.336,p<0.05), but not cotinine, 3HC, and N-oxides, showed significantly lower levels among children who lived in homes with smoking bans. Child age, hand surface area, home smoking ban, and reported exposure independently accounted for 21 % of the variance in HN levels (p = 0.002). HN accounted for 30 % of the variance in cotinine independent of child race and child age.

DISCUSSION

HN levels were associated with modifiable tobacco-related behaviors and shows promise as a marker of sources of THS pollution in a child's environment not captured by measurement of urinary cotinine alone. HN levels provide additional information about TSE, complementing other biomarkers when assessing children's overall TSE.

E-waste dismantling-related occupational and routine exposure to melamine and its derivatives: Estimating exposure via dust ingestion and hand-to-mouth contact

Melamine (MEL) and its derivatives are increasingly applied as nitrogenous flame retardants in consumer products. Nevertheless, limited information is available on their environmental occurrence and subsequent human exposure via multiple exposure pathways. In this study, we analysed MEL and its derivatives in dust (indication of the dust ingestion route) and hand wipe samples (indication of the hand-to-mouth route) collected in various microenvironments. The levels of ∑MELs in both dust (median: 24,100 ng/g) and participant hand samples (803 ng/m²) collected in e-waste dismantling workshops were significantly higher than those in samples collected in homes (15,600 ng/g and 196 ng/m², respectively), dormitories (13,100 ng/g and 227 ng/m², respectively) and hotel rooms (11,800 ng/g and 154 ng/m², respectively). Generally, MEL dominated in dust samples collected in e-waste dismantling workshops, whereas cyanuric acid dominated in hand wipe samples. This may occur partly because the latter is an ingredient in disinfection products, which are more frequently employed in daily lives during the COVID-19 pandemic. Exposure assessment suggests that dust ingestion is an important exposure pathway among dismantling workers and the general population, whereas hand-to-mouth contact could not be overlooked in certain populations, such as children and dismantling workers not wear gloves at work.

Organophosphate esters in children and adolescents in Liuzhou city, China: concentrations, exposure assessment, and predictors

Dermal contact with dust is commonly considered an important pathway of exposure to organophosphate esters (OPEs), but the importance of OPE uptake from diet is unclear. Herein, we used hand wipes to estimate OPE exposure from indoor dust and examined whether urinary OPE metabolite concentrations were influenced by sociodemographic characteristics, OPE amount in hand wipes, and dietary factors. OPEs were measured in urine and hand wipes from 6 to 18-year-old children and adolescents (n=929) in Liuzhou, China. Sociodemographic and dietary factors were obtained from questionnaire. Six OPE metabolites were detected in >70% of the urine samples, and seven OPEs were detected in >50% of the hand wipes. Estimated daily intakes (EDIs) were calculated using urinary OPE metabolites to investigate the total daily intake of OPEs, in which 0.36-10.1% of the total intake was attributed to the exposure from dermal absorption. In multivariate linear regression models, sex, age, and maternal education were significant predictors of urinary OPE metabolite concentrations. Urinary diphenyl phosphate (DPHP) is positively associated with its parent compounds 2-ethylhexyl-diphenyl phosphate (EHDPP) and triphenyl phosphate (TPHP) in hand wipes. High versus low vegetable intake was associated with a 23.7% higher DPHP (95% confidence interval (CI): 0.51%, 52.1%). Barreled water drinking was associated with a 30.4% (95% CI: 11.8%, 52.0%) increase in bis(1-chloro-2-propyl) 1-hydroxy-2-propyl phosphate (BCIPHIPP) compared to tap water drinking. Our results suggested the widespread exposure to OPEs in children and adolescents. In addition to dermal absorption, dietary intake may be an important exposure source of certain OPEs.

Measurement of polychlorinated biphenyls with hand wipes and matched serum collected from Chinese E-waste dismantling workers: Exposure estimates and implications

To date, dermal/hand-to-mouth exposure to chemicals in the e-waste recycling environment has not been sufficiently understood, and the importance of dermal absorption of chemicals in e-waste dismantling workers remains controversial. In this study, we utilized hand wipes and matched sera to characterize dermal/hand-to-mouth exposure to PCBs for e-waste dismantling workers, and potential effects on thyroid hormones were also assessed. PCB loadings in hand wipes varied from 0.829-265 ng wipe^-1 (11.3-2850 ng m^-2 wipe^-1), with 37.2 ng wipe^-1 (432 ng m^-2 wipe^-1) as the median value. Serum concentrations of PCBs ranged from 32.3-3410 ng g^-1 lipid weight (lw) with 364 ng g^-1 lw as the median value. Between wipes and sera, lower-chlorinated congeners (e.g. CB-28, -66, -74, -99,-105 and -118) showed significant associations (p < 0.01), but higher-chlorinated congeners (e.g. CB-138, -153, -156, -170, and -180) did not. These lower-chlorinated CBs were the major contributors to estimated dermal/hand-to-mouth average daily doses (ADDs) and the hazard index (HI). Correspondingly, their estimated contributions to serum levels by dermal absorption were also significant, with the contribution of CB-28 being as high as 21.4%. As a consequence, dermal absorption of some low-chlorinated congeners was a non-negligible route for e-waste dismantling workers. Although insignificant association was shown between serum PCBs and thyroid hormones, the potential health risk should be of concern due to the high levels of PCBs observed in workers' sera.

Identifying dust as the dominant source of exposure to heavy metals for residents around battery factories in the Battery Industrial Capital of China

Heavy metals (HMs) are constantly released into the environment during the production and use of batteries. Battery manufacturing has been ongoing for over six decades in the "Battery Industrial Capital" (located in Xinxiang City) of China, but the potential exposure pathways of residents in this region to HMs remain unclear. To clarify the exposure pathways and health risk of human exposure to HMs, hand wipe samples (n=82) and fingernail samples (n=36) were collected from residents (including young children (0-6 years old), children (7-12 years old) and adults (30-60 years old)) living around battery factories. The total concentrations of the target HMs (Zn, Mn, Cu, Pb, Ni, Cr, Cd, Co) in hand wipes ranged from 133 to 8040 μg/m², and those in fingernails ranged from 9.7-566 μg/g. HM levels in the hand wipe and fingernail samples both decreased with age, and higher HM levels were observed for males than females. The HM composition profiles in these two matrices represented a high degree of similarity, with Zn as the predominant element, and thus, oral ingestion and dermal exposure via dust were expected to be the most important HM exposure pathways for residents in this region. The non-carcinogenic risks (HQs) from dermal and oral ingestion exposure to Cd, Cr, and Pb were higher than those of the other five elements for all three populations, and the HQ_derm of Cd for young children was 2.1 (HQ_oral=0.6). Moreover, the hazard index (HI) values of ∑₈HMs for young children (HI_total=5.2, HI_oral=2.0, HI_dermal=3.2) and children (HI_total=1.6, HI_oral=1.3, HI_dermal=0.3) exceeded the safe threshold (1.0). Therefore, young children and children should be prioritized for protection from HM pollution, and more attention should be paid to young children's dermal exposure to Cd in this region.

Toddler behavior, the home environment, and flame retardant exposure

Toddlers are at increased risk of dust ingestion and subsequently flame retardant (FR) exposure because they often play close to the floor and mouth hands and objects. Exposure to some FRs have been associated to endocrine disruption and neurodevelopmental disorders. Previous research has shown higher FR concentrations in toddlers' serum and urine, but which toddler-behaviors influence exposure levels remains to be determined. We investigated how toddler-behaviors are associated to FRs in hand wipes (HWs) and saliva. Fifty 8-18 month-old children from the Linking EDCs in maternal Nutrition to Child health study, were visited at home. The child's behavior was observed and assessed using a questionnaire. Hand-to-object behavior frequency was associated with HW tris(chloroethyl) phosphate (TCEP), tris(1,3-dichloroisopropyl) phosphate (TDCIPP), tris(phenyl) phosphate, tris(methylphenyl) phosphate, and resorcinol bis(diphenyl phosphate) levels above the detection limit. Children playing with electronics multiple times per week had higher TDCIPP HW levels compared to children playing with electronics once per month or never (p = 0.032 and p = 0.046). Frequent mouth-to-object and frequent mouthing a pacifier were associated with lower TDCIPP (p = 0.019) and tris(2-chloroisopropyl) phosphate (TCIPP) HW levels, respectively (p = 0.002-0.019). Exposure estimates based on hand-to-mouth behavior did not exceed the available reference doses. This is the first study investigating toddler-behavior in relation to FR hand loadings. Although a range of behaviors was investigated, only a few showed a relation with FR HW levels, suggesting that toddler-behavior might not alone be responsible for the elevated FR levels in children. It is therefore important to explore other pathways including dermal absorption and inhalation.

Legacy and alternative flame retardants in house dust and hand wipes from South China

The present study investigated the occurrence of legacy and alternative halogenated flame retardants (FRs) in house dust (n = 51) from Guangzhou, South China and hand wipes collected from adults (n = 51) and children (n = 31). In addition to polybrominated diphenyl ether (PBDE) congeners (particularly BDE-209), several alternative FRs were also detected in >60% of dust samples, including decabromodiphenylethane (DBDPE; median: 4600 ng/g), bis(2-ethylhexyl)-3,4,5,6-tetrabromo-phthalate (BEH-TEBP; 43.9 ng/g), 1,2-bis(2,4,6-tribormophenoxy)ethane (BTBPE; 9.2 ng/g), pentabromotoluene (PBT; 10.1 ng/g), and syn- and anti-dechlorane plus (DPs, 24.5 ng/g). BDE-47, BDE-209, DBDPE, BEH-TEBP, and DPs were also frequently detected on hand wipes from children (median mass: 0.1-1.1 ng) and adults (0.1-1.2 ng). Linear regression models suggest that dust concentrations of BDE-47 and DPs had significant or marginally significant associations with their masses on children's (10^β = 2.82; 95% CI: 1.20, 6.64 and 10^β = 5.57, 95% CI: 1.85, 16.75, respectively) and adults' hands (10^β = 4.46; 95% CI: 0.92, 21.58 and 10^β = 5.11; 95% CI: 1.74, 14.96, respectively), whereas no association was observed for any other FRs. Most of the investigated demographic, environmental, or behavioral factors did not significantly influence the levels of halogenated FRs on human hands. Estimation of human exposure risks via hand-to-mouth contact and dust ingestion indicates that children are subjected to elevated exposure than adults, and the relative importance of the two pathways is chemical-specific.

Occupational exposure to polybrominated diphenyl ethers (PBDEs) and other flame retardant foam additives at gymnastics studios: Before, during and after the replacement of pit foam with PBDE-free foams

Coaches spend long hours training gymnasts of all ages aided by polyurethane foam used in loose blocks, mats, and other padded equipment. Polyurethane foam can contain flame retardant additives such as polybrominated diphenyl ethers (PBDEs), to delay the spread of fires. However, flame retardants have been associated with endocrine disruption and carcinogenicity. The National Institute for Occupational Safety and Health (NIOSH) evaluated employee exposure to flame retardants in four gymnastics studios utilized by recreational and competitive gymnasts. We evaluated flame retardant exposure at the gymnastics studios before, during, and after the replacement of foam blocks used in safety pits with foam blocks certified not to contain several flame retardants, including PBDEs. We collected hand wipes on coaches to measure levels of flame retardants on skin before and after their work shift. We measured flame retardant levels in the dust on window glass in the gymnastics areas and office areas, and in the old and new foam blocks used throughout the gymnastics studios. We found statistically higher levels of 9 out of 13 flame retardants on employees' hands after work than before, and this difference was reduced after the foam replacement. Windows in the gymnastics areas had higher levels of 3 of the 13 flame retardants than windows outside the gymnastics areas, suggesting that dust and vapor containing flame retardants became airborne. Mats and other padded equipment contained levels of bromine consistent with the amount of brominated flame retardants in foam samples analyzed in the laboratory. New blocks did not contain PBDEs, but did contain the flame retardants 2-ethylhexyl 2,3,4,5-tetrabromobenzoate and 2-ethylhexyl 2,3,4,5-tetrabromophthalate. We conclude that replacing the pit foam blocks eliminated a source of PBDEs, but not 2-ethylhexyl 2,3,4,5-tetrabromobenzoate and 2-ethylhexyl 2,3,4,5-tetrabromophthalate. We recommend ways to further minimize employee exposure to flame retardants at work and acknowledge the challenges consumers have identifying chemical contents of new products.

Assessment of dermal exposure to halogenated flame retardants: Comparison using direct measurements from hand wipes with an indirect estimation from settled dust concentrations

There are few studies estimating dermal exposure to halogenated flame retardants in adults. To fill this gap, sixty-one hand wipe samples were collected from a Norwegian adult cohort using gauze pads immersed in isopropanol. BDE-47, BDE-209, bis(2‑ethyl‑hexyl)‑3,4,5,6‑tetrabromophthalate (BEH-TEBP) and decabromodiphenylethane (DBDPE) were the most frequently detected chemicals. The highest median mass in hand wipes was that of sumEHFR (570 ng), followed by sumHBCDD (180 ng) and sumPBDE (2.9 ng). The high EHFR level was mainly driven by tetrabromobisphenol A (TBBPA) which accounted for 77% of the total mass. Positive and significant correlations were observed between FR levels in hand wipes and settled dust (0.26 < r < 0.56, p < 0.05), as well as between FR levels in hand wipes and the number of electronic consumer products at home (0.27 < r < 0.40, p < 0.05). Significant bivariate associations with number of laptops/tablets and phones/mobiles were further confirmed by multivariate linear regression analyses. Dermal exposure was estimated using the levels measured in handwipes. The estimated median dermal exposure was 2600, 840 and 6.2 pg/kg bw/d for sumEHFR, sumHBCDD and sumPBDE, respectively. Further, we compared these results with the dermal exposure as estimated indirectly by utilizing previously reported FR levels in settled dust collected from the residences of the same studied cohort. With the indirect approach, higher dermal exposures to sumPBDE but lower exposures to sumEHFR and sumHBCDD were observed compared to the direct dermal exposure estimated via hand wipes. Comparable exposure estimates between hand wipes and the indirect method were obtained for α‑, β‑tetrabromoethylcyclohexane (DBE-DBCH), DBDPE, BDE-28, -35, -49, -99, -153, 154, and -183. For other individual HFRs, the exposure estimates obtained from the two approaches were significantly different (Mann-Whitney U test, p < 0.05). Both methods gave similar dermal exposure estimates for many individual FRs. However, it is important to be aware of the value and limitations of each method when using them to estimate human exposure.

Lead exposure in young children over a 5-year period from urban environments using alternative exposure measures with the US EPA IEUBK model - A trial

The US Environmental Protection Agency (EPA) Integrated Exposure Uptake Biokinetic (IEUBK) model has been widely used to predict blood lead (PbB) levels in children especially around industrial sites. Exposure variables have strongly focussed on the major contribution of lead (Pb) in soil and interior dust to total intake and, in many studies, site-specific data for air, water, diet and measured PbB were not available. We have applied the IEUBK model to a comprehensive data set, including measured PbB, for 108 children monitored over a 5-year period in Sydney, New South Wales, Australia. To use this data set, we have substituted available data (with or without modification) for standard inputs as needed. For example, as an alternative measure for soil Pb concentration (μg/g), we have substituted exterior dust sweepings Pb concentration (μg/g). As alternative measures for interior dust Pb concentration (μg/g) we have used 1) 30-day cumulative petri dish deposition data (PDD) (as µg Pb/m²/30days), or 2) hand wipe data (as μg Pb/hand). For comparison, simulations were also undertaken with estimates of dust Pb concentration derived from a prior regression of dust Pb concentration (μg/g) on dust Pb loading (μg/ft²) as concentration is the unit specified for the Model. Simulations for each subject using observed data aggregated over the 5-year interval of the study, the most usual application of the IEUBK model, showed using Wilcoxon tests that there was a significant difference between the observed values and the values predicted by the Model containing soil with hand wipes (p < 0.001), and soil and PDD (p = 0.026) but not those for the other two sets of predictors, based on sweepings and PDD or sweepings and wipes. Overall, simulations of the Model using alternative exposure measures of petri dish dust (and possibly hand wipes) instead of vacuum cleaner dust and dust sweepings instead of soil provide predicted PbB which are generally consistent with each other and observed values. The predicted geometric mean PbBs were 2.17 ( ± 1.24) μg/dL for soil with PDD, 1.95 ( ± 1.17) μg/dL for soil with hand wipes, 2.36 ( ± 1.75) μg/dL for sweepings with PDD, and 2.15 ( ± 1.69) for sweepings with hand wipes. These results are in good agreement with the observed geometric mean PbB of 2.46 ( ± 0.99) μg/dL. In contrast to all other IEUBK model studies to our knowledge, we have stratified the data over the age ranges from 1 to 5 years. The median of the predicted values was lower than that for the observed values for every combination of age and set of measures; in some cases, the difference was statistically significant. The differences between observed and predicted PbB tended to be greatest for the soil plus wipes measure and for the oldest age group. Use of 'default dust' values calculated from the site-specific soil values, a common application of the IEUBK model, results in predicted PbB about 22% (range 0 to 52%) higher than those from soil with PDD data sets. Geometric mean contributions estimated from the Model to total Pb intake for a child aged 1-2 years was 0.09% for air, 42% for diet, 5.3% for water and 42% for soil and dust. Our results indicate that it is feasible to use alternative measures of soil and dust exposure to provide reliable predictions of PbB in urban environments.

Brominated and organophosphorus flame retardants in body wipes and house dust, and an estimation of house dust hand-loadings in Dutch toddlers

Children generally have higher Flame Retardant (FR) concentrations in serum compared to other age groups. Toddler behavior enhances direct contact with house dust since their frequent presence proximate to the floor, and their mouthing behavior. This study aimed to thoroughly investigate FR levels in body wipes of toddlers 8-18 months old) and in indoor dust using a noninvasive sampling technique. In this cross-sectional study, body wipes from hands, mouth and back, and indoor household dust samples were collected in twenty-one families and analyzed for one brominated- and seven organophosphorus FRs (polybrominated diphenyl ether 209 (BDE209), tris(2-chloroisopropyl) phosphate (TCIPP), tris(chloroethyl) phosphate (TCEP), tris(1,3-dichloroisopropyl) phosphate (TDCIPP), tris(phenyl) phosphate (TPHP), tris(methylphenyl) phosphate (TMPP), resorcinol bis(diphenyl phosphate) and bisphenol A bis(diphenyl phosphate)). Accelerated solvent extraction was used for extraction and the extract was measured with liquid chromatography combined with mass spectrometry. Non-parametric correlation analyses were performed to assess associations. All FRs were detected in body- and indoor dust samples (median range: 1.0ng/hand wipe (BDE209) to 65ng/hand wipe (TCIPP)) and were mostly correlated with each other. We estimated that approximately 260mg dust (range 50-880mg) accumulated on toddler's hands per day. Hand-to-mouth frequency was negatively associated with FR levels in wipes (τ = -0.38, p = 0.04). With increasing age FR concentrations (BDE209, TCEP, TDCIPP, TPHP and TMPP) on hands decreased significantly (p = 0.01-0.03). Girls had significantly less FRs (TCEP, TCIPP, TPHP and TMPP) on the hands (p = 0.01-0.03) than boys. This is to the best of the authors' knowledge the first study in Europe that measured brominated- as well as organophosphorus FRs in several types of body wipes from toddlers and that estimated the amount of house dust that accumulates on toddler's hands.