Abstract
BackgroundAwareness of the negative effects of smoking on children's health prompted a decrease in the self-reporting of parental tobacco use in periodic surveys from most industrialized countries. Our aim is to assess changes between ETS exposure at the end of pregnancy and at 4 years of age determined by the parents' self-report and measurement of cotinine in age related biological matrices.MethodsThe prospective birth cohort included 487 infants from Barcelona city (Spain). Mothers were asked about maternal and household smoking habit. Cord serum and children's urinary cotinine were analyzed in duplicate using a double antibody radioimmunoassay.ResultsAt 4 years of age, the median urinary cotinine level in children increased 1.4 or 3.5 times when father or mother smoked, respectively. Cotinine levels in children's urine statistically differentiated children from smoking mothers (Geometric Mean (GM) 19.7 ng/ml; 95% CI 16.83–23.01) and exposed homes (GM 7.1 ng/ml; 95% CI 5.61–8.99) compared with non-exposed homes (GM 4.5 ng/ml; 95% CI 3.71–5.48). Maternal self-reported ETS exposure in homes declined in the four year span between the two time periods from 42.2% to 31.0% (p < 0.01). Nevertheless, most of the children considered non-exposed by their mothers had detectable levels of cotinine above 1 ng/mL in their urine.ConclusionWe concluded that cotinine levels determined in cord blood and urine, respectively, were useful for categorizing the children exposed to smoking and showed that a certain increase in ETS exposure during the 4-year follow-up period occurred.
Highlights
Awareness of the negative effects of smoking on children's health prompted a decrease in the self-reporting of parental tobacco use in periodic surveys from most industrialized countries
In the 4 year interval of follow-up, a significant percentage of non-Spanish mothers could not be contacted for various reasons, but there were no statistically significant differences in neonatal environmental tobacco exposure between the retained group and the group which was lost in the 4 years span
In the group lost to follow up, the percentage of smoking mothers evaluated by biomarker was 29.5% and in the group retained for the follow up it was 33.6%, p = 0.27
Summary
Awareness of the negative effects of smoking on children's health prompted a decrease in the self-reporting of parental tobacco use in periodic surveys from most industrialized countries. Maternal self-reported smoking in periodic populationbased surveys revealed a decreasing trend or cessation of cigarette consumption during pregnancy [7,8,9] and during early life of their children [10,11]. In all these epidemiological studies, parental tobacco self-reporting has been the method of determining ETS exposure at home. Passive exposure from other sources beside home, such as bars, restaurants, etc. did not usually occur in children
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