Abstract
ObjectivesTo identify any association between implementing smoking regulation policies and workers’ urine cotinine concentration levels in Korea.MethodsFrom the first stage of the Korean National Environmental Health Survey conducted by the National Institute of Environmental Research from 2009 to 2011, 2,475 non-smoking workers selected. We analyzed the trend in the changes of cotinine concentration in urine using the general linear model and linear regression, in various jobs as categorized by the National Center for Health Statistics (NCHS) and Korea Standard Classification of Occupations (KSCO).ResultsThe urine cotinine concentration tended to decrease every year (2.91 ng/ml in 2009, 2.12 ng/ml in 2010, and 1.31 ng/ml in 2011), showing a decreasing trend (P < 0.001). The total subjects’ decreased cotinine concentration in urine between 2009 and 2011 was 2.72 ng/ml (54.1 % relative decrease). The changes in each subgroup’s urine cotinine concentration ranged from 1.59 to 6.03 ng/ml (33.2 to 77.5 %). All groups except for the managerial group (n = 49), which had a small sample size, had statistically significant negative regression coefficients (p < 0.05). The ranges of the decrease in urine cotinine were 2.75 ng/ml (53.6 %) for males and 2.72 ng/ml (54.9 %) for females. The negative slope in urine cotinine level was statistically significantly greater in men than women. The changes in urine cotinine by occupation as classified by the NCHS occupational categories ranged from 2.43 to 3.36 ng/ml (46.6 to 61.5 % relative decrease). The negative slopes in urine cotinine levels of the white-collar and farm workers were statistically significantly greater than those of the service workers and blue-collar workers. The change by occupation as classified by the KSCO ranged from 1.59 to 6.03 ng/ml (a 33.2 to 77.5 % relative decrease). The negative slopes in urine cotinine levels of the professionals and related workers and clerks were statistically significantly greater than those of the service workers and plant and machine operators and assemblers.ConclusionsThe cotinine concentration in urine among non-smoking worker groups tended to decline from 2009 to 2011. Such a result may be an indirect indicator of the effectiveness of smoking regulation policies including the revision of the National Health Promotion Act.
Highlights
Secondhand smoke is defined as the smoke involuntarily inhaled from tobacco smoked by a smoker
On the basis of ROC curve’s sensitivity (97.1 %) and specificity (95.1 %), the cut-off point of urine cotinine concentration was determined as 50 ng/ml
Urine cotinine concentration according to general characteristics The subjects of this study were 2,475 non-smoking workers surveyed from 2009 to 2011
Summary
Secondhand smoke is defined as the smoke involuntarily inhaled from tobacco smoked by a smoker. 40 % of children, 33 % of non-smoking males, and 35 % of non-smoking females are known to be exposed to ETS [3]. The secondhand smoke exposure rate in Korea (39.7 %) is lower than that of China (49.2 %) but higher than that of Finland (14.3 % in males and 13 % in females) or the U.S (20.2 %) [4,5,6,7]. In Korea, 58.6 % of male non-smokers and 41.8 % of female non-smokers are exposed to secondhand smoke at worksites [4]. A meta-analysis on studies of the U.S, Europe, China, and Japan in 2007 reported a 24 % increase in the risk for lung cancer among workers exposed to secondhand smoke and a 2.1-fold higher relative risk (95 % CI 1.3-2.6) in a highly exposed group [8]. Exposure to secondhand smoke in the workplace is reportedly about four times higher than at home [9], both of which suggest that workers are vulnerable to secondhand smoke
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