Abstract
Childhood environmental tobacco smoke (ETS) exposure is a risk factor for adverse health outcomes and may disproportionately burden lower socioeconomic status groups, exacerbating health disparities. We explored associations of demographic factors, stressful life events, and chemical co-exposures, with cotinine levels, among girls in the CYGNET Study. Data were collected from families of girls aged 6–8 years old in Northern California, through clinic exams, questionnaires and biospecimens (n = 421). Linear regression and factor analysis were conducted to explore predictors of urinary cotinine and co-exposure body burdens, respectively. In unadjusted models, geometric mean cotinine concentrations were higher among Black (0.59 ug/g creatinine) than non-Hispanic white (0.27), Asian (0.32), or Hispanic (0.34) participants. Following adjustment, living in a rented home, lower primary caregiver education, and lack of two biologic parents in the home were associated with higher cotinine concentrations. Girls who experienced parental separation or unemployment in the family had higher unadjusted cotinine concentrations. Higher cotinine was also associated with higher polybrominated diphenyl ether and metals concentrations. Our findings have environmental justice implications as Black and socio-economically disadvantaged young girls experienced higher ETS exposure, also associated with higher exposure to other chemicals. Efforts to reduce ETS and co-exposures should account for other disparity-related factors.
Highlights
Environmental tobacco smoke (ETS) exposure in children contributes to numerous adverse health outcomes including respiratory infections, ear infections, severe asthma, and impeded lung development [1,2]
Previous analyses from the study cohort examined in the present paper showed that levels of various chemicals tended to be higher in Black compared to white participants, including; all six measured polybrominated diphenyl ethers (PBDEs), as well as some metals and phthalates [23,24,25]
We examined whether stressful life events predicted cotinine concentrations using unadjusted linear regression and models adjusting for child’s primary caregiver educational attainment and home ownership
Summary
Environmental tobacco smoke (ETS) exposure in children contributes to numerous adverse health outcomes including respiratory infections, ear infections, severe asthma, and impeded lung development [1,2]. Though the prevalence of ETS, known as passive smoking or second-hand smoke, exposure among children is estimated to have declined in the U.S by 37% from 1999–2000. Res. Public Health 2019, 16, 4208; doi:10.3390/ijerph16214208 www.mdpi.com/journal/ijerph
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