Abstract
(1) Background: Environmental Tobacco Smoke (ETS) exposure remains a public health problem worldwide. The aims are to establish urinary (u-) cotinine reference values for healthy Italian children, to evaluate the role of the sampling time and of other factors on children’s u-cotinine excretion. (2) Methods: A cross-sectional study was performed on 330 children. Information on participants was gathered by a questionnaire and u-cotinine was determined in two samples for each child, collected during the evening and the next morning. (3) Results: Reference intervals (as the 2.5th and 97.5th percentiles of the distribution) in evening and morning samples were respectively equal to 0.98–4.29 and 0.91–4.50 µg L−1 (ETS unexposed) and 1.39–16.34 and 1.49–20.95 µg L−1 (ETS exposed). No statistical differences were recovered between median values found in evening and morning samples, both in ETS unexposed and exposed. Significant predictors of u-cotinine excretions were ponderal status according to body mass index of children (β = 0.202; p-value = 0.041 for evening samples; β = 0.169; p-value = 0.039 for morning samples) and paternal educational level (β = −0.258; p-value = 0.010; for evening samples; β = −0.013; p-value = 0.003 for morning samples). (4) Conclusions: The results evidenced the need of further studies for assessing the role of confounding factors on ETS exposure, and the necessity of educational interventions on smokers for rising their awareness about ETS.
Highlights
Environmental Tobacco Smoke (ETS) is one of the most important environmental risk factors for human health, and a well-known threat since the late sixties, when the Surgeon General of the United States, Jesse L
In our previous researches we demonstrated, by the use of some biological indicators of ETS exposure such as u-benzene [6] and u-cotinine [7], that ETS exposure of children is strongly related to parental smoking and their habits at home
Information obtained from the questionnaires evidenced that more than one third of the studied children were exposed to ETS and, according to the BMI, more than one quarter of them were overweight or obese
Summary
Environmental Tobacco Smoke (ETS) is one of the most important environmental risk factors for human health, and a well-known threat since the late sixties, when the Surgeon General of the United States, Jesse L. Steinfeld, helped to focalize the public attention on the effects of smoking itself, and on the effects of smoking on nonsmokers’ health [1]. Over the following 50 years, a growing number of adverse health effects related to ETS exposure have been demonstrated: cardiovascular diseases, respiratory disorders, lung cancer, and reproductive effects in women [1]. Maternal exposure to ETS during pregnancy has been associated to several. Res. Public Health 2018, 15, 817; doi:10.3390/ijerph15040817 www.mdpi.com/journal/ijerph
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