High Levels Of Environmental Tobacco Smoke Research Articles

Environmental tobacco smoke exposure and nocturnal symptoms among inner-city children with asthma.

Environmental tobacco smoke (ETS) is a frequent exposure and is linked to asthma among inner-city children. We sought to examine the relationship among ETS exposure, select asthma symptoms, and consequences among inner-city children with asthma. Data from interviews with primary caregivers of inner-city elementary school children with asthma were evaluated (n = 590). Caregiver reports of child asthma symptoms, exercise limitations, asthma management, health care use, and ETS exposure were examined. Smoking in the home was reported by 29.4% of primary caregivers. ETS exposure (yes/no) was not related to frequency of child nocturnal symptoms or other select asthma morbidity markers. However, among children exposed to ETS, the frequency and severity of child nocturnal symptoms were highest among children exposed to moderate-to-heavy levels of ETS. After controlling for child age, anti-inflammatory medication use, asthma primary care, and caregiver's education, exposure to higher levels of ETS was associated with nearly a 3-fold increase in nocturnal symptoms in children (odds ratio, 2.83; 95% CI, 1.22-6.55). Among elementary school inner-city children with asthma, exposure to higher levels of ETS was associated with increased frequency of nocturnal symptoms. Reducing the exposure of children with asthma to ETS should be a clear priority in developing effective asthma management plans for inner-city families.

Environmental tobacco smoke and lung cancer: a case-control study in Germany.

To assess the association between exposure to environmental tobacco smoke (ETS) and lung cancer, the authors personally interviewed 292 lifelong nonsmoking lung cancer cases (recruited from 15 hospitals in the study area) and 1,338 nonsmoking controls (randomly selected by population registries) between 1990 and 1996 in Germany. Subjects were asked by a standardized questionnaire about exposure to ETS in childhood, by spouse, at work, and in transportation and social settings. Several indicators of these different sources of exposure were investigated, using not or low exposed subjects as the reference category. The most informative quantification index was weighted duration of exposure (hours x level of smokiness). No effect of ETS exposure during childhood and no clear effect of spousal ETS were observed. However, for the highest category of exposure, clear effects of ETS at the workplace (odds ratio (OR) = 1.93; 95% confidence interval (CI): 1.04, 3.58), in vehicles (OR = 2.64; 95% CI: 1.30, 5.36), and from all sources combined (OR = 1.39; 95% CI: 0.96, 2.01) were found. Adjustment for occupational carcinogens, radon, and diet did not appreciably change the results. These findings suggest that exposures to high levels of ETS at the workplace and in other public indoor settings appear to be important risk factors for lung cancer risk in nonsmokers.

Personal exposure to environmental tobacco smoke: salivary cotinine, airborne nicotine, and nonsmoker misclassification.

A large study was conducted to assess exposure to environmental tobacco smoke (ETS) in a geographically dispersed study population using personal breathing zone air sampling and salivary cotinine levels. Approximately 100 self-reported nonsmoking subjects in each of 16 metropolitan areas were recruited for this investigation. Cumulative distributions of salivary cotinine levels for subjects in smoking and nonsmoking homes and workplaces exhibited a general trend of decreasing salivary cotinine levels with decreasing time spent in smoking environments. Median salivary cotinine levels for the four experimental cells in the study (product of smoking and nonsmoking home and workplaces) were comparable to those reported for a large national study of serum levels of cotinine (Third National Health and Nutrition Examination Survey, NHANES III), when the latter was corrected for expected differences between serum and saliva concentrations. However, the most highly exposed group in this study had a median salivary cotinine concentration approximately a factor of 2 greater than that of the comparable group in the NHANES III study. Misclassification rates, both simple (for self-reported nonsmokers) and complex (self-reported lifetime never smokers), were near the median of those reported for other studies. Estimated misclassification rates for self-reported lifetime never-smoking females are sufficiently high (2.95% using a discrimination level of 106 ng/ml) that, if used in the Environmental Protection Agency (EPA) risk assessment related to ETS and lung cancer, would place the lower 90% confidence interval (CI) for relative risk at nearly 1.00, i.e., no statistically significant increased risk. For the 263 most highly exposed subjects in the study whose self-reported nonsmoking status was accurate, the correlation between airborne exposure to nicotine and average salivary cotinine is so small, on an individual basis, that it makes the relationship useless for estimating exposure on a quantitative basis. When subjects are grouped according to likely categories of nicotine exposure, correlation between group median airborne nicotine exposure and salivary cotinine level increases dramatically. The comparison improves for the most highly exposed subjects, suggesting that such quantitative comparisons are useful for only those subjects who are exposed to the higher levels of ETS. However, airborne nicotine exposure for most of the subjects does not account for estimated systemic levels of nicotine, based on salivary cotinine levels.

Occupational exposure to environmental tobacco smoke: results of two personal exposure studies.

Personal monitoring is a more accurate measure of individual exposure to airborne constituents because it incorporates human activity patterns and collects actual breathing zone samples to which subjects are exposed. Two recent studies conducted by our laboratory offer perspective on occupational exposure to environmental tobacco smoke (ETS) from a personal exposure standpoint. In a study of nearly 1600 workers, levels of ETS were lower than or comparable to those in earlier studies. Limits on smoking in designated areas also acted to reduce overall exposure of workers. In facilities where smoking is permitted, ETS exposures are 10 to 20 times greater than in facilities in which smoking is banned. Service workers were exposed to higher levels of ETS than workers in white-collar occupations. For the narrower occupational category of waiters, waitresses, and bartenders, a second study in one urban location indicated that ETS levels to which wait staff are exposed are not considerably different from those exposure levels of subjects in the larger study who work in environments in which smoking is unrestricted. Bartenders were exposed to higher ETS levels, but there is a distinction between bartenders working in smaller facilities and those working in multiroom restaurant bars, with the former exposed to higher levels of ETS than the latter. In addition, ETS levels encountered by these more highly exposed workers are lower that those estimated by the Occupational Safety and Health Administration. Concomitant area monitoring in the smaller study suggests that area samples can only be used to estimate individual personal exposure to within an order of magnitude or greater.

Analysis of nicotine and cotinine in the hair of hospitality workers exposed to environmental tobacco smoke.

The purpose of this study was to determine if hair nicotine and cotinine levels reflect relative exposure to environmental tobacco smoke (ETS) in subjects who worked in the hospitality industry, where public smoking was permitted. Hair samples from 26 subjects were analyzed by gas chromatograph/mass spectrometry techniques for nicotine and cotinine. An exposure gradient was shown for nicotine but not cotinine. Among nonsmokers, those working in bars where there are no public smoking restrictions had the highest hair nicotine levels, which were close to levels found in smokers. Nicotine measured in hair is useful as a biological marker for exposure to ETS from multiple sources. Bar workers in particular are exposed to high levels of ETS, which may adversely affect the health of nonsmokers.

Effects of Environmental Tobacco Smoke on Serum Levels of Acute Phase Proteins in Schoolchildren

Background.Few biological changes due to long-term exposure to environmental tobacco smoke (ETS) have been identified. This study examined the relationship between exposure to ETS and serum levels of acute phase proteins among children.Methods.The concentrations of the third component of complement (C3c), haptoglobin (Hp), α1acid glycoprotein (α1AG), and ceruloplasmin (Cp) were determined in serum samples obtained from 480 schoolchildren. Exposure to ETS was assessed from responses to questionnaires.Results.Serum levels of C3c, Hp, and α1AG were significantly higher among boys living in households in which there were smokers other than their parents than among boys with no smokers in their family or those in households where only the father smoked. Levels of C3c, Hp, and α1AG in relation to the level of ETS exposure were significantly increased among boys exposed to ETS of 11 or more cigarettes per day. Among girls, increased α1AG levels were associated with exposure to high levels of ETS, but no differences were found in any of the other proteins. Cp levels were not affected by exposure to ETS among either boys or girls.Conclusions.These findings suggest that the serum levels of C3c, Hp, and α1AG among schoolchildren may reflect different levels of exposure to ETS. Boys seemed to be more susceptible to ETS exposure than girls.