Urinary Cotinine Levels Research Articles

Association between Friends' Use of Nicotine and Cannabis and Intake of both Substances among Adolescents.

Nicotine and cannabis use are common among adolescents and may be associated with behavioral problems, poor academic outcomes and use disorders. The goals of this analysis were the following: (1) Describe the influence of friends’ nicotine and cannabis smoking and vaping on self-reported use. (2) Describe the relationship between friends’ nicotine and cannabis use on participants’ urinary biomarkers of nicotine (cotinine) and cannabis (11-nor-9-carboxy-Δ⁹tetrahydrocannabinol=THC-COOH). This is a secondary analysis of survey and biomarker data collected in adolescents aged 12–21 between April 2017 and April 2018, in Long Island, New York. Bivariate and multivariable analyses were conducted using SPSS 26. A cutoff value of ≥10 ng/mL was used to signify recent usage for urinary cotinine and THC-COOH levels. Over one-third of the 517 surveyed adolescents reported using tobacco and one-third reported using cannabis. A significant relationship between friends’ substance use and self-use was found. For both tobacco and cannabis, over 90% (p < 0.01) of participants with urinary biomarker levels above cutoff had friends who used the respective substance. Friends’ nicotine and friends’ cannabis use were each independently associated with urinary biomarker levels for those substances (for nicotine, beta = 88.29, p = 0.03; for cannabis, beta = 163.58, p = 0.03). Friends’ use of nicotine and cannabis is associated with adolescents’ intake, as well as the physiological exposure to those substances. These findings underscore the importance of including peer influence in the discussion with adolescents about tobacco and cannabis use.

Psychosocial burden of addiction: A study in correlation to urinary cotinine levels in tobacco chewers

Background: Tobacco usage is a foremost avoidable risk factor for the progress and development of the psychological disease, its deleterious psychological effects through multiple mechanisms.To find out psychosocial impact in correlation to urinary cotinine levels of tobacco chewers (TC) and non tobacco chewers (NTC). Materials and Methods: A total of 600 TC and NTC (18–65 years) were studied using the Hamilton anxiety (Ham-A) and Hamilton depression (Ham-D) scale, Fagerstrom Test for Nicotine Dependence-Smokeless Tobacco (FTND-ST) scale, and structured questionnaire. Results: Psychosocial response by anxiety and depression scale for NTC and TC mean score comparison was found to be highly significant (P

THE RELATIONSHIP BETWEEN THE COTININE LEVEL IN URINE AND VITAMIN D IN THE UNIVERSITY STUDENTS

Background: Vitamin D deficiency is today acknowledged as a pandemic. Vitamin D deficiency and insufficiency are associated with many chronic diseases, including common cancers, cardiovascular diseases, metabolic syndrome, and infectious and autoimmune diseases.&#x0D; Objective: This study aims to investigate the relationship between the cotinine level in urine and Vitamin D.&#x0D; Methods: This study employed a descriptive and relational screening design. It was conducted with 74 smoking university students between January 2019 and March 2020. Data were collected through socio-demographic form and Fagerstrom test for nicotine dependence. Besides, the participating students’ blood and urine samples were taken in a suitable environment.&#x0D; Results: The average age of the participating students was 21.50±2.09. Of all the students, 71.6% were males, 62.2% were exposed to the sun between 12 p.m. and 2 p.m., and the average number of cigarettes smoked daily was 13.52±8.22. The average Vitamin D level in blood was 32.4±15.3 (ng/mL), and the average cotinine level in urine was 1.60 ± .32 (ng/L). No statistically significant relationships were found between the Vitamin D level and the cotinine level (p&lt;0.05).&#x0D; Conclusion: Smoking causes diseases and death in many people, and it is a changeable risk factor. Nursing practices on the struggle against smoking are effective. No significant relationships were found between the Vitamin D level in blood and cotinine level in urine. Similar studies are recommended to be conducted with larger groups and participants from different age groups.

Abstract 16510: Acute Use Impairs Vascular Function in Exclusive Juul Users (the Jive Study)

Introduction: The use of pod-based electronic cigarettes such as JUUL has especially increased among youth and young adults. Due to its popularity and high nicotine delivery as salts, JUUL warrants assessment of its cardiovascular effects. Hypothesis: JUUL use alters vascular function. Methods: In the JUUL Impact on Vascular Effects (JIVE) Study, we evaluated endothelial function and blood pressure (BP) in healthy young adults aged 18-40 who were either tobacco nonusers (N=23), exclusive combustible cigarette users (N=17) or exclusive JUUL users (N=15). Results: As shown in the figure, no differences were noted in baseline brachial artery FMD across the 3 groups. Both JUUL and combustible cigarette users had higher systolic and diastolic BP compared to nonusers (P&lt;0.01). Following 10-minute structured use, JUUL decreased FMD more than nonuse (P&lt;0.01) and was similar to combustible cigarette use (P=0.30 vs JUUL). These differences persisted in models adjusted for age, race and sex. Additionally, JUUL use induced an acute rise in systolic BP (6 ± 6mmHg) that differed from nonuse (0.3 ± 5 mmHg, P=0.001) but was similar to combustible cigarette use (8 mmHg, P=1.0). Urinary cotinine and nicotine levels were higher in combustible cigarette and JUUL users following acute exposure (general linear model adjusted for urinary creatinine with overall P&lt;0.01, combustible cigarette vs nonusers P&lt;0.01, JUUL vs nonusers P&lt;0.01). Conclusions: Our results indicate that acute and chronic JUUL use are associated with higher BP, and acute use with a decrease in endothelial function similar to acute combustible cigarette use, thereby suggesting that JUUL alters vascular function both chronically and upon acute exposure in healthy young adults. Further studies are needed to evaluate the long-term impact of JUUL use on vascular health.

Pregnant Mexican American Biopsychosocial/Cultural risks for adverse infant outcomes.

AimsTo test a model of psychosocial/cultural/biological risk factors for poor birth outcomes in Latina pregnant women.DesignAn observational study measuring acculturation, progesterone, cortisol, cotinine, age, marital status, income, stress, depressive symptoms and coping. We tested a structural equation model to predict risk.MethodsWe obtained a convenience sample (N = 515) of low medical risk pregnant Mexican American Hispanic women at 22–24 weeks of gestation. Bilingual research nurses collected data from blood, urine and questionnaires. Self‐report measures were the Beck Depression Inventory‐II, the Perceived Stress Scale, the Acculturation Rating Scale for Mexican Americans‐II and the Brief Cope. We measured progesterone and cortisol in plasma and cotinine levels in urine by enzyme‐linked immunoassays.ResultsA PLS‐SEM model revealed that Mexican American Hispanic pregnant women who were younger, single, lower income, more acculturated and who had greater negative coping, stress and depression were most at risk for having earlier and smaller babies.

Association of Cotinine-Verified Cigarette Exposure with Chronic Rhinosinusitis in Korean Adults.

Chronic rhinosinusitis is known to be influenced by cigarette exposure; however, this relationship is based on the presence of nasal polyps, and objective measurements of cigarette exposure in chronic rhinosinusitis are not well established. This study aimed to estimate the association between chronic rhinosinusitis and smoking status based on self-reported questionnaires and urinary cotinine levels according to the presence of nasal polyps. We analyzed a total of 23,621 participants who participated from the fifth Korea National Health and Nutrition Examination Survey (2010–2012). Serum total and specific IgE level were measured. Higher prevalence of chronic rhinosinusitis with nasal polyps was associated with current smoking status (OR = 1.43, 95% CI = 1.00–2.03). This association was prevalent in participants aged ≤ 50 years (OR = 1.76, 95% CI = 1.01–3.05), and higher urinary cotinine level showed correlation with higher prevalence of chronic rhinosinusitis with nasal polyps in this age group (OR = 1.04, 95% CI = 1.00–1.08). In addition, positive correlation between serum total IgE and urinary cotinine levels was greater in patients with chronic rhinosinusitis (β = 0.493, 95% CI = 0.071–0.916) than in controls (β = 0.062, 95% CI = 0.021–0.103). Aggressive smoking interventions should be performed in patients with chronic rhinosinusitis with nasal polyp, especially in cases of young adults or high serum IgE levels.

Introducing Machine Learning to Environmental Health Research; Exploring Random Forest in Prediction Modeling

BackgroundAccurately assessing tobacco smoke exposure in early life is important to understanding and preventing childhood asthma. In populations with relatively low smoking exposure, it becomes challenging to characterize the main exposure sources of tobacco smoke exposure. When creating a prediction model of questionnaire items to explain variability in nicotine metabolite concentrations, traditional approaches include using directed acyclic graphs, change-in-estimate procedure, comparing AIC and/or R2 statistics, and stepwise selection. These approaches may be improved upon with machine learning. MethodsUsing the CHILD Cohort Study, we measured urinary concentrations of nicotine biomarkers (cotinine and trans-3’-hydroxycotinine (3HC)) at low detection levels (0.03ng/mL) and questionnaire responses related to smoking and other lifestyle factors. Urine samples were collected along with questionnaires at 3-4 months of age. The concentrations were corrected for specific gravity. Random forest regression was used to assign variable importance scores to questionnaire items based on how well they predicted the urinary cotinine and 3HC concentrations. Combining knowledge from this machine learning technique with traditional model selection strategies, a multivariable linear regression prediction model was selected to assess how well questionnaires explained urinary cotinine and 3HC concentrations. Results76% and 89% of the infants had detectable urinary cotinine and 3HC levels, with the geometric mean levels consistent with light or intermittent second-hand smoke, third-hand smoke or possibly from diet. Final models explained 32% and 41% of cotinine and 3HC concentration variation in our sample (n=2,017). Questions related to prenatal smoking exposure, second-hand smoke, housing, breastfeeding, and socioeconomic factors were most important in predicting urinary concentrations at 3 months. ConclusionsTo facilitate complex exposure assessment in interdisciplinary projects, researchers have more sensitive tools from outside their traditional disciplines to improve models and generate new hypotheses. Variable importance plots are a relatively easy and interpretable way to incorporate machine learning into environmental health research.

Association of urinary cotinine-verified smoking status with hyperuricemia: Analysis of population-based nationally representative data

INTRODUCTIONSmoking status based solely on self-reporting is unreliable and might be inaccurate, particularly among women. This study investigated the association between urinary cotinine-verified smoking status and hyperuricemia in a nationwide Korean population.METHODSThis study included 5329 participants aged ≥19 years with information on smoking status, urine cotinine levels and serum uric acid. We determined smoking status according to self-reports and urinary cotinine levels. Multivariate linear regression analysis was used to measure the association between smoking exposure and serum uric acid levels. The effects of smoking on hyperuricemia were evaluated by multivariate logistic regression analysis.RESULTSBiochemically verified active and passive smokers comprised 22% (38.7% of men and 8.8% of women) and 12.3% (11.9% of men and 12.6% of women) of the study population, respectively. While reclassification rate of active smokers was 1.4% in men, 31.8% of cotinine-verified female active smokers were self-reported never smokers. Higher uric acid levels were observed with increased tobacco exposure among women (p-trend=0.007) but not among men. After adjusting for confounders, the risk of hyperuricemia increased with tobacco exposure only in women (p-trend=0.016).CONCLUSIONSCotinine-verified smoking status was associated with increased serum uric acid and hyperuricemia in a dose-response manner only in women. This study might provide evidence to support the importance of smoking cessation in women with gout and further studies are necessary to elucidate the underlying mechanism of the observed association.

Effects of smoking cessation on biological monitoring markers in urine

IntroductionUrinary nicotine and cotinine levels are often measured as biomarkers for tobacco smoke exposure. However, these biomarkers are not appropriate to evaluate the effects of quitting smoking for several days, because of their short half-lives. In this study, we focused on the changes in the urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) levels of 55 patients in a smoking cessation program, because of the long half-life. At the same time, urinary 7-methylguanine (m7Gua) and 8-hydroxy-2′-deoxyguanosine (8-OHdG), as DNA damage markers of cigarette smoking, were also measured.ResultsIn the subjects who completed the quit-smoking program (18 subjects out of 55), the urinary nicotine and cotinine levels decreased to 1.7 and 0.2% at 8 weeks after the first visit to the clinic. By contrast, the NNAL levels decreased to 12.3% at 8 weeks after quitting smoking. During the same period, the urinary m7Gua levels significantly decreased, from 27.32 μg/mg creatinine to 14.17 μg/mg creatinine by the elimination of subjects who showed increased levels of NNAL during the smoking cessation program. The 8-OHdG levels were also reduced within the same period, but were not significantly different. From the all data analysis, the urinary levels of cotinine and NNAL positively correlated with the level of m7Gua.ConclusionsNNAL may be an appropriate exposure marker for evaluating the smoking status of patients in a smoking cessation program. The urinary cotinine and NNAL levels positively correlated with the m7Gua levels.

Biomarkers of Exposure among USA Adult Hookah Users: Results from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013-2014).

Hookah smoking has become common in the USA, especially among young adults. This study measured biomarkers of exposure to known tobacco product toxicants in a population-based sample of exclusive, established hookah users. Urinary biomarker data from 1753 adults in Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study were used to compare geometric mean concentrations of biomarkers of exposure in exclusive, established past 30-day hookah users to never users of tobacco. Geometric mean ratios were calculated comparing hookah user groups with never users adjusting for age, sex, race/ethnicity, education, past 30-day marijuana use, secondhand smoke exposure and creatinine. Past 30-day hookah users (n = 98) had 10.6 times the urinary cotinine level of never tobacco users. Compared to never tobacco users, past 30-day hookah users had 2.3 times the level of the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), a metabolite of the tobacco-specific nitrosamine (TSNA) 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), 1.3 times higher polycyclic aromatic hydrocarbons (PAHs) 3-hydroxyfluorene and 1-hydroxypyrene, 1.8 times higher levels of acrylonitrile, 1.3 times higher levels of acrylamide, and 1.2 times higher levels of acrolein exposure. These data indicate that hookah use is a significant source of exposure to nicotine, carcinogens, and respiratory toxicants.

Thirdhand Smoke Contamination and Infant Nicotine Exposure in a Neonatal Intensive Care Unit: An Observational Study.

Thirdhand smoke (THS) is ultrafine particulate matter and residue resulting from tobacco combustion, with implications for health-related harm (eg, impaired wound healing), particularly among hospitalized infants. Project aims were to characterize nicotine (THS proxy) transported on neonatal intensive care unit (NICU) visitors and deposited on bedside furniture, as well as infant exposure. Cross-sectional data were collected from participants in a metropolitan NICU. Participants completed a survey and carbon monoxide breath sample, and 41.9% (n = 88) of participants (n = 210) were randomly selected for finger-nicotine wipes during a study phase when all bedside visitors were screened for nicotine use and finger-nicotine levels. During an overlapping study phase, 80 mother-infant dyads consented to bedside furniture-nicotine wipes and an infant urine sample (for cotinine analyses). Most nonstaff visitors' fingers had nicotine above the limit of quantification (>LOQ; 61.9%). Almost all bedside furniture surfaces (93.8%) and infant cotinine measures (93.6%) had values >LOQ, regardless of household nicotine use. Participants who reported using (or lived with others who used) nicotine had greater furniture-nicotine contamination (Mdn = 0.6 [interquartile range, IQR = 0.2-1.6] µg/m2) and higher infant cotinine (Mdn = 0.09 [IQR = 0.04-0.25] ng/mL) compared to participants who reported no household-member nicotine use (Mdn = 0.5 [IQR = 0.2-0.7] µg/m2; Mdn = 0.04 [IQR = 0.03-0.07] ng/mL, respectively). Bayesian univariate regressions supported hypotheses that increased nicotine use/exposure correlated with greater nicotine contamination (on fingers/furniture) and infant THS exposure. Potential furniture-contamination pathways and infant-exposure routes (eg, dermal) during NICU hospitalization were identified, despite hospital prohibitions on tobacco/nicotine use. This work highlights the surreptitious spread of nicotine and potential THS-related health risks to vulnerable infants during critical stages of development. THS contamination is underexplored in medical settings. Infants who were cared for in the NICU are vulnerable to health risks from THS exposure. This study demonstrated that 62% of nonstaff NICU visitors transport nicotine on their fingers to the NICU. Over 90% of NICU (bedside) furniture was contaminated with nicotine, regardless of visitors' reported household-member nicotine use or nonuse. Over 90% of infants had detectable levels of urinary cotinine during NICU hospitalizations. Results justify further research to better protect infants from unintended THS exposure while hospitalized.

Efficacy of standard nicotine replacement therapy (NRT) versus video-assisted nurse-led NRT on tobacco cessation: A randomized controlled pilot trial

IntroductionNicotine effectiveness has been tested in multiple forms to stop tobacco use. However, the evidence remains inconclusive for the efficacy of a single nicotine intervention. This study aims to test the efficacy of a nurse-led video-assisted nicotine replacement therapy (NRT) to standard NRT on tobacco addiction and cessation among tobacco users. DesignRandomised controlled trial (RCT) comparing two study groups (41/group) with blinded follow-up at two and four weeks. A video-assisted nurse-led NRT and routine standard treatment groups are compared. A weekly call reminder was placed to the video-assisted nurse-led group to take nicotine gum/lozenge and to attend follow-up regularly. MeasuresPrimary endpoints at two and four weeks were self-reported addiction status and tobacco cessation. A standardized urine cotinine test was performed to validate self-reported addiction status at five weeks. ResultsAddiction status was significantly (p < 0.001) improved in the video-assisted nurse-led NRT group. A significant improvement was observed in importance (p < 0.001) to quit tobacco at two weeks of follow-ups. The participants in the nurse-led group enable to boost their readiness (p < 0.001) to quit tobacco at the second and fourth-week follow-ups. There was a significant reduction in urine cotinine levels at 5th week (OR: 2.79, CI 1.26–6.18) in the nurse-led NRT group. ConclusionsA video-assisted nurse-led nicotine replacement therapy found effective in reducing tobacco use. Developing culturally appropriate material and technology use can be a cost-effective means to curb the problem of tobacco and substance abuse.

Urinary metabolites of furan in waterpipe tobacco smokers compared to non-smokers in home settings in the US

ObjectivesDetermine uptake of furan, a potential human carcinogen, in waterpipe tobacco (WPT) smokers in home settings. MethodsWe analysed data from a US convenience sample of 50 exclusive WPT smokers, mean age 25.3 years, and 25 non-smokers, mean age 25.5 years. For WPT smokers, data were collected at a home visit by research assistants during which participants smoked one WPT head of one brand for a mean of 33.1 min in their homes. Research assistants provided and prepared a WP for participants by weighing and loading 10 g of WPT in the WP head. At the completion of the smoking session, research assistants measured the remaining WPT. Cotinine and six furan metabolites were quantified in first morning urine samples provided on 2 consecutive days for non-smokers, and on the morning of a WPT smoking session and on the following morning for smokers. ResultsWPT smokers consumed a mean of 2.99 g WPT. In WPT smokers, urinary cotinine levels increased significantly 26.1 times the following morning; however, urinary metabolites of furan did not increase significantly. Compared to non-smokers, 2 furan metabolites, N-acetyl-S-[1-(5-acetylamino-5-carboxylpentyl)-1H-pyrrol-3-yl]-L-cysteine and N-acetyl-S-[1-(5-amino-5-carboxypentyl)-1H-pyrrol-3-yl]-L-cysteine sulfoxide, were significantly higher in WPT smokers in pre and in post WPT smoking levels. ConclusionsTo enable a more rigorous assessment of furan exposure from WPT smoking, future research should determine furan concentrations in WPT smoke, quantify furan metabolites from users of various WPT brands; and extend the investigation to social settings where WPT smoking is habitually practiced.

Relationships among cigarette smoking, urinary biomarkers, and urothelial carcinoma risk: a case-control study.

Cigarette smoke is a known risk factor for urothelial carcinoma (UC). However, there is limited information about the distributions and effects of volatile organic compounds (VOCs) on smoking-related UC risk. With this hospital-based case-control study, we explored the associations between urinary levels of cotinine and VOC metabolites (acrylamide, 1,3-butadiene, and benzene) and the risk of UC. Urological examinations and pathological verifications were used to confirm the diagnoses of UC. All study participants provided smoking-related information via questionnaires and face-to-face interviews; they also provided urine samples for the measurement of VOC metabolites, cotinine, and 8-hydroxydeoxyguanosine (8-OHdG), which was used as an indicator of oxidative stress. We applied multiple logistic regression analysis to estimate the risk of UC, and we found that levels of urinary cotinine and 8-OHdG were higher in the UC group than in the control group. Furthermore, urinary levels of VOC metabolites, including N-acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA), N-acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine, N-acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine-3, trans,trans-muconic acid (t,t-MA), and S-phenylmercapturic acid (SPMA), increased with increasing levels of urinary cotinine. After adjusting for potential risk factors, dose-response relationships were observed between UC risk and urinary levels of AAMA, t,t-MA, SPMA, and 8-OHdG. Participants with high urinary levels of cotinine, AAMA, t,t-MA, SPMA, and 8-OHdG had risks of UC that were 3.5- to 6-fold higher than those of participants with lower levels. Future, large-scale investigations of the risks of UC should be explored, and repeated measurement of VOC metabolites should be assessed.

Longitudinal association between environmental tobacco smoke exposure and behavioral problems in children from ages 5 to 9

Few studies have assessed the cumulative effects of exposure to environmental tobacco smoke (ETS11Environmental tobacco smoke.) in relation to children's neurobehavioral problems over time. We assessed the longitudinal associations between ETS exposure at age 5 and behavioral problems at ages 5, 7, and 9 using the Ewha Birth and Growth Cohort, in Seoul, Korea. Children with available urinary cotinine levels at age 5 and one or more behavioral problem scores measured with the Korean Version of Child Behavior Checklist (CBCL22Child behavior checklist.) at age 5, 7, and 9 were included in the study. Those whose mothers smoked during pregnancy were excluded, and a total of 179 children were included in the analysis. A linear mixed-model analysis using a REPEATED statement was conducted to assess whether ETS exposure was associated with the total, internalizing, and externalizing behavioral problem scores of the CBCL. The group with higher levels of cotinine showed continuously higher total and external behavioral problem scores from ages 5 to 9, which was seen after adjusting for preterm birth, father's education level, and television watching time. In addition, the difference in the total and external behavioral problem scores between the higher and lower cotinine groups at age 5 was statistically significant after a Bonferroni correction (p = 0.02 and 0.04, respectively), even though the fixed effect of cotinine level was almost but not statistically significant (p = 0.07 and 0.08, respectively). The results of this longitudinal cohort study provide evidence regarding the negative effects of ETS exposure in early childhood and their behavioral problems over time. This study supports the strengthening of anti-smoking policies used in educational interventions for parents, in order to reduce early ETS exposure in children.

Influence of Environmental Tobacco Smoke and Air Pollution on Fetal Growth: A Prospective Study.

Exposure to air pollution during pregnancy leads to adverse pregnancy outcomes. Few studies have evaluated the influences of air quality, including environmental tobacco smoke (ETS) and particulate matter (PM), on fetal development, which this study examined. This longitudinal correlation study used multiple linear regression data analysis of PM2.5/PM10, self-reported ETS exposure, urinary cotinine level, maternal characteristics, and birth parameters (gestational week, body weight, body length, head, and chest circumferences) with the effect of air quality on fetal growth. The study included 74 pregnant women (mean age 31.9 ± 4.2 years, body mass index 23.6 ± 3.8 kg/m2, average gestational duration 38.5 ± 0.8 weeks). ETS exposure decreased birth length by ≥1 cm, and potentially is an independent risk factor for fetal growth restriction, and pregnant women should avoid indoor and outdoor ETS. However, neither PM2.5/PM10 nor ETS was associated with low birth weight or small for gestational age. This study adds to the evidence base that ETS exposure of nonsmoking pregnant women affects the fetal birth length. Family members should refrain from smoking near expectant mothers, although smoking in the vicinity of their residential surroundings potentially exposes mothers and their fetuses to ETS. Public pollution and childbirth education classes should include details of indoor ETS.

Urinary Biomarkers of Environmental Tobacco Smoke Exposure and Asthma Morbidity in the School Inner-City Asthma Study

Introduction: Despite significant progress, asthma remains the most common and costly chronic disease of childhood. Unfortunately, exposure to environmental tobacco smoke (ETS), a major asthma precipitant, is common in the inner-city. The primary objectives of this study were to understand the sources and degree of ETS exposure, to determine if urinary cotinine can be reliably correlated with caregiver reports of a child’s ETS exposure, and to estab lish if urinary cotinine levels are independently associated with asthma morbidity or allergic sensitization in a …

Prevalence of urinary cotinine levels in children under 5\u2009years of age during consultations for acute respiratory disease at the emergency department of the Universidad de La Sabana clinic

BackgroundSeveral environmental factors favour the occurrence of acute respiratory disease, which is the main reason for paediatric consultations in our country (Colombia). Tobacco smoke is considered a significant environmental pollutant with a great impact on health. The objective of this study is to estimate the prevalence of cotinine levels measured in urine, in children between 1 to 60 months of age who attended an emergency department with acute respiratory disease.MethodsA cross-sectional study was conducted that included children between 1 and 60 months of age with acute respiratory disease who were admitted to the emergency department of the Universidad de La Sabana Clinic between April and July 2016.ResultsWe included 268 patients and 36% were female. Of the total population examined, 33.96% showed positive results for urinary cotinine, of whom 97.8% had values between 10 and 100 ng/ml, which is considered positive for exposure to second-hand smoke. The principal pathology was recurrent wheezing in 43.96% of these cases. Regarding the presence of smokers at home, it is important to mention that in 54.95% of the children with positive urinary cotinine test was no related with smokers at home. And in 45.05% of positive urinary cotinine was evidence of smokers at home, being associated with the positive result P < 0.001 and smoking within the house P = 0.018; smoking when children were present did not have significant P = 0.105. The activities performed after smoking such as hand washing, change of clothes, eating, brushing teeth, did not influence the test result P = 0.627.ConclusionsA high prevalence of urinary cotinine was observed, which is associated with the presence of a smoker at home, and this relationship was independent of the activities performed by the smoker after smoking. In addition, a positive test for urinary cotinine was presented in some children without documented exposure to cigarette smoke inside the home, which may be explained by the presence of environmental cotinine. Therefore, it is necessary to perform educational interventions aimed at parents and caregivers who smoke.

Early-Life Environmental Exposures and Childhood Obesity: An Exposome-Wide Approach.

Background:Chemical and nonchemical environmental exposures are increasingly suspected to influence the development of obesity, especially during early life, but studies mostly consider single exposure groups.Objectives:Our study aimed to systematically assess the association between a wide array of early-life environmental exposures and childhood obesity, using an exposome-wide approach.Methods:The HELIX (Human Early Life Exposome) study measured child body mass index (BMI), waist circumference, skinfold thickness, and body fat mass in 1,301 children from six European birth cohorts age 6–11 y. We estimated 77 prenatal exposures and 96 childhood exposures (cross-sectionally), including indoor and outdoor air pollutants, built environment, green spaces, tobacco smoking, and biomarkers of chemical pollutants (persistent organic pollutants, metals, phthalates, phenols, and pesticides). We used an exposure-wide association study (ExWAS) to screen all exposure–outcome associations independently and used the deletion-substitution-addition (DSA) variable selection algorithm to build a final multiexposure model.Results:The prevalence of overweight and obesity combined was 28.8%. Maternal smoking was the only prenatal exposure variable associated with higher child BMI (z-score increase of 0.28, 95% confidence interval: 0.09, 0.48, for active vs. no smoking). For childhood exposures, the multiexposure model identified particulate and nitrogen dioxide air pollution inside the home, urine cotinine levels indicative of secondhand smoke exposure, and residence in more densely populated areas and in areas with fewer facilities to be associated with increased child BMI. Child blood levels of copper and cesium were associated with higher BMI, and levels of organochlorine pollutants, cobalt, and molybdenum were associated with lower BMI. Similar results were found for the other adiposity outcomes.Discussion:This first comprehensive and systematic analysis of many suspected environmental obesogens strengthens evidence for an association of smoking, air pollution exposure, and characteristics of the built environment with childhood obesity risk. Cross-sectional biomarker results may suffer from reverse causality bias, whereby obesity status influenced the biomarker concentration. https://doi.org/10.1289/EHP5975

Secondhand tobacco smoke, does it have an impact on the neurobehavioral performance of the exposed children?

Secondhand tobacco smoke (SHS) is a significant public health problem for all ages worldwide. Children are more vulnerable to the health effects of SHS because of the inhalation of more air per body volume compared to adults. The study aimed to assess neurobehavioral performance among SHS exposed Egyptian basic school children (10-12years) and its relationship with urinary cotinine levels. Multistage cluster sampling was carried out, where 181 children (80 exposed and 101 non-exposed children) were recruited. A questionnaire on SHS exposure was sent to students' parents/caregivers. Urine samples were taken for assessment of cotinine levels by enzyme immunoassay. A Neurobehavioral test battery was measured. The exposed children had significantly lower performance in tests of attention (PASAT) [5.22 ± 5.10 vs. 6.98 ± 5.87, p = 0.035], visuomotor speed (Digit Symbol and Trail making A) [41.40 ± 18.01 vs. 46.53 ± 15.89 and 107.92 ± 44.34 vs. 92.44 ± 37.09; respectively] than non-exposed subjects. The neurobehavioral effects were correlated with urinary cotinine levels among children exposed to SHS compared to unexposed children. The study revealed poor performance in neurobehavioral domains of attention and visuomotor skills among children exposed to SHS. This necessitates the implementation of antismoking media awareness programs on the harmful effects of SHS and how to protect children from it.