Abstract
Understanding the determinants of childhood secondhand smoke (SHS) exposure is important in measuring and preventing exposure to this widespread environmental contaminant. We evaluated the ability of a broad set of factors to explain variability in serum cotinine, reflecting recent exposure, and hair cotinine, reflecting longer-term exposure. We included repeated measures from 223 elementary-school-age asthmatic children residing with a smoker. We used a manual model-building approach and likelihood ratio tests to select a model predicting each biomarker, and also compared the predictive ability of determinants using Akaike Information Criteria. Potential determinants included a comprehensive parent questionnaire, household nicotine, home ventilation characteristics, exposure in vehicles and others’ homes, child demographics, and family social class. Variables in each of these categories remained in the final model for both serum (R2 of 0.61) and hair cotinine (R2 of 0.45). A comprehensive set of factors was required to best predict cotinine. Studies should use biomarkers for the best quantitative assessment of SHS exposure. Hair cotinine may be a problematic measure because it was highly influenced by racial differences that were unexplained by SHS exposure. When biospecimen collection is not possible, a household nicotine measurement is warranted. If only questionnaires are available, multiple questions are required to best characterize exposure, such as number of cigarettes, hours spent in a room with concurrent smoking, maternal smoking, and approximate home size.
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Acknowledgements
This project was funded by National Heart Lung and Blood Institute R01 H165731 and an environmental epidemiology traineeship, National Institute of Environmental Health Science T32 ES007018. We thank the interviewers, environmental technicians, laboratory personnel, and families who participated in the Cincinnati Asthma Prevention Study; Dr. Julia Klein and her laboratory for hair cotinine analyses; and Dr. Julie Daniels, Dr. Brian Pence, Dr. Caroline Dilworth, and Dr. Mandy Golembesky for their assistance.
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Kalkbrenner, A., Hornung, R., Bernert, J. et al. Determinants of serum cotinine and hair cotinine as biomarkers of childhood secondhand smoke exposure. J Expo Sci Environ Epidemiol 20, 615–624 (2010). https://doi.org/10.1038/jes.2010.7
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DOI: https://doi.org/10.1038/jes.2010.7
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