Urine Cotinine Screening Detects Nearly Ubiquitous Tobacco Smoke Exposure in Urban Adolescents
Urine Cotinine Screening Detects Nearly Ubiquitous Tobacco Smoke Exposure in Urban Adolescents
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DOI：
10.1093/ntr/ntw390
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发表时间：
2017-09-01
影响因子：
4.7
通讯作者：
Jacob, Peyton, III
中科院分区：
文献类型：
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作者：
Benowitz, Neal L.;Jain, Shonul;Jacob, Peyton, III
简介：对烟草烟雾暴露进行常规生化评估可以采取更有效的干预措施，减少或预防青少年二手烟 (SHS) 相关疾病。我们的目的是使用尿液可替宁（主要尼古丁代谢物）测量在城市公立医院接受门诊护理的青少年中烟草烟雾暴露的患病率。方法：收集了 2013 年至 2014 年在扎克伯格旧金山总医院儿科或紧急护理诊所就诊的 466 名青少年的剩余尿液，该医院为收入和教育水平较低的家庭提供服务。大多数是西班牙裔或非裔美国人。尿液可替宁切点为0.05至0.25 ng/ml、0.25至30 ng/ml和30 ng/ml，分别用于将受试者分类为轻度二手烟或三手烟暴露者、二手烟或轻度/间歇性活跃使用者以及活跃烟草使用者。 结果：在受试者中，87%暴露于暴露状态，其中包括12%活跃吸烟者、46%二手烟暴露者和30%轻度暴露者。与其他群体 (0.56-1.13 ng/ml) 相比，非裔美国人的二手烟暴露组调整几何平均可替宁值 (1.48 ng/ml) 显着较高。结论：在吸烟率较低 (12%) 的城市，在公立医院诊所就诊的青少年中绝大多数 (87%) 都接触过烟草。这比使用血浆生物标志物的国家青少年流行病学研究报告的要高得多。由于二手烟与严重的呼吸道疾病有关，并且父母和青少年低估了二手烟的暴露情况，因此应考虑将常规生化筛查作为减少二手烟暴露的工具。光照暴露的临床意义需要研究。 意义：尿液生物标志物筛查发现，在城市公立医院接受治疗的青少年中，绝大多数（87%）都接触过烟草。由于二手烟与严重的呼吸道疾病有关，并且父母和青少年低估了二手烟的暴露情况，因此应考虑将常规生化筛查作为减少二手烟暴露的工具。
Introduction: Routine biochemical assessment of tobacco smoke exposure could lead to more effective interventions to reduce or prevent secondhand smoke (SHS)-related disease in adolescents. Our aim was to determine using urine cotinine (major nicotine metabolite) measurement the prevalence of tobacco smoke exposure among adolescents receiving outpatient care at an urban public hospital.Methods: Surplus urine was collected in 466 adolescents attending pediatric or urgent care clinics at Zuckerberg San Francisco General Hospital, serving families with lower levels of income and education, in 2013-2014. The majority were Hispanic or African American. Urine cotinine cut points of 0.05 to 0.25 ng/ml, 0.25 to 30 ng/ml, and 30 ng/ml were used to classify subjects as light SHS or thirdhand smoke exposed, SHS or light/intermittent active users, and active tobacco users, respectively.Results: Among subjects 87% were exposed, including 12% active smoking, 46% SHS and 30% lightly exposed. The SHS exposed group adjusted geometric mean cotinine values were significantly higher in African Americans (1.48 ng/ml) compared to other groups (0.56-1.13 ng/ml).Conclusions: In a city with a low smoking prevalence (12%), a large majority (87%) of adolescents seen in a public hospital clinic are exposed to tobacco. This is much higher than reported in national epidemiological studies of adolescents, which used a plasma biomarker. Since SHS is associated with significant respiratory diseases and parents and adolescents underreport exposure to SHS, routine biochemical screening should be considered as a tool to reduce SHS exposure. The clinical significance of light exposure needs to be investigated.Implications: Urine biomarker screening found that a large majority (87%) of adolescents treated in an urban public hospital are exposed to tobacco. Since SHS is associated with significant respiratory diseases and parents and adolescents underreport exposure to SHS, routine biochemical screening should be considered as a tool to reduce SHS exposure.