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Few studies have assessed the accuracy of self-reported questionnaires to determine smoking habits relative to urinary biomarkers. This study investigated urinary cotinine cut-off concentrations distinguishing active, passive and non-smokers among pregnant women who participated in the Japan Environment and Children’s Study, a nationwide birth cohort study. Pregnant participants with measured urinary cotinine concentrations (UCCs) and who completed self-reported questionnaires on smoking status were included (n = 89,895). The cut-off values (COVs) for active and passive smokers were calculated by fitting mixed normal distribution functions to UCCs. The sensitivity and specificity of the questionnaires were subsequently evaluated. The median (interquartile range) UCC was 0.24 (0.083–0.96) µg/g-creatinine, with the detection rate of 89%. The COV for distinguishing active smokers from passive and non-smokers was 36.8 µg/g-creatinine. When this COV was considered to represent the true condition, the questionnaire had a sensitivity of 0.523, a specificity of 0.998, a positive predictive value (PPV) of 0.967 and a negative predictive value (NPV) of 0.957. The COV for distinguishing passive smokers from non-smokers was 0.31 µg/g-creatinine, with the questionnaire having a sensitivity of 0.222, a specificity of 0.977, a PPV of 0.868 and an NPV of 0.644. As many as 78% of passive smokers might be misclassified as non-smokers.

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Exposure to insecticides containing organophosphate (OP) and neonicotinoid (NEO) compounds has been associated with adverse reproductive health outcomes. This study characterized and identified predictors of exposure to OP and NEO among 100 reproductive-age farmworkers from two intensive farming areas in Chiang Mai Province, Thailand, including 50 each from the Fang (FA) and Chom Thong (CT) districts. OP exposure was determined by measuring the urinary concentrations of six dialkylphosphates (DAPs), whereas NEO exposure was determined by measuring the urinary concentrations of NEO compounds and their metabolites (NEO/m). The most frequently detected OPs were diethylphosphate (DEP) and diethylthiophosphate (DETP), with DETP having the highest geometric mean (GM) concentration, 8.9 μg/g-creatinine. The most frequently detected NEO/m were N-desmethyl-acetamiprid (N-dm-ACE), imidacloprid (IMI), and thiamethoxam (THX), with IMI having the highest GM concentration, 8.7 μg/g-creatinine. Consumption of well water was the predominant determinant of OP and NEO exposure in this population. In addition to encouraging workers to use personal protective equipment, exposure of farmworkers to these compounds may be reduced by nation-wide monitoring agricultural insecticides and other pesticides in community drinking water resources.