Assessment of exposure to environmental tobacco smoke

Abstract

Since the early 1980s, there has been growing concern about potential adverse health effects related to exposure to environmental tobacco smoke (ETS). Evidence has accumulated on ill-health associated with ETS, and such exposure has now been documented among children and adults in many countries [1][2][3][4][5][6][7][8]. A major difficulty in studying the ill-health effects of ETS has been assessing exposure, since this may occur in multiple settings with highly variable concentrations and exposure profiles may vary considerably during different age periods. Accurate and precise exposure assessment is crucial, since health effects of ETS are likely to be relatively small in magnitude. Appropriate exposure assessment is also needed for inferring causality and for risk assessment. In addition, exposure assessment is obviously necessary for development of preventive strategies.The purpose of this paper is to present a theoretical framework for assessment of exposure to ETS, and to review current methods of exposure assessment in order to provide guidelines for choice of appropriate methods for different types of study. General definitions and concepts of exposure and its assessment will be presented, followed by definitions and components of ETS. The principles for assessment of ETS exposure will then be presented. Current methods of assessment will be reviewed in terms of their advantages and disadvantages, followed by a very brief summary of the ill-health effects of ETS. This allows the criteria for selection of the appropriate method of assessing ETS exposure to be set in context, and to be formulated as user guidelines. Definitions of concentration, exposure and dose ConcentrationConcentration is the amount of a contaminant at a particular location in a particular medium [9]. For example, for an air pollutant it is the amount of the material contained in a specified volume of air. Air pollutant concentrations are usually expressed as mass per unit volume, e.g. µg·m -3 , and gaseous pollutants may also be expressed as a mixing ratio with air, e.g. parts per million (ppm) by volume. Air pollutant concentrations vary in time and space. ExposureExposure is defined as the contact of pollutant with a susceptible surface of the human body [9][10][11]. For ETS, this means contact with the eyes, the epithelium of the nose, mouth and throat, and the lining of the airways and alveoli. With respect to time, there are a number of possible formulations, including instantaneous exposure, peak exposure, average exposure over a specified time period, and cumulative exposure [11]. The best approach to assess ETS exposure will depend on the aim of the study, the health outcome, and the resources. Personal monitoring of nicotine or RSPs is the best method in studies of short-term health effects with small study samples. Stationary measurements of indoor air nicotine or RSPs are suitable for overall monitoring of ETS in different microenvironments over time. Questionnaires and interviews are suitable when studying health outcomes ...

Disparities in exposure to tobacco smoke pollution at Romanian worksites

“…Unfortunately, the GATS questionnaire does not allow careful measurement of these parameters. The best method for assessing the level of exposure to SHS is to measure markers or biomarkers, including carbon monoxide in exhaled air and the level of cotinine in saliva, blood, urine or hair [20,21]. The data presented in the current study have not been verified by any biomarkers.…”

College students' exposure to secondhand smoke

“…In addition, it relied on a self-reported measure of the number of days on which students experienced exposure. Thus, we do not know anything about the duration of the exposure or the number of times during the day the students were exposed (see Jaakkola & Jaakkola, 1997 ). Finally, because the study relied on cross-sectional data, no causal statements can be made.…”

Assessment of chronic exposure to cigarette smoke and its change during pregnancy by segmental analysis of maternal hair nicotine

“…In recent years, hair nicotine has been used as a biomarker for assessing chronic exposure to ETS and active smoke, as it can cover wide time-windows (Nafstad et al 1995;Jaakkola and Jaakkola, 1997;Jaakkola et al, 2001;Segura et al, 2000). Determination of nicotine in the hair of pregnant women proved useful to obtain information on exposure in the whole gestation.…”