Determinants of Hair Nicotine Concentrations in Nonsmoking Women and Children: A Multicountry Study of Secondhand Smoke Exposure in Homes

Kim, Sungroul; Wipfli, Heather; Navas‐Acien, Ana; Dominici, Francesca; Ávila-Tang, Érika; Onicescu, Georgiana; Breysse, Patrick N.; Samet, Jonathan M.

doi:10.1158/1055-9965.epi-09-0337

Cited by 30 publications

(28 citation statements)

References 42 publications

(53 reference statements)

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“…In our study , toddlers had signifi cantly higher hair nicotine content than older children, which is consistent with a large international study of SHS exposure wherein younger children had consistently higher hair nicotine levels even after adjusting for the amount of time spent in the home ( Kim et al, 2009 ). Age appears to play a role in other biomarkers of SHS.…”

Section: Discussionsupporting

confidence: 91%

Secondhand Smoke Exposure and Hair Nicotine in Children: Age-Dependent Differences

Groner

Huang

Nicholson

et al. 2011

Nicotine &Amp; Tobacco Research

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Section: Discussionsupporting

confidence: 91%

Secondhand Smoke Exposure and Hair Nicotine in Children: Age-Dependent Differences

Groner

Huang

Nicholson

et al. 2011

Nicotine &Amp; Tobacco Research

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“…In addition, hair nicotine estimates personal SHS exposure over the last 3 months, and may represent exposures occurring outside the home. Hair nicotine concentrations can vary depending on the amount of time spent in the home when a smoker is present; time spent around smokers outside the home; absorption of nicotine from surfaces (so-called third-hand tobacco exposure); the race of the participant; and the presence or absence of hair treatments (38,39). In our study we chose a comprehensive assessment of potential exposure to SHS that included self-reporting; airborne nicotine concentrations in the home; and a biomarker of exposure (hair nicotine).…”

Section: Discussionmentioning

confidence: 99%

In-Home Air Pollution Is Linked to Respiratory Morbidity in Former Smokers with Chronic Obstructive Pulmonary Disease

Hansel¹,

McCormack²,

Belli³

et al. 2013

Am J Respir Crit Care Med

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Rationale: The effect of indoor air pollutants on respiratory morbidity among patients with chronic obstructive pulmonary disease (COPD) in developed countries is uncertain. Objectives: The first longitudinal study to investigate the independent effects of indoor particulate matter (PM) and nitrogen dioxide (NO 2 ) concentrations on COPD morbidity in a periurban community. Methods: Former smokers with COPD were recruited and indoor air was monitored over a 1-week period in the participant's bedroom and main living area at baseline, 3 months, and 6 months. At each visit, participants completed spirometry and questionnaires assessing respiratory symptoms. Exacerbations were assessed by questionnaires administered at clinic visits and monthly telephone calls. Measurements and Main Results: Participants (n ¼ 84) had moderate or severe COPD with a mean FEV 1 of 48.6% predicted. The mean (6 SD) indoor PM 2.5 and NO 2 concentrations were 11.4 6 13.3 µg/m 3 and 10.8 6 10.6 ppb in the bedroom, and 12.2 6 12.2 µg/m 3 and 12.2 6 11.8 ppb in the main living area. Increases in PM 2.5 concentrations in the main living area were associated with increases in respiratory symptoms, rescue medication use, and risk of severe COPD exacerbations. Increases in NO 2 concentrations in the main living area were independently associated with worse dyspnea. Increases in bedroom NO 2 concentrations were associated with increases in nocturnal symptoms and risk of severe COPD exacerbations. Conclusions: Indoor pollutant exposure, including PM 2.5 and NO 2 , was associated with increased respiratory symptoms and risk of COPD exacerbation. Future investigations should include intervention studies that optimize indoor air quality as a novel therapeutic approach to improving COPD health outcomes.Keywords: indoor air; chronic obstructive pulmonary disease; particulate matter; nitrogen dioxide; exacerbations Chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States and the fifth leading cause worldwide, is expected to become increasingly prevalent in upcoming decades (1, 2). Most COPD is caused by environmental exposures; in developed countries, this exposure is primarily cigarette smoke. After COPD begins, evidence indicates that it can be worsened by other environmental exposures. For example, outdoor particulate matter (PM) concentrations have been associated with an increase in COPD hospitalizations and mortality (3, 4). Similarly, outdoor nitrogen dioxide (NO 2 ) exposure has been linked to worse COPD morbidity, including higher rates of exacerbations (4-6).Although substantial evidence shows that outdoor air pollutants impact COPD, there is much less evidence for the impact of indoor air on COPD, especially in developed countries. Although the Global Initiative for Chronic Obstructive Lung Disease guidelines identify indoor air pollution resulting from burning wood and other biomass fuels as a major risk factor for COPD (7), exposures under these conditions are two to three orders of magnitude higher ...

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“…This renders hair nicotine as a safe measure towards assessing SHS and conducting a study with accuracy on adults. While collecting hair sample is time efficient, it could also add more validity to the study, since substances are found in higher levels and more easily than in tissues 26,27 Questionnaires may lack precision to quantify low levels of SHS exposure and are subject to recall and reporting bias , which may result to some degree of misclassification 15 . Furthermore, they are reported to be a "complementary" method rather than alternative ones, due to the fact that they can only be used to diminish another method's limitations 24 .…”

Section: Discussionmentioning

confidence: 99%

“…This pool of prospective questions was developed based on three factors: 1) The sources previously identified by our research group to be related to elevated levels of biomarker assessed exposure to SHS 16,17,18 2) A detailed literature review of previous studies that had assessed SHS exposure and hair nicotine concentrations 15,19,20,21,22 and 3) Domains included within the standardized global adult tobacco survey (GATS) and the global youth tobacco survey (GYTS) 23,28 . During participant recruitment, 10-100 mg of hair was concurrently collected from the occipital region of the scalp from each subject and stored in paper envelopes in a dry dark area until analysis.…”

Section: Sample Collection and Nicotine Assessmentmentioning

confidence: 99%

“…Until now no inexpensive method for assessment of last week's exposure to SHS have been developed 13,14 . Having the ability to properly validate a questionnaire in order to quantify exposure to SHS has not yet been achieved in a number of studies 15 , and is bound to aid patients' monitoring and implementing targeted interventions. The development of a score that could be routinely used to indicate the extent of SHS exposure, and provide an estimate of the level of the exposure occurred is necessary.…”

Section: Introductionmentioning

confidence: 99%

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The Secondhand Smoke Exposure Scale (SHSES): A hair nicotine validated tool for assessing exposure to secondhand smoke among elderly adults in primary care

Vardavas¹,

Agaku²,

Filippidis³

et al. 2017

Tob. Prev. Cessation

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INTRODUCTION Accurate estimation of exposure to Secondhand Smoke (SHS) is important in both research and clinical practice. We aimed to develop, an easy to implement, biomarker validated scale to provide an estimation of adult exposure to SHS for use within primary health care or epidemiological research. METHODS A pool of 26 baseline questions evaluating exposure to SHS was administered to 178 non-smoking adults (mean age 68.1 years), recruited from both urban and rural primary health care practices in Crete, Greece in November 2011, while concurrent hair samples were collected and nicotine concentrations were measured. To generate scores for each question item, we fitted a backward linear regression using the main predictors of SHS exposure selected from the initial pool of questions, weighted against each individuals biomarker evaluated exposure. RESULTS Among the pool of participants and weighted according to hair nicotine levels, in descending order, the most important sources of SHS exposure were the home (5 points, β=0.37), the family car (3 points, β=0.20), public places (2 points, β=0.15) and the workplace (1 point, β=0.013), the relative weighting of which led to the development of an 11-point scale to assess exposure to SHS. For every unit increase in the score, there was an associated increase in mean hair nicotine concentrations by 1.35 ng/mg (95%CI: 1.25-1.45, p<0.0001) CONCLUSIONS The SHS exposure score (SHSES) may be a useful tool in an estimating the level of the exposure to SHS among elderly adults and investigating the relationship between SHS exposure and potential health outcomes.

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Determinants of Hair Nicotine Concentrations in Nonsmoking Women and Children: A Multicountry Study of Secondhand Smoke Exposure in Homes

Cited by 30 publications

References 42 publications

Secondhand Smoke Exposure and Hair Nicotine in Children: Age-Dependent Differences

Secondhand Smoke Exposure and Hair Nicotine in Children: Age-Dependent Differences

In-Home Air Pollution Is Linked to Respiratory Morbidity in Former Smokers with Chronic Obstructive Pulmonary Disease

The Secondhand Smoke Exposure Scale (SHSES): A hair nicotine validated tool for assessing exposure to secondhand smoke among elderly adults in primary care

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