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Environmental Tobacco Smoke Exposure Among Children by Urinary Biomarkers and Parent Report.

Authors
  • Leventer-Roberts, Maya1
  • Grinshpun, Ayala2
  • Kohn, Elkana3
  • Andra, Syam S4
  • Arora, Manish4
  • Berkovitch, Matitiahu5
  • Kozer, Eran6
  • Landrigan, Philip7
  • Levine, Hagai8
  • 1 Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai (M Leventer-Roberts, SS Andra, M Arora, and H Levine), New York, NY; Department of Pediatrics, Icahn School of Medicine at Mount Sinai (M Leventer-Roberts), New York, NY. Electronic address: [email protected]
  • 2 Pediatric Emergency Unit, Shamir Medical Center (Assaf Harofeh) (A Grinshpun and E Kozer), Tzrifin, Israel; Shamir Academic Nursing School, Shamir Medical Center (A Grinshpun), Tzrifin, Israel. , (Israel)
  • 3 Clinical Pharmacology and Toxicology Unit, Shamir Medical Center (Assaf Harofeh) (E Kohn and M Berkovitch), Tzrifin, Israel. , (Israel)
  • 4 Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai (M Leventer-Roberts, SS Andra, M Arora, and H Levine), New York, NY.
  • 5 Clinical Pharmacology and Toxicology Unit, Shamir Medical Center (Assaf Harofeh) (E Kohn and M Berkovitch), Tzrifin, Israel; Sackler School of Medicine, Tel Aviv University (M Berkovitch and E Kozer), Tel Aviv, Israel. , (Israel)
  • 6 Pediatric Emergency Unit, Shamir Medical Center (Assaf Harofeh) (A Grinshpun and E Kozer), Tzrifin, Israel; Sackler School of Medicine, Tel Aviv University (M Berkovitch and E Kozer), Tel Aviv, Israel. , (Israel)
  • 7 Program for Global Public Health and the Common Good, Schiller Institute for Integrated Science and Society, Boston College (P Landrigan), Chestnut Hill, Mass.
  • 8 Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai (M Leventer-Roberts, SS Andra, M Arora, and H Levine), New York, NY; Braun School of Public Health, Hebrew University-Hadassah (H Levine), Jerusalem, Israel. , (Israel)
Type
Published Article
Journal
Academic pediatrics
Publication Date
Jan 09, 2021
Identifiers
DOI: 10.1016/j.acap.2021.01.004
PMID: 33434701
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

The goal of this study was to describe environmental tobacco smoke (ETS) exposure using urinary biomarkers and its correlation with parent report, among children presenting to emergency room. This is a case control study among children aged 3 to 12 years at a tertiary pediatric emergency department in Israel. Children with respiratory (case) or gastrointestinal (control) symptoms were recruited and their accompanying parent completed a short survey. Urine samples were obtained and analyzed for nicotine, cotinine trans-3'-hydroxycotine. Clinical data were extracted from medical records. We compared tobacco exposure using urinary biomarkers, parent report, and Pearson's product-moment correlation, including 95% confidence intervals, between cases and controls. Forty-nine cases with respiratory symptoms and 96 controls with gastrointestinal symptoms were enrolled in the study. Parent-reported ETS exposure in the previous month was higher in the cases compared to control (71.4% vs 57.3%), although the difference was not statistically significant. The mean values of detectable biomarkers did not differ by between cases and controls. However, there was a correlation between urinary biomarkers and reported ETS exposure (0.278-0.460 for various biomarkers) only among cases. The majority of children in this study had detectable nicotine urinary biomarkers, regardless of their symptoms. However, correlation between parental report and urinary biomarkers was only found among children with symptoms potentially related to ETS. These findings imply that parents of children without respiratory symptoms may underestimate exposure. Efforts to educate parents and caregivers on the risks associated with exposure to ETS should be intensified, regardless of illness. Copyright © 2021 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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