Kaufman Farla Lynn, Kharrazi Martin, Delorenze Gerald Nicholas, Eskenazi Brenda, Bernert John Thomas
Public Health Institute, Berkeley, California, USA.
J Expo Anal Environ Epidemiol. 2002 Jul;12(4):286-95. doi: 10.1038/sj.jea.7500224.
Environmental tobacco smoke (ETS) exposure has been studied in relation to many diseases. The ability of a study to find an association between exposure and disease is, in part, determined by the accuracy of the exposure measure. This study examined how accurately one question, the number of smokers in the household, asked at birth, predicts ETS exposure in pregnant nonsmokers as assessed by serum cotinine. Blood specimens, drawn at 15-19 weeks gestation, from 783 women who participated in a prenatal screening program in California in 1992 were analyzed for cotinine. Serum cotinine was significantly correlated with the number of smokers in the household (r=0.35, P<0.001, geometric mean cotinine (nanograms per milliliter) for 0 smokers=0.06, 1 smoker=0.18, 2 or more smokers=0.29). Using multiple regression, the number of smokers in the household accounted for 11% of the variation in serum cotinine. Cotinine concentrations were twice as high in women living with one or more smokers compared to women not living with a smoker, when reported exposure (0 or >0 h) at home, work and other places was similar. Thus, the number of household smokers can account for a statistically significant amount of variation in serum cotinine and omission of this information would result in an underestimation of ETS exposure. Although use of this question alone does not provide an adequate estimation of ETS exposure as determined by serum cotinine, the results of this study indicate that this question is an important component of assessing ETS exposure.
环境烟草烟雾（ETS）暴露与许多疾病的关系已得到研究。一项研究发现暴露与疾病之间关联的能力，部分取决于暴露测量的准确性。本研究考察了出生时询问的一个问题，即家庭中吸烟者的数量，能多准确地预测孕妇非吸烟者的ETS暴露，以血清可替宁来评估。对1992年在加利福尼亚参加产前筛查项目的783名妇女在妊娠15 - 19周时采集的血样进行了可替宁分析。血清可替宁与家庭中吸烟者的数量显著相关（r = 0.35，P < 0.001，0名吸烟者的几何平均可替宁（纳克/毫升）= 0.06，1名吸烟者 = 0.18，2名或更多吸烟者 = 0.29）。使用多元回归分析，家庭中吸烟者的数量占血清可替宁变异的11%。当报告在家、工作场所和其他地方的暴露时间（0或>0小时）相似时，与不与吸烟者同住的妇女相比，与一名或多名吸烟者同住的妇女的可替宁浓度高出两倍。因此，家庭中吸烟者的数量可在统计学上解释血清可替宁的显著变异量，遗漏该信息会导致对ETS暴露的低估。尽管仅使用这个问题并不能充分估计由血清可替宁确定的ETS暴露，但本研究结果表明这个问题是评估ETS暴露的一个重要组成部分。
