Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, Georgia 30602-2102, USA.
Environ Health Perspect. 2012 Jul;120(7):1010-6. doi: 10.1289/ehp.1104413. Epub 2012 Apr 6.
With an increase in indoor smoking bans, many smokers smoke outside establishments and near their entrances, which has become a public health concern.
We characterized the exposure of nonsmokers to secondhand smoke (SHS) outside a restaurant and bar in Athens, Georgia, where indoor smoking is banned, using salivary cotinine and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL).
In a crossover study, we assigned 28 participants to outdoor patios of a restaurant and a bar and an open-air site with no smokers on three weekend days; participants visited each site once and stayed for 3 hr. We collected saliva and urine samples immediately before and after the visits (postexposure) and on the following morning and analyzed samples for cotinine and total NNAL, respectively. Regression models were fitted and changes in biomarkers were contrasted between locations.
Postexposure and preexposure geometric mean salivary cotinine concentrations differed by 0.115 ng/mL [95% confidence interval (CI): 0.105, 0.126)] and by 0.030 ng/mL (95% CI: 0.028, 0.031) for bar and restaurant visits, respectively. There were no significant post- and preexposure differences in cotinine levels after control site visits, and changes after bar and restaurant site visits were significantly different from changes after control site visits (p < 0.001). Results comparing next-day and preexposure salivary cotinine levels were similar. Next-day creatinine-corrected urinary NNAL concentrations also were higher than preexposure levels following bar and restaurant visits [1.858 pg/mg creatinine higher (95% CI: 0.897, 3.758) and 0.615 pg/mg creatinine higher (95% CI: 0.210, 1.761), respectively], and were significantly different from changes after the control visits (p = 0.005).
Salivary cotinine and urinary NNAL increased significantly in nonsmokers after outdoor SHS exposure. Our findings indicate that such exposures may increase risks of health effects associated with tobacco carcinogens.
随着室内吸烟禁令的增加，许多吸烟者在室外和其入口附近的场所吸烟，这已成为一个公共卫生问题。
我们使用唾液可替宁和尿液中 4-（甲基亚硝氨基）-1-（3-吡啶基）-1-丁醇（NNAL）来描述佐治亚州雅典一家餐厅和酒吧室外的非吸烟者接触二手烟（SHS）的情况，而该餐厅和酒吧禁止室内吸烟。
在一项交叉研究中，我们将 28 名参与者分配到餐厅和酒吧的户外露台以及一个没有吸烟者的露天场地，每个周末的三天，参与者每次访问一个地点，停留 3 小时。我们在访问前后（暴露后）以及次日早上采集唾液和尿液样本，并分别分析样本中的可替宁和总 NNAL。我们拟合了回归模型，并比较了不同地点的生物标志物变化。
与酒吧和餐厅访问相比，暴露后和暴露前唾液可替宁浓度的几何平均值分别相差 0.115ng/ml（95%置信区间：0.105，0.126）和 0.030ng/ml（95%置信区间：0.028，0.031）。在控制场所访问后，可替宁水平没有明显的暴露后和暴露前差异，而酒吧和餐厅场所访问后的变化与控制场所访问后的变化明显不同（p < 0.001）。比较次日和暴露前唾液可替宁水平的结果相似。与酒吧和餐厅访问后相比，次日肌酐校正的尿液 NNAL 浓度也较高（肌酐校正后分别高 1.858pg/mg 肌酐（95%置信区间：0.897，3.758）和 0.615pg/mg 肌酐（95%置信区间：0.210，1.761）），并且与控制访问后的变化明显不同（p = 0.005）。
非吸烟者在室外 SHS 暴露后唾液可替宁和尿液 NNAL 显著增加。我们的研究结果表明，这种暴露可能会增加与烟草致癌物质相关的健康影响的风险。
