Fit for Work Ltd, Cromwell, Central Otago, New Zealand.
Tob Control. 2013 May;22(e1):e66-72. doi: 10.1136/tobaccocontrol-2012-050488. Epub 2012 Aug 7.
To evaluate the effectiveness of the US Navy and Marine Corps tobacco policy in protecting submariners from secondhand smoke (SHS) by determining if non-tobacco users experienced a significant increase in urinary cotinine levels at sea when compared with in port levels.
From February to August 2009, 634 volunteers recruited from nine US Navy submarines completed a survey to collect demographic data, information on tobacco use and pre-deployment exposure to SHS. Non-tobacco users (n=239) were requested to provide two urine samples (pre-deployment and while at sea) to quantify exposure to SHS using urinary cotinine as a biomarker. Matched samples were analysed using liquid chromatography-tandem mass spectrometry.
Overall, deployed cotinine levels were 2.1 times the in port levels in non-tobacco using submariners (95% CI 1.8 to 2.4, p<0.001, n=197). A significant increase in deployed urinary cotinine levels was found aboard six of nine submarines (p<0.05). A subgroup of submariners (n=91) who reported no SHS exposure within 10 days prior to in port cotinine sampling had deployed cotinine levels 2.7 times the in port levels (95% CI 2.2 to 3.3, p<0.001). Applying a 4.5:1 urine cotinine to serum cotinine correction factor, submariners' deployed geometric means are similar to recent US male population values at the 75th percentile.
This study provides evidence that non-tobacco using submariners were exposed to SHS. Exposure was seen in all submarine classes and was not limited to personnel working in proximity to the smoking area. The existing policy was inadequate to protect non-smokers from exposure to SHS and required revision. As a result of a policy review, informed by this study, smoking below decks was banned aboard all US Navy submarines effective 31 December 2010.
通过确定非吸烟者在海上与在港口时的尿中可替宁水平相比是否显著升高，来评估美国海军和海军陆战队的烟草政策在保护潜艇人员免受二手烟（SHS）危害方面的效果。
2009 年 2 月至 8 月，从 9 艘美国海军潜艇中招募了 634 名志愿者完成了一项调查，以收集人口统计学数据、烟草使用信息和部署前接触 SHS 的信息。非吸烟者（n=239）被要求提供两份尿液样本（部署前和海上时），以尿中可替宁作为生物标志物来量化接触 SHS 的情况。使用液相色谱-串联质谱法对匹配的样本进行分析。
总体而言，非吸烟者在部署时的尿中可替宁水平是在港时的 2.1 倍（95%CI 1.8 至 2.4，p<0.001，n=197）。在 9 艘潜艇中的 6 艘潜艇上发现部署后的尿中可替宁水平显著升高（p<0.05）。一组报告在港口尿中可替宁采样前 10 天内没有接触 SHS 的潜艇人员（n=91），其部署后的可替宁水平是港口时的 2.7 倍（95%CI 2.2 至 3.3，p<0.001）。应用尿可替宁与血清可替宁的 4.5:1 校正因子，潜艇人员的部署几何平均值与最近的美国男性人口第 75 百分位值相似。
本研究提供了非吸烟者接触 SHS 的证据。所有潜艇级别都有暴露，并且不限于在吸烟区附近工作的人员。现有的政策不足以保护不吸烟者免受 SHS 的危害，需要进行修订。由于本研究提供的政策审查，从 2010 年 12 月 31 日起，美国所有海军潜艇都禁止在舱内吸烟。
