Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.
School of Human Services, University of Cincinnati, Cincinnati, Ohio, USA.
Tob Control. 2018 Mar;27(2):217-219. doi: 10.1136/tobaccocontrol-2016-053602. Epub 2017 Mar 30.
Dust and surfaces are important sources of lead and pesticide exposure in young children. The purpose of this pilot study was to investigate if third-hand smoke (THS) pollutants accumulate on the hands of children who live in environments where tobacco is used and if hand nicotine levels are associated with second-hand smoke (SHS), as measured by salivary cotinine.
Participants were parents and children (n=25; age mean (SD)=5.4 (5.3) years) presenting to the emergency department with a potentially SHS-related illness. A convenience sample of participants were recruited at baseline from an ongoing two-group, randomised controlled trial of a SHS reduction and tobacco cessation intervention. Parents were current smokers; thus, all children were at risk of SHS and THS exposure to varying extents. Primary outcome measures, which were assessed in child participants only, were hand nicotine and salivary cotinine. Parents reported sociodemographics and smoking patterns; children's medical records were abstracted for chief complaint, medical history and discharge diagnosis.
All children had detectable hand nicotine (range=18.3-690.9 ng/wipe). All but one had detectable cotinine (range=1.2-28.8 ng/mL). Multiple linear regression results showed a significant positive association between hand nicotine and cotinine (p=0.009; semipartial r=0.24), independent of child age.
The higher-than-expected nicotine levels and significant association with cotinine indicate that THS may play a role in the overall exposure of young children to tobacco smoke toxicants and that hand wipes could be a useful marker of overall tobacco smoke pollution and a proxy for exposure.
ClinicalTrials.gov Identifier: NCT02531594.
灰尘和表面是幼儿铅和农药暴露的重要来源。本初步研究的目的是调查生活在使用烟草环境中的儿童的手上是否会积聚三手烟 (THS) 污染物，以及手尼古丁水平是否与通过唾液可替宁测量的二手烟 (SHS) 相关。
研究对象为因疑似 SHS 相关疾病而到急诊就诊的父母和儿童（n=25；年龄平均（标准差）=5.4（5.3）岁）。从正在进行的一项 SHS 减少和烟草戒断干预的两组随机对照试验的便利样本中招募参与者。父母是当前吸烟者；因此，所有儿童都面临着不同程度的 SHS 和 THS 暴露风险。仅在儿童参与者中评估的主要结局指标是手尼古丁和唾液可替宁。父母报告了社会人口统计学和吸烟模式；从儿童病历中摘录了主要诉求、病史和出院诊断。
所有儿童的手上都可检测到尼古丁（范围=18.3-690.9ng/拭子）。除一个儿童外，所有儿童的可替宁（范围=1.2-28.8ng/ml）都可检测到。多元线性回归结果显示，手尼古丁与可替宁之间存在显著正相关（p=0.009；偏部分 r=0.24），与儿童年龄无关。
高于预期的尼古丁水平和与可替宁的显著相关性表明，THS 可能在幼儿整体暴露于烟草烟雾毒物中起作用，并且手拭子可能是整体烟草烟雾污染的有用标志物，也是暴露的替代标志物。
ClinicalTrials.gov 标识符：NCT02531594。
