Terao A, Konishi M, Baba S, Mannami T
Kochi Prefectural Chuo-higashi Health Center.
Nihon Koshu Eisei Zasshi. 1998 Jan;45(1):3-14.
An epidemiological study in an urban population was conducted to investigate exposure to tobacco smoke using two biochemical markers of smoking. In 1993 and 1994, expired air carbon monoxide (EACO) concentrations were determined with a small portable CO monitor for 4,619 subjects aged 30 and over, who had been randomly selected from residents of S-city in Osaka Pref, and who had received a health examination for cardiovascular disease at the National Cardiovascular Center. Urinary cotinine (UCOT) concentrations were determined using gas chromatography for 480 subjects, who were nonsmokers, and who had received a health examination during Sep. and Nov. in 1994. They also completed a questionnaire about smoking habits and potential of passive smoking. In this study smoking prevalences were 45% in men and 11% in women according to the questionnaire. Among nonsmokers 55% of men and 46% of women reported some degree of exposure to tobacco smoke. The EACO levels were related to the number of cigarettes smoked per day in a dose-response fashion. The time elapsed since last smoked and the usual depth of inhalation, in addition to the number of cigarettes, had effects to EACO level. The optimal EACO cut-off points selected to differentiate smokers and nonsmokers were between 6 and 7 ppm for men, and 5 and 6 ppm for women with a sensitivity and a specificity of about 90%. The hours spent with tobacco smoke at home, whether there was a smoking spouse or not, and the time elapsed since last inhalation of smoke affected EACO level in nonsmokers. The frequency of going to an amusement place, a bar or a restaurant, and the hours spent with tobacco smoke in a work place had effects on UCOT level in non-smokers. The proper use of biochemical markers for tobacco smoke may be of value in developing more effective strategies for smoking problems control.
在城市人群中开展了一项流行病学研究，以使用两种吸烟生化标志物调查烟草烟雾暴露情况。1993年和1994年，使用小型便携式一氧化碳监测仪对4619名30岁及以上的受试者测定呼出气体一氧化碳（EACO）浓度，这些受试者是从大阪府S市居民中随机选取的，且在国立心血管中心接受了心血管疾病健康检查。对480名非吸烟者测定尿可替宁（UCOT）浓度，这些非吸烟者于1994年9月至11月期间接受了健康检查。他们还完成了一份关于吸烟习惯和被动吸烟可能性的问卷。根据问卷，本研究中男性吸烟率为45%，女性为11%。在非吸烟者中，55%的男性和46%的女性报告有一定程度的烟草烟雾暴露。EACO水平与每日吸烟支数呈剂量反应关系。除吸烟支数外，上次吸烟后经过的时间以及通常的吸入深度也对EACO水平有影响。用于区分吸烟者和非吸烟者的最佳EACO切点，男性为6至7 ppm，女性为5至6 ppm，敏感性和特异性约为90%。在家中接触烟草烟雾的时长、是否有吸烟的配偶以及上次吸入烟雾后经过的时间，均会影响非吸烟者的EACO水平。去娱乐场所、酒吧或餐馆的频率以及在工作场所接触烟草烟雾的时长，会影响非吸烟者的UCOT水平。正确使用烟草烟雾生化标志物可能对制定更有效的吸烟问题控制策略具有价值。
