| Children's Exposure to Environmental Tobacco Smoke: Using Diverse Exposure Metrics to Document Ethnic/Racial Differences Ken Sexton,1 John L. Adgate,2 Timothy R. Church,2 Stephen S. Hecht,3 Gurumurthy Ramachandran,2 Ian A. Greaves,2 Ann L. Fredrickson,2 Andrew D. Ryan,2 Steven G. Carmella,3 and Mindy S. Geisser2 1School of Public Health, University of Texas, Brownsville, Texas, USA; 2Division of Environmental and Occupational Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA; 3University of Minnesota Cancer Center, Minneapolis, Minnesota, USA Abstract
Four metrics were used to assess exposure to environmental tobacco smoke (ETS) for a probability sample (n = 152) of elementary school-age children in two economically disadvantaged neighborhoods: a) caregiver responses to a baseline questionnaire (BQ) about smoking status and behavior ; b) 48-hr time-activity (T-A) data on location and time spent by children in the presence of tobacco smoke ; c) total urinary cotinine as a marker for nicotine uptake ; and d) urinary NNAL [4-(methylnitrosamino) -1-(3-pyridyl) -1-butanol] + NNAL-Gluc [4-(methylnitrosamino) -1- (3-pyridyl) -1-(O-ß -d-glucopyranuronosyl) butane] as a marker for uptake of the tobacco-specific lung carcinogen 4-(methylnitrosamino) -1-(3-pyridyl) -1-butanone (NNK) . Consistent differences in ETS exposure by ethnicity and race were observed. Although data were insufficient to determine differences for NNAL + NNAL-Gluc, BQ responses, T-A data, and cotinine levels all indicated that average ETS exposure was highest for African-American children, moderately high for those designated "other" (white, Southeast Asian, Native American) , moderately low for Hispanic children, and lowest for Somali immigrant children. For example, in February 2000, mean cotinine levels were 14.1 ng/mL for African Americans, 12.2 ng/mL for other, 4.8 ng/mL for Hispanics, and 4.4 ng/mL for Somalis. The BQ and T-A data together were reasonably good predictors of total cotinine levels (adjusted r2 = 0.69) , and based on limited data, measured total cotinine values were a relatively good predictor of NNAL + NNAL-Gluc (adjusted r2 = 0.73) . The results suggest that when children are exposed to ETS primarily in their homes, questionnaires and T-A logs might be effective screening tools for identifying those likely to experience higher uptake of nicotine. Key words: children's health, cotinine, environmental tobacco smoke, ethnicity, questionnaires, race. Environ Health Perspect 112:392-397 (2004) . doi:10.1289/ehp.6473 available via http://dx.doi.org/ [Online 12 November 2003]
Address correspondence to K. Sexton, Environmental and Occupational Health, School of Public Health, University of Texas, Brownsville Regional Campus, 80 Fort Brown, RAHC Bldg., Brownsville, TX 78520 USA. Telephone: (956) 554-5168. Fax: (956) 554-5152. E-mail: ksexton@utb.edu This study was supported by two STAR grants (825813 and 826789) from the U.S. Environmental Protection Agency, National Center for Environmental Research ; a grant from the Legislative Commission on Minnesota Resources ; and grant CA-81301 from the National Cancer Institute. The authors declare they have no competing financial interests. Received 21 May 2003 ; accepted 12 November 2003.
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