3 research outputs found
Contribution of thirdhand smoke to overall tobacco smoke exposure in pediatric patients: study protocol.
BackgroundThirdhand smoke (THS) is the persistent residue resulting from secondhand smoke (SHS) that accumulates in dust, objects, and on surfaces in homes where tobacco has been used, and is reemitted into air. Very little is known about the extent to which THS contributes to children's overall tobacco smoke exposure (OTS) levels, defined as their combined THS and SHS exposure. Even less is known about the effect of OTS and THS on children's health. This project will examine how different home smoking behaviors contribute to THS and OTS and if levels of THS are associated with respiratory illnesses in nonsmoking children.MethodsThis project leverages the experimental design from an ongoing pediatric emergency department-based tobacco cessation trial of caregivers who smoke and their children (NIHR01HD083354). At baseline and follow-up, we will collect urine and handwipe samples from children and samples of dust and air from the homes of smokers who smoke indoors, have smoking bans or who have quit smoking. These samples will be analyzed to examine to what extent THS pollution at home contributes to OTS exposure over and above SHS and to what extent THS continues to persist and contribute to OTS in homes of smokers who have quit or have smoking bans. Targeted and nontargeted chemical analyses of home dust samples will explore which types of THS pollutants are present in homes. Electronic medical record review will examine if THS and OTS levels are associated with child respiratory illness. Additionally, a repository of child and environmental samples will be created.DiscussionThe results of this study will be crucial to help close gaps in our understanding of the types, quantity, and clinical effects of OTS, THS exposure, and THS pollutants in a unique sample of tobacco smoke-exposed ill children and their homes. The potential impact of these findings is substantial, as currently the level of risk in OTS attributable to THS is unknown. This research has the potential to change how we protect children from OTS, by recognizing that SHS and THS exposure needs to be addressed separately and jointly as sources of pollution and exposure.Trial registrationClinicalTrials.gov Identifier: NCT02531594 . Date of registration: August 24, 2015
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Comparison of Liquid Chromatography Mass Spectrometry and Enzyme-Linked Immunosorbent Assay Methods to Measure Salivary Cotinine Levels in Ill Children.
Objective: Cotinine is the preferred biomarker to validate levels of tobacco smoke exposure (TSE) in children. Compared to enzyme-linked immunosorbent assay methods (ELISA) for quantifying cotinine in saliva, the use of liquid chromatography tandem mass spectrometry (LC-MS/MS) has higher sensitivity and specificity to measure very low levels of TSE. We sought to compare LC-MS/MS and ELISA measures of cotinine in saliva samples from children overall and the associations of these measures with demographics and TSE patterns. Method: Participants were nonsmoking children (N = 218; age mean (SD) = 6.1 (5.1) years) presenting to a pediatric emergency department. Saliva samples were analyzed for cotinine using both LC-MS/MS and ELISA. Limit of quantitation (LOQ) for LC-MS/MS and ELISA was 0.1 ng/ml and 0.15 ng/ml, respectively. Results: Intraclass correlations (ICC) across methods = 0.884 and was consistent in sex and age subgroups. The geometric mean (GeoM) of LC-MS/MS = 4.1 (range: < LOQ - 382 ng/mL; 3% < LOQ) which was lower (p < 0.0001) than the ELISA GeoM = 5.7 (range: < LOQ - 364 ng/mL; 5% < LOQ). Similar associations of cotinine concentrations with age ( < -0.10, p < 0.0001), demographic characteristics (e.g., income), and number of cigarettes smoked by caregiver ( > 0.07, p < 0.0001) were found regardless of cotinine detection method; however, cotinine associations with sex and race/ethnicity were only found to be significant in models using LC-MS/MS-derived cotinine. Conclusions: Utilizing LC-MS/MS-based cotinine, associations of cotinine with sex and race/ethnicity of child were revealed that were not detectable using ELISA-based cotinine, demonstrating the benefits of utilizing the more sensitive LC-MS/MS assay for cotinine measurement when detecting low levels of TSE in children
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Cotton pillow samplers for assessment of thirdhand smoke in homes of smokers and nonsmokers with children
Secondhand smoke (SHS) exposure is a major cause of illnesses in children and leaves a persistent and toxic residue indoors called thirdhand smoke (THS) that adheres to various surfaces, permeates materials, accumulates in household dust, and is subsequently re-emitted into the air. THS, like SHS, has been shown to contain multiple toxic chemicals, including carcinogenic tobacco-specific nitrosamines (TSNAs). Children are highly susceptible to tobacco smoke pollutants, and simple methods for assessing children’s SHS and THS exposure are needed. Therefore, we evaluated the performance of a cotton pillow used as a passive sampler in homes of children with caregivers who smoke tobacco, with and without home smoking bans, as well as nonsmokers. We deployed a commercially available organic cotton travel pillow, which was left in the home for a median of 9.1 days. Pillow component nicotine levels were significantly higher in homes of smokers without a ban as compared to smokers and nonsmokers who had a ban (e.g., median pillowcase nicotine 337.7 ng/g per day vs. 72.5 ng/g per day and 0.1 ng/g per day, respectively) and differences were similar to those for air nicotine. Pillowcase TSNAs were detected mainly in the homes of smokers without a smoking ban. Pillow component (pillowcase, fabric, and filling) nicotine levels were highly correlated with air nicotine levels (rho = 0.76-0.88, all P < 0.001). Nicotine in the pillow components was also highly correlated with urinary cotinine in the children (rho = 0.65 to 0.81, all P < 0.001) and other measures of tobacco smoke exposure. Pillow performance as a sampler is promising, given the ease and simplicity of sample deployment