PMID- 32866238 OWN - NLM STAT- MEDLINE DCOM- 20210405 LR - 20210901 IS - 1469-994X (Electronic) IS - 1462-2203 (Print) IS - 1462-2203 (Linking) VI - 23 IP - 2 DP - 2021 Jan 22 TI - Thirdhand Smoke Contamination and Infant Nicotine Exposure in a Neonatal Intensive Care Unit: An Observational Study. PG - 373-382 LID - 10.1093/ntr/ntaa167 [doi] AB - INTRODUCTION: Thirdhand smoke (THS) is ultrafine particulate matter and residue resulting from tobacco combustion, with implications for health-related harm (eg, impaired wound healing), particularly among hospitalized infants. Project aims were to characterize nicotine (THS proxy) transported on neonatal intensive care unit (NICU) visitors and deposited on bedside furniture, as well as infant exposure. METHODS: Cross-sectional data were collected from participants in a metropolitan NICU. Participants completed a survey and carbon monoxide breath sample, and 41.9% (n = 88) of participants (n = 210) were randomly selected for finger-nicotine wipes during a study phase when all bedside visitors were screened for nicotine use and finger-nicotine levels. During an overlapping study phase, 80 mother-infant dyads consented to bedside furniture-nicotine wipes and an infant urine sample (for cotinine analyses). RESULTS: Most nonstaff visitors' fingers had nicotine above the limit of quantification (>LOQ; 61.9%). Almost all bedside furniture surfaces (93.8%) and infant cotinine measures (93.6%) had values >LOQ, regardless of household nicotine use. Participants who reported using (or lived with others who used) nicotine had greater furniture-nicotine contamination (Mdn = 0.6 [interquartile range, IQR = 0.2-1.6] microg/m2) and higher infant cotinine (Mdn = 0.09 [IQR = 0.04-0.25] ng/mL) compared to participants who reported no household-member nicotine use (Mdn = 0.5 [IQR = 0.2-0.7] microg/m2; Mdn = 0.04 [IQR = 0.03-0.07] ng/mL, respectively). Bayesian univariate regressions supported hypotheses that increased nicotine use/exposure correlated with greater nicotine contamination (on fingers/furniture) and infant THS exposure. CONCLUSIONS: Potential furniture-contamination pathways and infant-exposure routes (eg, dermal) during NICU hospitalization were identified, despite hospital prohibitions on tobacco/nicotine use. This work highlights the surreptitious spread of nicotine and potential THS-related health risks to vulnerable infants during critical stages of development. IMPLICATIONS: THS contamination is underexplored in medical settings. Infants who were cared for in the NICU are vulnerable to health risks from THS exposure. This study demonstrated that 62% of nonstaff NICU visitors transport nicotine on their fingers to the NICU. Over 90% of NICU (bedside) furniture was contaminated with nicotine, regardless of visitors' reported household-member nicotine use or nonuse. Over 90% of infants had detectable levels of urinary cotinine during NICU hospitalizations. Results justify further research to better protect infants from unintended THS exposure while hospitalized. CI - (c) The Author(s) 2020. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. FAU - Northrup, Thomas F AU - Northrup TF AD - Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX. FAU - Stotts, Angela L AU - Stotts AL AD - Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX. AD - Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX. FAU - Suchting, Robert AU - Suchting R AD - Department of Psychiatry and Behavioral Sciences, UTHealth, McGovern Medical School, Houston, TX. FAU - Khan, Amir M AU - Khan AM AD - Department of Pediatrics, UTHealth, McGovern Medical School, Houston, TX. FAU - Green, Charles AU - Green C AD - Department of Pediatrics, UTHealth, McGovern Medical School, Houston, TX. AD - Center for Clinical Research and Evidence-Based Medicine, UTHealth, McGovern Medical School, Houston, TX. FAU - Klawans, Michelle R AU - Klawans MR AD - Department of Family and Community Medicine, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston, TX. FAU - Quintana, Penelope J E AU - Quintana PJE AD - School of Public Health, San Diego State University, San Diego, CA. FAU - Hoh, Eunha AU - Hoh E AD - School of Public Health, San Diego State University, San Diego, CA. FAU - Hovell, Melbourne F AU - Hovell MF AD - Center for Behavioral Epidemiology and Community Health, School of Public Health, San Diego State University, San Diego, CA. FAU - Matt, Georg E AU - Matt GE AD - Department of Psychology, San Diego State University, San Diego, CA. LA - eng GR - R01 ES027815/ES/NIEHS NIH HHS/United States GR - R03 HD088847/HD/NICHD NIH HHS/United States GR - R01 HL103684/HL/NHLBI NIH HHS/United States GR - UL1 TR003167/TR/NCATS NIH HHS/United States GR - R01 HL107404/HL/NHLBI NIH HHS/United States PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't PL - England TA - Nicotine Tob Res JT - Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco JID - 9815751 RN - 0 (Particulate Matter) RN - 0 (Tobacco Smoke Pollution) RN - 6M3C89ZY6R (Nicotine) RN - K5161X06LL (Cotinine) SB - IM MH - Adult MH - Cotinine/urine MH - Cross-Sectional Studies MH - Female MH - Humans MH - Infant MH - Infant, Newborn MH - Intensive Care Units, Neonatal/*statistics & numerical data MH - Male MH - Nicotine/*analysis MH - Particulate Matter/*analysis MH - Random Allocation MH - Tobacco Smoke Pollution/*analysis MH - Tobacco Use/*epidemiology MH - United States/epidemiology PMC - PMC7822104 EDAT- 2020/09/01 06:00 MHDA- 2021/04/07 06:00 PMCR- 2021/08/31 CRDT- 2020/09/01 06:00 PHST- 2020/01/13 00:00 [received] PHST- 2020/08/26 00:00 [accepted] PHST- 2020/09/01 06:00 [pubmed] PHST- 2021/04/07 06:00 [medline] PHST- 2020/09/01 06:00 [entrez] PHST- 2021/08/31 00:00 [pmc-release] AID - 5899789 [pii] AID - ntaa167 [pii] AID - 10.1093/ntr/ntaa167 [doi] PST - ppublish SO - Nicotine Tob Res. 2021 Jan 22;23(2):373-382. doi: 10.1093/ntr/ntaa167.