PMID- 34297932 OWN - NLM STAT- MEDLINE DCOM- 20211117 LR - 20240214 IS - 1096-0953 (Electronic) IS - 0013-9351 (Print) IS - 0013-9351 (Linking) VI - 202 DP - 2021 Nov TI - Differential associations of hand nicotine and urinary cotinine with children's exposure to tobacco smoke and clinical outcomes. PG - 111722 LID - S0013-9351(21)01016-1 [pii] LID - 10.1016/j.envres.2021.111722 [doi] AB - BACKGROUND: Children's overall tobacco smoke exposure (TSE) consists of both inhalation of secondhand smoke (SHS) and ingestion, dermal uptake, and inhalation of thirdhand smoke (THS) residue from dust and surfaces in their environments. OBJECTIVES: Our objective was to compare the different roles of urinary cotinine as a biomarker of recent overall TSE and hand nicotine as a marker of children's contact with nicotine pollution in their environments. We explored the differential associations of these markers with sociodemographics, parental smoking, child TSE, and clinical diagnoses. METHODS: Data were collected from 276 pediatric emergency department patients (Median age = 4.0 years) who lived with a cigarette smoker. Children's hand nicotine and urinary cotinine levels were determined using LC-MS/MS. Parents reported tobacco use and child TSE. Medical records were reviewed to assess discharge diagnoses. RESULTS: All children had detectable hand nicotine (GeoM = 89.7ng/wipe; 95 % CI = [78.9; 102.0]) and detectable urinary cotinine (GeoM = 10.4 ng/ml; 95%CI = [8.5; 12.6]). Although hand nicotine and urinary cotinine were highly correlated (r = 0.62, p < 0.001), urinary cotinine geometric means differed between racial groups and were higher for children with lower family income (p < 0.05), unlike hand nicotine. Independent of urinary cotinine, age, race, and ethnicity, children with higher hand nicotine levels were at increased risk to have discharge diagnoses of viral/other infectious illness (aOR = 7.49; 95%CI = [2.06; 27.24], p = 0.002), pulmonary illness (aOR = 6.56; 95%CI = [1.76; 24.43], p = 0.005), and bacterial infection (aOR = 5.45; 95%CI = [1.50; 19.85], p = 0.03). In contrast, urinary cotinine levels showed no associations with diagnosis independent of child hand nicotine levels and demographics. DISCUSSION: The distinct associations of hand nicotine and urinary cotinine suggest the two markers reflect different exposure profiles that contribute differentially to pediatric illness. Because THS in a child's environment directly contributes to hand nicotine, additional studies of children of smokers and nonsmokers are warranted to determine the role of hand nicotine as a marker of THS exposure and its potential role in the development of tobacco-related pediatric illnesses. CI - Copyright (c) 2021 Elsevier Inc. All rights reserved. FAU - Mahabee-Gittens, E Melinda AU - Mahabee-Gittens EM AD - Division of Emergency Medicine, Cincinnati Children's Hospital Medical Center, College of Medicine, University of Cincinnati, Cincinnati, OH, USA. Electronic address: melinda.mahabee-gittens@cchmc.org. FAU - Merianos, Ashley L AU - Merianos AL AD - School of Human Services, University of Cincinnati, Cincinnati, OH, USA. FAU - Jandarov, Roman A AU - Jandarov RA AD - Department of Environmental Health, Division of Biostatistics and Bioinformatics, University of Cincinnati College of Medicine, Cincinnati, OH, USA. FAU - Quintana, Penelope J E AU - Quintana PJE AD - School of Public Health, San Diego State University, San Diego, CA, USA. FAU - Hoh, Eunha AU - Hoh E AD - School of Public Health, San Diego State University, San Diego, CA, USA. FAU - Matt, Georg E AU - Matt GE AD - Department of Psychology, San Diego State University, San Diego, CA, USA. LA - eng GR - R01 ES027815/ES/NIEHS NIH HHS/United States GR - R01 HD083354/HD/NICHD NIH HHS/United States GR - R01 ES030743/ES/NIEHS NIH HHS/United States GR - S10 RR026437/RR/NCRR NIH HHS/United States GR - P30 DA012393/DA/NIDA NIH HHS/United States GR - R21 ES032161/ES/NIEHS NIH HHS/United States GR - K01 DA044313/DA/NIDA NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20210721 PL - Netherlands TA - Environ Res JT - Environmental research JID - 0147621 RN - 0 (Tobacco Smoke Pollution) RN - 6M3C89ZY6R (Nicotine) RN - K5161X06LL (Cotinine) SB - IM MH - Child MH - Child, Preschool MH - Chromatography, Liquid MH - *Cotinine MH - Humans MH - Nicotine/analysis MH - Tandem Mass Spectrometry MH - Nicotiana MH - *Tobacco Smoke Pollution/analysis PMC - PMC8578289 MID - NIHMS1727848 OTO - NOTNLM OT - Cotinine OT - Environmental tobacco smoke OT - Secondhand smoke OT - Thirdhand smoke OT - Tobacco smoke pollution COIS- Declaration of interests The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2021/07/24 06:00 MHDA- 2021/11/18 06:00 PMCR- 2022/11/01 CRDT- 2021/07/23 20:10 PHST- 2021/05/04 00:00 [received] PHST- 2021/07/13 00:00 [revised] PHST- 2021/07/15 00:00 [accepted] PHST- 2021/07/24 06:00 [pubmed] PHST- 2021/11/18 06:00 [medline] PHST- 2021/07/23 20:10 [entrez] PHST- 2022/11/01 00:00 [pmc-release] AID - S0013-9351(21)01016-1 [pii] AID - 10.1016/j.envres.2021.111722 [doi] PST - ppublish SO - Environ Res. 2021 Nov;202:111722. doi: 10.1016/j.envres.2021.111722. Epub 2021 Jul 21.