Abstract
Objective
The goal of this study was to describe environmental tobacco smoke (ETS) exposure
using urinary biomarkers and its correlation with parent report, among children presenting
to emergency room.
Methods
This is a case control study among children aged 3 to 12 years at a tertiary pediatric
emergency department in Israel. Children with respiratory (case) or gastrointestinal
(control) symptoms were recruited and their accompanying parent completed a short
survey. Urine samples were obtained and analyzed for nicotine, cotinine trans-3’-hydroxycotine.
Clinical data were extracted from medical records. We compared tobacco exposure using
urinary biomarkers, parent report, and Pearson's product-moment correlation, including
95% confidence intervals, between cases and controls.
Results
Forty-nine cases with respiratory symptoms and 96 controls with gastrointestinal symptoms
were enrolled in the study. Parent-reported ETS exposure in the previous month was
higher in the cases compared to control (71.4% vs 57.3%), although the difference
was not statistically significant. The mean values of detectable biomarkers did not
differ by between cases and controls. However, there was a correlation between urinary
biomarkers and reported ETS exposure (0.278–0.460 for various biomarkers) only among
cases.
Conclusions
The majority of children in this study had detectable nicotine urinary biomarkers,
regardless of their symptoms. However, correlation between parental report and urinary
biomarkers was only found among children with symptoms potentially related to ETS.
These findings imply that parents of children without respiratory symptoms may underestimate
exposure. Efforts to educate parents and caregivers on the risks associated with exposure
to ETS should be intensified, regardless of illness.
Keywords
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Article Info
Publication History
Published online: January 08, 2021
Accepted:
January 2,
2021
Received:
July 2,
2020
Footnotes
The authors have no conflicts of interest to disclose.
Identification
Copyright
Copyright © 2021 by Academic Pediatric Association
