Urinary mutagenicity after controlled exposure to environmental tobacco smoke (ETS)

Mutagenic activity of overnight urine from healthy non-smoking subjects

Urinary mutagenicity was evaluated in relation to environmental mutagen exposure (i.e., diet, indoor/outdoor activities, residential area etc.) on the day prior to sample collection, and also considering factors that contribute to the variability of Salmonella mutagenicity assay results. Overnight urine samples from 283 healthy non-smoking residents of northeast Italy (46% males, 20-62 years) were analyzed for mutagenicity on sensitive Salmonella typhimurium strain YG1024 with S9 mix employing the preincubation version of the plate incorporation assay (i.e., the Salmonella reverse mutation test). Urinary mutagenicity varied between 0.02 and 9.84 rev/ equiv. ml, and 7% of samples were positive (i.e., sample elicited a two-fold increase in revertants). There was an evident increase in mutagenicity in subjects with increased intake of mutagen-rich meals (n = 80) (P < 0.01 and positive urine 13% vs. 5%, P = 0.025). Indoor-exposed subjects (n = 65) also showed a higher percentage of positive urine (14% vs. 5%, P = 0.015). In particular, those subjects exposed to cooking fumes the previous evening (n = 28) revealed higher urinary mutagenicity (P = 0.035, positive urine 25% vs. 5%, P < 0.001) than non-indoor exposed. The sources of variability of the mutagenicity assay, mainly the histidine content of the urine concentrate (z = 4.06, P < 0.0001), and to a lesser extent bacterial inoculum size (z = 2.33, P = 0.019), also significantly influenced urinary mutagenicity values. In a linear multiple regression analysis, their effects were still significant (i.e., histidine content P = 0.026 and inoculum size P = 0.021), but the effects of diet, indoor exposure, and other environmental exposures (i.e., traffic and heating system exhausts, residential area) were not. It is concluded that the previous day's exposure to mutagen-rich meals and cooking fumes may influence the presence of mutagenic activity in the overnight urine of non-smoking subjects. This mutagenic activity, which remains in contact with bladder mucosa for several hours, could be considered risk factors for colorectal adenoma and possibly other cancers (i.e., bladder) in non-smokers. Accurate control of histidine content and bacterial inoculum size is strongly recommended when investigating the mutagenic activity of urine from non-smokers.

Genotoxicity of environmental tobacco smoke: a review

Environmental tobacco smoke (ETS), or second-hand smoke, is a widespread contaminant of indoor air in environments where smoking is not prohibited. It is a significant source of exposure to a large number of substances known to be hazardous to human health. Numerous expert panels have concluded that there is sufficient evidence to classify involuntary smoking (or passive smoking) as carcinogenic to humans. According to the recent evaluation by the International Agency for Research on Cancer, involuntary smoking causes lung cancer in never-smokers with an excess risk in the order of 20% for women and 30% for men. The present paper reviews studies on genotoxicity and related endpoints carried out on ETS since the mid-1980s. The evidence from in vitro studies demonstrates induction of DNA strand breaks, formation of DNA adducts, mutagenicity in bacterial assays and cytogenetic effects. In vivo experiments in rodents have shown that exposure to tobacco smoke, whole-body exposure to mainstream smoke (MS), sidestream smoke (SS), or their mixture, causes DNA single strand breaks, aromatic adducts and oxidative damage to DNA, chromosome aberrations and micronuclei. Genotoxicity of transplacental exposure to ETS has also been reported. Review of human biomarker studies conducted among non-smokers with involuntary exposure to tobacco smoke indicates presence of DNA adducts, urinary metabolites of carcinogens, urinary mutagenicity, SCEs and hypoxanthine-guanine phosphoribosyltransferase (HPRT) gene mutations (in newborns exposed through involuntary smoking of the mother). Studies on human lung cancer from smokers and never-smokers involuntarily exposed to tobacco smoke suggest occurrence of similar kinds of genetic alterations in both groups. In conclusion, these overwhelming data are compatible with the current knowledge on the mechanisms of carcinogenesis of tobacco-related cancers, occurring not only in smokers but with a high biological plausibility also in involuntary smokers.

Urinary mutagenicity and thioethers in nonsmokers: role of environmental tobacco smoke (ETS) and diet

The urinary excretion of mutagens and thioethers was investigated in a controlled diet study and in two field studies. A diet containing charcoal-broiled meat and other items rich in mutagenic compounds increased the urinary mutagenicity as assessed in Salmonella typhimurium strain TA98 with metabolic activation approximately 46-fold compared to a diet low in mutagens. The excretion of thioethers after ingestion of the diet rich in mutagens also increased significantly when compared to the diet low in mutagens. The increase was associated with the content of preformed thioethers in the diet. In the first field study with 21 nonsmokers, urinary mutagenicity as assessed in Salmonella typhimurium strain TA98 and excretion of thioethers showed no relation to either the self-reported exposure to environmental tobacco smoke (ETS) or to serum cotinine concentrations used as an objective marker for ETS exposure. In the second field study, urinary mutagenicity was determined with a tobacco-smoke sensitive Salmonella typhimurium strain YG1024 with metabolic activation. No correlation was found between the mutagenic activity in urine and ETS exposure duration, nicotine on the personal sampler, cotinine in saliva and cotinine in urine. Our results suggest that real-life ETS exposure does not measurably increase either urinary mutagen or urinary thioether excretion. Furthermore, diet seems to be the most important source for both urinary mutagen and thioether excretion in nonsmokers.

Environmental tobacco smoke

In 1992, the U.S. Environmental Protection Agency (EPA) issued a "draft" assessment of ETS and lung cancer in adults and respiratory disorders in children. Relying on weak and inconclusive epidemiological data, the supposed similarity between ETS and MS, the presence of "known or suspected carcinogens" in MS and by extrapolation in ETS, and the "biological plausibility" of an adverse relationship between ETS and health, the EPA recommended that ETS be classified as a "Group A (known human) carcinogen." Fundamental physical and quantitative chemical differences among ETS, MS, and SS and human exposure to each smoke were disregarded: The three are not equivalent nor is ETS exposure a quantitative variant of cigarette smoking. A substantial difference in retention percentage overlays the huge dosimetric difference between exposures. As a result, the "dosage" of ETS retained is miniscule relative to MS. Also, conclusions reached by the EPA and the use of tenuous relationships as bases for Group A classification are unwarranted because of failure to consider the data upon which the "tumorigenicity" of the ETS components was based, questions on the presence and/or levels of these components in MS, and data indicating that a 25- to 30-fold decrease of a high-level dose of MS or MS condensate diminished the effects observed in bioassays from pronounced to zero, i.e., a threshold was demonstrated. Finally, EPA overlooked the more than 100 tobacco smoke components known to inhibit the tumorigenic action of many of the listed "tumorigens."

Mainstream and environmental tobacco smoke

Environmental tobacco smoke (ETS) is derived from cigarette smoldering and active smoker exhalation. Its composition displays broad quantitative differences and redistributions between gas and respirable suspended particulate (RSP) phases when compared with the mainstream smoke (MSS) that smokers puff. This is because of different generation conditions and because ETS is diluted and ages vastly more than MSS. Such differences prevent a direct comparison of MSS and ETS and their biologic activities. However, even assuming similarities on an equal mass basis, ETS-RSP inhaled doses are estimated to be between 10,000- and 100,000-fold less than estimated average MSS-RSP doses for active smokers. Differences in effective gas phase doses are expected to be of similar magnitude. Thus the average person exposed to ETS would retain an annual dose analogous to the active MSS smoking of considerably less than one cigarette dispersed over a 1-year period. By contrast, consistent epidemiologic data indicate that active smoking of some 4-5 cigarettes per day may not be associated with a significantly increased risk of lung cancer. Similar indications also obtain for cardiovascular and respiratory diseases. Since average doses of ETS to nonsmoking subjects in epidemiologic studies are several thousand times less than this reported intake level, the marginal relative risks of lung cancer and other diseases attributed to ETS in some epidemiologic studies are likely to be statistical artifacts, derived from unaccounted confounders and unavoidable bias.

Significance of exposure to benzene and other toxic compounds through environmental tobacco smoke

In order to assess the uptake of benzene from environmental tobacco smoke (ETS) and to estimate its contribution to the total body burden of benzene observed in non-smokers, two experimental studies have been conducted. Controlled exposure to high levels of ETS equivalent to 10 ppm CO for 9 h and 20 ppm for 8 h resulted in a nonsignificant increase in blood benzene levels and a significant increase in exhaled CO, COHb and cotinine in serum and urine. The slightly rising blood concentration of benzene following experimental ETS exposure was paralleled by an increased exhalation of benzene and aromatic hydrocarbons and in contrast to blood levels, this increase was significant. The blood levels of benzene obtained during exposure were comparable to those observed at the time of admission to the laboratory, when biomarkers of ETS uptake, e.g. cotinine in serum and urine, were at the limit of detection, thus demonstrating that these background levels were not from ETS exposure. No difference in the urinary excretion of phenol, the main metabolite of benzene, was found during the experimental periods. The background levels of urinary phenol in unexposed nonsmokers were rather high, demonstrating that phenol excreted in urine must be formed from several endogenous and exogenous precursors. In the light of our findings it is highly questionable whether exposure to benzene from ETS under real life conditions poses a cancerogenic risk to the general population, which is measurable today or in the future by toxicological or epidemiological methods.

Importance of exposure to gaseous and particulate phase components of tobacco smoke in active and passive smokers

The uptake of tobacco smoke constituents from gaseous and particulate phases of mainstream smoke (MS), inhaled by smokers, and of environmental tobacco smoke (ETS), breathed in by non-smokers, was investigated in two experimental studies. Tobacco smoke uptake was quantified by measuring carboxyhemoglobin (COHb), nicotine and cotinine in plasma and urine and the data obtained were correlated with urinary excretion of thioethers and of mutagenic activity. An increase in all biochemical parameters was observed in smokers inhaling the complete MS of 24 cigarettes during 8 h, whereas only an increase in COHb and, to a minor degree, in urinary thioethers was found after smoking the gas phase of MS under similar conditions. Exposure of non-smokers to the gaseous phase of ETS or to whole ETS at similar high concentrations for 8 h led to identical increases in COHb, plasma nicotine and cotinine as well as urinary excretion of nicotine and thioethers which were much lower than in smokers. Urinary mutagenicity was not found to be elevated under either ETS exposure condition. As shown by our results, the biomarkers most frequently used for uptake of tobacco smoke (nicotine and cotinine) indicate on the one hand the exposure to particulate phase constituents in smoking but on the other hand the exposure to gaseous phase constituents in passive smoking. Particle exposure during passive smoking seems to be low and a biomarker which indicates ETS particle exposure is as yet not available. These findings emphasize that risk extrapolations from active smoking to passive smoking which are based on cigarette equivalents or the use of one biomarker (e.g. cotinine) might be misleading.

Analysis of mutagenic activity in human urine after concentration on different resins and high-performance liquid chromatography

Smokers' urine was tested for mutagenic activity on Salmonella typhimurium strain TA1538 with metabolic activation after adsorption on different resins and desorption with organic solvents. The amounts of XAD-2 were 1.25 and 5 g/100 ml urine, the amounts of alumina, cyanopropyl and C18 were all 5 g/100 ml and extrelut 80 g/100 ml. Adsorbed organic chemicals were eluted with acetone from XAD-2, with dichloromethane from extrelut and with a series of solvents from the other resins (hexane, toluene, dichloromethane and methanol). All columns gave similar results, with the exception of extrelut, which had poor recovery of mutagenic activity. Higher resin/urine ratios and sequences of columns gave better results. The organic eluates from XAD-2 columns loaded with the urine of patients treated with cyclophosphamide and melphalan were mutagenic on strain TA1535 with S9, and some mutagenic activity was also detectable in the aqueous eluate. Cisplatin was adsorbed on XAD-2, C18 and extrelut, but was eluted only from extrelut using dimethylformamide as a solvent. Smokers' urine was separated into several fractions with high-performance liquid chromatography, using C-18 columns with a series of solutions of 2.5 mM phosphoric acid and acetone or with a gradient of methanol. Several fractions containing dissolved organic compounds and no histidine were mutagenic with metabolic activation, but the overall mutagenic activity was still lower than the one detected with one-step chromatography on XAD-2. Using XAD-2 resins with a high ratio of resin to urine still seems to be the method of choice for studying urinary mutagenicity.

Biomonitoring after controlled exposure to environmental tobacco smoke (ETS)

A rough estimation of the amounts of tobacco smoke components taken up by active and passive smoking suggests that, in the case of passive smoking, gas phase constituents in ETS are of greater relevance than particle-bound substances. Since this aspect is of importance for the risk evaluation of passive smoking, it was decided that it should be investigated further in a series of exposure studies with human volunteers. The ETS exposure conditions were characterized by measuring tobacco smoke components such as carbon monoxide (CO), nitrogen oxides (NOx), nicotine, formaldehyde, tobacco-specific nitrosamines (N-nitrosonornicotine (NNN), 4-methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), benzo(a)pyrene (BaP) and particulate matter in the air of the exposure room. The biomonitoring covered carboxyhemoglobin (COHb), thioethers and mutagenic activity in urine. These parameters were compared to those observed after controlled active smoking. It was found that urinary thioether excretion increased in non-smokers after extremely high ETS exposure. This effect could be attributed to gas phase ETS components. Urinary mutagenicity was not measurably increased in non-smokers under these conditions. This indicates that in passive smoking, as opposed to smoking, the gas phase might be more important in terms of possible effects than the particulate matter. It would, therefore, be misleading to make extrapolations based on the burden of smoking to establish the burden of passive smoking.

Urinary excretion of mutagens in passive smokers

Six healthy young volunteers with no history of active smoking were asked to keep on their Western diets avoiding the consumption of alcoholic beverages, excess coffee, any sort of medicament, and the known pro- and/or anti-mutagen-containing foods and drinks, 24 h before and during the experiments. They were exposed passively to cigarette smoke produced by 4 habitual smokers in an unventilated 48.6 m3 room for 8 h. The carbon monoxide concentration was 18.85 +/- 7.3 ppm during the 8-h exposure. Frameshift mutagens were isolated from 10-h urine samples using chloroform and were tested for mutagenicity in the Salmonella/mammalian microsome assay employing Salmonella typhimurium TA98. Although clearly enhanced, no significant mutagenic activity could be found with 25 ml equivalent urine/plate after passive exposure to cigarette smoke. The weak mutagenicities found were highly significant when 50 ml equivalent urine/plate was tested. No direct correlation was observed between urine mutagenicity and the urinary cotinine concentration. The results obtained are discussed with reference to inconsistent reports in the literature concerning the mutagenicity of urine after passive smoking.