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Zhong Q, Li Y, Mei X, Li J, Huang Y. Assessment of passive human exposure to tobacco smoke by environmental and biological monitoring in different public places in Wuhan, central China. Int J Hyg Environ Health 2022; 244:114008. [PMID: 35870316 DOI: 10.1016/j.ijheh.2022.114008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/08/2022] [Accepted: 07/13/2022] [Indexed: 12/01/2022]
Abstract
Passive exposure to tobacco smoke is a global public health problem, while there are few data on public place monitoring and general population exposure assessment in central China. This study aimed to examine the levels of airborne nicotine (n = 256) in ten kinds of different public places in Wuhan, central China, and assess short-term and long-term smoke exposure in 340 non-smokers aged 18-67 who worked in these public places using tobacco biomarkers [i.e., cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), respectively]. The highest median concentration of airborne nicotine (17.0 μg/m3) was observed in internet cafes, approximately 304-fold of the lowest value found in nurseries (55.9 ng/m3). Among the other studied public places, restaurants had the highest median concentrations (ng/m3) of airborne nicotine (3,120), followed by subway stations (810), hotels (624), government officess (286), middle schools (269), health institutions (268), public institutions (190), and primary schools (140). Urinary cotinine and NNAL were found in almost all the participants, and the highest concentrations were found in non-smokers from the internet cafes [specific gravity (SG)-corrected urinary median concentrations: 23.1 ng/mL, geometric mean (GM): 24.1 ng/mL, range: 0.62-1679 ng/mL] for cotinine and 104 pg/mL (GM: 97.6 pg/mL, range: 32.3-236 pg/mL) for NNAL, respectively]. Urinary cotinine concentrations in male non-smokers (median: 2.02 ng/mL) were significantly higher than those in female non-smokers (1.44) (P < 0.01). Participants aged 18-27 were detected with the highest urinary cotinine and NNAL concentrations. Urinary cotinine and NNAL concentrations were significantly correlated with daily and monthly working hours, respectively. Besides, a positive correlation was observed between log-transformed urinary concentrations of cotinine and NNAL (r = 0.32, P < 0.001). This is the first time to report matched data on airborne nicotine and urinary cotinine/NNAL among employees in different public places. This study demonstrated ubiquitous exposure to environmental tobacco smoke in the studied public places.
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Affiliation(s)
- Qing Zhong
- Institute of Health Education, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, PR China
| | - Yilin Li
- Institute of Health Education, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, PR China
| | - Xin Mei
- Institute of Health Education, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, PR China
| | - Junlin Li
- Institute of Health Education, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, PR China.
| | - Yuanxia Huang
- Institute of Health Education, Wuhan Centers for Disease Control and Prevention, Wuhan, Hubei, 430024, PR China.
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Helina M, Jayaputra NH, Palutturi S. Health Behavior of Adolescent Smokers During Covid-19 Pandemic. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.7170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This research aims to determine the health behavior of adolescent smokers during the COVID-19 pandemic.
METHOD: Both quantitative and qualitative analyses were conducted simultaneously using the design of “t” and Chi-square test through the distribution of questionnaires to 135 respondents as well as descriptive design and case studies, respectively. The data were collected by 13 informants through in-depth interviews, observation, and documentation.
RESULTS: The results showed that 5 out of the 6 indicators of the demographic characteristics were correlated to the economic pressure of the families of adolescent smokers which also correlates with their health behavior during the COVID-19 pandemic.
CONCLUSION: The increase in the price of cigarettes and family control are measures that regulate children from buying cigarettes.
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Rosen L, Zucker D, Guttman N, Brown N, Bitan M, Rule A, Berkovitch M, Myers V. Protecting Children From Tobacco Smoke Exposure: A Randomized Controlled Trial of Project Zero Exposure. Nicotine Tob Res 2021; 23:2003-2012. [PMID: 34021353 DOI: 10.1093/ntr/ntab106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 05/19/2021] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Young children are vulnerable to harm from tobacco smoke exposure (TSE). This study assessed the effect of Project Zero Exposure-an intervention program designed to help parents protect children from TSE-on children's exposure. METHODS Randomized controlled trial of a home-based, theory-driven intervention. Parents of young children (<8 y) in families with a smoking parent were eligible. The intervention included feedback on child TSE (hair nicotine), and home air quality (PM2.5), with motivational interviewing. Families were randomized to: intervention group (IG, N = 69), regular control group (RCG, N = 70), or to a secondary enhanced control group, (ECG, N = 20). Child hair samples were taken at baseline and follow-up. We report on child TSE in the IG versus RCG at six months. RESULTS Most enrolled families completed the trial (IG: 98.6%[68/69], RCG: 97.1%[68/70]). Log hair nicotine (LHN [ng/mg]) decreased in both the IG (Baseline: -1.78 ± 1.91, Follow-up: -2.82 ± 1.87, p = .003) and RCG (Baseline: -1.79 ± 1.54, Follow-up: -2.85 ± 1.73, p = .002), but did not differ between groups at study end (p = .635). Three of five parentally-reported outcomes showed improvement over time in the IG, and one in the RCG. Among IG participants, 90% found hair nicotine feedback useful. CONCLUSIONS No difference between the intervention and control groups was found on the objective biomarker, LHN. Child TSE decreased during the trial in intervention and control groups. Trial participation, which included hair nicotine monitoring, may have contributed to decreasing exposure in both groups. Concurrent control group improvements may partially explain lack of proven intervention benefit. Biomarker monitoring warrants further investigation for reduction of child TSE. IMPLICATIONS Project Zero Exposure is an intervention program designed to help parents protect their children from TSE. Results from the randomized controlled trial of the program showed no difference between groups at study end, but a clear and substantial reduction in child exposure to tobacco smoke from beginning to end of the trial, in both intervention and control groups. Biomarker monitoring, a key element of the trial, was used with all participants. Biomarker monitoring of child exposure to tobacco smoke may help parents become aware of their child's exposure and better protect them, and should be explored as a means to reduce child TSE. Clinical Trial Registration: NCT02867241.
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Affiliation(s)
- Laura Rosen
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - David Zucker
- Department of Statistics, Hebrew University, Jerusalem, Israel
| | - Nurit Guttman
- Department of Communications, Tel Aviv University, Ramat Aviv, Israel
| | - Nili Brown
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Michal Bitan
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
- Department of Statistics, Tel Aviv University, Ramat Aviv, Israel
| | - Ana Rule
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mati Berkovitch
- Assaf Harofeh Medical Center, Be'er Ya'akov, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
| | - Vicki Myers
- Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel
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Hassan L, Moser A, Rorman E, Groisman L, Naor Y, Shinar E, Gat R, Jaffe E, Novack V, Kloog I, Novack L. Human biologic monitoring based on blood donations to the National Blood Services. BMC Public Health 2020; 20:469. [PMID: 32268895 PMCID: PMC7140578 DOI: 10.1186/s12889-020-08588-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/25/2020] [Indexed: 12/28/2022] Open
Abstract
Background The ambient exposure does not always reflect the internal levels of pollution absorbed in the body. While human biomonitoring (HBM) could provide a valid estimate of exposure extent, it is usually an expensive and a heavily manpowered enterprise. Using samples collected during blood donations for HMB may provide a more efficient platform for a routine biomonitoring. Methods The current study is aimed to explore the feasibility of using the national blood banking system for the purposes of HBM, to compare between residents of a suspected polluted area in northern Israel (Haifa Bay) to the rest of the country. Specifically, we will assemble a geographically representative sample of blood donors residing in the study area and of the general population, to test for four industry and traffic-related metals: lead (Pb), cadmium (Cd), arsenic (As) and chromium (Cr). Samples of whole blood from donors will be tested in the Laboratory of Public Health Services managed by the Ministry of Health. The information on donors’ biomarkers levels will be further linked with the air pollution and meteorological data assessed at the location of the blood collection sites (short-term exposure) and donors’ permanent address (long-term exposure), as recorded by the monitoring stations spread throughout Israel and the satellite-based exposure models. The association between biomarkers and ambient environmental exposures will be assessed. The samples’ collection is planned for 2 years of 2020–2021. Discussion The information collected in this study could lead to environmental regulations within Haifa Bay area aimed to prevent exposure to high levels of hazardous chemicals.
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Affiliation(s)
- Lior Hassan
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Sderot Rager 151, 84101, Beer-Sheva, Israel.,Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Asher Moser
- Blood Services Center, Magen David Adom, Tel Aviv-Yafo, Israel
| | - Efrat Rorman
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Luda Groisman
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Yamit Naor
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Eilat Shinar
- National Public Health Laboratory, Tel Aviv-Yafo, Israel
| | - Roni Gat
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Sderot Rager 151, 84101, Beer-Sheva, Israel.,Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel
| | - Eli Jaffe
- Blood Services Center, Magen David Adom, Tel Aviv-Yafo, Israel
| | - Victor Novack
- Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel.,Soroka University Medical Center, Beer-Sheva, Israel
| | - Itai Kloog
- Department of Geography, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Lena Novack
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Sderot Rager 151, 84101, Beer-Sheva, Israel. .,Negev Environmental Health Research Institute, Soroka University Medical Center, Beer-Sheva, Israel.
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Ein-Mor E, Berman T, Barnett-Itzhaki Z, Göen T, Ergaz-Shaltiel Z, Natsheh J, Ben-Chetrit A, Haimov-Kochman R, Calderon-Margalit R. Newborn infant urinary cotinine and birth outcomes in the Jerusalem Environment Mother and Child Cohort Study. Int J Hyg Environ Health 2019; 222:1054-1058. [PMID: 31324382 DOI: 10.1016/j.ijheh.2019.07.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/07/2019] [Accepted: 07/11/2019] [Indexed: 11/16/2022]
Abstract
BACKGROUND Environmental tobacco smoke (ETS) exposure during pregnancy can cause preterm delivery and childhood cancer. The aim of this study was to measure ETS exposure in pregnant women and in newborn infants in Israel using urinary cotinine measurements, to assess predictors of ETS exposure in these vulnerable groups, and to assess associations with birth effects (birth weight, birth length, head circumference) in newborn infants. METHODS We analyzed urinary cotinine and creatinine in 265 non-smoking pregnant women and 97 newborns, and analyzed associations with self-reported exposure to ETS, paternal smoking, sociodemographic variables and with birth outcomes (birth weight, birth length, head circumference). RESULTS 37.7% of pregnant women and 29.0% of infants had urinary cotinine concentrations above the level of quantification (LOQ) of 1 μg/L, whereas 63.8% and 50.5%, respectively, had urinary cotinine concentrations above the level of detection (LOD) of 0.5 μg/L. Median unadjusted and creatinine adjusted urinary concentrations of cotinine in pregnant women were 0.7 μg/L, and 0.9 μg/g creatinine, respectively, and in newborn infants were 0.5 μg/L, and 1.3 μg/g creatinine, respectively. We did not find an association between maternal and infant urinary cotinine level. Maternal (but not infant) urinary cotinine was significantly associated with paternal smoking (p < 0.05). Infant (but not maternal) cotinine above the LOQ was negatively associated with birth weight (p < 0.05). CONCLUSIONS In this high socioeconomic cohort, almost a third of newborn infants born to non-smoking mothers had quantifiable levels of urinary cotinine. This is the first study showing that newborns with quantifiable urinary cotinine levels have lower birth weight.
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Affiliation(s)
- Eliana Ein-Mor
- Hadassah-Hebrew University Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel
| | - Tamar Berman
- Public Health Services, Ministry of Health, Jerusalem, Israel; Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Tel-Aviv, Israel
| | - Zohar Barnett-Itzhaki
- Public Health Services, Ministry of Health, Jerusalem, Israel; Bioinformatics Department, School of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich- Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Juma Natsheh
- Neonatology Department Hadassah Medical Center, Jerusalem, Israel
| | | | - Ronit Haimov-Kochman
- Department of Obstetrics and Gynecology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Ronit Calderon-Margalit
- Hadassah-Hebrew University Braun School of Public Health, POB 12272, Jerusalem, 91120, Israel
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Rees VW. The promise - and pitfalls - of smoke-free policy adoption. Isr J Health Policy Res 2019; 8:41. [PMID: 31053151 PMCID: PMC6500036 DOI: 10.1186/s13584-019-0313-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 04/29/2019] [Indexed: 11/26/2022] Open
Abstract
Environmental Tobacco Smoke (ETS) is a major, preventable cause of morbidity and mortality, disproportionately impacting vulnerable populations. Policy measures, guided by the WHO’s Framework Convention of Tobacco Control, have focused on the broad adoption of smoke-free laws. While smoke-free policies are effective in reducing ETS exposure, limited policy dissemination and suboptimal implementation strategies have limited their impact. New research reported by Berman and colleagues in this journal brings these issues into sharper focus. Substantial advances in tobacco control policy have been achieved in Israel, including widening of smoke-free laws, since the passing of a Knesset bill in 2012. However, Berman and co-authors present found no reduction in ETS exposure in a nationally representative sample of non-smoking Israeli adults in 2016 compared with an earlier benchmark measured in 2011. In line with research from international settings, they found that ETS exposure was higher among a traditionally vulnerable subpopulation. The findings serve to remind us that the mere adoption of a policy will not translate into meaningful public health impact without applying best practice implementation strategies. Above all, this work emphasizes the continual need for new research to improve existing policies and inform new policy approaches in pursuit of an end to the harm arising from the global tobacco epidemic.
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Affiliation(s)
- Vaughan W Rees
- Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard T.H. Chan School of Public Health, Kresge Building, 6th Floor, 677 Huntington Ave, Boston, MA, 02115, USA.
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