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. 2022 Mar 21;19(6):3746.
doi: 10.3390/ijerph19063746.

Exposure and Risk Assessment of Second- and Third-Hand Tobacco Smoke Using Urinary Cotinine Levels in South Korea

Jiyeon Yang  1 , Shervin Hashemi  1 , Wonseok Han  2 , Yoojin Song  2 , Youngwook Lim  1
Affiliations

Exposure and Risk Assessment of Second- and Third-Hand Tobacco Smoke Using Urinary Cotinine Levels in South Korea

Jiyeon Yang et al. Int J Environ Res Public Health. .

Abstract

Exposure to environmental tobacco smoke (ETS) is the reason for approximately 1% of global mortality. ETS exposure can happen either as inhalation of direct cigarette smoke (second-hand smoke) or its associated residue particles (third-hand smoke), especially when living with a smoker in the same family. This study investigated the association between the urinary cotinine levels, as biomarkers of exposure to tobacco smoke, of smokers and those exposed to second-hand and third-hand smoke while living in the same family, through a Korean nationwide survey. Direct assessment of ETS exposure and its lifetime effect on human health is practically difficult. Therefore, this study evaluated the internal estimated daily intake (I-EDI) of nicotine and equivalent smoked cigarette per day (CPD). The carcinogenic and non-carcinogenic inhalation risks of ETS exposure were assessed by considering the calculated equivalent CPD and composition of cigarette smoke of high-selling cigarette brands in South Korea. The results show that there is a statistically significant positive correlation between the cotinine levels of smokers and those of the non-smokers living in the same family. The risk assessment results yielded that hazard index (HI) and total excess lifetime cancer risk (ECR) for both second-hand and third-hand smoke exposure can exceed 1 and 1 × 10-6, respectively, especially in women and children. In the composition of the cigarette smoke, 1,3-butadiene and acrolein substances had the highest contribution to HI and ECR. Consequently, the provision of appropriate plans for smoking cessation as a strategy for the prevention of ETS exposure to women and children is deemed necessary.

Keywords: cotinine; environmental tobacco smoke; excess lifetime cancer risk; hazard index; second-hand smoke; third-hand smoke.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Condition of urinary NNAL and cotinine in (a) positive control (active smokers) and (b) non-smoker subjects.
Figure 2
Figure 2
Correlation of urine cotinine levels of active and passive smokers living in the same family according to the age of the passive ETS exposure subjects: (a) all ages, (b) adults (age ≥19), (c) adolescents (ages 12–18), and (d) children (ages 6–11).
Figure 3
Figure 3
Assessment of hazard quotient for the composition of cigarette smoke to SHS exposure subjects based on age: (a) 6–10 years old, (b) 11–13 years old, (c) 14–18 years old, and (d) 19 years old and above.
Figure 4
Figure 4
Assessment of hazard quotient for the composition of cigarette smoke to THS exposure subjects based on age: (a) 6–10 years old, (b) 11–13 years old, (c) 14–18 years old, and (d) 19 years old and above.
Figure 5
Figure 5
Assessment of excess lifetime cancer risk for the composition of cigarette smoke to SHS exposure subjects based on age: (a) 6–10 years old, (b) 11–13 years old, (c) 14–18 years old, and (d) 19 years old and above.
Figure 6
Figure 6
Assessment of excess lifetime cancer risk for the composition of cigarette smoke to THS exposure subjects based on age: (a) 6–10 years old, (b) 11–13 years old, (c) 14–18 years old, and (d) 19 years old and above.
Figure 7
Figure 7
Assessment of (a) hazard index and (b) total excess lifetime cancer risk for the composition of cigarette smoke to ETS exposure subjects based on age.
See this image and copyright information in PMC

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