Plasma, salivary and urinary cotinine in non-smoker Italian women exposed and unexposed to environmental tobacco smoking (SEASD study).
BACKGROUND
The aim of this study was to compare cotinine determinations in three biological fluids for assessing environmental tobacco smoke (ETS) exposure in female non-smokers (n=1605) in Italy.


METHODS
Information about ETS exposure at home, in the workplace, and in other places within the previous week was collected via questionnaire. Plasma, salivary and urinary cotinine levels were measured. Cotinine levels of > or =0.1 ng/mL for plasma, > or =0.2 ng/mL for saliva, and > or =0.5 ng/mL for urine were used to determine biochemical exposure.


RESULTS
Median cotinine levels were significantly higher in exposed than in unexposed women (0.21 vs. 0.05 ng/mL in plasma, 0.80 vs. 0.41 ng/mL in saliva, and 9.74 vs. 5.30 ng/mL in urine). Self-reported ETS exposure was significantly related to biochemical exposure [odds ratio 2.99, (95% CI 2.40-3.72) for plasma; 1.90 (1.51-2.39) for saliva; and 2.67 (2.14-3.34) for urine]. Cotinine significantly increased with increasing exposure level, regardless of the exposure source. Among self-reported exposed subjects, higher percentages of cotinine level above the cut-off, i.e., indicating exposure, were found in saliva (76%) and urine (75%) than in plasma (52%).


CONCLUSIONS
In general, women correctly reported their ETS exposure status. Both non-invasive salivary and urinary cotinine determinations seem preferable in epidemiological studies, in view of their higher sensitivity, when compared to plasma cotinine.
Simoni
Marzia
M
Unità di Epidemiologia Ambientale Polmonare, Istituto di Fisiologia Clinica, CNR, Via Trieste 41, 56126 Pisa, Italy.
Baldacci
Sandra
S
Puntoni
Roberto
R
Pistelli
Francesco
F
Farchi
Sara
S
Lo Presti
Elena
E
Pistelli
Riccardo
R
Corbo
Giuseppe
G
Agabiti
Nerina
N
Basso
Salvatore
S
Matteelli
Gabriella
G
Di Pede
Francesco
F
Carrozzi
Laura
L
Forastiere
Francesco
F
Viegi
Giovanni
G