title: Plasma, salivary and urinary cotinine in non-smoker Italian women exposed and unexposed to environmental tobacco smoking (SEASD study).
abstract: 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.
authors: Unità di Epidemiologia Ambientale Polmonare, Istituto di Fisiologia Clinica, CNR, Via Trieste 41, 56126 Pisa, Italy.
authors: Marzia
authors: M
authors: Simoni
authors: Sandra
authors: S
authors: Baldacci
authors: Roberto
authors: R
authors: Puntoni
authors: Francesco
authors: F
authors: Pistelli
authors: Sara
authors: S
authors: Farchi
authors: Elena
authors: E
authors: Lo Presti
authors: Riccardo
authors: R
authors: Pistelli
authors: Giuseppe
authors: G
authors: Corbo
authors: Nerina
authors: N
authors: Agabiti
authors: Salvatore
authors: S
authors: Basso
authors: Gabriella
authors: G
authors: Matteelli
authors: Francesco
authors: F
authors: Di Pede
authors: Laura
authors: L
authors: Carrozzi
authors: Francesco
authors: F
authors: Forastiere
authors: Giovanni
authors: G
authors: Viegi