title: Secondhand tobacco smoke: a source of lead exposure in US children and adolescents.
abstract: OBJECTIVE
  We evaluated the relationship between secondhand tobacco smoke (SHS) exposure and blood lead levels in US children and adolescents.
  
  
  METHODS
  We analyzed data from 6830 participants aged 3-19 years in the National Health and Nutrition Examination Survey (1999-2004) who were not active smokers and for whom SHS exposure information and blood lead measurements were available.
  
  
  RESULTS
  After multivariable adjustment, participants in the highest quartile of serum cotinine (≥ 0.44 μg/L) had 28% (95% confidence interval = 21%, 36%) higher blood lead levels than had those in the lowest quartile (< 0.03 μg/L). Similarly, blood lead levels were 14% and 24% higher in children who lived with 1 or with 2 or more smokers, respectively, than they were in children living with no smokers. Among participants for whom lead dust information was available, the associations between SHS and blood lead levels were similar before and after adjustment for lead dust concentrations.
  
  
  CONCLUSIONS
  SHS may contribute to increased blood lead levels in US children. Lead dust does not appear to mediate this association, suggesting inhalation as a major pathway of exposure. Eliminating SHS exposure could reduce lead exposure in children.
authors.affiliation: Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
authors.forename: Andria
authors.initials: A
authors.lastname: Apostolou
authors.forename: Esther
authors.initials: E
authors.lastname: Garcia-Esquinas
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Fadrowski
authors.forename: Pat
authors.initials: P
authors.lastname: McLain
authors.forename: Virginia M
authors.initials: VM
authors.lastname: Weaver
authors.forename: Ana
authors.initials: A
authors.lastname: Navas-Acien
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003367:Cotinine / Q000097:blood; D003430:Cross-Sectional Studies; D003710:Demography; D004781:Environmental Exposure / Q000009:adverse effects / Q000032:analysis*; D005260:Female; D006798:Housing / Q000592:standards; D006801:Humans; D019570:Inhalation Exposure; D007854:Lead / Q000097:blood*; D008297:Male; D009749:Nutrition Surveys; D012111:Residence Characteristics; D012923:Social Class; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014481:United States; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D007854:Lead; D003367:Cotinine