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Urinary Cotinine Concentration and Self-Reported Smoking Status in 1075 Subjects Living in Central Italy

INAIL, Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Via di Fontana Candida 1, Monteporzio Catone, 00078 Rome, Italy
Lazio Regional Health Service, Department of Epidemiology, Via Cristoforo Colombo 112, 00147 Rome, Italy
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(4), 804;
Received: 6 March 2018 / Revised: 13 April 2018 / Accepted: 17 April 2018 / Published: 19 April 2018
(This article belongs to the Special Issue Environmental Tobacco Smoke: Exposure and Effects)
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Background: Urinary cotinine, a metabolite of nicotine, is a marker of tobacco smoke exposure. A cutoff value for cotinine concentration can be set to distinguish smokers from non-smokers, independently from self-declared status. Method: Cotinine was determined by isotopic dilution High Performance Liquid Chromatography coupled to tandem mass spectrometry (HPLC-MS/MS) between 2013 and 2014 on urine samples of a population of 1075 subjects. Results: 296 subjects have a cotinine level higher than 100 μg/g of creatinine (cutoff), with a median cotinine concentration of 1504.70 μg/g of creatinine. The mean is 27.5% of smokers and 60.5% in this group are females. The median value for non-smokers is 5.6 μg/g of creatinine. Two hundred and seventy-five subjects declared to be smokers in the questionnaire, but 6 (2.2%) present urinary cotinine levels lower than cutoff; 800 subjects declared to be non-smokers, but 26 of them presented urinary cotinine levels that were higher than the cutoff (3.3%). Conclusion: Using the cutoff of 100 μg/g, the misclassification of smokers resulted to be 2.2%, indicating that the selected value is suitable for studying the human exposures to environmental and occupational pollutants, including those produced by smoking. View Full-Text
Keywords: biomarkers; urinary cotinine; environmental tobacco smoke; smoking; cutoff; HPLC-MS/MS biomarkers; urinary cotinine; environmental tobacco smoke; smoking; cutoff; HPLC-MS/MS

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Paci, E.; Pigini, D.; Bauleo, L.; Ancona, C.; Forastiere, F.; Tranfo, G. Urinary Cotinine Concentration and Self-Reported Smoking Status in 1075 Subjects Living in Central Italy. Int. J. Environ. Res. Public Health 2018, 15, 804.

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