Biomarkers of Exposure among USA Adult Hookah Users: Results from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013–2014)
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Interview Data
2.3. Demographics and Potential Confounders
2.4. Tobacco Use Patterns
2.5. Biospecimen Collection
2.6. Biomarker Data
2.7. Laboratory Methods for Urinary Biomarkers
2.8. Statistical Analysis
3. Results
3.1. Characteristics of the Study Population by Tobacco Use Status
3.2. Biomarkers of Exposure by Hookah Use Status
3.3. Relation between Frequency of Product Use and Tobacco-Specific Biomarker Concentrations
3.4. Exposure Biomarkers by Type of Hookah Tobacco Used
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Acknowledgments
Disclaimer
Conflicts of Interest
References
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Biomarker of Exposure (Abbreviation) | Half-Life | Analytical Assay Method |
---|---|---|
Urinary Nicotine Metabolites ^ | ||
Cotinine (COTT) | 16–18 h | All nicotine metabolites were assessed using two separate isotope dilution high performance liquid chromatography/tandem mass spectrometric (HPLC-MS/MS) methods [20,21] |
Nicotine (NICT) | 1–2 h | |
Cotinine N-oxide (COXT) | N/A | |
Nicotine 1′-oxide (NOXT) | N/A | |
Norcotinine (NCCT) | N/A | |
Nornicotine (NNCT) | N/A | |
trans-3′-Hydroxycotinine (HCTT) | 6.4 h | |
Minor Tobacco Alkaloids | ||
Anabasine (ANBT) | 16 h | Same as above |
Anatabine (ANTT) | 10 h | |
Arsenic and Arsenic Compounds | ||
Arsenous Acid | 10 h | All arsenic compounds were assessed using high performance liquid chromatography/inductively coupled plasma dynamic reaction cell mass spectrometry (HPLC-ICP-DRC-MS) |
Arsenic Acid | 10 h | |
Dimethylarsinic acid | 10 h | |
Monomethylarsonic acid | 10 h | |
Tobacco Specific Nitrosamines (TSNAs) | ||
4-methylnitrosamino)-4-(3-pyridyl)-1-butanol (NNAL) | 10.3 days [31] | All TSNAs were assessed using isotope dilution high performance liquid chromatography/atmospheric pressure chemical ionization tandem mass spectrometry (HPLC-MS/MS) [22] |
N’-nitrosonornicotine (NNN) | N/A | |
N’-nitrosoanatabine (NAT) | N/A | |
N’-nitrosoanabasine (NAB) | N/A | |
Metals | ||
Beryllium (UBE) | Several years | All metals were assessed using inductively coupled plasma mass spectrometry (ICP-MS) [23,24] |
Cadmium (UCD) | 13.6 years | |
Cobalt (UCO) | Several days | |
Manganese (UMN) | 39 days | |
Lead (UPB) | 1–2 months in blood & soft tissues, years to decades in bone | |
Strontium (USR) | 47.3 h | |
Thallium (UTL) | 1–3 days | |
Uranium (UUR) | 24 h | |
Polycyclic Aromatic Hydrocarbons (PAHs) | ||
1-Naphthol or 1-hydroxynaphthalene (1-NAP) | 4.3 h | All PAHs were assessed using enzymatic hydrolysis, on-line solid phase extraction, and isotope dilution liquid chromatography tandem mass spectrometry [27] |
2-Naphthol or 2-hydroxynaphthalene (2-NAP) | 9.4 h | |
3-Hydroxyfluorene (3-FLU) | 8.2 h | |
2-Hydroxyfluorene (2-FLU) | 2.1 h | |
1-Hydroxyphenanthrene (1-PHE) | 5.1 h | |
1-Hydroxypyrene (1-PYR) | 6.0 h | |
2-Hydroxyphenanthrene and 3-Hydroxyphenanthrene (2-3PHE) | 4.1 h | |
Volatile Organic Compounds (VOCs) | ||
2-Methylhippuric acid (2MHA) (Xylene) | 34 h | All VOCs were assessed using isotope dilution UPLC-MS/MS [28,29] |
3,4-Methylhippuric acid (34MH) (Xylene) | 34 h | |
N-Acetyl-S-(2-carbamoylethyl)-L-cysteine (AAMA) (Acrylamide) | 11 or 17.4 h | |
N-Acetyl-S-(N-methylcarbamoyl)-L-cysteine (AMCA) (N,N-Dimethylformamide/isocyanates) | 23 h | |
N-Acetyl-S-(benzyl)-L-cysteine (BMA) (Toluene) | <10 h | |
N-Acetyl-S-(2-carboxyethyl)-L-cysteine (CEMA) (Acrolein) | N/A | |
N-Acetyl-S-(1-cyano-2-hydroxyethyl)-L-cysteine (CYHA) (Acrylonitrile) | N/A | |
N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) (Acrylonitrile) | 8 h | |
N-Acetyl-S-(3,4-dihydroxybutyl)-L-cysteine (DHBM) (1,3 Butadiene) | N/A | |
N-Acetyl-S-(2-carbamoyl-2-hydroxyethyl)-L-cysteine (GAMA) (Acrylamide) | 19 or 25.1 h | |
N-Acetyl-S-(2-hydroxyethyl)-L-cysteine (HEMA) (Acrylonitrile, vinyl chloride, ethylene oxide) | >5 h | |
N-Acetyl-S-(2-hydroxypropyl)-L-cysteine (HPM2) (Propylene Oxide) | N/A | |
N-Acetyl-S-(3-hydroxypropyl)-L-cysteine (HPMA) (Acrolein) | N/A | |
N-Acetyl-S-(3-hydroxypropyl-1-methyl)-L-cysteine (HPMM) (Crotonaldehyde) | N/A | |
N-Acetyl-S-(4-hydroxy-2-methyl-2-buten-1-yl)-L-cysteine (IPM3) (Isoprene) | N/A | |
Mandelic acid (MADA) | 2.1, 3.6, or 3.9 h | |
N-Acetyl-S-(4-hydroxy-2-buten-1-yl)-L-cysteine (MHB3) (1,3 Butadiene) | >9 or <6 h * | |
Phenylglyoxylic acid (PGHA) (Ethylbenzene, styrene) | 8.1, 8.8 or 10.5 h | |
N-Acetyl-S-(phenyl)-L-cysteine (PMA) (Benzene) | 9.1 h | |
2-Thioxothiazolidine-4-carboxylic acid (TTCA) (Carbon Disulfide) | 8 h |
Characteristics | Never Users of Tobacco Products (n = 1655) | Exclusive, Established, Past 30-Day Hookah User (n = 98) | ||||||
---|---|---|---|---|---|---|---|---|
N | % | 95% Confidence Interval | N | % | 95% Confidence Interval | |||
Lower | Upper | Lower | Upper | |||||
Sex | ||||||||
Male | 607 | 37.5 | 34.9 | 40.1 | 53 | 57.6 | 46.6 | 67.8 |
Female | 1048 | 62.5 | 59.9 | 65.1 | 45 | 42.5 | 32.2 | 53.4 |
Age group (years) | ||||||||
18–21 | 445 | 10.3 | 9.1 | 11.6 | 46 | 42.5 | 31.3 | 54.5 |
22–24 | 234 | 5.8 | 4.8 | 7.0 | 30 | 26.1 | 17.8 | 36.6 |
25+ | 976 | 83.9 | 82.1 | 85.5 | 22 | 31.4 | 20.5 | 44.8 |
Race/ethnicity | ||||||||
White, Non-Hispanic | 785 | 55.9 | 52.1 | 59.6 | 46 | 48.2 | 38.1 | 58.4 |
Other | 870 | 44.1 | 40.4 | 47.9 | 52 | 51.9 | 41.6 | 61.9 |
Education | ||||||||
Less than high school or GED | 290 | 16.2 | 14.1 | 18.5 | 10 | 8.95 | 5.1 | 15.2 |
High school diploma | 433 | 25.4 | 21.9 | 29.3 | 20 | 15.5 | 9.5 | 24.4 |
Some college or higher | 932 | 58.4 | 54.4 | 62.2 | 68 | 75.6 | 65.5 | 83.4 |
Current product use | ||||||||
Every day | - | - | - | - | 7 | 6.9 ^ | 3.5 | 13.3 |
Some days | - | - | - | - | 91 | 93.1 | 86.7 | 96.5 |
Past 30-day use of marijuana | ||||||||
No | 1632 | 99.4 | 99.0 | 99.7 | 72 | 73.7 | 62.9 | 82.2 |
Yes | 20 | 0.6 | 0.3 | 1.0 | 25 | 26.3 | 17.8 | 37.1 |
N | Mean | 95% confidence interval | N | Mean | 95% confidence interval | |||
SHS Exposure (hours, past 7 days) | 1655 | 1.9 | 1.4 | 2.4 | 98 | 4.8 | 2.3 | 7.2 |
Creatinine level | 1646 | 128.7 | 123.0 | 134.4 | 98 | 159.1 | 141.5 | 176.6 |
Biomarkers of Exposure | Never Users of Tobacco Products (n = 1655) | % Above LOD | Exclusive, Established, Past 30-day Hookah User (n = 98) | % Above LOD | |
---|---|---|---|---|---|
Cotinine (COTT) (µg/g) | N | 1644 | 98 | ||
0.42 (0.36, 0.48) | 98.8% | 5.45 ^ (2.81, 10.58) | 100.0% | ||
N | 1633 | 97 | |||
Total Nicotine Equivalents (TNE-2) (µmol/g) | 0.006 (0.005, 0.007) | - | 0.09 ^ (0.04, 0.17) | - | |
N | 1653 | 98 | |||
4-methylnitrosamino)-4-(3-pyridyl)-1-butanol (NNAL) (ng/g) | 0.92 ^ (0.82, 1.04) | 50.7% | 2.21 (1.59, 3.08) | 83.5% | |
N | 1655 | 98 | |||
3-Hydroxyfluorene (3-FLU) (ng/g) | 63.98 (60.32, 67.86) | 99.2% | 74.22 (60.65, 90.82) | 100.0% | |
N | 1655 | 98 | |||
1-Hydroxypyrene (1-PYR) (ng/g) | 128.14 (120.67, 136.07) | 85.2% | 148.30 (126.43, 173.94) | 92.3% | |
N | 1652 | 98 | |||
Cadmium (UCD) (ng/g) | 148.77 (139.59, 158.55) | 93.4% | 70.23 (60.29, 81.80) | 82.2% | |
N | 1653 | 98 | |||
Lead (UPB) (ng/g) | 351.14 (330.28, 373.31) | 99.9% | 271.85 (226.73, 325.96) | 100.0% | |
N | 1653 | 98 | |||
N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) (µg/g) | 1.27 (1.19, 1.36) | 84.9% | 2.80 (1.98, 3.98) | 96.0% | |
N | N | 1653 | 97 | ||
N-Acetyl-S-(3-hydroxypropyl)-Lcysteine (HPMA) (µg/g) | 262.06 (247.45,277.54) | 99.6% | 257.82 (216.17, 307.49) | 100.0% |
Biomarker | Exclusive, Established, Past 30-Day Hookah User (n = 98) | Never Users of Tobacco Products (n = 1655) (Ref) | ||
---|---|---|---|---|
95% CI | ||||
Geometric Mean Ratio | Lower | Upper | ||
Total Nicotine Equivalents (TNE-2) | 11.63 ^ | 5.49 | 24.68 | 1.00 |
Cotinine (COTT) | 10.57 ^ | 4.94 | 22.61 | 1.00 |
4-methylnitrosamino)-4-(3-pyridyl)-1-butanol (NNAL) | 2.29 | 1.52 | 3.46 | 1.00 |
3-Hydroxyfluorene (3-FLU) | 1.28 | 1.01 | 1.63 | 1.00 |
1-Hydroxypyrene (1-PYR) | 1.33 | 1.09 | 1.63 | 1.00 |
Cadmium (UCD) | 0.93 | 0.76 | 1.14 | 1.00 |
Lead (UPB) | 1.19 | 0.99 | 1.43 | 1.00 |
N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) | 1.81 | 1.17 | 2.81 | 1.00 |
N-Acetyl-S-(3-hydroxypropyl)-L-cysteine (HPMA) | 1.09 | 0.89 | 1.33 | 1.00 |
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Travers, M.J.; Rivard, C.; Sharma, E.; Retzky, S.; Yucesoy, B.; Goniewicz, M.L.; Stanton, C.A.; Chen, J.; Callahan-Lyon, P.; Kimmel, H.L.; et al. Biomarkers of Exposure among USA Adult Hookah Users: Results from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013–2014). Int. J. Environ. Res. Public Health 2020, 17, 6403. https://doi.org/10.3390/ijerph17176403
Travers MJ, Rivard C, Sharma E, Retzky S, Yucesoy B, Goniewicz ML, Stanton CA, Chen J, Callahan-Lyon P, Kimmel HL, et al. Biomarkers of Exposure among USA Adult Hookah Users: Results from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013–2014). International Journal of Environmental Research and Public Health. 2020; 17(17):6403. https://doi.org/10.3390/ijerph17176403
Chicago/Turabian StyleTravers, Mark J., Cheryl Rivard, Eva Sharma, Sandra Retzky, Berran Yucesoy, Maciej L. Goniewicz, Cassandra A. Stanton, Jiping Chen, Priscilla Callahan-Lyon, Heather L. Kimmel, and et al. 2020. "Biomarkers of Exposure among USA Adult Hookah Users: Results from Wave 1 of the Population Assessment of Tobacco and Health (PATH) Study (2013–2014)" International Journal of Environmental Research and Public Health 17, no. 17: 6403. https://doi.org/10.3390/ijerph17176403