Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018
Abstract
:1. Introduction
2. Materials and Methods
2.1. Korean NHANES (KNHANES)
2.2. Subject Selection
2.3. Measurement of SHS Exposure Rate
2.4. Covariates
2.5. Statistical Analysis
3. Results
3.1. UCo Concentration and SHS Exposure Rate in Nonsmokers by Years
3.2. UCo Concentration in Nonsmokers by Subjects’ Characteristics
3.3. UCo-Measured SHS Exposure Rate by Subjects’ Characteristics
3.4. Factors Related to SHS Exposure Rates
4. Discussion
4.1. UCo Concentrations and SHS Exposure Rate
4.2. Inconsistency between Self-Reported and UCo-Measured SHS Exposure Rate
4.3. Factors Associated with SHS Exposure Measured Using Urine Cotinine Level
4.4. Policy Suggestions
4.5. Strength and Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
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Measures | Years | ||||||||
---|---|---|---|---|---|---|---|---|---|
2009 | 2010 | 2011 | 2014 | 2015 | 2016 | 2017 | 2018 | ||
UCo Concentration ** (Geometric meanand 95% CL, N = 28,574) | 9.28 (8.24–10.26) | 5.45 (4.85–6.13) | 3.88 (3.51–4.27) | 1.63 (1.53–1.74) | 1.49 (1.39–1.60) | 1.03 (0.97–1.10) | 1.06 (1.00–1.14) | 1.06 (1.00–1.13) | |
SHS Exposure rate | Self-reporting, at indoor home (No. and weighted%, N = 28,569) | 449 (13.4) | 148 (13.5) | 142 (11.4) | 360 (10.2) | 321 (7.8) | 254 (6.1) | 223 (4.6) | 173 (3.7) |
Self-reporting, at indoor public places * (No. and weighted%, N = 22,206) | - | - | - | 1701 (50.0) | 1261 (33.2) | 852 (20.7) | 808 (19.4) | 666 (15.4) | |
Self-reporting, at indoor workplaces (No. and weighted%, N = 16,825) | 922 (44.0) | 424 (53.8) | 379 (49.6) | 788 (40.9) | 617 (28.0) | 412 (17.8) | 351 (13.6) | 337 (12.2) | |
Cotinine measurements *** (No. and weighted%, N = 26,427) | 2115 (75.1) | 1097 (91.4) | 1159 (93.1) | 3415 (95.9) | 3639 (90.2) | 3214 (74.9) | 3234 (72.6) | 3574 (80.0) |
Variables | Participants (N, Weighted %) | UCo (ng/mL) | ||
---|---|---|---|---|
Geometric Mean | 95% CL | |||
Sex (N = 28,574) | Male | 10,035 (40.4) | 2.0 | 1.9–2.1 |
Female | 18,539 (59.6) | 1.7 | 1.6–1.8 | |
Age (N = 28,574) | 65 over | 7485 (17.1) | 1.4 | 1.3–1.5 |
45–64 | 10,945 (37.9) | 1.6 | 1.5–1.7 | |
19–44 | 10,144 (45.0) | 2.2 | 2.1–2.3 | |
Income (N = 28,436) | 4Q | 6651 (26.3) | 1.6 | 1.5–1.8 |
3Q | 7043 (24.7) | 1.7 | 1.6–1.8 | |
2Q | 7182 (24.9) | 1.8 | 1.7–1.9 | |
1Q | 7560 (26.3) | 2.0 | 1.9–2.2 | |
Occupation (N = 28,574) | Blue-collar | 4535 (16.6) | 1.8 | 1.7–1.9 |
White-collar | 9721 (38.3) | 1.8 | 1.7–1.9 | |
Agriculture | 1520 (3.5) | 2.1 | 1.8–2.4 | |
Unemployed | 12,799 (41.6) | 1.8 | 1.7–1.8 | |
Region (N = 28,574) | Urban | 229,992 (84.2) | 1.8 | 1.7–1.8 |
Rural | 5582 (15.8) | 2.0 | 1.8–2.3 | |
House type (N = 28,574) | General | 13,715 (48.3) | 2.1 | 2.0–2.2 |
Apartment | 14,859 (51.7) | 1.6 | 1.5–1.6 | |
Monthly drinking (N = 28,553) | No | 14,709 (46.9) | 1.5 | 1.5–1.6 |
Yes | 13,844 (53.1) | 2.1 | 2.0–2.2 | |
SHS at home (N = 28,569) | No | 26,499 (92.4) | 1.7 | 1.6–1.7 |
Yes | 2070 (7.6) | 4.4 | 3.9–4.9 | |
SHS at indoor public places (N = 22,206) | No | 16,918 (73.2) | 1.1 | 1.1–1.2 |
Yes | 5288 (26.8) | 1.7 | 1.6–1.9 | |
SHS in indoor workplaces (N = 16,825) | No | 12,595 (73.1) | 1.4 | 1.4–1.5 |
Yes | 4230 (26.9) | 3.5 | 3.2–3.8 |
Variables | LOD < UCo ≤ 20 ng/mL (N = 26,427) * | |
---|---|---|
Overall exposure | 21,447 (82.5) | |
Sex | Male | 7789 (86.4) |
Female | 13,658 (80.0) | |
Age | 65 over | 5493 (78.5) |
45–64 | 8554 (84.4) | |
19–44 | 7400 (82.5) | |
Income | 4Q | 5624 (81.5) |
3Q | 5441 (83.2) | |
2Q | 5304 (81.8) | |
1Q | 4980 (83.7) | |
Occupation | Blue-collar | 3615 (87.9) |
White-collar | 7466 (83.9) | |
Agriculture | 1103 (81.2) | |
Unemployed | 9263 (79.2) | |
Region | Urban | 17,399 (82.8) |
Rural | 4048 (80.9) | |
House type | General | 10,597 (85.9) |
Apartment | 10,850 (79.5) | |
Monthly drinking | No | 10,890 (80.0) |
Yes | 10,539 (84.9) | |
SHS at home | No | 19,828 (81.7) |
Yes | 1614 (93.0) | |
SHS in indoor public places | No | 12,710 (79.6) |
Yes | 4362 (89.3) | |
SHS in indoor workplaces | No | 9599 (82.6) |
Yes | 3330 (91.7) |
Variables | Univariate | Multiple | |
---|---|---|---|
LOD < UCo ≤ 20 ng/mL OR (95% CL) | |||
Sex | Female (ref) vs. Male | 1.58 (1.46–1.72) | 1.43 (1.25–1.64) |
Age | >65 (ref) | 1 | 1 |
45–64 | 1.30 (1.16–1.44) | 1.10 (0.90–1.34) | |
19–44 | 1.48 (1.33–1.64) | 1.21 (1.01–1.45) | |
Income | 4Q (ref) | 1 | 1 |
3Q | 1.02 (0.92–1.14) | 0.94 (0.81–1.09) | |
2Q | 1.12 (0.99–1.27) | 1.06 (0.90–1.25) | |
1Q | 1.17 (1.03–1.33) | 1.07 (0.90–1.29) | |
Occupation | Blue-collar worker (ref) | 1 | 1 |
White-collar worker | 0.72 (0.63–0.81) | 0.77 (0.67–0.90) | |
Agriculture | 0.60 (0.46–0.78) | 0.70 (0.53–0.93) | |
Unemployed | 0.53 (0.47–0.59) | 1.13 (0.85–1.49) | |
Region | Rural (ref) vs. Urban | 1.13 (0.96–1.34) | 1.29 (1.04–1.59) |
House type | Apartment (ref) vs. General | 1.57 (1.40–1.75) | 1.55 (1.32–1.81) |
Monthly drinking | No (ref) vs. Yes | 1.41 (1.30–1.51) | 1.17 (1.04–1.32) |
SHS at home | No (ref) vs. exposure | 2.97 (2.33–3.79) | 3.90 (2.56–5.95) |
SHS in indoor public places | No (ref) vs. exposure | 2.14 (1.90–2.41) | 1.51 (1.28–1.79) |
SHS in indoor workplaces | No (ref) vs. exposure | 2.31 (1.97–2.72) | 2.06 (1.64–2.58) |
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Sim, B.; Park, M.-B. Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018. Int. J. Environ. Res. Public Health 2021, 18, 9284. https://doi.org/10.3390/ijerph18179284
Sim B, Park M-B. Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018. International Journal of Environmental Research and Public Health. 2021; 18(17):9284. https://doi.org/10.3390/ijerph18179284
Chicago/Turabian StyleSim, Boram, and Myung-Bae Park. 2021. "Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009–2018" International Journal of Environmental Research and Public Health 18, no. 17: 9284. https://doi.org/10.3390/ijerph18179284