Serum cotinine cut-points for secondhand smoke exposure assessment in children under 5 years

Background Serum cotinine has become the most widely used biomarker of secondhand smoke exposure (SHS) over time in all ages. The aim of this study was to review the serum cotinine cut-points used to classify children under 5 years as exposed to SHS. Methods A systematic review performed in the Pubm...

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Detalles Bibliográficos
Autores: Mourino, Nerea, Ruano-Raviña, Alberto, Varela Lema, Leonor, Fernández, Esteve|||0000-0003-4239-723X, López Medina, María José|||0000-0003-4402-2239, Santiago-Pérez, María Isolina, Rey-Brandariz, Julia, Giraldo Osorio, Alexandra, Pérez-Ríos, Mónica|||0000-0003-4456-6631
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:284197
Acceso en línea:https://ddd.uab.cat/record/284197
https://dx.doi.org/urn:doi:10.1371/journal.pone.0267319
Access Level:acceso abierto
Palabra clave:Adolescent
Adult
Child
Child, Preschool
Cotinine
Environmental Exposure
Humans
Nutrition Surveys
Prevalence
Smoke-Free Policy
Tobacco Smoke Pollution
Descripción
Sumario:Background Serum cotinine has become the most widely used biomarker of secondhand smoke exposure (SHS) over time in all ages. The aim of this study was to review the serum cotinine cut-points used to classify children under 5 years as exposed to SHS. Methods A systematic review performed in the Pubmed (MEDLINE) and EMBASE databases up to April 2021 was conducted using as key words "serum cotinine", "tobacco smoke pollution" (MeSH), "secondhand smoke", "environmental tobacco smoke" and "tobacco smoke exposure". Papers which assessed SHS exposure among children younger than 5 years old were included. The PRISMA 2020 guidelines were followed. Analysis was pre-registered in PROSPERO (registration number: CRD42021251263). Results 247 articles were identified and 51 fulfilled inclusion criteria. The selected studies were published between 1985-2020. Most of them included adolescents and adults. Only three assessed postnatal exposure exclusively among children under 5 years. None of the selected studies proposed age-specific cut-points for children < 5 years old. Cut-point values to assess SHS exposure ranged from 0.015 to 100 ng/ml. The most commonly used cut-point was 0.05 ng/ml, derived from the assay limit of detection used by the National Health and Nutrition Examination Survey (NHANES). Conclusions No studies have calculated serum cotinine age-specific cut-points to ascertained SHS exposure among children under 5 years old. Children's age-specific cut-points are warranted for health research and public health purposes aimed at accurately estimating the prevalence of SHS exposure and attributable burden of disease to such exposure, and at reinforcing 100% smoke-free policies worldwide, both in homes, private vehicles and public places.