Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study
Objectives Cotinine is the gold standard to estimate prevalence of secondhand tobacco smoke (SHS) exposure, and assay limit of detection (LOD) cut-points are typically used regardless of age. Our aim was to compare the concordance between mother-reported SHS exposure and serum cotinine categorising...
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BMJ Publishing Group
2021-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/11/6/e044829.full |
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| author | Joseph M Braun Kimberly Yolton Mónica Pérez-Ríos Bruce Lanphear Nerea Mourino Maria Isolina Santiago-Pérez |
| author_facet | Joseph M Braun Kimberly Yolton Mónica Pérez-Ríos Bruce Lanphear Nerea Mourino Maria Isolina Santiago-Pérez |
| author_sort | Joseph M Braun |
| collection | DOAJ |
| description | Objectives Cotinine is the gold standard to estimate prevalence of secondhand tobacco smoke (SHS) exposure, and assay limit of detection (LOD) cut-points are typically used regardless of age. Our aim was to compare the concordance between mother-reported SHS exposure and serum cotinine categorising children as exposed with the assay LOD or age-specific cut-points.Design Data from the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort.Setting Hospital or participants’ homes.Participants 389 pregnant women aged 18 years and older, between 13 and 19 weeks of gestation, living in a five-county region of the Cincinnati, Ohio metropolitan area, and with follow-up on their children at birth and ages 12, 24, 36 and 48 months.Primary and secondary outcome measures Children’s serum cotinine, mother-reported active smoking and SHS exposure were available at birth and during follow-up visits. We used Cohen’s kappa index to assess concordance between maternal self-report and child’s serum cotinine concentrations. We estimated optimal age-specific cut-points, their sensitivity–specificity and positive–negative predictive values with receiver operating characteristic curves.Results Self-reported exposure and cotinine data were available for 280 women who gave birth to singleton child. When applying the assay LOD (0.015 ng/mL), concordance between maternal report and serum cotinine, without accounting for age, was below 0.23 at all times. When using age-specific cut-points (12 months: 0.11 ng/mL; 24 months: 0.08 ng/mL; 36 months: 0.05 ng/mL and 48 months: 0.04 ng/mL), concordance improved, being low at 12 months (0.39), moderate at 24 and 36 months (0.47 and 0.43) and high at 48 months (0.62).Conclusions Concordance between mother-reported SHS exposure among children under 5 years and serum cotinine improved considerably after applying the cohort-specific and age-specific cut-points. Future studies are necessary to verify these results. |
| format | Article |
| id | doaj-art-24097f363b8844c7a9479f44f0e5abd4 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-24097f363b8844c7a9479f44f0e5abd42024-11-20T07:00:07ZengBMJ Publishing GroupBMJ Open2044-60552021-06-0111610.1136/bmjopen-2020-044829Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort studyJoseph M Braun0Kimberly Yolton1Mónica Pérez-Ríos2Bruce Lanphear3Nerea Mourino4Maria Isolina Santiago-Pérez5Department of Epidemiology, Brown University, Providence, Rhode Island, USADepartment of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USADepartment of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, SpainDepartment of Health Sciences, Simon Fraser University – Vancouver, Vancouver, British Columbia, CanadaDepartment of Preventive Medicine and Public Health, University of Santiago de Compostela, Santiago de Compostela, SpainEpidemiology Unit, Xunta de Galicia, Santiago de Compostela, SpainObjectives Cotinine is the gold standard to estimate prevalence of secondhand tobacco smoke (SHS) exposure, and assay limit of detection (LOD) cut-points are typically used regardless of age. Our aim was to compare the concordance between mother-reported SHS exposure and serum cotinine categorising children as exposed with the assay LOD or age-specific cut-points.Design Data from the Health Outcomes and Measures of the Environment (HOME) Study, a prospective pregnancy and birth cohort.Setting Hospital or participants’ homes.Participants 389 pregnant women aged 18 years and older, between 13 and 19 weeks of gestation, living in a five-county region of the Cincinnati, Ohio metropolitan area, and with follow-up on their children at birth and ages 12, 24, 36 and 48 months.Primary and secondary outcome measures Children’s serum cotinine, mother-reported active smoking and SHS exposure were available at birth and during follow-up visits. We used Cohen’s kappa index to assess concordance between maternal self-report and child’s serum cotinine concentrations. We estimated optimal age-specific cut-points, their sensitivity–specificity and positive–negative predictive values with receiver operating characteristic curves.Results Self-reported exposure and cotinine data were available for 280 women who gave birth to singleton child. When applying the assay LOD (0.015 ng/mL), concordance between maternal report and serum cotinine, without accounting for age, was below 0.23 at all times. When using age-specific cut-points (12 months: 0.11 ng/mL; 24 months: 0.08 ng/mL; 36 months: 0.05 ng/mL and 48 months: 0.04 ng/mL), concordance improved, being low at 12 months (0.39), moderate at 24 and 36 months (0.47 and 0.43) and high at 48 months (0.62).Conclusions Concordance between mother-reported SHS exposure among children under 5 years and serum cotinine improved considerably after applying the cohort-specific and age-specific cut-points. Future studies are necessary to verify these results.https://bmjopen.bmj.com/content/11/6/e044829.full |
| spellingShingle | Joseph M Braun Kimberly Yolton Mónica Pérez-Ríos Bruce Lanphear Nerea Mourino Maria Isolina Santiago-Pérez Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study BMJ Open |
| title | Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study |
| title_full | Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study |
| title_fullStr | Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study |
| title_full_unstemmed | Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study |
| title_short | Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study |
| title_sort | secondhand tobacco smoke exposure among children under 5 years old questionnaires versus cotinine biomarkers a cohort study |
| url | https://bmjopen.bmj.com/content/11/6/e044829.full |
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