Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers

John D. Clark, James D. Wilkinson, William G. LeBlanc, Noella Dietz, Kristopher Arheart, Lora E. Fleming, David J Lee

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: Self-reported exposure to secondhand smoke (SHS) has been associated with elevated inflammatory markers in adults. The association between SHS indicated by serum cotinine and markers of inflammation has not been investigated in adult workers. Methods: Using the subpopulation of employed participants (20 years and older) who were non-smokers and denied home SHS exposure from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, the association between serum cotinine and inflammatory markers (C-reactive protein, fibrinogen, homocysteine, and white blood cells) was analyzed. Inflammatory marker values were log-transformed and expressed as geometric means with 95% confidence intervals (CI). Serum cotinine was categorized as either no cotinine (below the detection limit), low cotinine (above the detection limit and <0.2 ng/ml), or high cotinine (≥0.2 and <15.0 ng/ml). The association between serum cotinine and inflammatory markers was analyzed using univariate and multivariate-adjusted linear regression. Results: Geometric mean serum cotinine was significantly higher among non-smokers reporting SHS exposure in the workplace (0.17 vs. 0.10 ng/ml, P < 0.01). Workers exposed to low and high levels of cotinine had significantly higher homocysteine levels relative to non-exposed workers; mean homocysteine differences remained significant in the multivariable model (i.e., 0.363 and 0.491 mg/dl increase, respectively). Conclusion: Exposure to SHS as measured by serum cotinine may result in increased homocysteine levels among adult workers. These results provide further evidence in support of universal workplace smoking restrictions in order to protect worker health. Further research is required to determine the adverse effects of workplace SHS exposure on cardiovascular risk.

Original languageEnglish
Pages (from-to)626-632
Number of pages7
JournalAmerican Journal of Industrial Medicine
Volume51
Issue number8
DOIs
StatePublished - Aug 1 2008

Fingerprint

Cotinine
Tobacco Smoke Pollution
Tobacco
Homocysteine
Workplace
Serum
Limit of Detection
Nutrition Surveys
C-Reactive Protein
Fibrinogen
Linear Models
Leukocytes
Biomarkers
Smoking
Confidence Intervals
Inflammation

Keywords

  • Inflammatory markers
  • National health and nutrition examination survey (NHANES)
  • Occupational health
  • Secondhand tobacco smoke
  • Tobacco use

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Clark, J. D., Wilkinson, J. D., LeBlanc, W. G., Dietz, N., Arheart, K., Fleming, L. E., & Lee, D. J. (2008). Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers. American Journal of Industrial Medicine, 51(8), 626-632. https://doi.org/10.1002/ajim.20591

Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers. / Clark, John D.; Wilkinson, James D.; LeBlanc, William G.; Dietz, Noella; Arheart, Kristopher; Fleming, Lora E.; Lee, David J.

In: American Journal of Industrial Medicine, Vol. 51, No. 8, 01.08.2008, p. 626-632.

Research output: Contribution to journalArticle

Clark, JD, Wilkinson, JD, LeBlanc, WG, Dietz, N, Arheart, K, Fleming, LE & Lee, DJ 2008, 'Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers', American Journal of Industrial Medicine, vol. 51, no. 8, pp. 626-632. https://doi.org/10.1002/ajim.20591
Clark JD, Wilkinson JD, LeBlanc WG, Dietz N, Arheart K, Fleming LE et al. Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers. American Journal of Industrial Medicine. 2008 Aug 1;51(8):626-632. https://doi.org/10.1002/ajim.20591
Clark, John D. ; Wilkinson, James D. ; LeBlanc, William G. ; Dietz, Noella ; Arheart, Kristopher ; Fleming, Lora E. ; Lee, David J. / Inflammatory markers and secondhand tobacco smoke exposure among U.S. workers. In: American Journal of Industrial Medicine. 2008 ; Vol. 51, No. 8. pp. 626-632.
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abstract = "Background: Self-reported exposure to secondhand smoke (SHS) has been associated with elevated inflammatory markers in adults. The association between SHS indicated by serum cotinine and markers of inflammation has not been investigated in adult workers. Methods: Using the subpopulation of employed participants (20 years and older) who were non-smokers and denied home SHS exposure from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, the association between serum cotinine and inflammatory markers (C-reactive protein, fibrinogen, homocysteine, and white blood cells) was analyzed. Inflammatory marker values were log-transformed and expressed as geometric means with 95{\%} confidence intervals (CI). Serum cotinine was categorized as either no cotinine (below the detection limit), low cotinine (above the detection limit and <0.2 ng/ml), or high cotinine (≥0.2 and <15.0 ng/ml). The association between serum cotinine and inflammatory markers was analyzed using univariate and multivariate-adjusted linear regression. Results: Geometric mean serum cotinine was significantly higher among non-smokers reporting SHS exposure in the workplace (0.17 vs. 0.10 ng/ml, P < 0.01). Workers exposed to low and high levels of cotinine had significantly higher homocysteine levels relative to non-exposed workers; mean homocysteine differences remained significant in the multivariable model (i.e., 0.363 and 0.491 mg/dl increase, respectively). Conclusion: Exposure to SHS as measured by serum cotinine may result in increased homocysteine levels among adult workers. These results provide further evidence in support of universal workplace smoking restrictions in order to protect worker health. Further research is required to determine the adverse effects of workplace SHS exposure on cardiovascular risk.",
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N2 - Background: Self-reported exposure to secondhand smoke (SHS) has been associated with elevated inflammatory markers in adults. The association between SHS indicated by serum cotinine and markers of inflammation has not been investigated in adult workers. Methods: Using the subpopulation of employed participants (20 years and older) who were non-smokers and denied home SHS exposure from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, the association between serum cotinine and inflammatory markers (C-reactive protein, fibrinogen, homocysteine, and white blood cells) was analyzed. Inflammatory marker values were log-transformed and expressed as geometric means with 95% confidence intervals (CI). Serum cotinine was categorized as either no cotinine (below the detection limit), low cotinine (above the detection limit and <0.2 ng/ml), or high cotinine (≥0.2 and <15.0 ng/ml). The association between serum cotinine and inflammatory markers was analyzed using univariate and multivariate-adjusted linear regression. Results: Geometric mean serum cotinine was significantly higher among non-smokers reporting SHS exposure in the workplace (0.17 vs. 0.10 ng/ml, P < 0.01). Workers exposed to low and high levels of cotinine had significantly higher homocysteine levels relative to non-exposed workers; mean homocysteine differences remained significant in the multivariable model (i.e., 0.363 and 0.491 mg/dl increase, respectively). Conclusion: Exposure to SHS as measured by serum cotinine may result in increased homocysteine levels among adult workers. These results provide further evidence in support of universal workplace smoking restrictions in order to protect worker health. Further research is required to determine the adverse effects of workplace SHS exposure on cardiovascular risk.

AB - Background: Self-reported exposure to secondhand smoke (SHS) has been associated with elevated inflammatory markers in adults. The association between SHS indicated by serum cotinine and markers of inflammation has not been investigated in adult workers. Methods: Using the subpopulation of employed participants (20 years and older) who were non-smokers and denied home SHS exposure from the National Health and Nutrition Examination Survey (NHANES) 1999-2002, the association between serum cotinine and inflammatory markers (C-reactive protein, fibrinogen, homocysteine, and white blood cells) was analyzed. Inflammatory marker values were log-transformed and expressed as geometric means with 95% confidence intervals (CI). Serum cotinine was categorized as either no cotinine (below the detection limit), low cotinine (above the detection limit and <0.2 ng/ml), or high cotinine (≥0.2 and <15.0 ng/ml). The association between serum cotinine and inflammatory markers was analyzed using univariate and multivariate-adjusted linear regression. Results: Geometric mean serum cotinine was significantly higher among non-smokers reporting SHS exposure in the workplace (0.17 vs. 0.10 ng/ml, P < 0.01). Workers exposed to low and high levels of cotinine had significantly higher homocysteine levels relative to non-exposed workers; mean homocysteine differences remained significant in the multivariable model (i.e., 0.363 and 0.491 mg/dl increase, respectively). Conclusion: Exposure to SHS as measured by serum cotinine may result in increased homocysteine levels among adult workers. These results provide further evidence in support of universal workplace smoking restrictions in order to protect worker health. Further research is required to determine the adverse effects of workplace SHS exposure on cardiovascular risk.

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