Childhood Asthma/Tobacco Smoke



Fate and Transport

Exposure Pathway

Methods for Monitoring in the Environment

Methods for Measuring Human Exposure

Strategies for Preventing or Controlling Exposure

Respiratory Harmful Effects

Deposition, Absorption, and Metabolism

Dose-Response Relationship

Organ Sites of Toxicity


Risk Assessment/Risk Management Considerations


Return to 5103/5104 Home

Methods for Measuring Human Exposure to Environmental Tobacco Smoke (ETS)

  • Exposure depends on several factors:
    o number of smokers in the enclosed area
    o size and nature of area
    o degree of ventilation
    o Due to these factors, a more reliable measure of human exposure is through body fluids like blood or urine versus respired air.

  • Carbon monoxide in the blood (COHb) maybe useful for comparing degrees of smoke inhalation in acute exposures, BUT important to remember:
    o carbon monoxide comes from other sources
    o exhaled CO is not valid in indicating chronic exposure to ETS.
    o measuring CO in the blood and respired air probably not the best measure for human exposure to ETS

  • Nicotine and Cotinine in urine, saliva or blood through radioimmuno assay
    o Best markers because only source could be tobacco smoke for non-smokers, and levels increase with increased exposure to tobacco smoke
    o Wong et al. (2002) demonstrated that increasing restrictions placed on where and when smoking in the house were significantly associated with lower urinary cotinine concentrations in children with asthma.


Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects (1986) from

Gergen, PJ, Mitchell, H and Lynn, H (2002). Understanding the seasonal pattern of childhood asthma: Results from the national cooperative inner-city asthma study. The Journal of Pediatrics: 141, 631-636.

Wong et. al. (2002) Children’s exposure to environmental tobacco smoke in the home: comparison of urine cotinine and parental reports. Archives of Environmental Health: 57, 584-591