探討問卷評估二手菸暴露與尿中cotinine之相關性—以高雄市罹患慢性支氣管炎婦女為研究對象

Correlation between environmental tobacco smoke exposure evaluated by questionnaires and cotinine level in urine-One example from the study of chronic bronchitis among women in Kaohsiung city.

姚凡壹(Fan-Yi Yao)

指導教授 ： 吳明蒼

高雄醫學大學/健康科學院/職業安全衛生研究所/碩士(2005年)

摘要

目的：使用尿中cotinine濃度，來探討問卷調查抽菸及二手菸暴露量效度。

方法：本研究為社區基礎病例對照研究法。研究個案為高屏區中央健保局民國89年度一月至十二月健保資料中40歲以上（包括40歲）的女性，且均居住在高雄縣市五年以上。病例組為在研究期間被診斷為慢性支氣管炎( ICD-9 code: 491 )至少兩次，且排除其他呼吸道疾病；對照組為沒有呼吸道疾病的女性。對個案進行問卷訪視、肺功能檢查及檢體（尿）收集。利用LC/MS/MS分析cotinine濃度。

結果：總共分析171位婦女之尿中cotinine，其中4位平常為吸菸者，而167位無抽菸習慣。有抽菸者體內代謝之cotinine濃度（n=4，mean ± SE：184.45 ± 355.21ng/mL，範圍：1.36－717.22 ng/mL），比沒抽菸習慣者（n=167，6.85 ± 69.29 ng/mL，0.08－896.60 ng/mL）高，且有顯著性地差異（p=0.005）。其中進一步分析67位婦女問卷有三天及二十四小時以內之二手煙暴露情形，沒有婦女在這三天及二十四小時內有抽菸史，但在在三天內有二手菸暴露者之cotinine濃度（n=23，2.72 ± 3.02 ng/mL，0.13－12.45 ng/mL），比沒暴露者（n=44，0.79 ± 0.63 ng/mL，0.14－3.36 ng/mL）高，且有顯著差異（p < 0.001）；在二十四小時內有二手菸暴露者之cotinine濃度（n=9，3.08 ± 3.81 ng/mL，0.53－12.45 ng/mL），比沒暴露者（n=58，1.21 ± 1.51 ng/mL，0.13－9.34 ng/mL）高，且有顯著差異（p=0.017）。三天內二手菸暴露劑量與cotinine濃度以Spearman correlation cofficient檢定有相關性（r=0.56，n=23，p=0.01），cotinine濃度會因為二手菸暴露越多而越高。

結論：此研究顯示使用問卷確實可以評估吸菸和二手菸之暴露。

關鍵字

慢性支氣管炎 ； 二手菸

並列摘要

Objective：
Our study aim is to use urine cotinine level to verify the environmental tobacco exposure (ETS) evaluated by questionnaire among women in the Kaohsiung city.

Methods：
A community-based case-control study was conducted. The potential study subjects were from the data of Bureau National Health Insurance between January and December, 2000. Eligible cases and controls were female who were 40 years old and over and had lived in Kaohsiung city for 5 years and over. Potential study cases were those who were diagnosed with chronic bronchitis (ICD-9 code: 491) without other respiratory diseases at least 2 times in the year 2000. Potential controls were those who were healthy and were excluded other airway diseases. Questions about potential environmental risk factors, pulmonary function test, and one-spot urine sample were collected from each study woman. Continine level was measured by LC/MS/MS.

Result：
In total, 171 women（4 smokers and 167 non-smokers） provided their urine samples for cotinine measurements. Mean（±SE, range） cotinine levels in smokers （n=4）were 184.45 ng/mL（± 355.21 ng/mL, 1.36－717.22 ng/mL）, significantly higher than those in non-smokers（n=167, 6.85 ± 69.29 ng/mL, 0.08－896.60 ng/mL）（p=0.005）. We feather analyzed 67 women who had information about the smoking status in 3 days and 24 hours prior to urine collection. No study women had smoked cigarettes. The cotinine level among 23 women who had ETS exposure in these three days（2.72 ± 3.02 ng/mL, 0.13－12.45 ng/mL） were significantly higher than those without ETS exposure（n=44, 0.79 ± 0.63 ng/mL, 0.14－3.36 ng/mL）（p < 0.001）. The cotinine level among 9 women who had ETS exposure during the past 24 hours（3.08 ± 3.81 ng/mL, 0.53－12.45 ng/mL） were significantly higher than those without ETS exposure（n=58, 1.21 ± 1.51 ng/mL, 0.13－9.34 ng/mL）（p=0.017）. The high correlation was also noted between the amount （cigarette stick）of ETS exposure and urinary cotinine levels （Spearman correlation coefficiency, r=0.56, n=23, p=0.01）.

Discussion:
The study suggests that the smoking status among women can be correctly estimated by our questionnaire.

並列關鍵字

environmental tobacco exposure ； cotinine ； chronic bronchitis.

參考文獻

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