Korean J Fam Pract. 2018; 8(3): 341-347  https://doi.org/10.21215/kjfp.2018.8.3.341
The Relationship between Urinary Cotinine and Blood Lead, Mercury and Cadmium Concentrations in Korean Adolescents: The 2010–2011 Korean National Health and Nutrition Examination Survey
Jung-Woo Sohn, Seock-Hwan Lee*, Jae-Hang Cho, Hyun-Sug Bae
Department of Family Medicine, Daegu Medical Center, Daegu, Korea
Seock-Hwan Lee
Tel: +82-53-560-7390, Fax: +82-53-560-7499
E-mail: fmdsky@hanmail.net
ORCID: http://orcid.org/0000-0002-0638-643X
Received: May 10, 2017; Revised: July 11, 2017; Accepted: July 30, 2017; Published online: June 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Tobacco smoke consists of a variety of hazardous chemicals, including heavy metals. Exposure to tobacco smoke in childhood and adolescence makes one more vulnerable to various diseases. The aim of this study was to investigate the association between urinary cotinine (UCot) concentration and serum heavy metal concentration in adolescents.
Methods: This cross-sectional study was conducted on 445 persons participated in the Korean National Health and Nutrition Examination Survey (2010–2011), were between 13 and 19 years of age, and who underwent UCot and serum heavy metal concentration analysis. The correlation between serum lead, mercury and cadmium concentrations and urinary low-cotinine and high-cotinine concentrations was analyzed.
Results: Serum concentrations of lead and cadmium in the high-cotinine group were significantly higher than those in the low-cotinine group. However, serum mercury concentration did not correlate with UCot concentration. Only serum cadmium concentration showed a significant correlation with UCot concentration after adjustment for age and sex. By contrast, serum lead and cadmium concentrations significantly correlated with UCot concentration after adjustment for region and frequency of fish and seaweed intake.
Conclusion: Smoking is a source of exposure to heavy metals and various hazardous chemicals. As exposure to tobacco smoke increases the absorption of lead and cadmium, policies and countermeasures against smoking and exposure to second-hand smoking are needed, for promotion of national health. Further studies on the risk of smoking in children and adolescents are needed.
Keywords: Smoking; Cotinine; Heavy Metals; Adolescents
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