간접흡연에 노출된 청소년의 요 코티닌 배설량
Urine Cotinine and Environmental Tobacco Exposure in Korean Adolescents
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연구배경: 간접흡연에 노출되고 있는 청소년을 대상으로 간접흡연 노출 특성에 따른 요 코티닌 분포를 알아보기 위하여 본 연구를 수행하였다. 방법: 서울의 2개, 강릉, 울산에서 각 1개 인문계 고등학교 1학년 1467명(여자 22.2%)을 대상으로 직접 흡연 및 간접흡연 노출 특성에 대한 설문조사와 요 코티닌 농도를 측정하였다. 성별에 따라 간접흡연 노출 특성을 비교하고, 요 코티닌 양성률에 영향을 주는 특성을 조사하였다. 결과: 직접흡연율은 남자 6.9%, 여자 0.9%이었다. 요 코티닌은 흡연자에서 중앙값 19.5 ㎍/L (범위, 0-2341 ㎍/L), 비흡연자에서 0 ㎍/L (범위, 0-1359 ㎍/L)이었고 비흡연 청소년의 요 코티닌 양성율은 2.9%이었다. 간접흡연에 노출되는 장소는 남자에서 PC방(79.6%), 집(39.4%), 학교(11.5%), 공공장소(5.9%) 순이었고 여자에서 집(40.9%), PC방(33.2%), 공공장소(28.0%), 학교(15.2%) 순이었다. 간접흡연 노출 빈도는 남자에서 주 1-4회(58.9%), 월 1-2회 이하(23.6%), 거의 매일(17.6%) 순이었고, 여자에서 주 1-4회(48.8%), 거의 매일(26.5%), 월 1-2회 이하(24.7%) 순이었다. 간접흡연 노출 시간은 남자에서 30분 미만(71.5%), 30분-2시간(21.0%), 2시간 초과(7.5%) 순이었고, 여자에서는 30분 미만(89.1%), 30분-2시간(9.0%), 2시간 초과(1.9%) 순으로 남자에서 노출되는 시간이 더 길었다. 흡연하는 친구와 접촉은 남자에서 더 많았고(32.6% vs. 17.1%), 부모의 흡연 상태는 청소년의 성별에 따라 차이를 보이지 않았다. 비흡연자에서 다양한 간접흡연 노출 특성은 요 코티닌 양성 여부에 따라 차이를 보이지 않았다. 결론: 비흡연 청소년의 요 코티닌 양성률이 낮고 간접흡연의 특성이 요 코티닌 양성률에 영향을 주지 않는 것으로 보아 요 코티닌은 청소년에서 간접흡연을 잘 반영하지 않는 것으로 보인다.
Abstract
Background: The aim of this study was to elucidate the relationship of environmental tobacco smoke (ETS) exposure and the urine cotinine concentrations in Korean adolescents. Methods: The study population was 1st grade high school adolescents (n = 1467, girls 22.2%) recruited from four high schools, two from Seoul, one from Kangleung and one from Woolsan. We obtained information on active smoking and ETS exposure through self-reported questionnaire and urine cotinine concentrations. Results: The prevalence of active smoking was 6.9% in boys and 0.9% in girls. Median urine cotinine concentrations were 19.5 ㎍/L (range, 0-2341 ㎍/L) among smokers, and 0 ㎍/L (range, 0-1359 ㎍/L) among nonsmokers. The positive rate of urine cotinine among nonsmokers exposed to ETS was 2.9%. Boys were exposed to ETS in the order of frequency in PC room (79.6%), home (39.4%), school (11.5%), and public places (5.9%); girls were exposed in the order of frequency in home (40.9%), PC room (33.2%), public places (28.0%), and school (15.2%). The frequency and duration of ETS exposure were significantly larger and longer in boys than in girls. Boys contacted friends who smoked more than girls did (32.6% vs. 17.1%). Parents’ smoking status was similar both in boys and girls. Any information on ETS exposure did not differ according to the detectable urine cotinine among nonsmoking adolescents. Conclusion: Low positive rate of urine cotinine and no association of urine cotinine with various ETS exposure history re-flect that urine cotinine may not be a good marker for ETS exposure in Korean adolescents.
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