MEASUREMENT OF EXPOSURE TO ENVIRONMENTAL TOBACCO-SMOKE IN PREGNANT-WOMEN

The authors compared three methods used to measure exposure to environ mental tobacco smoke in pregnant women: personal air monitor, urine co tinine, and questionnaire. Environmental tobacco smoke exposure assess ment methods were compared for agreement using Cohen's Kappa and the S pearman rank order correlation coefficient. Women who reported exposur e had significantly higher levels of air nicotine concentration compar ed with women who reported no exposure, but urine cotinine did not dif fer. Air nicotine was, more highly correlated with home exposure (r = 0.34) than work exposure (r = 0.18). Urine cotinine correlated with wo rk exposure (r = 0.14) but neither home nor social exposure. Agreement was ''fair'' (Kappa = 0.29) when self-reported exposure was compared with air monitor, but agreement was ''poor'' when urine cotinine was c ompared with serf-report (Kappa = 0.08) and air monitor (Kappa = 0.10) . In low environmental tobacco smoke exposure environments, all three methods for measuring exposure may have a role, although modification to monitoring protocols will be needed to improve monitoring sensitivi ty and exposure classification.