Metabolites of a tobacco-specific lung carcinogen in the urine of elementary school-aged children

Limited data are available in the literature on carcinogen uptake by childr en exposed to environmental tobacco smoke (ETS). In this study, we quantifi ed metabolites of the tobacco-specific lung carcinogen 4-(methytnitrosamino )-1-(3-pyridyl)-1-butanone (NNK) in the urine of elementary school-aged chi ldren participating in the School Health Initiative: Environment, Learning, Disease study, a school-based investigation of the environmental health of children. The metabolites of NNK are 4-(methylnitrosamino)-1-(3-pyridyl)-1 -butanol (NNAL) and its glucuronide (NNAL-Glue). We also measured cotinine and its glucuronide (total cotinine). Urine samples were collected from 204 children. Seventy (34.3%) of these had total cotinine greater than or equa l to5 ng/ml. NNAL or NNAL-Gluc was detected in 52 of 54 samples with total cotinine greater than or equal to5 ng/ml and in 10 of 20 samples with total cotinine <5 ng/ml. Levels of NNAL plus NNAL-Gluc and total cotinine were s ignificantly higher when exposure to ETS was reported than when no exposure was reported. However, even when no exposure to ETS was reported, levels o f NNAL, NNAL-Gluc, and NNAL plus NNAL-Gluc were higher than in children wit h documented low exposure to ETS, as determined by cotinine levels <5 ng/ml . Levels of NNAL, NNAL-Gluc, and cotinine were not significantly different in samples collected twice from the same children at 3-month intervals. Lev els of NNAL plus NNAL-Gluc in this study were comparable with those observe d in our previous field studies of adults exposed to ETS. There was a 93-fo ld range of NNAL plus NNAL-Gluc values in the exposed children. The results of this study demonstrate widespread and considerable uptake of the tobacc o-specific lung carcinogen NNK in this group of elementary school-aged chil dren, raising important questions about potential health risks. Our data in dicate that objective biomarkers of carcinogen uptake are important in stud ies of childhood exposure to ETS and cancer later in life.