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American Public Health Association
133rd Annual Meeting & Exposition
December 10-14, 2005
Philadelphia, PA
APHA 2005
3169.0: Monday, December 12, 2005 - 12:30 PM

Abstract #102739

Cotinine levels in Northern Plains Indian infants

Leslie L. Randall, RN, MPH, Northwest Portland Area Indian Health Board/Northwest Epidemiology Program, Centers for Disease Control and Prevention/Division of Reproductive Health/ MCH Epidemiology Team, 527 SW Hall Suite 300, Portland, OR 97201, 503-228-4185, lhr6@cdc.gov, Elaine Gunter, MS, National Center for Environmental Health, Division of Laboratory Sciences, Centers for Disease Control and Prevention, 4770 Buford Highway, Mailstop F20, Atlanta, GA 30341, and Thomas K. Welty, MD, MPH, Aberdeen Area Tribal Chairmans Health Board, 5990 East Jeremy Lane, Flagstaff, AZ 86004.

Background: Rates of tobacco use among American Indians and Alaska Natives are the highest of all racial groups in the United States. Studies have shown that prenatal and childhood environmental tobacco smoke (ETS) exposure can cause problems such as low birth weight, Sudden Infant Death Syndrome (SIDS), otitis media, childhood asthma, and other respiratory problems.

Methods: While conducting a case control study about infant mortality in the Northern Plains, we obtained blood specimens from 58 infants (seven deceased case infants and 51 living control infants). The reference range for ETS exposure is < 5 ng/ml, no exposure; 5-15 ng/ml exposed; > 15 ng/ml, equivalent to active smoker.

Results: The highest cotinine level was 38.76 ng/ml in a postmortem sample. Of the 58 infants, 29 (50.0%) had levels less than 5 ng/ml, 12 (20.7%) had levels between 5-15 ng/ml, and 9 (15.5%) had levels over 15 ng/ml. Levels were unavailable for 8 (13.8%) because of insufficient blood samples. Conclusions: Over 1/3 of the infants studied had cotinine levels indicating significant exposure to cigarette smoke, and over 15 % of the infants had cotinine levels similar to those seen in active smokers.

Public Health Implications: Cigarette smoke exposure for these infants could ultimately pose a risk for SIDS and impact their long-term health, resulting in respiratory ailments. Previous studies have shown that parents who reduce their infants' and children's exposure to smoke decrease their cotinine levels, educational efforts should be directed at eliminating or reducing smoke exposure to all infants and children.

Learning Objectives:

Keywords: American Indians, Infant Health

Related Web page: www.ihs.gov/PublicInfo/PublicAffairs/PressReleases/index.asp

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Maternal and Child Health issues for American Indians, Alaska Natives, and Native Hawaiians

The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA