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Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e318158a486
Original Articles

Declining Trends in Serum Cotinine Levels in US Worker Groups: the Power of Policy

Arheart, Kristopher L. EdD; Lee, David J. PhD; Dietz, Noella A. PhD; Wilkinson, James D. MD, MPH; Clark, John D. III MS; LeBlanc, William G. PhD; Serdar, Berrin MD, PhD; Fleming, Lora E. MD, PhD

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Objective: To explore trends in cotinine levels in US worker groups.

Methods: Using NHANES III data, serum cotinine levels of US workers not smokers nor exposed to secondhand smoke (SHS) at home were evaluated for trends by occupational/industrial and race/ethnicity-gender sub-groups.

Results: Decreases from 1988 to 2002 ranged from 0.08 to 0.30 ng/mL (67% to 85% relative decrease), with largest absolute reductions in: blue-collar and service occupations; construction/manufacturing industrial sectors; non-Hispanic Black male workers.

Conclusions: All worker groups had declining serum cotinine levels. Most dramatic reductions occurred in sub-groups with the highest before cotinine levels, thus disparities in SHS workforce exposure are diminishing with increased adoption of clean indoor laws. However, Black male workers, construction/manufacturing sector workers, and blue-collar and service workers have the highest cotinine levels. Further reductions in SHS exposure will require widespread adoption of workplace clean air laws without exemptions.

©2008The American College of Occupational and Environmental Medicine


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