Institutional members access full text with Ovid®

Share this article on:

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

Journal of Occupational and Environmental Medicine: January 2008 - Volume 50 - Issue 1 - p 57-63
doi: 10.1097/JOM.0b013e318158a486
Original Articles

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.

From the Department of Epidemiology and Public Health (Drs Arheart, Lee, Dietz, Wilkinson, LeBlanc, and Fleming and Mr Clark); Sylvester Comprehensive Cancer Center (Drs Lee, Dietz, Wilkinson, and Fleming), University of Miami Miller School of Medicine; and School of Public Health (Dr Serdar), Florida International University, Miami, Fla.

Address correspondence to: Lora E. Fleming, MD, PhD, Department of Epidemiology and Public Health, University of Miami School of Medicine, P.O. Box 016069 (R-669), Miami, FL 33101; E-mail:

©2008The American College of Occupational and Environmental Medicine