The contribution of secondhand tobacco smoke to blood lead levels in US children and adolescents: a cross-sectional analysis of NHANES 2015-2018. Academic Article uri icon


  • BACKGROUND: Lead is a major developmental neurotoxicant in children, and tobacco smoke has been suggested as a source of lead exposure in vulnerable populations. This study evaluates the contribution of secondhand tobacco smoke (SHS) to blood lead levels (BLLs) in children and adolescents. METHODS: We analyze data from 2,815 participants aged 6-19years who participated in the National Health and Nutrition Examination Survey (2015-2018) to investigate the association between serum cotinine levels and BLLs. A multivariate linear regression was conducted to estimate geometric means (GMs) and the ratios of GMs after adjusting for all covariates. RESULTS: The geometric means of BLLs in study participants aged 6-19years were 0.46g/dl (95% CI 0.44, 0.49). After adjusting for relevant participant characteristics, the geometric means of BLLs were 18% (BLL 0.48g/dl, 95% CI 0.45, 0.51) and 29% (BLL 0.52g/dl, 95% CI 0.46, 0.59) higher in participants who had intermediate serum cotinine levels (0.03-3ng/mL) and those who had high serum cotinine levels (>3ng/mL) respectively, compared to participants who had low serum cotinine levels (BLL 0.41g/dl, 95% CI 0.38, 0.43). CONCLUSIONS: SHS exposure may be a source of BLLs in US children and adolescents. Efforts to reduce lead exposure in children and adolescents should include strategies to reduce SHS exposure.

published proceedings

  • BMC Public Health

author list (cited authors)

  • Obeng, A., Roh, T., Aggarwal, A., Uyasmasi, K., & Carrillo, G.

complete list of authors

  • Obeng, Alexander||Roh, Taehyun||Aggarwal, Anisha||Uyasmasi, Kido||Carrillo, Genny

publication date

  • June 2023