广西南宁市成人尿液中可替宁和NNAL总量摄入情况分析

Analysis on the total intake of cotinine and NNAL in adult urine in Nanning, Guangxi

目的了解广西南宁市成年人可替宁和NNAL总量摄入情况,为制定相关控烟措施提供参考。方法在广西南宁市随机选择200户家庭,根据自述的烟草暴露情况分成吸烟组和非吸烟组各100户,对调查户中丈夫和妻子进行问卷调查和尿样检测,分析体内的可替宁和4-(甲基亚硝胺)-1-(3-吡啶基)-1-丙醇(NNAL)总量。结果共调查386人,尿液可替宁、NNAL总量水平之间存在正相关(r=0.697,P<0.05),它们检测浓度的平均值分别为3.20 ng/mL和0.010 pmol/mL,检出率分别为97.41%和72.02%。不同吸烟状况的NNAL总量检出率差异有统计学意义(P<0.05),现在吸烟者可替宁和NNAL总量检出浓度平均值远高于未吸烟、曾经吸烟者(P值均<0.05),每日不同吸烟量的吸烟者可替宁、NNAL总量检出浓度平均值差异均有统计学意义(P<0.05),男性NNAL总量检出率高于女性(P<0.05),男性可替宁和NNAL总量检出浓度平均值远高于女性(P<0.05)。丈夫吸烟的女性可替宁、NNAL总量检出率以及检出浓度平均值分别高于丈夫不吸烟的女性(P<0.05)。农村居民NNAL总量检出率和可替宁、NNAL总量检出浓度平均值分别高于城市居民(P<0.05)。不同教育程度NNAL总量检出率差异有统计学意义(P<0.05)。不同的朋友中吸烟者数量类型NNAL总量检出率和可替宁、NNAL总量检出浓度平均值差异均有统计学意义(P<0.05)。工作场所不限烟的NNAL总量检出率和可替宁、NNAL总量检出浓度平均值均高于工作场所限烟(P<0.05)。多因素分析结果显示,现在吸烟、丈夫吸烟和工作场所不限烟是尿液中检出NNAL总量的危险因素。结论大部分受调查者处于直接或间接的烟草烟雾暴露之中,对生命健康造成潜在威胁。应进一步强化公共场所禁烟措施,提高公众对烟草暴露危险程度的认知,有效减少二手烟、三手烟的危害。

Objective To investigate the total intake of cotinine and NNAL for adults in Nanning,Guangxi,providing the reference for the formulation of relevant measures on tobacco control.Methods Two hundred households were selected in Nanning,Guangxi,and they were divided into either a smoking group or a nonsmoking group with 100 households in each,according to their self-reported tobacco exposure.Questionnaire and urine sample test were performed on the husband and wife in the household in order to analyze the total amount of cotinine and 4-(methylnitrosamine)-1-(3-pyridyl)-1-butanol(NNAL).Results In total,386 person were investigated.There was a positive correlation between the urine cotinine and the total NNAL(r=0.697,P<0.05).The median of the concentrations of cotinine and NNAL in urine were 3.20 ng/ml and 0.010 pmol/ml,and the detection rate were 97.41%and 72.02%,respectively.The detection rate of total NNAL with different smoking status was statistically significant(P<0.05).The average detected concentrations of cotinine and total NNAL for current smokers was much higher than non-smokers and former smokers(P<0.05).There was a statistically significant difference in the average levels of cotinine and total NNAL detected in smokers with different amounts of smoking per day(P<0.05).The total detection rate of NNAL in men was much higher than women(P<0.05),and the average of the total detected concentrations of cotinine and NNAL in men was much higher than women(P<0.05).Women whose husbands were smokers had higher detection rates and average detected concentrations of cotinine and NNAL than females whose husbands were not smokers(P<0.05).The total detection rate of NNAL and the average detected concentrations of cotinine and NNAL in rural residents were higher than urban residents(P<0.05).There was a statistically significant difference in the total detection rate of NNAL with different education levels(P<0.05).There were statistically significant differences in the total detection rate of NNAL and the average detected concentrations of cotinine and total NNAL with different numbers and different types of smokers among their friends(P<0.05).The total detection rate of NNAL and the average detected concentrations of cotinine and NNAL in the workplace without smoking restriction were higher than the workplace with smoking restriction(P<0.05).The multivariate analysis showed that current smokers,husbands were smokers,and workplace without smoking restriction were the risk factors for the total amount of NNAL detected in urine.Conclusions Most of the respondents were exposed to direct or indirect tobacco smoke,which posed a potential threat to life and health.It is necessary to strengthen anti-smoking measures in public places,improve public awareness on the risk of exposure to tobacco,and effectively reduce the harm of second-hand smoke and third-hand smoke.