OBJECTIVES : Smoking is associated with numerous health risks, including an increase in volatile organic compound (VOC) metabolites, which are detectable via urine analysis. This study seeks to characterize homes in which pediatric (<18 years) individuals in the United States (US) are exposed to tobacco smoke and to determine if the urinary VOC metabolite of Acrylonitrile, N-Acetyl-S-(2-cyanoethyl)-L-cysteine (CYMA) is more common in samples taken from those living in a household with indoor smoke exposure.

METHODS : This analysis utilized the US National Health and Nutrition Examination Survey (NHANES) for 2015-2016. Pediatric participants included in the VOC metabolite urine analysis, dietary interview, and demographic interview were eligible for inclusion in this study. Descriptive statistics were collected to characterize households with smokers and to identify variables potentially related to CYMA levels. An adjusted, weighted logistic regression was developed to determine if having a urinary VOC metabolite of Acrylonitrile in the highest quartile of measured respondents (urinary CYMA level ≥ 3.18 ng/mL) was associated with indoor smoke exposure at home.

RESULTS : 249 pediatric participants were included in the analysis, 30.12% of whom reported living in a home where at least one person smoked indoors. The measured CYMA levels ranged from 0.354-115.00. Socioeconomic status, including poverty level and size of home, were not statistically significant predictors of whether someone was smoking within the home. Pediatric participants in the highest quartile of measured urinary CYMA levels were more likely to live in a household with someone who smoked inside (adjusted-OR: 5.29, 95% CI: 1.93-14.47).

CONCLUSIONS : Past research indicates long-term exposure to Acrylonitrile is associated with reduced health outcomes. In this study, individuals in the highest quartile of measured CYMA levels were significantly more likely to live with someone who smoked indoors. Pediatric individuals in the US are exposed to increased health risks when smoking occurs within the home.