Exposure to environmental tobacco smoke and children health.

This paper reviews the investigations of the effects of pre- and/or postnatal exposure to environmental tobacco smoke (ETS) on children health reported in the literature. The evidence from epidemiological studies demonstrate that children's exposure to ETS is a risk factor for a variety of diseases, including respiratory disorders and middle ear disease. However, the current research base on the ETS-associated risks is still inadequate to fully support strategies, programs and policy development in this area. For example, it is not definitively determined what methods should be used for assessing ETS exposure and predicting potential health risks of exposed children. Based on the available data, we tried to find out which methods seem to be most desirable for quantifying ETS exposure in children. It is our opinion that among all biomarkers, the measurements of blood, saliva or urinary cotinine and hair nicotine are, as for today, the most specific and sensitive methods for an objective assessment of ETS exposure in children. A combination of the measurement of body fluids cotinine and hair nicotine with the questionnaire and interview-derived information seems to be the optimal method for assessing ETS exposure in children.