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Associations between urinary cotinine and symptoms of attention deficit/hyperactivity disorder and autism spectrum disorder

Kim, Kyoung Min, Lim, Myung Ho, Kwon, Ho-Jang, Yoo, Seung-Jin, Kim, Eun-jung, Kim, Jun Won, Ha, Mina, Paik, Ki Chung
Environmental research 2018 v.166 pp. 481-486
autism, biomarkers, children, cognition, cotinine, inhalation exposure, odds ratio, questionnaires, screening, second hand smoke
The present study investigated associations between urinary cotinine levels as a biomarker of secondhand smoke exposure and symptoms of attention deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD).A total of 520 child participants (200 with ADHD, 67 with ASD, and 253 normal control subjects) were assessed using the Korean version of the ADHD rating scale (K-ARS), Autism spectrum screening questionnaire (ASSQ), and Behavioral Assessment System for Children, second edition (BASC-2). The Korean version of the computer-based continuous performance test was used to assess cognitive function. Urinary cotinine was evaluated as a biomarker of secondhand smoke exposure.Urinary cotinine levels were significantly and positively associated with K-ARS score (B = 4.00, p < 0.001), ASSQ score (B = 1.71, p = 0.030), the behavioral problem subscales of the BASC-2 (B = 1.68–3.52, p < 0.001–0.045), and omission and commission errors in the continuous performance test (B = 6.21–8.42, p < 0.001–0.019). Urinary cotinine levels were also associated with the increased odds ratio of ADHD (OR = 1.55, 95% CI 1.05–2.30, p = 0.028) and ASD (OR = 1.89, 95% CI 1.12–3.21, p = 0.018).Urinary cotinine levels were associated with lower behavioral adaptation and cognitive function and increased odds ratios of ADHD and ASD, indicating a negative effect of secondhand smoke exposure on the symptomatic manifestation of ADHD and ASD.