Tobacco Smoke is a Major Source of Aromatic Amine Exposure in U.S. Adults: 2013-2014 National Health and Nutrition Examination Survey (NHANES)

Cigarette smoking increases the risk of cancer, cardiovascular diseases, and premature death. Aromatic amines (AAs) are found in cigarette smoke and are well-established human bladder carcinogens. We measured and compared total urinary levels of 1-aminonaphthalene (1AMN), 2-aminonaphthalene (2AMN), and 4-aminobiphenyl (4ABP) in adults who smoked cigarettes exclusively and in adult nonusers of tobacco products from a nationally representative sample of non-institutionalized U.S. population in the 2013-2014 National Health and Nutrition Examination Survey. Sample-weighted geometric mean concentrations of AAs in adults who smoked cigarettes exclusively compared to adult nonusers were 30 times higher for 1AMN and 4-6 times higher for 2AMN and 4ABP. We evaluated the association of tobacco-smoke exposure with urinary AAs using sample-weighted multiple linear regression models to control for age, sex, race/ethnicity, diet, and urinary creatinine. Secondhand smoke exposure status was categorized using serum cotinine (SCOT) among adult nonusers (SCOT≤10 ng/mL). The exposure for adults who smoked cigarettes exclusively (SCOT>10 ng/mL) was categorized based on the average number of self-reported cigarettes smoked per day (CPD) in the five days prior to urine collection. The regression models show AAs concentration increased with increasing CPD (p