Active and passive smoking and blood lead levels in U.S. adults: Data from the Third National Health and Nutrition Examination Survey

Abstract

Lead is a component of tobacco and tobacco smoke. We examined the relationship between current, former, and passive smoking and blood lead levels in a nationally representative sample of 16,458 U.S. adults, aged 17 years or older, who participated in the Third National Health and Nutrition Examination Survey (1988–1994). We used linear and logistic regression modeling, adjusting for known covariates, to determine the relationship between smoking and blood lead levels. Geometric mean blood lead levels were 1.8 μg/dl, 2.1 μg/dl, and 2.3 μg/dl in never-smokers with no, low, and high cotinine levels, respectively. Levels were 2.9 μg/dl in former smokers and 3.5 μg/dl in current smokers. The adjusted linear regression model showed that geometric mean blood lead levels were 30% higher (95% CI=24%–36%) in adults with high cotinine levels than they were in those with no detectable cotinine. Active and passive smoking is associated with increased blood lead levels in U.S. adults.