International Journal of Preventive Medicine (Int J Prev Med)2008-7802922018021318811881ENDepartment of Family Medicine, Jeju National University Hospital & Department of Medicine, Graduate School of Jeju National University, Jeju Self‑governing ProvinceDepartment of Family Medicine, Jeju National University Hospital & Department of Family Medicine, School of Medicine, Jeju National University, Jeju Self‑governing ProvinceDepartment of Family Medicine, Jeju National University Hospital & Department of Family Medicine, School of Medicine, Jeju National University, Jeju Self‑governing Province20180213<p><span class="fontstyle0"><strong>Background</strong>: </span><span class="fontstyle2">We evaluated the relationship between secondhand smoke (SHS) inhalation, as verifed by urinary cotinine levels, and bone health. </span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">We analyzed the nationwide, population‑based, cross‑sectional health survey. We included 1936 men aged 50 years or older who checked bone mineral density (BMD) from the Korean National Health and Nutrition Examination Survey (2008–2010). Current smokers assessed by urinary cotinine levels higher than 500 ng/mL were excluded (</span><span class="fontstyle3">n </span><span class="fontstyle2">= 616). Exposure to SHS was determined using a 50 ng/mL urinary cotinine threshold.<br /></span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">The estimated prevalence of SHS exposure in our cohort was 13.9%. After adjusting for age and body mass index (BMI), T‑scores at total femur (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001), femoral neck (</span><span class="fontstyle3">P </span><span class="fontstyle2">&lt; 0.001), and lumbar spine (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.004) were lower in SHS exposure versus nonexposure groups. Impaired bone health (osteopenia or osteoporosis) at femoral neck or lumbar spine was evident in 61.7% and 48.6% of SHS exposure and nonexposure cases, respectively (</span><span class="fontstyle3">P </span><span class="fontstyle2">= 0.004). Moreover, after adjusting for age, BMI, and health habits, the odds ratio for impaired bone health in the SHS exposure group was 1.89 (95% confdence interval: 1.31–2.74). </span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Our fndings suggest that SHS exposure, determined by urinary cotinine levels, is negatively associated with BMD and is a leading cause of impaired bone health in Korean men.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Biomarker, bone density, cotinine, tobacco smoke pollution</span> </p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/1881http://ijpm.mui.ac.ir/index.php/ijpm/article/download/1881/2164