Carboxyhemoglobin Levels Induced by Cigarette Smoking Outdoors in Smokers.

Content Provider	Europe PMC
Author	Schimmel, Jonathan George, Naomi Schwarz, John Yousif, Sami Suner, Selim Hack, Jason B.
Abstract	Introduction Non-invasive screening of carboxyhemoglobin saturation (SpCO) in the emergency department to detect occult exposure is increasingly common. The SpCO threshold to consider exposure in smokers is up to 9%. The literature supporting this cutoff is inadequate, and the impact of active smoking on SpCO saturation remains unclear. The primary objective was to characterize baseline SpCO in a cohort of smokers outdoors. Secondary objectives were to explore the impact of active smoking on SpCO and to compare SpCO between smokers and non-smokers. Methods This was a prospective cohort pilot study in two outdoor urban public areas in the USA, in a convenience sample of adult smokers. SpCO saturations were assessed non-invasively before, during, and 2 min after cigarette smoking with pulse CO-oximetry. Analyses included descriptive statistics, correlations, and a generalized estimating equation model. Results Eighty-five smokers had mean baseline SpCO of 2.7% (SD 2.6) and peak of 3.1% (SD 2.9), while 15 controls had SpCO 1.3% (SD 1.3). This was a significant difference. Time since last cigarette was associated with baseline SpCO, and active smoking increased mean SpCO. There was correlation among individual smokers’ SpCO levels before, during, and 2 min after smoking, indicating smokers tended to maintain their baseline SpCO level. Conclusions This study is the first to measure SpCO during active smoking in an uncontrolled environment. It suggests 80% of smokers have SpCO ≤ 5%, but potentially lends support for the current 9% as a threshold, depending on clinical context.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC6013732&blobtype=pdf
ISSN	15569039
Volume Number	14
DOI	10.1007/s13181-017-0645-1
PubMed Central reference number	PMC6013732
Issue Number	1
PubMed reference number	29285649
Journal	Journal of Medical Toxicology [J Med Toxicol]
e-ISSN	19376995
Language	English
Publisher	Springer US
Publisher Date	2017-12-28
Publisher Place	New York
Access Restriction	Open
Rights License	© American College of Medical Toxicology 2017
Subject Keyword	Carbon monoxide SpCO Carboxyhemoglobin Smoking Cigarette
Content Type	Text
Resource Type	Article
Subject	Health, Toxicology and Mutagenesis Toxicology