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8.A. - Page 32 TABLE 1 Demographic Characteristics of the Sample Variable Weighted % Geometric Mean of Cotinine P (n = 5002) (95% Confidence Interval) Housing type <.001 Detached house 81 0.031 (0.026-0.038) Attached house 7 0.053 (0.035-0.079) Apartment 12 0.075 (0.062-0.091) Gender .037 Male 52 0.039 (0.031-0.048) Female 48 0.033 (0.028-0.040) Age .014 <12y 53 0.040 (0.033-0.048) >-12 y 45 0.032 (0.026-0.039) Race/ethnicity <.001 Black 14 0.105 (0.090-0.122) Hispanic 21 0.026 (0.022-0.031) White 59 0.031 (0.025-0.040) Other 6 0.033 (0.020-0.0501) Federal poverty -level ratio <.001 <--100 18 0.085 (0.068-0.105) 101-200 21 0.054 (0.041-0.072) >200-300 18 0.031 (0.023-0.043) >300-400 15 0.028 (0.021-0.036) >400 28 0.020 (0.016-0.025) im-. . Type of housing: go - Q Detached house © Attached house 20 " Q Apastmeffi X2.0 FIGURE 1 Percentage of children who are unexposed by housing type and cotinine cutoff. The y-axis shows the proportion of children who are unexposed at 3 different cotinine cutoff levels. These levels, displayed on the x-axis, are <0.015, <0.05, <1, and <2 ng/mL cotinine. Thetypes of bars for each of the different housing types: detached house, attached house, and apartment. race/ethnicity (Table 2). The highest level of exposure was found in white children who were living in apart- ments (99%), followed by black chil- dren who were living in apartments (96%); Hispanic and other race/ethnic groups had much lower levels of expo- sure (73% and 64%, respectively; P < .001). Black children who were living in attached houses had exposure rates similar to those who were living in apartments (92%), whereas the rates were much lower for white (76%), His- panic (70%), and other (80%) children (P< .05). Black children who were liv- ing in detached houses also had higher rates of exposure (89%) than white (68%), Hispanic (66%), and other (74%) children (P < .001). When we performed a stratified analysis of chil- dren in the wealthiest category (those more than or equal to 4 times the fed - eral poverty level), we found that the relationship between exposure and multiunit housing persisted (data not shown). In the unadjusted Tobit regression model, with the natural log of cotinine as the dependent variable, the percentage increase in cotinine levels for children who were living in apartments com- pared with children who were living in detached homes was 140% (95% confi- dence interval: 87-301); for children liv- ing in attached homes compared with those living in detached homes, the per- centage increase was 69% (95% confi- dence interval: 21-135). In the Tobit model adjusted for age, gender, and fed- eral poverty -level ratio, including race/ ethnicity and housing -type interactions (Table 3), white children who were liv- ing in apartments had a 212% increase in cotinine levels over those who were living in detached houses (P = .003); black children who were living in apartments had a 46% increase (P < .05) in cotinine levels. Differences for other race/ethnic categories were not significant. DISCUSSION The majority of US children who live in homes where no one smokes inside have biochemical evidence of tobacco - smoke exposure, and cotinine levels are significantly higher in children who live in apartments, compared with those who live in detached houses. Al- though it is likely that some of this ex- cess exposure is from family members who smoke only outside of the home but carry in tobacco residue on their clothes, this is unlikely to explain all of the discrepancy. In addition, our data are consistent with the findings from Kraev et al,27 which showed that 89% of low-income apartments with no smokers had detectable air nico- tine concentrations. The finding that children are at riskfor tobacco -smoke exposure in apart - 88 WILSON et al Downloaded from www.pediatrics.org. Provided by San Mateo Medical Center on December 13, 2010