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Updated: Mar 11, 2026
Breath Collection from Children for Disease Biomarker Discovery
Published on: February 14, 2019
Detecting biomarkers of secondhand marijuana smoke in young children
Karen M Wilson1,2, Michelle R Torok2,3, Binnian Wei4
1Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York.
Insights
Secondhand marijuana smoke exposure was detected in 16% of young children hospitalized with bronchiolitis. Exposure was more common in non-white children and those with tobacco smoke exposure.
Area of Science:
- Environmental Health
- Pediatrics
- Toxicology
Background:
- The health effects of secondhand marijuana smoke on children remain largely unknown.
- Advancements in analytical methods now permit the detection of secondhand marijuana smoke exposure in pediatric populations.
Purpose of the Study:
- To investigate the prevalence of secondhand marijuana smoke exposure in children hospitalized with bronchiolitis.
- To identify potential demographic or exposure correlates of marijuana smoke exposure in this cohort.
Main Methods:
- A cohort of 43 children aged 1 month to 2 years hospitalized with bronchiolitis in Colorado (2013-2015) was studied.
- Urine samples were analyzed for cotinine and marijuana metabolites, specifically COOH-THC, using liquid chromatography-tandem mass spectrometry (LC/MS/MS).
- Parental surveys were administered to gather additional exposure information.
Main Results:
- Carboxy-THC (COOH-THC), a marijuana metabolite, was detected in 16% of the analyzed urine samples.
- Children identified as non-white exhibited higher rates of exposure compared to white children (44% vs. 9%, P < 0.05).
- A significant association was observed between detectable COOH-THC and higher cotinine levels, indicating concurrent tobacco smoke exposure (56% vs. 7%, P < 0.01).
Conclusions:
- Metabolites of marijuana smoke are detectable in children, with 16% of this cohort showing evidence of exposure.
- Detectable COOH-THC was more prevalent in children with co-existing exposure to tobacco smoke.
- Further research is crucial to elucidate the health consequences of marijuana smoke exposure in children and to guide public health strategies.
Background:
The impact of secondhand marijuana smoke exposure on children is unknown. New methods allow detection of secondhand marijuana smoke in children.
Methods:
We studied children ages 1 mo to 2 y hospitalized with bronchiolitis in Colorado from 2013 to 2015. Parents completed a survey, and urine samples were analyzed for cotinine using LC/MS/MS (limits of detection 0.03 ng/ml) and marijuana metabolites including COOH-THC (limits of detection 0.015 ng/ml).
Results:
A total of 43 subjects had urine samples available for analysis. Most (77%) of the subjects were male, and 52% were less than 1 y of age. COOH-THC was detectable in 16% of the samples analyzed (THC+); the range in COOH-THC concentration was 0.03-1.5 ng/ml. Two subjects had levels >1 ng/ml. Exposure did not differ by gender or age. Non-white children had more exposure than white children (44 vs. 9%; P < 0.05). 56% of children with cotinine >2.0 ng/ml were THC+, compared with 7% of those with lower cotinine (P < 0.01).
Conclusion:
Metabolites of marijuana smoke can be detected in children; in this cohort, 16% were exposed. Detectable COOH-THC is more common in children with tobacco smoke exposure. More research is needed to assess the health impacts of marijuana smoke exposure on children and inform public health policy.
