Different aspects of the environmental tobacco smoke (ETS) exposure of children in Germany have been investigated in the German Environmental Survey for Children (GerES IV). The field work of GerES IV was conducted from 2003 to 2006 using questionnaires, indoor air monitoring and human biomonitoring. About half of Germany's 3- to 14-year-old children lived in households with at least one smoker. The number of smokers in the household had a significant influence on the concentrations of several indoor air contaminants (VOC and aldehydes). Human biomonitoring data on cotinine were used to identify the levels of exposure to ETS. Urinary cotinine is correlated with several predictors of ETS and is also associated with other toxicants in non-smoking children, e.g. cadmium. Temporal comparison indicated that in the last 15 years no decrease of children's ETS exposure has been achieved in Germany.
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