Background: Environmental tobacco smoke (ETS) can cause or exacerbate awide range of adverse health effects, including cancer, respiratory infections and cardiovascular disease (CVD). There is limited and inconsistent evidence of an
association between ETS exposure and inflammatory markers. Aim of the work: To examine the relationship of ETS exposure measured by urinary cotinine level with systemic inflammatory markers that included high-sensitive C reactive protein (hs-CRP), homocysteine, inter-leukin-6 (IL-6), and fibrinogen among non-smoker nurses. Subjects and methods: A cross-sectional study was conducted to study one hundred and forty eight non-smoker nurses at Shebin Al-Kom Teaching hospital.Participants were interviewed and a urine sample for quantitative determination of urinary cotinine level was collected. A blood sample was withdrawn for measuring hs-CRP, homocysteine, IL-6 and fibrinogen levels. Results: With increasing urinary cotinine level, hs-CRP, homocysteine, fibrinogen and IL-6 levels increased, reaching a
significant level for hs-CRP and homocysteine not the others. Multivariate regression analysis after adjusting for age, education, BMI and duration of employment, revealed that nurses with ETS exposure had a significant higher levels of hs-CRP, fibrinogen and homocysteine. Summary and recommendations: Regular and repetitive exposure to ETS leads to relevant effects on inflammatory system rather than cytokine system.Longitudinal studies are necessary to determine the potential causal relevance of this association and to test the clinical important effect on susceptibility to inflammatory
disease.