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38 µg/g creatinine). Compared to unexposed individuals (serum cotinine ≤0.015 ng/ml) and controlling for confounders, presumptive second-hand tobacco smoke exposure (serum cotinine 0.015 to ≤10 ng/ml and 0 cigarettes per day, CPD) was significantly associated with 36% higher 2CYEMA levels (p 0.0001). Smoking 1-10 CPD was significantly associated with 6720% higher 2CYEMA levels (p 0.0001). We show that tobacco smoke is an important source of acrylonitrile exposure in the US population and provide important biomonitoring data