Assessment of risk for asthma initiation and cancer and heart disease deaths among patrons and servers due to secondhand smoke exposure in restaurants and bars.

BACKGROUND: Despite efforts to reduce exposure to secondhand smoke (SHS), only 5% of the world's population enjoy smoke-free restaurants and bars. METHODS: Lifetime excess risk (LER) of cancer death, ischaemic heart disease (IHD) death and asthma initiation among non-smoking restaurant and bar servers and patrons in Minnesota and the US were estimated using weighted field measurements of SHS constituents in Minnesota, existing data on tobacco use and multiple dose-response models. RESULTS: A continuous approach estimated a LER of lung cancer death (LCD) of 18 × 10(-6)(95% CI 13 to 23 × 10(-6)) for patrons visiting only designated non-smoking sections, 80 × 10(-6)(95% CI 66 to 95 × 10(-6)) for patrons visiting only smoking venues/sections and 802 × 10(-6)(95% CI 658 to 936 × 10(-6)) for servers in smoking-permitted venues. An attributable-risk (exposed/non-exposed) approach estimated a similar LER of LCD, a LER of IHD death about 10(-2) for non-smokers with average SHS exposure from all sources and a LER of asthma initiation about 5% for servers with SHS exposure at work only. These risks correspond to 214 LCDs and 3001 IHD deaths among the general non-smoking population and 1420 new asthma cases among non-smoking servers in the US each year due to SHS exposure in restaurants and bars alone. CONCLUSIONS: Health risks for patrons and servers from SHS exposure in restaurants and bars alone are well above the acceptable level. Restaurants and bars should be a priority for governments' effort to create smoke-free environments and should not be exempt from smoking bans.

Secondhand smoke exposure in the nonsmoking section: how much protection?

INTRODUCTION: Secondhand smoke (SHS) exposure continues to be a problem in bars and restaurants where smoking is permitted. This study measures the relative SHS exposure reduction in nonsmoking sections of establishments that allow some smoking. METHODS: Measurements were conducted simultaneously in the smoking and nonsmoking sections of 14 Minnesota hospitality venues. All of the 16 two-hr visits included photometer measurements of fine particles (PM2.5) and 12 of the visits also included measurements of 4 gas-phase tracers of SHS. RESULTS: The median ratio of nonsmoking/smoking section PM2.5 concentrations was 0.65 with an interquartile range (IQR) of 0.49-0.72. Measurements conducted after implementation of a smoking ban at 13 of the venues resulted in a smoking section PM2.5 post-ban/pre-ban ratio of 0.06 (IQR = 0.02-0.16). The median nonsmoking/smoking section ratios for gas-phase compound were 0.67 (IQR = 0.35-0.78) for pyridine, 0.52 (IQR = 0.30-0.70) for pyrrole, 0.43 (IQR = 0.35-0.84) for 3-EP, and 0.27 (IQR = 0.16-0.47) for nicotine. These results are consistent with the expectations of differential removal: the lowest ratios are for the least volatile, most strongly sorbing gases and the highest ratios for less sorbing gases and PM2.5. CONCLUSIONS: Designated nonsmoking sections in establishments that allow some smoking resulted in a median PM2.5 reduction of 35% compared with a 94% reduction after a smoking ban. The only adequate protection from cigarette smoke exposure is to eliminate smoking in indoor spaces.

Indoor particle levels in small- and medium-sized commercial buildings in California.

This study monitored indoor and outdoor particle concentrations in 37 small and medium commercial buildings (SMCBs) in California with three buildings sampled on two occasions, resulting in 40 sampling days. Sampled buildings included offices, retail establishments, restaurants, dental offices, and hair salons, among others. Continuous measurements were made for both ultrafine and fine particulate matter as well as black carbon inside and outside of the building. Integrated PM(2.5), PM(2.5-10), and PM(10) samples were also collected inside and outside the building. The majority of the buildings had indoor/outdoor (I/O) particle concentration ratios less than 1.0, indicating that contributions from indoor sources are less than removal of outdoor particles. However, some of the buildings had I/O ratios greater than 1, indicating significant indoor particle sources. This was particularly true of restaurants, hair salons, and dental offices. The infiltration factor was estimated from a regression analysis of indoor and outdoor concentrations for each particle size fraction, finding lower values for ultrafine and coarse particles than for submicrometer particles, as expected. The I/O ratio of black carbon was used as a relative measure of the infiltration factor of particles among buildings, with a geometric mean of 0.62. The contribution of indoor sources to indoor particle levels was estimated for each building.

Volatile organic compounds in small- and medium-sized commercial buildings in California.

While small- and medium-sized commercial buildings (SMCBs) make up 96% of the commercial buildings in the U.S., serving a large variety of uses, little information is available on indoor air quality (IAQ) in SMCBs. This study investigated 37 SMCBs distributed across different sizes, ages, uses, and regions of California. We report indoor concentrations and whole building emission rates of a suite of 30 VOCs and aldehydes in these buildings. There was a considerable range in the concentrations for each of the contaminants, especially for formaldehyde, acetaldehyde, decamethylcyclopentasiloxane, d-limonene, 2-butoxyethanol, toluene, 2,2,4-trimethylpentanediol diisobutyrate, and diethylphthalate. The cause of higher concentrations in some building categories generally corresponded to expected sources, for example, chloroform was higher in restaurants and grocery stores, and formaldehyde was higher in retail stores and offices. Factor analysis suggests sources in SMCBs include automobile/traffic, cleaning products, occupant sources, wood products/coating, and plasticizers. The comparison to health guidelines showed that formaldehyde concentrations were above the chronic RELs required by the OEHHA (9 µg/m³) in 86% of the buildings. Data collected in this study begins to fill the knowledge gap for IAQ in SMCBs and helps us understand the indoor sources of VOCs to further improve indoor air quality in SMCBs.

Effect of temperature and humidity on formaldehyde emissions in temporary housing units.

The effect of temperature and humidity on formaldehyde emissions from samples collected from temporary housing units (THUs) was studied. The THUs were supplied by the U.S. Federal Emergency Management Administration (FEMA) to families that lost their homes in Louisiana and Mississippi during the Hurricane Katrina and Rita disasters. On the basis of a previous study, four of the composite wood surface materials that dominated contributions to indoor formaldehyde were selected to analyze the effects of temperature and humidity on the emission factors. Humidity equilibration experiments were carried out on two of the samples to determine how long the samples take to equilibrate with the surrounding environmental conditions. Small chamber experiments were then conducted to measure emission factors for the four surface materials at various temperature and humidity conditions. The samples were analyzed for formaldehyde via high-performance liquid chromatography. The experiments showed that increases in temperature or humidity contributed to an increase in emission factors. A linear regression model was built using the natural log of the percent relative humidity (RH) and inverse of temperature (in K) as independent variables and the natural log of emission factors as the dependent variable. The coefficients for the inverse of temperature and log RH with log emission factor were found to be statistically significant for all of the samples at the 95% confidence level. This study should assist in retrospectively estimating indoor formaldehyde exposure of occupants of THUs.

Change in indoor particle levels after a smoking ban in Minnesota bars and restaurants.

BACKGROUND: Smoking bans in bars and restaurants have been shown to improve worker health and reduce hospital admissions for acute myocardial infarction. Several studies have also reported improved indoor air quality, although these studies generally used single visits before and after a ban for a convenience sample of venues. PURPOSE: The primary objective of this study was to provide detailed time-of-day and day-of-week secondhand smoke-exposure data for representative bars and restaurants in Minnesota. METHODS: This study improved on previous approaches by using a statistically representative sample of three venue types (drinking places, limited-service restaurants, and full-service restaurants), conducting repeat visits to the same venue prior to the ban, and matching the day of week and time of day for the before- and after-ban monitoring. The repeat visits included laser photometer fine particulate (PM2.5) concentration measurements, lit cigarette counts, and customer counts for 19 drinking places, eight limited-service restaurants, and 35 full-service restaurants in the Minneapolis/St. Paul metropolitan area. The more rigorous design of this study provides improved confidence in the findings and reduces the likelihood of systematic bias. RESULTS: The median reduction in PM2.5 was greater than 95% for all three venue types. Examination of data from repeated visits shows that making only one pre-ban visit to each venue would greatly increase the range of computed percentage reductions and lower the statistical power of pre-post tests. Variations in PM2.5 concentrations were found based on time of day and day of week when monitoring occurred. CONCLUSIONS: These comprehensive measurements confirm that smoking bans provide significant reductions in SHS constituents, protecting customers and workers from PM2.5 in bars and restaurants.

Unattached radon progeny as an experimental tool for dosimetry of nanoaerosols: proposed method and research strategy.

In this paper the authors discuss a method using 1-nm particulate radon decay products as an experimental tool in the study of local lung deposition and dosimetry for nanoaerosols. The study of aerosol exposure and dosimetry measurements, and related quantitative assessment of health effects, are important to the understanding of the consequences of air pollution, and are discussed widely in the scientific literature. During the last 10 years the need to correlate aerosol exposure and biological effects has become especially important due to rapid development of a new, revolutionary industry--nanotechnology. Quantitative assessment of aerosol particle behavior in air, in lung deposition, and dosimetry in different parts of the lung, particularly for nanoaerosols, remains poor despite several decades of study. Direct nanoparticle dose measurements on humans are still needed in order to validate the hollow cast, animal studies, and lung deposition modeling. The issue of the safe use of radon progeny in such measurements is discussed. One of the properties of radon progeny is that they consist partly of 1-nm radioactive particles called unattached activity; having extremely small size and high diffusion coefficients, these particles can be potentially useful as radioactive tracers in the study of nanometer-sized aerosols.

Formaldehyde and other volatile organic chemical emissions in four FEMA temporary housing units.

Indoor concentrations of 33 volatile organic chemicals were measured in four unoccupied temporary housing units (THUs) belonging to the U.S. Federal Emergency Management Administration (FEMA). The highest level contaminants in the THUs include formaldehyde, acetic acid, and 2,2,4-trimethyl-1,3-pentanediol diisobutyrate (TXIB) with median concentrations of 440, 425, and 36 ppb, respectively. A number of volatile organic compounds (VOCs) were higher than published concentrations in other dwellings, but whole THU emission factors for most chemicals were either lower than or similar to values reported for newly constructed homes. However, several chemicals exceeded previously measured new building emission rates by over a factor of 5. Materials were collected from the THUs, and emission factors were determined using small chambers to identify the potential source of indoor contaminants. The individual materials were grouped by material type, and emissions were used to derive exposure concentrations for comparison to reference values. Using material loading factors and ventilation rates that are relevant to the trailers, all of the material types we tested had at least two chemicals (formaldehyde and nonanal) with derived concentrations in excess of chronic reference exposure levels or odor thresholds. The extensive use of composite wood products, sealants, and vinyl coverings, combined with the low air exchange rates relative to material surface areas, may explain the high concentrations of some VOCs and formaldehyde.

Mucous membrane and lower respiratory building related symptoms in relation to indoor carbon dioxide concentrations in the 100-building BASE dataset.

UNLABELLED: Indoor air pollutants are a potential cause of building related symptoms and can be reduced by increasing ventilation rates. Indoor carbon dioxide (CO(2)) concentration is an approximate surrogate for concentrations of occupant-generated pollutants and for ventilation rate per occupant. Using the US EPA 100 office-building BASE Study dataset, we conducted multivariate logistic regression analyses to quantify the relationship between indoor CO(2) concentrations (dCO(2)) and mucous membrane (MM) and lower respiratory system (LResp) building related symptoms, adjusting for age, sex, smoking status, presence of carpet in workspace, thermal exposure, relative humidity, and a marker for entrained automobile exhaust. In addition, we tested the hypothesis that certain environmentally mediated health conditions (e.g., allergies and asthma) confer increased susceptibility to building related symptoms. Adjusted odds ratios (ORs) for statistically significant, dose-dependent associations (P < 0.05) for combined mucous membrane, dry eyes, sore throat, nose/sinus congestion, sneeze, and wheeze symptoms with 100 p.p.m. increases in dCO(2) ranged from 1.1 to 1.2. Building occupants with certain environmentally mediated health conditions were more likely to report that they experience building related symptoms than those without these conditions (statistically significant ORs ranged from 1.5 to 11.1, P < 0.05). PRACTICAL IMPLICATIONS: These results suggest that provision of sufficient per-person outdoor ventilation air, could significantly decrease prevalence of selected building related symptoms. The observed relationship between indoor minus outdoor CO(2) concentrations and mucous membrane and lower respiratory symptoms suggests that air contaminants are implicated in the etiology of building related symptoms. Levels of indoor air pollutants that are suspected to cause building related symptoms could be reduced by increasing ventilation rates, improving ventilation effectiveness, or reducing sources of indoor air pollutants, if known.