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Report to CORESTA SURVEY OF INDOOR AIR QUALITY VENTILATION, AND SMOI~ING ACTIVITY IN RESTAURANTS July 1, 1999 322220856

Report to CORESTA SURVEY OF INDOOR AIR QUALITY, VENTILATION, AND SMOKING ACTIVITY IN RESTAURANTS H. R. Bohanon, Jrt, J.-J. Piad6*, M. Schorp*, Y. Saint-Jalm+ t R. J. Reynolds Tobacco Co. Winston-Salem, NC, USA, *Philip Morris Europe, Neuch~tel, Switzerland, + Seita, Fleury-les-Aubrais, France ABSTRACT As a CORESTA ETS Sub-Group activity, six different participants in six different countries conducted a survey of indoor air quality, ventilation and smoking activity in restaurants. This work was to assess methods and determine major hurdles to performing such studies in a sound and reliable way. A number of typical medium-priced restaurants were surveyed during lunch or dinner. The objectives were: 1. To survey restaurants in several different countries. 2. To determine acceptability of indoor air conditions as judged by occupants of the restaurant space. 3. To assess concentrations of environmental tobacco smoke (ETS) present in the selected spaces. 4. To appraise the ventilation system including operation and maintenance (O&M) of heating, ventilating, and air conditioning (HVAC) systems and estimate outdoor air ventilation rates. 5. To determine smoking rates in the restaurants observed. 6. To investigate correlation between the smoking rates, ventilation rates, ETS concentrations, and occupant perceptions of restaurant indoor air quality. This report discusses the results and conclusions from this survey. INTRODUCTION This project was designed to survey restaurants in a number of countries where smoking is permitted. The hypothesis is that most restaurateurs operate their restaurants so that 80% or more of the patrons perceive the air quality to be acceptable. Restaurants were selected to be typical of the country. The surveys were conducted during the lunch and/or dinner period. The protocol suggested selecting high occupancy days. Thirty-four restaurants in six countries were surveyed, adding valuable data to the published information regarding indoor environmental conditions or ventilation in existing restaurants. This pilot study was not designed to yield representative data for the individual countries due to the small number of samples. 322220857

Country Participating Organizations Principal Investigator(s) France Seita Mr. Yves Saint-Jalm L. H. P.* Louis Harris France Japan Japan Tobacco Inc. Korea Switzerland United Kingdom United States Korea Ginseng and Tobacco Research Institute Philip Morris Rothmans International British American Tobacco Co. Ltd. Imperial Tobacco Co. Philip Morris R. J. Reynolds Tobacco Co. Lorillard Tobacco Co. Dr. Masao Matsukura Mr. Isao Ishii Mr. Takuya Asai Mr. Takumi Nishina Dr. Moon Soo Rhe¢ Dr. J.-J. Piad~ Dr. Matthias Schorp Mr. L. Poget Mr. Barrio Frost Mr. Nigel Warren COVANCE Mr. Hoy Bohanon Mr. David Taylor Mr. Robin Wilson Table 1: Participants in the Survey * Laboratorie d'Hygi6ne de la ville de Paris (Dr. A. M. Laurant) METHODS A model protocol was issued for this survey. The test results from each country differ slightly in content due to local adaptations of the protocol. Model Protocol The model protocol was slightly modified in each country to address regional differences and to accommodate specific situations. The model protocol addressed the following subjects: 1) Selection of Buildings A minimum of five restaurants in different buildings should be tested. The restaurants and buildings should be dissimilar (e.g. not all hotel dining rooms). 2) Procedure for Selecting Sampling Spaces Within the Restaurant Where there are smoking and nonsmoking sections, one sample should be from each section. 3) Procedure for Selecting Sampling Locations in Spaces Sampling should be conducted in the breathing zone and not be unduly influenced by fans or ventilation systems, or or by direct exposure to sidestream or mainstream smoke plumes. 4) Qualitative Assessment of Ventilation System (Natural or Mechanical) 322220858

The protocol addressed both natural and mechanical ventilation systems. Mechanical systems should be assessed as to adequacy, cleanliness and structural integrity. 5) Determination of Outside Air Quality Local ambient monitoring station data on air quality should be obtained if aw~ilable from local air quality authority. Direct measurement of the lbllowing analytes should be obtained immediately outside of the establishment being tested: RSP, UVPM, FPM, solanesol, carbon monoxide, carbon dioxide, temperature and relative humidity (RH). 6) Determination of Indoor Air Quality Indoor air quality measurements should be made in duplicate in at least two sampling locations for each restaurant. If the restaurant has a smoking and a nonsmoking section, at least one measurement should be made in each section. Concentrations of RSP should be determined by the method described by Conner et al. Samples should be collected for at least tbur hours during testing. Concentrations of UVP~ should be determined by the method described by Conner et al. Samples should be collected for at least lbur hours during testing. Concentrations of FPM should be determined by the method described by Ogden et al. This analytical method utilizes the same sample as that collected for the determinations of RSP and UVPM described above. Concentrations of solanesol should be determined by the method described by Ogden et al. This analytical method utilizes the same sample as that collected for the determinations of RSP and UVPM described above. Concentrations of nicotine should be determined by EPA method I P-2A. Samples should be collected for at least four hours during testing. Concentrations of 3-EP should be determined by the method described by Ogden et al. This analytical method utilizes the same sample as that collected for the determinations of nicotine described above. In addition, measurements should be made for carbon monoxide, carbon dioxide, temperature and relative humidity. 7) Determination of Smoking Activity Two methods lbr determining smoking activity were recommended. The first method is collecting and counting the cigarette butts. The second method is visual observation of smoking. 8) Determination of Occupancy of Test Space The number of people in each room or smoking or nonsmoking area should be counted every thirty minutes separating counts of patrons and employees. 9) Determination of Quantity of Outside Air Supplied to Test Spaces Method i - [lave test and balance (T&B) engineering consultant measure HVAC and establish a ventilation rate. 322220859

Method 2 - Use CO.,. measurements along with counts of people in the space to estimate air exchange rates. Method 3 - Use tracer gas to determine air exchange rates. 10) Indoor Air Quality Questionnaire A questionnaire was designed that recorded gender, age, smoking status and asked about visitation to the establishment. The environmental questions addressed temperature, odor, drafts, noise, smoke, lighting and acceptability. Depending on the country, these questions were translated and adapted. In some cases questions were added to the original questionnaire. 11) Scheduling The testing should be scheduled during high occupancy times in the restaurant. 12) Analysis In this observational study, the analysis should use the observed data without modification. In some environmental studies, background correction is appropriate. Since this study was not designed to specifically collect background data, no corrections should be made in the analysis. 4 322220860

Testing in Each Country Table 2. Shows the actual testing that occurred in each location. France Japan Korea Switzerland United United Kingdom States Number of 5 4 5 5 10 5 Restaurants Number of days 3 2 2 2 1 2 Single or Sing. Dup. Dup. Dup. Dup. Dup. Duplicate Sample Outside RSP No Yes Yes Yes Yes No Outside UVPM Outside FPM No No Yes No Outside Solanesol No Yes Outside CO Yes Yes Outside C02 Yes Yes outside Temp. Yes Yes Outside Rft Yes Yes Indoor RSP Yes Yes Indoor UVPM Yes Yes Indoor FPM Yes No Indoor Solanesol Yes Yes Indoor CO Yes Yes Indoor CO_, Yes Yes Indoor Temp. Yes Yes Indoor RH Yes Yes Indoor Nicotine Yes Yes Indoor 3-EP Yes Yes Smoking Activity Yes Yes Occupancy Yes Yes Ventilation Rate Yes Yes Questionnaire Yes Yes Questionnaire Yes No modified/adapted Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes No Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes Ycs No IYcs 322220861

RESULTS AND DISCUSSION Occupant Judgement Restaurant owners are motivated by business reasons to satisfy their customers. However, unlike comments on obvious items such as food, services and ambience, it is sometimes difficult for the owners to receive feedback specific to indoor environmental quality. The situation is further complicated by the fact that the owner strives to accommodate a wide range of individual prel~rences. Little guidance on how to provide acceptable indoor environmental conditions for restaurants is available. Some national or international ventilation standards or guidelines provide some general in|brmation, but that information is generally not specific for the hospitality sector. The Pilot Study Protocol provided a questionnaire, which sought basic information on the occupants, and assessed their perception towards a number of indoor environmental conditions, such as noise, temperature, draft, odor, humidity, freshness, tobacco smoke, and indoor environmental quality. In addition, France and Switzerland both added a question concerning indoor air quality, following what has recently been done in the frame of the European Building Audit (Bluyssen 1995). Questionnaires were completed on the same days as indoor air measurements ~vere performed. The time required to fill out a questionnaire was normally less than five minutes. In general, the wait staffadministered questionnaires, typically after they took orders for lunch or dinner. Some patrons declined to answer the questionnaires. The completed questionnaires were returned to the wait stall In total, 1370 questionnaires were returned by the restaurant patrons in five countries. No reliable estimate could be obtained for the non-response rate. The wait staff received a small gratuity for the additional workload. For the analysis of the questionnaires, the responses on the 5-point scales were converted to "Satisfied .... Rather Satisfied", ~'Neither", "Rather Dissatisfied", and "Dissatisfied." The responses marking the two lower ratings ("Rather Dissatisfied" and "Dissatisfied") were consolidated to estimate the "% Dissatisfied" with each of the indoor environmental parameters. When available, the 10-point scale was analyzed as in the European Building Audit (Bluyssen 1995) to derive the "% Dissatisfied" with indoor air quality (IAQ). This percentage was then averaged with the % dissatisfied fbr indoor environmental quality (IEQ) to derive the inverse estimate of"% Overall Acceptance." (figures 1 and 2). Excluding those restaurants that had less than 20 questionnaires returned or highly variable ventilation rates led to a subset of the data comprising 15 restaurants, which could be further analyzed. Table 3 presents the "'% Dissatisfied" assessments consolidated by country for each indoor environmental parameter. Dissatisfaction rates above 20% were observed in some countries for Air Draft, Air Freshness and Noise. Dissatisfaction rates with regard to indoor air quality and indoor environmental quality range between 3.1 and 12.0% and are not significantly different. 322220862

Table 3: Questionnaires - Summary Restaurants "Percent Dissatisfied" Country France Japan Switzerland USA UK Percent Dissatisfied Temp Draft llumid Fresh Smoke 5.7 8.7 5.0 37.9 4.3 17.4 6.5 19.6 3.9 38.5 12.0 15.8 8.0 15.8 9.2 7.7 7.2 l 1.8 n.d. n.d. 17.5 12.0 14.2 12.9 2.7 Noise Odor IAQ IEQ 27.0 10.5 7.8 6.9 31.5 2.2 n.d. 12.0 15.8 19.1 3.1 2.7 17.2 8.1 n.d. 3.0 n.d. n.d. 5.0 n.d. Figure 1 depicts the cumulative percentages for overall acceptance per country for all restaurants. Figure 2 shows the ratings for overall acceptance separating the data into smoker and nonsmoker responses for those restaurants having more than 20 questionnaires returned, and where the ventilation rate was found to be constant. In general, non-smokers tend to be slightly more dissatisfied than are smokers. oVERALL ACCF.PTANCE Indoor environmental design guidelines and Fig. 2: % Overall Acceptance among Sntokem v$ N(m-$mokem in 15 Restaur~nt~ 100 90 g5 1 2 3 4 5 6 7 8 ~ 10 11 12 13 14 15 Restaurant No. standards provide for "guidance values" of dissatisfaction in the range of 10 - 30% (EUR 14449 EN, 1992) or tbr more than 80% acceptance (ASHRAE 62-1989). These guidance values are based on experimental studies (Cain 1983) or field tests in some workplace environments (Fanger 1988). The data presented above indicate that physical stressors such as noise and draft challenge those limits. On the other hand, occupants in real-world environments appear to have diffi~rcnt expectations towards air quality parameters. The acceptance rate observed in this study is indeed substantially higher than what would have been predicted ti-om the results of the above studies, including the most recent one by Walker et al. (1997). 322220863

Concentration of ETS The CORESTA Restaurant Pilot Study combined the efforts from six different laboratories in as many different countries. A large amount of data was generated, reflecting the diverse situations that can be encountered when monitoring indoor air constituents in restaurants. Despite an initial agreement on the nature of the analytes and the methods to assess their levels, the difficulties of conducting this Pilot Study highlight the need for a commonly agreed methodology and validation of that methodology, including field tests. Detection of outliers Indoor air monitoring in restaurants often calls for environmental analyses at the ppb level. Despite the great care taken in performing the measurements, and even if the method is well controlled, (as checked by QA samples) erroneous results often do occur. They may be due to failures in the sampling, or may be the result of a strongly irdaomogeneous environment. In addition, ETS markers, such as UVPM and FPM, may yield implausibly high results due to interference from other combustion sources. It is very useful to obtain two or more replicate determinations per location. This helps to detect outliers and may give an indication of the most plausible result. In this data set, about 5% of the raw data were outliers. Additional information can be derived, however, from the auto- correlation that prevails among the set of ETS markers as discussed below. It is not a simple task to perform this two-dimensional cross-checking using statistical tools, therefore the outliers were identified by visual evaluation. Completion of the CORESTA inter-laboratory study that is on- going tbr all these methods should help in detecting outliers by providing an estimate of the method reproducibility. Results and correlation As an example, the scatter plots showing all the cross-correlation between the analytical parameters for the Swiss data set are shown in Figure 3. The monitored ETS-markers fall into two groups: the gas-phase compounds (nicotine SN and 3-ethenylpyridine EP3) and the estimates tbr ETS-derived particulate-phase concentrations(the UVPM and FPM estimations and the one obtained from solanesol, SPM). These estimations of the level of ETS-derived particulate matter (or ETS-RSP) were pertbrmed as recommended in Nelson et al., 1997. In addition, the concentrations of respirable suspended particles (RSP) are also reported. 322220864

Fig. 3 Scatter Plots between the 6 determinations (RSP, ETS-markers) Swiss Data, Z ILl FPM RSP UVPM SPM SN EP3 n=80 These plots, as well as those generated from the other countries' data sets, suggest the following observations: Within the particulate-.phase, there is a very good correlation between the two spectrometric estimations. Fhis is not surprising since both determinations are made from the same sample. Conversely, an outlying point should be investigated for possible intert~rence. There are two obvious cases (discussed below) in the Swiss data set, The solanesol concentration (or the derived SPM estimation) is also well correlated with UVPM or FPM There are, however, some points that show lower SPM than UVPM or FPM, mostly at low s~noke levels. This effect is illustrated in Figure 4, showing the ratio of SPM to UVPM as a function of UVPM. • O~er the whole database, it appears that the RSP level does not correlate well with ETS-RSP le~,els. The gas phase data are well correlated. There is a trend towards a lower nicotine / 3- ethenylpyridine ratio at lower smoke levels as illustrated in Figure 5, that shows this ratio as a function of nicotine levels. As nicotine exhibits much larger sorption effects, this ratio will 322220865

be higher in fresh ETS. This is more likely to happen in those situations where ETS levels are highest (Eatough 1993, Guerin 1992). Fig 4. SolanesoI-PMIUVPM vs UVPM (Swiss Data) 3.5 ........................................................... ~ :3.0 3.5 Fig. 5 Nicotinel3VP ratio vs. nicotine level (US data) 3.0 2.0 1.5 0.5 0.0 0 2 4 6 8 10 0.0 100.0 200.0 300.0 UVPM (uglm3) Nicotine (uglm3) The • Methodology assessment: technical remarks examination of the different data sets suggests the following observations: The problems that were noticed in some countries with the solanesol analysis could be traced to a sampling in transparent filter holders and to a modification in the HPLC procedure. A non-zero intercept in the regression line of UVPM vs. FPM occurred in one data set, suggesting an erroneous blank 35 correction. 30 The variability among replicates ® 25 increased at higher ETS levels. It is ~ 20 possible that some of these high :; ~ 15 measurements resulted from direct ~ 10 exposure of one sampling port to a smoke source, yielding an analytical 5 value that is not representative ot" the 0 assessed environment. Fig 6. UVPMINicotine vs Nicotine (Swiss Data) 0 10 20 30 40 50 Nicotine (ug/m3) Finally, some data sets exhibited an elevated scattcr that could not be explained. Completion of the on-going inter-laboratory study for all these methods should reduce sources of variability and provide an estimate of method reproducibility. Methodology assessment: interpreting results from the different analytes The results for the evaluation of particulate matter concentrations can also be correlated to the gas phase data. The scatter is higher, reflecting the physical differences between both classes of compounds. At higher levels, the ratios arc more consistent as the impact of sorption effects is 10 322220866

less important, either because the smoke is more fresh or because the elevated levels make these sorption effects relatively less prominent. In this case the ratio of ETS-RSP to nicotine is close to 5, comparable to the values found in experimental settings or when fresh smoke data are included into the evaluations (Van Loy 1998). It can be observed that ratios between the levels of gas phase and particulate phase compounds become extremely variable at low ETS concentrations. See figure 6 (Swiss data), which shows that the ratio of SPM to nicotine exhibits a large scatter below nicotine concentrations of 5-10 ~tg/m~. At these low levels, using nicotine concentration to predict the ETS-RSP levels appears to be inappropriate. Note that the scatter does not appear to be due to analytical uncertainties in the solanesol determinations. In many of the cases when very low values were found for solanesol, compared to the spectrometric markers (UVPM or FPM), the nicotine levels were also very low suggesting that an artifact elevated the spectrometric results. In the Swiss data set, for instance, the two samplings that yielded highly elevated results for UVPM and FPM could be traced. It appeared that the errors were due to the presence of an open fireplace in the room. In this case, the solanesol still provided an estimation of ETS-RSP. Fig. 7 ETS-RSP in Restaurants n=~5~ Fig. 8 ETS-RSP by Country ~ n=152 250 • ~ measured 300 -- ~O~200 __ Iogn ::)rmal j! 250 i ~ ~ xx • France i': ~ 100 150 u.I ~ ~ ,= x Swiss 0% 10% 20% 30/, 40% SO% 60% 70'/* 80"/, 90% IlXP/, ~* cumulative frequency 0 . ,. Country ETS Concentrations Figure 7 shows the distribution of the best estimates for ETS-RSP concentrations while figure 8 shows a plot of concentrattons by country. Ventilation There are different ways tt~ estimate ventilation rates They include: 1. Measuring the rate of the air introduced into the restaurant through mechanical means. These direct measures are accurate if all of the air is controlled through a mechanical system. If there is significant infiltration, these methods will underestimate the ventilation rates. 2. Using C()_, as a tracer gas v~here the w~lume generated is estimated as a function of the nu~nber of people present. 3. Using an introduccd tracer gas such as SF,,. 11 322220867

A simple dynamic model using CO2 as a tracer gas provides estimates for the total mechanical plus infiltration air in the restaurants. Where there are multiple days or measurements, the average is used as the best estimate. Restaurants are categorized as having highly variable ventilation if (1) the estimated ventilation varies by a ratio of 2:1 or greater; or if (2) the constant ventilation model does not visibly fit the observed conditions. In the survey, 89 meals were observed in 33 restaurants from which a ventilation rate can be estimated. It is usual to normalize the ventilation rates in some way to take into account the scale of the location. One method is to compare to the area and another is to compare to the population. In design standards, the area and person normalization sometimes become a simple ratio due to the fact that maximum occupancy is stated as a constant ratio to area. In the following, the ASHRAE 62-1989 factor of 70 people per 100 m2 is used as the design value. The design rates fbr maximum occupancy are shown as l/s-person (design). 14 ~" 12 "~ 10 t- ~ 4 ~n 2 .,,. 0 Fig 9. Ventilation rates in Restaurants 89 meals in 33 restaurants measured Iognormal Fig 10. Ventilation rates in Restaurante 89 meals in 33 restaurants 14.0 .. 12.0 ............. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100 00 t i } % cumulative frequency country ~10.0 80 6.0 40 2.0 • France • • Japan ~ Korea ~L~ The graphs of the distribution of measured ventilation rates in Figure 9 are shown in terms of l/s- person (design). Figure 10 shows ventilation rate by country. A ventilation standard rate of 10 i/s-person (ASHRAE 62-1989) is highlighted as a reference value. A lognormal distribution seems to fit this data set. The median is 2.5 1/s-person. The geometric standard deviation is 2.1. Smoking Rates Figures 11 and 12 illustrate the smoking rates measured in the restaurants in terms of cigarettes per hour per person. These data also can be characterized by a lognormal distribution. 3 Fig. 11 Smoking rates in Restaurants 91 meals m 34 restaurants 0% t0% 20% 30% 40% 50% 60% 70% 80% 90% 100% cumulative frequency Fig. 12 Smoking rates in Restaurants 91 meals i~1 34 ~estaurants 4 35 ~~5 05 i Country ~. France • Japan == Korea 'xUK • USA 322220868

The protocol recommended two methods of determining the smoking rates. '[he first method is to collect and count the cigarette butts periodically (every thirty minutes). Another method tried, but deemed unreliable, was to count the number of people smoking every thirty minutes. Figure 13 illustrates that these methods do not correlate. Some of the survey participants used a third method - continuous observation of smoking behavior. This method obviously would not have the problems observed wilh the thirty-minute smoker counts. Correlation between occupant judgement, ETS level and ventilation Figure 14 indicates no relationship between ventilation rates and overall acceptance. Figure 15 provides little evidence fi)r a relationship between ETS-RSP levels and overall acceptance, as perceived by the patrons in a real-world environment. Acceptance for tobacco smoke was almost equally high (Figure 16), with a tendency acceptance level at any measured ETS levels. Fig. 13 buttsv~ observed smokers R"~ = 0 0584 25 • p =0,13 2o • • 10' ~ 5 0 of the nonsmokers clustering around the 80% 100 ® ~ ~5 70 Fig 14. %Overall Acceptance vs Ventilation among Smokers and Nonsmokers in 15 Restaurants -=NS+FS ..- Ventilation I/s-mz Fig 15. %Overall Acceptance v= ETS-RSP among Smokers and Nonsmokers In 15 Restaurants 100 .... 95. , 85! • , 80. • ,~kers • 75 I ~ • NS+FS 70I • 1 10 100 1000 ETS-RSP (~ g/m=) Fig. 16 % Acceptance (SMOKE) vs ETS-RSP among Smoker= and NO~ Smoker= in 15 restaurants I + 95 , - - - 901 o • 85 • o • ~ o°O o • 751 • 0 7O 55 0 200 250 100 154~ ETS-RSP (ug/m3) 13 322220869

CONCLUSIONS The Restaurant study undertaken by the CORESTA ETS Sub-Group was conceived as a pilot study to determine the main methodological problems encountered in measuring indoor air constituents, determining ventilation rates, and assessing occupants' perception of indoor environmental parameters. From this experiment, it is possible to make several recommendations to improve protocols used in such surveys and improve the quality of the collected data. Questionnaire The survey returned 1370 questionnaires that were analyzed to estimate, for each country, the "Percent Dissatisfied" towards a list of indoor environmental parameters. Dissatisfaction rates above 20% were observed for Air Draft, Air Freshness and Noise in some countries. Dissatisthction rates with regard to indoor air quality (1AQ) and indoor environmental quality (IEQ) are in the range between 3.1 and 12.0%, with no significant difference in responses to questions about IAQ and IEQ where both questions were asked. This dissatisfaction rate is lower than would be predicted from results obtained through laboratory, tests. A new questionnaire will be proposed, based on the results of this pilot study. In particular, a restructuring of the questions will avoid response transformations. Chemical measurements Methodological differences in the various methods used by different laboratories may impair the comparability of the resulting data. ldeaIly, the protocol should rely on fully standardized methods (i.e. ISO Standards) and require the participating laboratories apply the prescribed methodology. Another advantage of using standardized methods is that the variability parameters of such methods are known, making data interpretation easier. Standardized methods are available or in preparation for RSP, UVPM, FPM, solanesol, nicotine and 3-ethenylpyridine as ETS markers in indoor air. Consolidating information from different markers greatly helps reducing the sources of bias in the determinations. Solanesol appears to be a reliable marker for ETS-t~M. Its inherent advantage is that one can report an absolute concentration tbr a tobacco-specific compound, in addition to using it as a surrogate standard that is linked through laboratory experiments to an ETS-PM level (like the spectroscopic detcrminationsl. ETS particulate phase/vapor phase ratios are highly variable at ETS concentrations usually found under conditions of adequate ventilation or moderate smoking rates. At higher ETS concentrations, these ratios arc more consistent, but thc correlation between gas-phase and particulate-phase markers does not appear to be sufficiently robust to recommend sampling markers for onc class only. The choice of sampling locations in tested arcas is critical. It is not possible to recommend a single method tbr selecting the sampling points due to the variety of situations encountered in the rcal world. Great care should be taken to select sampling points that give the ~'best estimates" of the measured parameters and their variability in the tested area (taking into account smoking and non smokin~u .sections, if prcscnt). Practical considerations like space avzfilability, disturbance, 14 322220870

etc. may also reduce the choice. As is often the case in air monitoring, sampling results may only be representative of the conditions prevailing in a micro-environment and, thus, may not be applicable to the whole indoor environment under investigation. Taking duplicate sample.; at each sampling point in order to eliminate possible outliers is recommended. The avaihtble methods to evaluate ETS in indoor air require sampling periods of several hours and thus give only an average value over that period. As the concentrations of ETS related compounds may vary considerably during testing periods, methods for measuring ETS compounds on a short period basis would be a helpthl tool for a more accurate assessment of the temporal and spatial variability of the ETS concentrations. Ventilation The determination of ventilation rates in tested restaurants by direct measure of mechanical systems was quite difficult. A modeling method proved useful in this study. CO, levels were measured continuously and a mathematical model was used to calculate the ventilation rates taking into account the occupancy and volume of test spaces. This method requires several t~atures: counting precisely all the people present in the tested area (patrons, employees and investigators) • choosing correctly the CO: sampling points (ideally near the exhaust if there is only one) • measuring indoor and outdoor CO_, level. However, this method does not give accurate results in the following situations: • in case of multiple connected rooms because the calculation model is diflicult to establish and because more exte~sive measurements are required • in case of low occupation rate, because the CO_, levels are too close to the threshold and the calculation is practicalJy impossible. Two alternative methods may be used. These methods were not tested. One established method USeS SF6 as tracer gas. (% decay with the ventilation system on after the establishment has closed and the people haxe left should be studied as an alternate method. The SF6 tracer gas method is potentially the best one. The ventilation system audit should remain included in the protocol. Observations This study has demonstrated that the smoking rate should be determined by counting the butts rather than a visual assessment of the number of people smoking. A constant visual monitoring regime is acceptable. It i: also important to count all the people present in the tested locations and not only the clients. REFERENCES ANSI/ASHRAE Standard 62-1989, Ventilation lbr Acceptable Indoor Air Quality, Atlanta: ASIIRAE inc., 1989. 15 322220871

Bluyssen P.M., De Oliveira Fernandez E., Fanger P.O.. Groes L., Clausen G., Roulet C.A., Bernhard C.A., and Valbjorn O. European Audit Project to Optimize Indoor Air Quality and Energy Consumption in Office Buildings. CEC Contract JOU2-CT92-0022, TNO Building and Construction Research, Delft, Final Report, 1995. Cain W.S., Leaderer B., Isseroff R., Berglund L.G., Huey R.J., Lipsitt E.D., and Perlman D. Ventilation Requirements in Buildings I. Control of Occupancy Odor and Tobacco Smoke Odor. Atmos Environ 17(6): 1183-I 197, 1983. Commission of the European Communities (CEC) Report No. 11. Guidelines for Ventilation Requirements in Buildings. EUR 14449 EN, 1992. Eatough D.J. Assessing exposure to environmental tobacco smoke. In: Modeling of indoor air quality and exposure, ASTM STP 1205, Nagda ed., pp 42-63, 1993 Fanger, P.O. Introduction of the olf- and the decipol-unit to quanti~ air pollution perceived by humans indoors and outdoors. Energy and Buildings 12(1): 1-6, 1988. Guerin M.R., Jenkins R.A. and Tomkins B.A. Mainstream and sidestream cigarette smoke, In: The Chemistry of Environmental Tobacco Smoke, Composition and Measurement, Max Eisenberg (ed.), Lewis Publishers (Boca Raton) pp 75-85, 1992. Nelson P.R., Conrad F.W.. Kelly S.P., Maiolo K.C. Richardson J.D. and Ogden M.W. Composition Of environmental tobacco smoke (ETS) from international cigarettes and determination of ETS-RSP: Particulate matter. Environ. Int., 23(1): 47-52, 1997. Walker J.C., Nelson P.R., Cain W.S., Utell M.J., Joyce M.B., Morgan W.T., Steichen Y.J., Pritchard W.S., and Stancill M.W. Perceptual and Psychophysiological Responses of Non- smokers to a Range o.f Environmental Tobacco Smoke Concentrations. Indoor Air 7:173-188, 1997. Conner, J.M., Oldaker, G.B., III, and Murphy, J.J. Method for assessing the contribution of environmental tobacco smoke to respirable suspended particles in indoor environments. Environ Tecbnol, I ! : 18% 196, 1990. Ogden, M.W.. Heavner, D.L., Foster, T.L.. Maiolo, K.C., Cash, S.L., Richardson, J.D., Martin, P., Simmons, P.S., Conrad, F.W. and Nelson, P.R., . Personal monitoring system for measuring environmental tobacco smoke exposure. Environ Technol 17:239-250, ! 996. Van Loy, M.D., Nazaroff W.W. and Daisey J.M. Nicotine as a Marker .]or Environmental Tobacco Smoke. Implications of Sorption on Indoor Sub[ace Materials, J. Air & Waste Manage Assoc. 48: 959-968, 1998. 16 322220872

Appendix 2 - Sensory Measures 322220873

CORESTA ETS SUB-GROUP RESTAURANT SURVEYS IN FRANCE, JAPAN, SWITZERLAND, UNITED STATES, UNITED KINGDOM, AND KOREA Summary Questionnaire Analysis and Results Contents: 1. Questionnaires 2. Questionnaires- General Information 3. Questionnaires- Results Summary Report 4. New proposed questionnaire 5. References Appendix A: Appendix B: Appendix C: Appendix D: Pilot Study Model Questionnaire French Questionnaire Swiss Questionnaire UK Questionnaire 322220874

1. Questionnaires The U.S., Korea, and Japan used the Pilot Study Model Questionnaire without modification. France, the U.K., and Switzerland used modifications of the questionnaire. Copies of the Pilot Study Model Questionnaire and the modified questionnaires are attached in Appendices A-D. 2. Questionnaires - General Information 2.1 Selection of restaurants and administration of questionnaire The selection of restaurants followed a non-representative sampling procedure. The country samples represent "snap-shots" of particular restaurants, frequented by more or less "usual" clients. Therefore any self-selection bias can not be excluded. To minimise such bias, sampling was extended during several time periods (dates/time of day) by restaurant. Questionnaires were administered by the restaurant staff, typically after orders had been taken and while the guests waited for their lunch or dinner to be served. The restaurant staff collected the completed questionnaires. A small gratuity was given to the staff for this additional workload. 2.2 Questions on client characteristics Gender Age Smoking Status Time presence male, female <30, 30-49, >50 Smoker (S), Non-Smoker (NS), Former Smoker (FS) <30 rain., >30 min. 2.3 Questions on indoor environment characteristics 2.3.1 Pilot Study Model Questionnaire Short descriptors of questions 8a "Temp 1" 8b "Odour 1" 8c "Draft" 8d "Noise" 8e "Smoke" 8f "Lighting" 8g "Temp 2" 8h "Fresh" 8i "Crowd" 8j "Humid" 8k "Odour 2" 81 "Environ" 322220875

2.3.2 Question on indoor air quality (IAQ) In the Pilot Study Model Questionnaire, there is no question directly related to the acceptability of indoor air quality. Although there is no standard question that would reliably assess "indoor air quality," the question and scale on the acceptability of indoor air quality, as outlined below, has been used by others (Bluyssen 1995): How would you rate the overall acceptability of the indoor air quality in this room at this moment? 0 .... Clearly acceptable (_) (_) (__) .... Just acceptable (_~ .... Just not acceptable (_) (_.) .... Clearly not acceptable 2.3.3 5-point scale of the Pilot Study Model Questionnaire Occupants were asked to tick either of the five options on questions 8a-81: (1) = strongly agree (2) = agree (3) = neither (4) = disagree (5) = strongly disagree 3 322220876

2.3.4 Transformation "Best Notes" and "Percent Dissatisfied" The questionnaire responses to all questions 8a-I ("Pilot Study Model Questionnaire, February 14, 1996) were transformed into "best notes" denoted as ~['and "dissatisfied" denoted as ~' according to the scheme listed below: All indoor environment characteristics, i.e., all responses to questions 8a to 81, are transformed according to the same 5-point scale: 1 = satisfied 2 = rather satisfied 3 = neither 4 = rather dissatisfied 5 = dissatisfied "Best Note" "dissatisfied" "dissatisfied" Thus, the table above reads: 4 322220877

8a 8b 8c 8d 8e 8f 8g 8h 8i 8j 8k 8~ 5 5 2 4 4 4 4 4 4 5 5 1 1 1 4 5 5 4 1 1 4 5 5 4 1 5 4 1 5 4 1 1 4 5 Due to the lack of an orderly arrangement of responses, care needs to be exercised to correctly convert the questionnaire into numeric values as suggested above. For example, responses to question 8a circled as (4) and (5) convert into 4 = rather dissatisfied, and 5 = dissatisfied, whereas responses to question 8e circled as (4) and (5) convert into 2 = rather satisfied and 1 = satisfied. 2.4 Interpretation of the Questionnaire - "Percent Dissatisfied" and "Percent Acceptance" For the interpretation of the questionnaires, 4 = rather dissatisfied, and 5 = dissatisfied are grouped together to yield "% Dissatisfied." From those, the inverse estimate is derived to yield "% Acceptance." When available, the 10-point scale on indoor air quality (IAQ) was analysed as in the European Building Audit (Bluyssen 1995), to derive the "% Dissatisfied" with respect to IAQ. This percentage was the averaged with the "% Dissatisfied" for indoor environmental quality (IEQ), to derive the inverse estimate of "% Overall Acceptance." 322220878

2.5 Summary Report 2.5.1 Questions on indoor environment characteristics analysed Temperature Draft Humidity Freshness Smoke Noise Odour Indoor Air Quality (IAQ) Indoor environmental Quality (IEQ) 2.5.2 Exclusion of restaurants Excluding those restaurants that had less than 20 questionnaires returned or had highly unstable ventilation rates led to a subset of data comprising 15 restaurants, which could be further analysed for potential relationships between ETS levels and/or ventilation rates and occupant perceptions. 3. Results Summary Report 3.1 Countries Country Analysed Questionnaires France yes Japan yes Korea no Switzerland yes UK yes USA yes 3.2 Summary client characteristics Table 1 summarises the questionnaire results for client characteristics 6 322220879

Table 1. Client (;t-m-aclBis~s (~ 5 424 4 co 5 284 10 221 5 ~ 533 467 3~1 60.9 29.9 70.1 465 535 54.2 45.8 S 382 ,52.8 90 48.9 424 87 37.6 487 137 404 39.4 2132 234 54.8 21.8 153 562 29.5 482 47.8 120 19.1 90.4 30.5 44.6 468 86 153 ~8 57.9 ~Ornn >30 rnn 14.2 858 198 882 40,8 992 88 91.2 73.9 28.1 <lh >lh 3.3 Summary indoor environment characteristics 3.3.1 Summary of "% Dissatisfied" by country Tables 2, 2a, and 2b: Summary of "%Dissatisfied" by country Table 2: Questionnaires - Summary Restaurant Percent Dissatisfied In general: dissatisfied = "dissatisfied + rather dissatisfied" COUNTRY France Japan Switzerland USA UK Temp Draft 5,7 8 7 4.3 17.4 3.9 38.5 8.0 15.8 72 11.8 Percent dissatisfied (%) Humid Fresh Smoke Noise Odor IAQ IEQ 5.0 37.9 17.5 27.0 10.5 7.8 6.9 65 19.6 12.0 31.5 22 n d. 12.0 9.2 7.7 12.9 17.2 8.1 n.d. 3.0 n.d. n.d. 2.7 n.d. n d. 5.0 nd. ]able 2a: Questionnaires - Summary Restaurant Percent Dissatisfied for IAQ-IEQ In general: dissatisfied = 'dissatisfied + rather dissatisfied" COUNTRY =rance Japan Switzerland USA UK Percent dissatisfied (%) IAQ 78 n.d. 31 n.d. 5.0 IEQ 6.9 12.0 2.7 3.0 n.d IAQ-IEQ 7.4 12.0 2.9 3.0 5.0 IAQ-IEQ I Smoker 6.2 11.1 3.6 1.2 1.1 IAQ-IEQ / NS+FS 80 12.8 2.5 3.6 6.2 7 322220880

Table 2b: Questionnaires - Summary Restaurant Percent Dissatisfied for IAQ-IEQ In general: dissatisfied = "dissatisfied + rather dissatisfied" France with Restaurants 1, 4; Japan 2, 3, 4; Switzerland: 1, 3, 4, 5; USA: 1, 3, 4, 5; UK: 6, 9 Percent dissatisfied (%) USA IAQ IEQ IAQ-IEQ IAQolEQ/Smoker IAQ-IEQ / NS+FS France Japan Switzerland USA UK 8.2 7.4 11.3 3.3 3.2 n.d. 7.8 113 3.6 3.2 6.2 5.1 7.9 4.0 1.3 1.6 8.9 14.3 3.3 3.7 10.6 3.3.2 Summary of mean votes by country Table 3 and fig. 1 Summary of mean votes by country Table 3: Questionnaires - Summary Restaurant Mean Votes Scale: 1=satisfied, 2=rather satisfied, 3=neither, 4=rather dissatisfied, 5=dissatisfied COUNTRY France Japan Switzerland USA Temp 1 69 2.09 1.56 1 88 Draft 1.75 2.63 294 2 40 Humid t .77 2.32 2.08 2.30 Mean of Votes Fresh Smoke 3.21 2.10 2.90 2.36 255 216 2.08 2.23 Noise Odor IEQ 2.53 2.50 1.95 3.01 2.08 2.57 2.39 2 16 1.62 2.58 2.13 1.82 Fig. 1: Mean Votes for air characteristics by country 4.00 .............................................................................. 3. 5O I ~ France ~ 3.00 Jl_l_Japan "~• I ~ Switzerland "6 2.50 I"~'usA ~c 2.00 Scale: ~" 1 =satisfied 1.50 2=rather sat i 3=neither 1.00 4=rather dissat. 5=dissatisfied 8 322220881

3.3.3 Percents and cumulative percents for "Overall Acceptance" Fig. 2 and 3: Percents and cumulative percents for "Overall Acceptance" by country Fig. 2: Percents for "Overall Acceptance" by country 80.0 70.0 60.0 50.0 40.0 30.0 200 10.0 0.0 Satisfied Rather sat. Neither Rather dissat. Dissatisfied OVERALL ACCEPTANCE I1-1 France rllJapan Switzerland 100.0 90,0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0 Fig. 3: Cumulative percents for "Overall Acceptance" by country I..-..~ France I---~--- Sw itzerland ].-.~-- USA J-_.~--_ UK Satisfied Rather sat. Neither Rather dissat OVERALL ACCEPTANCE Dissatisfied 322220882

3.3.4 Contingency tables client characteristics vs. "Overall Acceptance" and "Smoke" Table 6: Significance results in contingency tables for "Overall Acceptance" vs client characteristics (Smoking status with two groups: Smokers versus NS+FS) COUNTRY France Japan Switzerland USA UK Significance result of group differences for overall acceptance according to: Restaurant Gender Age Smoking status Time presence Table 7: Significance results in contingency tables for "Smoke" vs client characteristics (Smoking status with two groups: Smokers versus NS+FS) Significance result of group differences for smoke according to: COUNTRY Restaurant Gender Age Smoking status Time presence France Japan Switzerland USA UK Legend: *** (p<=0.01); ** (0.01<p<=0.05); * (0.05<p<=0.01); = (0.10<p) 3.3.5 "Overall Acceptance" vs. ETS-RSP levels Fig. 4: % "Overall Acceptance" vs. ETS-RSP among Smokers and Non- 100 95 9O 85 80 75 70 65 Smokers NS+FS Smokers in 15 restaurants 0 0 • 0 • 0 0 0 I0 100 1000 ETS-RSP (uglm 3) 10 322220883

3.3.6 "Overall Acceptance" vs. ventilation rates 100 95 90 85 8o 75 70 65 Fig. 5: "% Overall Acceptance" vs ventilation rates among Smokers and Non-Smokers in 15 restaurants o ~Do • o o • °° o • o o • Smokers o NS+FS 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 8.0 9.0 10.0 I/s-m 2 3.3.7 "Acceptance Smoke" vs. ETS-RSP levels 100 95 90 85 8o 75 70 65 60 55 5o Fig. 6: % Acceptance(SMOKE) vs ETS-RSP among Smokers and Non- Smokers in 15 restaurants o a ~ o • o • • o o o o o • Smoker o NS+FS 0 50 100 150 200 250 ETS-RSP (uglm3) 11 322220884

4. References Bluyssen P.M., De Oliveira Fernandez E., Fanger P.O., Groes L., Clausen G., Roulet C.A., Bernhard C.A., Valbjorn O. European Audit Project to Optimize Indoor Air Quality and Energy Consumption in Office Buildings. CEC Contract JOU2- CT92-0022, TNO Building and Construction Research, Dell, Final Report, 1995. 12 322220885

5. New proposed questionnaire RESTAURANT Date I I I I I I I Timel I I Table No.I I We are interested in your opinion. Please mark your answer 1. Age under 30 (_) 30-49 (_) 50+ (_~ 2. Gender Male (_) Female (_) 3. Smoking Status Nonsmoker (_) Smoker O o How would you rate the indoor air quality at this moment? 0 .... clearly acceptable (_) (_)....just acceptable (__) .... just not acceptable (_) (J (_) (_) .... clearly not acceptable 5o How do you feel about the indoor conditions now .... ? rather rather satisfied satisfied neither dissatisfied dissatisfied Temperature Humidity Air Movement Noise Tobacco Smoke Odor Overall Conditions THANK YOU FOR PARTICIPATING IN THIS SURVEY 13 322220886

Appendix A: Pilot Study Model Questionnaire DRAFT QUESTIONNAIRE FOR RESTAURANT PATRONS We are interested in your opinion. (P/ease mark your answer) 1. Gender? El Male El Female 2. Age (years) El Under 30 El 30-49 El 50+ 3. Smoking Status? 4. How is your health ? 5. How long have you been here? Are you especially sensitive to chemicals? Former Smoker Non-Smoker Smoker Excellent Good Fair Just Arrived less than 1 hr. More than 1 hr. Yes No Unsum 7. How many days each L~7 Less than 4 month do you come El More than 4 here? 8. Right now, how do you judge each of the following statements about this environment? (Please circle the number) Strongly Strongly Agree Agree Neither Disagree Disagree (1) (2) (3) (4) (5) a. The temperature is comfortable. 1 2 3 4 5 b. The air smells pleasant. 1 2 3 4 5 c. The environment is too drafty. 1 2 3 4 5 d. The environment is too noisy. 1 2 3 4 5 14 322220887

e. The air is too smoky. 1 2 3 4 f. The lighting is acceptable 1 2 3 4 g. The temperature is too warm. 1 2 3 4 h. The air is fresh. 1 2 3 4 i. The environment is too crowded 1 2 3 4 The air is too humid. f 2 3 4 k. There are unpleasant odors. 1 2 3 4 I. The environment is acceptable. 1 2 3 4 5 5 5 5 5 5 5 5 o If you have been here El before, how do you judge the conditions now E1 compared to your previous visit(s) ? Better Same Worse Unsure Thank you 15 322220888

Appendix B: French Questionnaire QUESTIONNAIRE RESTAURANT Date I I I I I I I Heurel I Ih I I Iron Table N° I__1 Votre opinion nous int~resse. Pourriez-vous r~pondre & quelques questions ? 1. Etes-vous ....... un homme I-I ...une femme [] Dans quelle tranche d'&ge vous situez-vous ? moins de 30 ans [] de 30 ~ 49 ans [] plus de 50 ans [] Fumez vous? Oui [] Non [] Plus maintenant, mais r~guli~rement dans le pass~ [] Depuis combien de temps ~tes-vous arriv6(e) dans ce restaurant? moins de 30 min. [] plus de 30 min. [] 16 322220889

En cet instant, comment jugierez-vous les conditions dans la piece et son environnement climatique? (Veuillez entourner le num6ro correspondant & votre r6ponse) Tout & fait Assez Ni I'un ni Pas tellement d'accord d'accord I'autre d'accord (1) (2) (3) (4) Pas du tout d'accord a. La temperature est agrdable (1) (2) (3) (4) (5) b. II y a trop de courants d'air (1) (2) (3) (4) (5) c. L'air est trop humide (1) (2) (3) (4) d. L'air est frais (1) (2) (3) (4) e. L'air est trop enfum~ (1) (2) (3) (4) (5) f. II y a trop de bruit (1) (2) (3) (4) (5) g. II n'y a pas d'odeurs (1) (2) (3) (4) (5) h. L'odeur est agrdable (1) (2) (3) (4) (5) i. La qualit~ d'air est satisfaisante (1) (2) (3) (4) j. Les conditions d'environnement sont satisfaisantes (1) (2) (3) (4) (5) (5) (5) 17 322220890

o Si ce n'est pas votre premiere visite, par rapport & votre experience pr~c~dente, diriez-vous que ces conditions sont... [] meilleures [] semblables [] pires [] ne sait pas MERCI BEAUCOUP 18 322220891

Appendix C: Swiss Questionnaire SVP, un formulaire par personne. QUESTIONNAIRE RESTAURANT Date I I I I I I I Heurel I I Table Nr. I I o Votre tranche d'~-ge moins de 30 (_) 30-49 (_) plus de 50 O 2. Vous ~tes ...... une femme (.I ...un homme (_) Fumez vous? Oui (_) Non (_,~ Plus maintenant, mais r~guli~rement dans le pass~ (_) ° Depuis combien de temps 6tes vous arrival(e) dans ce restaurant? Moins de 30 min. (_) Plus de 30 min. (_) Comment jugeriez-vous en cet instant la qualit~ de I'air? (_) (~ .... tout ~ fair acceptable (_) (~ O ....d peu pres acceptable (_~ .... pas tout ~ fa# acceptable (_) (_) (_) (_) .... totalement inacceptable 19 322220892

o Comment jugeriez vous en cet instant les conditions dans la pi6ce et son environnement climatique? Temp6rature confortable [~ [~ [~ [~ [~ inconfortable [~ [~ [~ [~ courants d'air Mouvements d'air air immobile ~ trop sec frais clair Air ambiant Odeur tr~s forte odeur d~sagrdable pas d'odeur agr#.able Bruit aucun bruit ~-J [~ [~ ~ [~ trop de bruit non-satisfaisantes Au total les conditions d'ambiance sont satisfaisantes [~ [~ ~ ~ ~ Si ce n'est pas votre premiere visite, par rapport a votre experience pr~c~dente, diriez-vous que ces conditions sont i~ meilleures I~ identiques I~ pires I~ ne sais pas MERCI BEAUCOUP ¥~P~ o 2O 322220893

Appendix D: UK Questionnaire Covance and the Restaurateurs Association of Great Britain are carrying out a survey of Air Quality within UK restaurants We are interested in your opinion (Please mark your answer) 1. Gender? I-i Male [] Female 2. Age? [] Under 30 [] 30-49 [] 50+ 3. Smoking Status? [] Never Smoker (less than 50 cigarettes lifetime) [] Former Smoker [] Current Smoker 4. How long have you been here? [] Less than 30 mins [] More than 30 mins o At this moment how do you judge each of the following statements about this environment (please mark the answer which corresponds to your judgement) The temperature is .... [] too cold [] cold [] acceptable [] hot [] too hot The air movement is ... [] too draughty [] acceptable [] insufficient The cooking smells are.. [] unacceptable [] acceptable [] hardly noticeable [] not noticeable The amount of tobacco smoke is... [] unacceptable [] acceptable [] hardly noticeable [] not noticeable Overall air quality is... [] poor [] acceptable [] good [] very good Thank you for your participation 21 322220894

Box number File collected File returned 1 0 JAN 2001 322220895

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