This Brown & Williamson (B&W) report, "Environmental Tobacco Smoke: Why is it a Problem?", appears to be an internally produced presentation about secondhand smoke. It is undated, but references a 1986 National Academy of Sciences report, which places it after that date.
The document presents reasons for dealing with the "Worst Case Scenario" about secondhand smoke, specifically pointing out that:
"1. ETS is chemically different than MS [mainstream] smoke."
2. ETS exposure is chronic.
3. The shape of the biological dose-response curve is unknown."
The document lists studies that have shown that secondhand smoke causes harm, and specifically points out the dangers is is said to pose to pregnant women, children and the lung function of adults:
"Dose-response relationships exist between low birthweight children and pregnant women with daily ETS exposure, number of cigarettes smoked by father...Household ETS exposure is linked to retarded growth and development and chronic ear infections."
"ETS exposure causes respiratory symptons in some children,"
"Decreases in lung function due to ETS: 0 to 0.5% per year. This effect not clinically important but may:
--reflect pathophysiological effects
--may be a factor is later development of chronic airflow obstruction."
The document also makes statements about the inadequacy of ventilation to deal with ETS. On page 17 (Bates No. 620002369) it states that a ventilation rate of 50-60 cubic feet per minute (cfm) per person is required to provide satisfactory indoor air quality when ETS is present. According to Don Shopland, (who brought this document to Doc-Alert's attention), under the old ASHRAE guidelines a rate of just 20-35 cfm per occupant was suggested when smokers were present.
The document goes on to state that,
"There is probably no practical ventilation rate that could satisfy 80% of more nonsmoking visitors," and that "segretation of smokers and nonsmokers is not a solution" because the "rate of migrations of smoke from smoking to nonsmoking areas is unknown," and "common ventilation/filtration systems negate any benefits of segregation."
The above report could hold important ramifications for public health authorities who are working to protect the public from exposure to secondhand smoke.
Fields
Notes
Thanks to Don Shopland of Georgia for bringing this document to Doc-Alert's attention, and for summarizing some of the very important points made in the document.
Quotes
[From Page 9-10, Bates No. 620002361/2362]
REASONS FOR ACCEPTING WORST CASE SCENARIO
1. ETS IS CHEMICALLY DIFFERENT FROM MS [mainstream] SMOKE,
2. ETS EXPOSURE IS CHRONIC.
THE SHAPE OF THE BIOLOGICAL DOSE-RESPONSE CURVE IS UNKNOWN.
SUMMARY OF CONCLUSIONS DRAWN FROM STUDIES REVIEWED
CHILDHOOD STUDIES
1. RATIOS FOR INCREASED PREVALENCE OF RESPIRATORY
SYMPTOMS: 1.2 - 1.8, THEREFORE ETS EXPOSURE CAUSES RESPIRATORY SYMPTOMS IN SOME CHILDREN.
2. DECREASES IN LUNG FUNCTION DUE TO ETS: 0 TO 0.5% PER YEAR. THIS EFFECT IS NOT CLINICALLY IMPORTANT BUT MAY:
- REFLECT PATHOPHYSIOLOGICAL EFFECTS
- BE A FACTOR IN LATER DEVELOPMENT OF CHRONIC
AIRFLOW OBSTRUCTION,
3. DOSE-RESPONSE RELATIONSHIPS EXIST BETWEEN LOW BIRTHWEIGHT
CHILDREN AND:
- PREGNANT WOMEN WITH DAILY ETS EXPOSURE.
- NUMBER OF CIGARETTES SMOKED BY FATHER.
4. HOUSEHOLD ETS EXPOSURE IS LINKED TO RETARDED GROWTH AND
DEVELOPMENT AND CHRONIC EAR INFECTIONS.
[From Page 15-17, Bates Nos. 620002367/2369]
IMPACT OF ETS ON INDOOR AIR QUALITY
0DOUR
l. ETS AROUSES ODOUR RESPONSES. OBJECTIONABLE ODOUR GENERATED BY ETS GREATLY EXCEEDS THAT GENERATED BY SIMPLE OCCUPANCY UNDER COMPARABLE CONDITIONS OF OCCUPANCY, DENSITY,
TEMPERATURE AND RELATIVE HUMIDITY.
2. TOBACCO SMOKE ODOUR IS STABLE OVER TIME. CURRENT
VENTILATION AND AIR CLEANING REQUIREMENTS DO NOT REMOVE
ODOUR.
3. 0DOUR DERIVES PRIMARILY FROM THE VAPOUR PHASE.
4. 0DOUR GOVERNS REACTIONS OF VISITORS. IRRITATION GOVERNS
REACTIONS OF OCCUPANTS.
IRRITATION
1. EYE IRRITATION IS THE MOST IMPORTANT NEGATIVE FACTOR.
2. EYE BLINK CORRELATES WITH SENSORY IRRITATION AT HIGH
LEVELS OF ETS (C0>5 PPM).
3. IRRITATION CAN BE ATTRIBUTED TO THE PARTICULATE PHASE.
4. IRRITATION MAY REMAIN AFTER REMOVAL OF IRRITANT,
5. CUTANEOUS SENSITIVITY TO TOBACCO LEAF OR SMOKE EXTRACTS
DOES NOT CORRELATE WITH SUBJECTIVE SYMPTOMS.
VENTILATION
1. LOW HUMIDITY EXACERBATES ODOUR AND IRRITATION TO ETS.
2. VENTILATION RATES OF 50-60 CFM PER PERSON ARE REQUIRED
TO PROVIDE SATISFACTORY INDOOR AIR QUALITY WHERE ETS
IS PRESENT.
3. THERE IS PROBABLY NO PRACTICAL VENTILATION RATE THAT COULD SATISFY 80% OR MORE NON-SMOKING VISITORS.
4. SEGREGATION OF SMOKER/NON-SMOKERS IS NOT A SOLUTION.
ASHRAE GUIDELINES FOR VENTILATION
TARGET: SATISFY 80% OF VISITORS TO A ROOM.
NON-SMOKING: 5-8 CFM PER OCCUPANT.
SMOKING: 20-35 CFM PER OCCUPANT.
ASHRAE GUIDELINES CONSIDERED INADEQUATE DUE TO:
1. BASED ON LITERATURE VALUES, ASHRAE GUIDELINES SATISFY
50-75% VISITORS AND NON-SMOKING OCCUPANTS NOT 80%.
2. NON-SMOKERS HAVE LOWER THRESHOLD VALUES FOR OBJECTIONS
WHICH SHOULD TAKE PRECEDENCE.
SEGREGATION OF SMOKERS / NON-SMOKERS
NOT A SOLUTION:
1. RATE OF MIGRATION OF SMOKE FROM SMOKING TO NON-SMOKING
AREAS IS UNKNOWN.
2. COMMON VENTILATION/FILTRATION SYSTEMS NEGATE ANY
BENEFITS OF SEGREGATION.
ENVIRONMENTAL TOBACCO SMOKE: WHY IS IT A PROBLEM?
ISSIES TO BE ADDRESSED:
0
i. POLITICAL:
2, SOCIAL
- GUIDELINES
- LEGISLATIONS
- HEALTH CONCERNS
- INDOOR AIR QUALITY
3, TECHNICAL:
- NATURE OF ETS
- ASSESSING EXPOSURE-DOSE-RESPONSE
f
/
G;~000;~353
LIMITATIONS OF INDUSTRIAL EXPOSURE GUIDELINES
WITH RESPECT TO ETS
,
ACCEPTABLE LIMITS APPLY TO INDIVIDUAL COMPONENTS
NOT A COMPLEX MIXTURE, SYNERGISTIC EFFECTS ARE
UNKNOWN,
O
1
.
LIMITS ARE INTERPRETED AS TLV, TWA, STEL, ETC,
I,E, LIMITEDEXPOSURE, ETS EXPOSURE MAY BE CHRONIC,
RAHIFICATIONS ARE UNCLEAR,
LIMITS APPLY TO NORMAL, HEALTHY POPU~TIONS NOT TO
POPULATIONS AT RISK,
,
.
.
THERE ARE CONSTITUENTS OF ETS FOR WHICH THERE ARE NO
GUIDELINES,
ETS MY UNDERGO SECONDARY REACTIONS GENERATING POSSIBLY
MORE HAZARDOUS COMPOUNDS,
TOXICITY OF SOME CONSTITUENTS (# 4) AND SECONDARY
PRODUCTS IS UNKNOWN,
LZ .... : .........
62000~355
BASIS FOR HEALTH CONCERNS
STUDY TYPE
AILMENT INVESTIGATED
0
CHILDHOOD
POPULATIONS AT RISK
EXTRAPOLATION FROM SMOKERS
SPOUSAL
LUNG FUNCTION
LUNG FUNCTION
LUNG FUNCTION, LUNG
OTHER CANCERS
LUNG CANCER
CANCER,
._7
SUM~RY OF CONCLUSIONS DRAWN FROM STUDIES REVIEWED
CHILDHOOD STUDIES
i,
RATIOS FOR INCREASED PREVALENCE OF RESPIRATORY
SYMPTOMS: 1,2 - 1,8,
THEREFORE ETS EXPOSURE CAUSES RESPIRATORY SYMPTOMS IN
SOME CHILDREN,
O
,
DECREASES IN LUNG FUNCTION DUE TO ETS: U TO 0,5~ PER YEAR,
THIS EFFECT IS NOT CLINICALLY IMPORTANT BUT MAY:
- REFLECT PATHOPHYSIOLOGICAL EFFECTS
- BE A FACTOR IN LATER DEVELOPMENT OF CHRONIC
AIRFLOW OBSTRUCTION,
,
DOSE-RESPONSE RELATIONSHIPS EXIST BETWEEN LOW BIRTHWEIGHT
CHILDREN AND:
- PREGNANT WOMEN WITH DAILY ETS EXPOSURE,
- NUMBER OF CIGARETTES SMOKED BY FATHER,
q, HOUSEHOLD ETS EXPOSURE IS LINKED TO RETARDED GROWTH AND
DEVELOPMENT AND CHRONIC EAR INFECTIONS,
T
SUMMARY DF CONCLUSIONS DRAWN FROM STUDIES REVIEWED
SPOUSAL STUDIES
ii
FOR 11 OUT nP ]~ GROUPS (8 SEPARATE STUDIES) OF NON
SMOKERS EXPOSED TO ETS, THE RELATIVE RISK OF LUNG
CANCER EXCEEDS 1.0. HOWEVER THIS IS SIGNIFICANT
(P<0.OS) IN ONLY 5 OF THESE GROUPS.
O
2. SUMMARy ESTIMATES PLACE RESTIVE RISK OF LUNG CANCER
IN NON-SMOKERS AT 1.34, WITH A RANGE OF VALUES 1.15-1.52.
,
MISCLASSIFICATIDN BIAS DOES NOT ACCOUNT FOR ALL THE
INCREASED RISK, RECALCULATI~OF RELATIVE RISK, USING
10, 20, ~O AND 40~ MISCLASDIFICATION RATES YIELDS A
MINIMUM RELATIVE RISK OF
1.25 FOR NON-SMOKERS MARRIED TO SMOKERS AND
1.08 FOR NON-SMOKERS MARRIED TO NON-SMOKERS BUT
EXPOSED TO ETS.
CALLS FOR FURTHER RESEARCH
O
EPIDEMIOLOGY
1, LONGITUDINAL STUDIES TO INVESTIGATE EFFECTS OF ETS
EXPOSURE ON LUNG FUNCTION
- TO CONTROL FOR HOUSING/CLIMATE
- TO ASSESS DEVELOPMENT OF AIRWAY HYPER-RESPONSIVENESS,
2, COHORT STUDIES OF NORMAL AND AT-RISK POPULATIONS"
- ASTHMATICS
- OBSTRUCTIVE LUNG DISORDER PATIENTS
- ANGINA AND HEART DISEASE PATIENTS,
3. AssEsS THE INTERACTION BETWEEN ETS AND RADON EXPOSURE,
4, EXAMINE MECHANISMS THROUGH WHICH PATERNAL SMOKING
ADVERSELY AFFECTS FETAL GROWTH IN NON-SMOKING MOTHERS
- EXCRETION AND ABSORPTION OF ETS
- TRANSPLACENTAL METABOLISM,
NON-EPIDEMIOLOGY
i, DETERMINE THE CARCINOGENIC CONSTITUENTS OF ETS
- CONCENTRATIONS IN DAILY ENVIRONMENTS,
2, EXPLORE THE ETIOLOGIC ROLE OF INHALED DECAY PRODUCTS,
3, OUANTIFY THE DOSE-RESPONSE RELATIONSHIP USING BIOLOGICAL
MARKERS,
4, ANIMAL STUDIES TO:
- EVALUATE TIMING OF PHYSIOLOGICAL CHANGES IN LUNG FUNCTION
- ASSESS CHANGES IN CARDIOVASCULAR FUNCTIONS.
6;~000;336S
O
IBPACT OF ETS ON INDOOR AIR QUALITY
0DOUR
lJ
ETS AROUSES ODOUR RESPONSES, OBJECTIONABLE ODOUR GENERATED
BY ETS GREATLY EXCEEDS THAT GENERATED BY SIMPLE OCCUPANCY
UNDER COMPARABLE CONDITIONS OF OCCUPANCYJ DENSITY,
TEMPERATURE AND RELATIVE HUMIDITY.
O
1
TOBACCO SMOKE ODOUR IS STABLE OVER TIME, CURRENT
VENTILATION AND AIR CLEANING REQUIREMENTS DO NOT REMOVE
ODOUR,
3. 0DOUR DERIVES PRIMARILY FROM THE VAPOUR PHASE,
0DOUR GOVERNS REACTIONS OF VISITORS.
REACTIONS OF OCCUPANTS.
]RRITATION GOVERNS
x
G~OOO~3G7
O
IRRITATION
EYE IRRITATION IS THE MOST IMPORTANT NEGATIVE FACTOR.
2, EYE BLINK CORRELATES WITH SENSORY IRRITATION AT HIGH
LEVELS OF ETS (C0~5 PPM),
3, IRRITATION CAN BE ATTRIBUTED TO THE PARTICULATE PHASE,
4, IRRITATION MAY REMAIN AFTER REMOVAL OF IRRITANT,
5, CUTANEOUS SENSITIVITY TO TOBACCO LEAF OR SMOKE EXTRACTS
DOES NOT CORRELATE WITH SUBJECTIVE SYMPTOMS,
G OOO2 GS
'O
VENTILATION
1, Low HUMIDITY EXACERBATES ODOUR AND IRRITATION TO ETS,
1
VENTILATION RATES OF 50-60 CFM PER PERSON ARE REQUIRED
TO PROVIDE SATISFACTORY INDOOR AIR QUALITY WHERE ETS
IS PRESENT,
3, THERE IS PROBABLY NO PRACTICAL VENTILATION RATE THAT
COULD SATISFY 80~ OR MORE NON-SMOKING VISITORS,
4, SEGREGATION OF SMOKER/NON-SMOKERS IS ROT A SOLUTION,
fi200023G9
ASHRAE GUIDELINES FOR VENTILATION
0
TARGET
: SATISFY 80~ OF VISITORS TO A ROOM,
NON-SMOKING: 5-8 CFM PER OCCUPANT,
SMOKING : 20-35 CFM PER OCCUPANT,
ASHRAE GUIDELINES CONSIDERED INADEQUATE DUE TO:
i, BASED ON LITERATURE VALUES, ASHRAE GUIDELINES SATISFY
S0-75% VISITORS AND NON-SMOKING OCCUPANTS NOT 80~,
2. NON-SMOKERS HAVE LOWER THRESHOLD VALUES FOR OBJECTIONS
WHICH SHOULD TAKE PRECEDENCE,
G;~OOOP~.?.70
J
SEGREGATION OF SMOKERS / NON-SMOKERS
NOT A SOLUTION:
i, RATE OF'MIGRATION OF SMOKE FROM SMOKING TO NON-SMOKING
AREAS IS UNKNOWN,
0
2. COMMON VENTILATION/FILTRATION SYSTEMS NEGATE ANY
BENEFITS OF SEGREGATION,
L)
G20002371
CALLS FOR FURTHER RESEARCH
SUBJECTIVE
i, FIELD STUDIEG TO DETERMINE AN APPROPRIATE VISITOR
ACCEPTABILITY RATE,
1
INVESTIGATE THE EFFECT OF FILTRATION OF ETS, BOTH PHASES,
INCLUDING VENTILATION AND CLEANING SYSTEMS ON ABATEMENT
OF DISCOMFORT.
3. DETERMINE APPROPRIATE OBJECTIVE PHYSIOLOGICAL OR
BIOCHEMICAL INDICES TO MEASURE IRRITATION,
OBJECTIVE
i, DETERMINE CONSTITUENTS OF ETS RESPONSIBLE
2. COMPARE NORMAL AND ATOPIC INDIVIDUALS,
FOR IRRITATION.
m
