Tobacco Documents Online

EXH1h11 A r I =NV i RCNME'JTAL TOBACCJ SMOKi= : A-4NDBCGK = :? IASScSSMENT, MITIGATION, AND PREVENTION OF _XFCS~RES ~ James Repace, EPA, and Donald Shopland, OSH AUDIENCE: The audience for this handbook would be decision-makers such as labor and management officials concerned with workplace exposures, public health officials and corporate medical directors who are concerned wirh making hea;th policy recommendatiois, educators, industrial hygienists and safety officers, indoor air pollution investigators concerned with ETS in buildings, and legislators who are considering legislation to restrict smoking in workplaces, restaurants, and public access buildings. MATERIAL: The recent reports of the Surgeon General on Involuntary Smoking and the National Academy of Science on Environmentmental Tobacco Smoke, as well as the forthcoming report by IARC on Passive Smoking will be summarized and organized according to the outline below. Other authoritative material will be added as appropriate. LEVEL OF PRESENTATION: At a technical level appropriate to the subject matter, but simplified with graphics and summaries so that the material can be grasped by the wide audience described above, as for example, an article In Scientific American. AUTHORS: 8-12 selected experts will provide written chapters on IBM-compatible floppy disks. (Authors to be hired by EPA, OSH/CDC, NCI, NHLBI, PHS1 PEER REVIEW: Peer review will be handled institutionaily through NIH. A contractor will convert all disks to a single system to produce a profession- ally-edited first draft for peer review by participating agencies. In the event some authors cannot provide floppy copy, contractor will provide data entry. (Contractor to be hired by EPA1 Peer-reviewed comments to be handled by an editorial board, with members designated by participating organizations. (Executive reviewers may be hiredl PRODUCTION: A second conctractor will producs camera-ready copy for printing, including final reproductions of all graphics. First printing will be done by EPA. (Contractor to be hired by OSHI DETAILED OUTLINE WITH AUTHORS AND ESTIMATED PAGES I. HEALTH EFFECTS OF TO8ACC0 SMOKE (overview written by OSH: Author: Shoplandl A. HEALTH EFFECTS AT HIGH DOSES (20 pp: OSH: Shopland) i. The diseases of smoking, emphasis on low smoking rates a. Cancer: dose-response, effect of duration and intensity of smoking. b. Heart Disease " ~ 01 c. Lung Disease " fO; d. Pregnancy " , O p e. Public Health Implications: age-specific mortality; productivity lo~

-2- B. HEALTri EFFECTS AT LOW DOSES (40 pp: NCI; NHLBI; EPAI 1. Effects of ETS on chronic diseases in healthy populations: a. Lung Cancer, Other Cancers tNCi: Pechacek:: Burns; SamaYl 20 pp. b. Coronary Heart Disease iNHLBI: Morosco: 5 pp.1 c. Respiratory Sympto!ns, Infections, Lung Disease and lung function INHLBI: Morosco: 5 ppi ii. Effects of ETS on High Risk populations: asthmatics, cnildren, High risk populations: pre-existing disease states, hyper-allergics. 110 pp Hulka? I It. RISK ASSESSMENT OF ETS (5-10 pp: EPA, NRL: Repace & Lowreyl A. LUNG CANCER (Preamble: what is done for other carcinogens: Anderson paperl B. TOTAL MORTALITY C. WORKPLACE PROOUCT I V I TY III. DIAGNOSIS OF EXPOSURES TO ENYIRONMENTAL TOBACCO SMOKE 140 pp: EPA, Repace & Lo% A. EVIDENCE FOR PANDEMIC EXPOSURE: FIELD STUDIES OF ETS. 9. EVIDENCE FOR DOSE: SUMMARY OF NICOTINE, COTiNINE STUDIES SHOWING IMPORTANCE OF HOME AND WORKPLACE: CURRENT EXPOSURE PROBABILITIES C. GENERATION, FATE, AND TRANSPORT OF ETS. 0. EXPOSURE AND DOSE ESTIMATION i. Models IRepace and Lowreyl il. Monitoring: Area monitoring, personal monitoring, biochemical measures. (EPA: 15 pp; Spengler; Hammond; Leaderer; Lewtasl E. MEAS1REtrENT TECHNIQUES iEPA: 25 pp: Leadererl GO %3 i. Individual Constituents: RSP, Nicotine, 00, others. <n '17 F. CONSTITlENTS OF ETS IOSH: Shopland: Hoffmann, 5 pp] O IV. MITIGATION OF EXPOSURES TO ENYIRONMENTAL TOBACCO SMOKE 145 ppi 0 M+ A. LIMITS IMPOSEO BY COMFORT AND 000R CONSIDERATIONS (Acute) IEPA: Leaderer, 20 B. VENTILATION AND AIR CLEANING FOR EXPOSURE REDUCTION (Repace & Lowrey, Leadere, C. EFFICACY OF SPATIAL ANO TEM'ORAL SEPARATION, esp in Restaurants IRepace & l.owr 0. EFFICACY OF SOURCE CONTROL (Repace & Lowreyl r E. WMAT CONST 1 TUTES REASONABLY SMOKE-FREE A 1 RI

-3- V. °REVENTION OF EXPOSURES TO =NVIRONMENTAL TOBACCO SMOKE (100 A. REVIEW OF LEGISLATIVE APPROACHES TO SMOKING RESTRICTIONS 1. STATE LEGISLATION (OSH: Don Garnerl (Thru mid 1987: 50 pp1 2. LOCAL CASE HISTORIES: MAJOR CITIES (N.Y., S.F., LA, Cambridge MA) [Mark Pertschuk: 10 pp1 B. WORKPLACE SMOKING POLICIES (ODPHP: 70 pp 1 1. CASE STUDIES: (Anne Kiefhaber: Mike Ericson/Nancy Rogatil (20 pp1 C. ECONOMIC RATIONALE FOR WORKPLACE SMOKING RESTRICTIONS (20 pp , Marvin <ris D. SMOKING AREAS IN RESTAURANTS: ARE THEY PRACTICAL? (5 pp EPAI E. SCHOOL, DAY CARE, & HEALTH CARE POLICIES (10 pp, OSH: Hulkal F. POLICIES OF AIRLINES/AIRPORTS, OTHER TRANSPORT (15 pp, ???? Yates, ASMAI G. SMOKING IN THE HOME: RECOhMENDATIONS FOR PARENTS AND SPOUSES WHO SMOKE [Repace & Shoplandl (5 pp1 H. REACTION TO RESTRICTIONS ON SMOKING IN PUBLIC & IN THE WORKPLACE 1. GENERAL PUBLIC 20pp fOSH: Roper, ALA, TI, BNA, OSH, ODPHP SURVEYSI 2. ORGANIZED LABOR 15 pp(NHLBI: Sydney Parker?1 3. TOBACCO INDUSTRY 5 pp IShopland/Repacel V1. LEGAL AND SOCIOLOGICAL ISSUES IN THE WORKPLACE 130 pp: Matt Meyers & Mike Per VII. ATTITUDES OF RELIGIOUS GROUPS ??? VIII. INFORMATION RESOURCES: SOURCES, PEOPLE, ORGANIZATIONS (EPA, OSH; 10 ppi 1. Government 2. Ma,jor voluntaries/health organizations 3. Policital 4. Private 5. Technical GID ~ C11 FINANCIAL RESOURCES: O O EPA OSH/CDC NCI NHLBI ODPHP N