Lorillard
the Epa Review Draft: Health Effects of Passive Smoking: Assessment of Lung Cancer in Adults and Respiratory Disorders in Children
Fields
- Type
- REPT, OTHER REPORT
- BIBL, BIBLIOGRAPHY
- Area
- SPEARS,ALEXANDER/EXEC CONF ROOM STORAGE
- Alias
- 87654290/87654312
- Site
- G65
- Request
- R1-004
- R1-041
- R1-048
- R1-132
- R1-041
- Named Organization
- Ahf, American Health Foundation
- Ajph
- Am J Epidemiology
- American Journal of Epidemiology
- American Review of Respiratory Disease
- Archives of Environmental Health
- Ashrae
- Ashrae Soeh Indoor Air Quality 89
- Assn of Indoor Air Pollution + Passive S
- British Medical Journal
- Chest
- Environment Intl
- Environmental Health Perspectives
- Environmental Research
- Environmental Tobacco Smoke
- Epa, Environmental Protection Agency
- Ets Environmental Tobacco Smoke
- European Journal of Respiratory Diseases
- Excerpta Medica
- Exp Pathol
- Gan No Rinsho
- Indoor Air
- Indoor Air 90 Proceedings
- Indoor Air Quality
- Intl Journal of Cancer
- Intl Journal of Epidemiology
- J Air Waste Manage Assn
- J Allergy Clin Immunol
- Japca
- Jnci
- Journal of Epidemiology + Community Heal
- Lancet
- Mutation Research
- Nejm
- New England Journal of Medicine
- Nutr Cancer
- Office of Health + Environmental Assessm
- Oncology Times
- Pediatrics
- Present + Future of Indoor Air Quality
- Proceedings Indoor Air 90 Toronto Canada
- Proceedings of the Intl Symposium Mcgill
- Proceedings Toxicology Forum 1990 Annual
- Report From Workshop on Effects + Exposu
- Respiratory Illnesses Among Japanese + C
- Risk Analysis
- Science
- Second Annual Meeting Intl Society for E
- Soc Sci Med
- Soeh
- Acta Paediatr Scan
- Ajph
- Named Person
- Adlkofer, F.
- Ahlborn, W.
- Anderson, L.
- Baker, R.
- Berglund, B.
- Berwick, M.
- Bieva, C.J.
- Brunekreef, B.
- Chapman, R.S.
- Colley, T., J.R.
- Coultas, D.
- Deserres, F.J.
- Du, Y.
- Ecobichon, J.
- Ekwo, E.E.
- Faccini, J.
- Fleming, D.W.
- Gao, Y.T.
- Gardner, G.
- Goren, A.I.
- Haley, N.
- Harrington, W.
- Hellmann, S.
- He, X.
- Hirayama
- Holma, B.
- Holst, F.A.
- Honicky, R.E.
- Hosein, H.R.
- Janerich, D.
- Kabat, G.
- Kasuga, H.
- Katzenstein, A.
- Kerigan
- Kerigan, A.
- Kilpatrick, S.
- Koo
- Koo, L.C.
- Krupnick, A.J.
- Layard, M.
- Leaderer, B.
- Lebowitz, M.D.
- Lee, P.
- Letzel, H.
- Mantel, N.
- Martin, C.
- Matsushima, T.
- Mccullough, J.
- Melia, Rjw
- Mitchell, E.
- Mumford, J.
- Nordvall, S.L.
- Oldaker, G.
- Osborne, J.S.
- Ownby, D.
- Perry, R.
- Piade, J.
- Platt, S.
- Pope, C.
- Quackenboss, J.J.
- Robertson, G.
- Rylander, R.
- Scherer, G.
- Sidney, S.
- Sobue, T.
- Speizer, F.
- Springer
- Sterling, T.D.
- Tewes, F.J.
- Uberla, K.
- Vaughan, W.
- Verlag
- Vonmeyerinck, L.
- Watkins, C.J.
- Watts, R.
- Winding, O.
- Wu, A.H.
- Wynder, E.
- Ahlborn, W.
- Date Loaded
- 05 Jun 1998
- Master ID
- 87653565/6821
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United States Office ol Health and EPA6OO'889 067F
Ermrironmentat Protection Environmental Assessment July 1989
AAgency Washmflton DC 20460
Research and Development
.=.EPA Indoor Air
Reference
Bibliography

APPENDIX I
RECENT PUBLICATIONS ON ETS
The authors of the EPA Review Draft failed to consider a
number of pertinent studies, reviews, analyses and criticisms on
ETS which were available in the published literature at the time
the Review Draft was written. (See comments re: Lung Cancer,
Exposure Studies and Children's Studies).
In addition, a number of studies and reviews on ETS have
been published recently which would warrant inclusion in any
subsequent revision of the Draft. These studies and reviews,
together with selected summaries and quotations, are listed below.
I. LUNG CANCER
A.
Primary Studies
1. Kabat, G. "Epidemiologic Studies of the Relationship
Between Passive Smoking and Lung Cancer", Proceedinas,
Toxicology Forum 1990 Annual Winter Meeting, Washington,
D.C., February, 1990: 187-199.
Preliminary results from the on-going American
Health Foundation study of 90 nonsmoker lung
cancer cases indicate no statistically
significant associations for lung cancer among
males or females who were exposed to ETS during
childhood or adulthood (in the home or the
workplace).
2. Sobue, T. "Association of Indoor Air Pollution and
Passive Smoking with Lung Cancer", Gan no Rinsho 36(3):
329-333, 1990. Translation.
Sobue and colleagues, in a study of lung cancer
among non-smoking women in Osaka, Japan,
reported no statistically significant
associations between ETS exposures during
childhood or adulthood and lung cancer among
nonsmokers. The researchers noted, however, a
statistically significant increased risk of
lung cancer among women who had used wood or
straw as cooking fuels.

3. Janerich, D. et al, "Lung Cancer and Exposure to
Tobacco Smoke in the Household", NEJM 323(10): 632-636,
1990.
In a highly publicized article, researchers
from the U.S. reported that household exposure
of 25 or more smoker years during childhood
and adolescence could double the risk of lung
cancer. However, the study noted that exposures
to spousal smoking, smoking in the workplace,
and smoking in social settings were not
significantly associated with nonsmoker lung
cancer incidence, nor were cumulative exposures
during adulthood or over a lifetime.
B. Studies on Confounding Factors
1. Rylander, R., et al., "Lung Cancer Risk by Oral
Exposure," Present and Future of Indoor Air Quality,
C.J. Bieva, et al. (eds.), (Amsterdam: Excerpta Medica,
1989): 91-100.
"A risk factor of 1.3 was found for black tea
and of 2.4 for green tea drinkers regardless
of smoking habits."
2. Tewes, F.J., "Lung Cancer Risk and Mutagenicity of
Tea," Environmental Research (52): 23-33, 1990.
"Analysis of the data demonstrated an adjusted
and statistically significant increased lung
cancer risk of 2.7 among those who drank green
tea. Several brands of tea commonly drank in
Hong Kong were assayed for mutagenicity using
Ames assay. Significantly elevated levels of
mutagenic activity were found to be present
after metabolic activation using cell-free
extracts of cecal bacteria from rats. These
data suggest that further research is needed
to understand the possible consequences to
human health of ingestants taken at low doses
but long duration over the normal lifespan,
- 2 -

and the possible interactive effect between
mutagens in tea and other ingestants and
inhalants in human cancer etiology."
3. Koo, L., "Environmental Tobacco Smoke and Lung
Cancer: Is it the Smoke or the Diet?" Present and
Future of Indoor Air Qualitv, C.J. Bieva, et al. (eds.),
(Amsterdam: Excerpta Medica, 1989): 91-100.
"Because Chinese females in Hong Kong with no
history of smoking have high incidence rates
of lung cancer, and high prevalence rates of
chronic bronchitis, various studies have been
conducted to evaluate the role of inhaled and
ingested substances in their etiology. Data
on lifetime exposures to environmental tobacco
smoke did not show dose-response effects with
risk for lung cancer. There were also
inconsistencies when trying to see whether ETS
was related to chronic bronchitis."
4. He, X., "An Epidemiological Study of Lung Cancer in
Xuan Wei County, China." Second Annual Meetina of the
International Society for Environmental Epidemioloav
,(ISEE1, Berkeley, California: August 13-15, 1990.
Abstract. .
"The result shows that, in females who do not
smoke, the presence of lung cancer is
statistically significantly associated (at
alpha-0.05) with chronic bronchitis and family
history of lung cancer, the results also suggest
an association of lung cancer with duration of
cooking food, but not with passive smoking."
5. Du, Y., "Indoor Air Pollution and Woman Lung Cancer."
Indoor Air 90 Proceedinas, Toronto, Canada: 59-64, 1990.
"The OR of coal fumes exposure for woman was as
high as 14.5."
3

C. Published Critiques and Issue Analyses
1. Layard, M., "Assessing the Validity of a Japanese
Cohort Study," Present and Future of Indoor Air ouality,
C.J. Bieva, et al. (eds.), (Amsterdam: Excerpta Medica,
1989): 177-180.
"Our analyses strongly suggest that reported
death rates in the Hirayama cohort were
substantially lower than Japanese national
rates because mortality among persons lost to
follow-up was higher than among those
successfully traced."
2. Kilpatrick, S., "An Example of Extra-Poisson
Variation Suggesting an Under-Specified Model," Present
and Future of Indoor Air Quality, C.J. Bieva, et al.
(eds.), (Amsterdam: Excerpta Medica, 1989): 83-90.
3. Wynder, E. and Kabat, G., "Environmental Tobacco
Smoke and Lung Cancer: A Critical Assessment," Indoor
Air Quality, H. Kasuga, (ed.), (Berlin-Heidelberg:
Springer-Verlag, 1990): 5-15.
"No consistent association has been reported
for lung cancer and exposure to ETS in
childhood, which might be expected to exert a
greater effect, especially when followed by
exposure throughout adulthood. Of course recall
of ETS exposure in childhood is more difficult
than recall of such exposure in adulthood."
4. Katzenstein, A., "An Estimate of Adult Mortality
in the United States from Passive Smoking; A Response,"
Environment International, 16: 175-193, 1990.
5. Mantel, N., "What Is the Epidemiologic Evidence for
a Passive Smoking-Lung Cancer Association?" Indoor Air
oualitv, H. Kasuga, (ed.), (Berlin-Heidelberg:
Springer-Verlag, 1990): 341-347.
4

6. Rylander, R., "Environmental Tobacco Smoke and Lung
Cancer," The New England Journal of Medicine 323 (12):
834, 1990.
"Studies evaluating the hypothesis of a relation
between exposure to environmental tobacco smoke
and lung cancer must take into account other
environmental risk or protection factors and
the possibility that exposure to environmental
tobacco smoke may be confounded. This has not
been considered in the majority of such
studies. Until this has been done, the claim
of causality between environmental tobacco
smoke and lung cancer remains uncertain."
7. Faccini, J., "The Role of Histopathology in the
Evaluation of Risk of Lung Cancer from Environmental
Tobacco Smoke," Exp. Fathol 37 (1-4): 177-180, 1989.
"Current clinical practice for treating lung
cancer does not provide adequate
histopathological evaluation for the clear
distinction between primary and metastatic
neoplasia. Reliance on such clinical diagnosis
jeopardizes the scientific validity of many
epidemiological studies designed to assess the
risk of inhalation of environmental tobacco
smoke (ETS)."
8. Layard, M., "Environmental Tobacco Smoke and Cancer:
The Epidemiologic Evidence," Environmental Tobacco Smoke,
Proceedings of the International Svmposium at McGill
University 1989, J. Ecobichon, (ed.), (Lexington, Mass.:
D.C. Health, 1990): 99-115.
9. Mantel, N., "The Passive Smoking Myth," Present
and Future of Indoor Air Quality, C.J. Bieva, et al.
(eds.), (Amsterdam: Excerpta Medica, 1989): 155-159.
10. Lee, P., "Passive Smoking and Lung Cancer; Fact or
Fiction?" Present and Future of Indoor Air Quality,
C.J. Bieva, et al. (eds.), (Amsterdam: Excerpta Medica,
1989): 119-128.
- 5 -

11. Adlkofer, F., "Exposure to ETS and its Biological
Effects: A Review," Present and Future of Indoor Air
Quality, C.J. Bieva, et al. (eds.), (Amsterdam: Excerpta
Medica, 1989): 189-196.
12. Uberla, K. and Ahlborn, w., "Passive Smoking and
Lung Cancer: A Reanalysis of Hirayama's Data," Indoor
Air Quality, H. Kasuga (ed.), (Berlin-Heidelberg:
Springer-Verlag, 1990): 333-340.
13. Letzel, H. and Uberla, K., "Meta-Analyses on Passive
Smoking and Lung Cancer," Indoor Air Quality, H. Kasuga
(ed.), (Berlin-Heidelberg: Springer-Verlag, 1990):
316-322.
6

II. STUDIES ON ETS/EXPOSURE ASSESSMENT
1. Watts, R., et al., "Cotinine Analytical Workshop
Report: Consideration of Analytical Methods for
Determining Cotinine in Human Body Fluids as a Measure
of Passive Exposure to Tobacco Smoke," Environmental
Health Perspectives, 84: 173-182, 1990.
2. Vaughan, W., "Impact of a "Designated Smoking Area"
Policy on Nicotine Vapor and Particle Concentrations in
a Modern Office Building," y7. Air-Waste Manaae Assoc.,
40, (7): 1012-1017, 1990.
3. Haley, N., "Elimination of Cotinine from Body
Fluids: Disposition in Smokers and Nonsmokers," AJPH
79, (8): 1046-1048, 1989.
"Differences in the mode of uptake and
absorption of nicotine and possible differences
in nicotine metabolism may play roles in the
clearance rate differences between smokers
and nonsmokers."
4. Von Meyerinck, L., et al., "Exposure of Rats and
Hamsters to Sidestream Smoke from Cigarettes in a
Subchronic Inhalation Study," Exp. Pathol, 37 (1-4): 186-
189, 1989. Poster.
"A 90-day feasibility study was performed in
which rats and hamsters were exposed to the
sidestream smoke of cigarettes. The only
histopathological changes observed were
hyperplasia and metaplasia of the epithelium
covering the dorsal nasal turbinate bones in
rats. These effects were reversible within
90 days."
7

5. Scherer, G., "Biomonitoring of Exposure to
Potentially Genotoxic Substances from Environmental
Tobacco Smoke," Environment International, 15: 49-56,
1989.
"No statistically significant increase was found
in the urinary mutagenicity after either of
the two exposure regimens, whereas thioether
excretion was significantly elevated. The
data suggest that nonsmokers in real-life
situations take up very, low doses of ETS
constituents, and detoxification of the
genotoxic substances inhaled i-s effective."
6. Leaderer, B., "Assessing Exposures to Environmental
Tobacco Smoke," Risk Analysis, 10, (1): 19-26, 1990.
7. Oldaker, G., et al., "Results from Surveys of
Environmental Tobacco Smoke in Offices and Restaurants,"
Indoor Air Ouality, H. Kasuga (ed.) (Berlin-Heidelberg:
Springer-Verlag, 1990): 99-104.
8. Sterling, T.D., "ETS in Offices and When Smoking Is
Restricted to Designated But Not Separately Ventilated
Areas," Indoor Air Quality, H. Kasuga (ed.)
(Berlin-Heidelberg: Springer-Verlag, 1990): 120-129.
9. Baker, R., "The Origins and Properties of
Environmental Tobacco Smoke," Environment International,
16: 231-245, 1990.
10. Coultas, D., "Questionnairq Assessment of Lifetime
and Recent Exposure to Environmental Tobacco Smoke,"
American Journal of EDidemioloav, 130, (2): pp. 338-347,
1989.

11. Coultas, D. et al., "A Personal Monitoring Study to
Assess Workplace Exposure to Environmental Tobacco Smoke,"
AJPH, 80, (8): pp. 988-990, 1990.
"The controversial effects of involuntary
smoking in the workplace need further
investigation. The conduct of such research
would be facilitated by the development of
unintrusive and accurate methods of exposure
assessment. Alternative approaches include
active and passive monitoring, biological
markers, and questionnaires. We have shown
that personal monitoring for tobacco smoke
components can be accomplished in the
workplace."
12. Perry, R. et al., "Indoor Air Quality: The
Contribution of Environmental Tobacco Smoke," Indoor Air
Quality, H. Kasuga (ed.) (Berlin-Heidelberg:
Springer-Verlag, 1990): 62-75.
13. Piade, J. et al., "Assessment of ETS Impact on Office
Air Quality," Indoor Air Quality, H. Kasuga (ed.)
(Berlin-Heidelberg: Springer-Verlag, 1990): 112-119.
14. Robertson, G., "Source, Nature, and Symptomology of
Indoor Air Pollutants," Indoor Air Quality, H. Kasuga
(ed.) (Berlin-Heidelberg: Springer-Verlag, 1990): 393-
402.
15. Quackenboss, James J., "Indoor-Outdoor Relationships
for Particulate Matter: Exposure Classifications and
Health Effects," Environment International, 15: 353-360,
1989. 1
