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SHOoK, HARDY& BACON REPORT ON RECENT ETS AND IAQ DEVELOPMENTS April 30, 1993

REPORT ON'RECENT ETS AND IAQ DEVELOPMENTS - IN THIS ISSUE - IN THE UNITED STATES REGULATORY AND LEGISLATIVE MATTERS • Update on pending ETS/IAQ bills includes summary of most recent hearings held on Traficant H. R. 881, p. 1. • "The EPA Report: Why the Tobacco Control World Will Never be the Same," p. 1. • EPA will'study carpets in attempt to d'upli- cace Anderson Laboratories study, p. 2. ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS • Latest activities in Broin, p. 3. • Zwillman plans to dismiss suit, p. 4. ETS/IAQ LITIGATION NbT INVOLVING CIGARETTE MANUFACTURERS • Class action is filed against carpet industry, p. 4. • Handicap discrimination suit Hinman is decided in Washington, p. 5. • Government workers will not get increased ventilation after ruling in AFGE case, p. 5. OTHER DEVELOPMENTS • McDonald's will not include shareholder proposall on smoking ban in proxy state- ment, p. 6. • Other fast-food chains are keeping an eye on McDonald's test smoking ban, p. 6. SCIENTIFIC/TECHNICAL ITEMS ISSUE 46 RECENT/UPCOMING MEETINGS • Report from Indoor Environment '93, p. 7. • IAQ Congress will be held in June, p. 8. SMOKING POLICIES AND RELATED ISSUES • Sharon Boyce of BAT writes letter to the editor of Tobacco Contro4 and Repace and Lowrey respond, p. 10. IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS • Activity in Australia, Canada, Philippines, Taiwan and United Kingdom, p. 11. ETS-RELATED LITIGATION INVOLVING CIGARETTE MANUFACTURERS • AFCO files application for special leave to appeal, p. 12. OTHER DEVELOPMENTS • Australian restaurants are surveyed in smoking policies, p. 13. • Doctors in India say ETS is more toxic than mainstream smoke, p. 13.

- TABLE OF CONTENTS - Issue 46 Apri130, 1993 IN THE UNITED STATES REGULATORY AND LEGISLATIVE MATTERS U.S. CONGRESS [1] Updates on Federal ETS/IAQLegislation; Hearing Held on H.R. 881 ...................................I U.S. ENVIRONMENTAL PROTECTION AGENCY (EPA) [2] "The EPA Report: Why the Tobacco Control World Will Never be the Same," David M. Burns, Tobacco Control2(1): 3-4 ............................................................................. 1 [3] EPA to Study Carpet Emissions ...............................................................................................2 STATE AND LOCAL GOVERNMENTS [4] ETS-Related State and Local Legislative Activities ...................................................................2 (5) IAQ-Related State and Local Legislation ..................................................................................3 ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS (6] Broin: Lorillard Renews Motion for Sanctions ......................................................................... 3 [7] Ztui!lman: Plaintiff Says He Will Dismiss Case ........................................................................4 ETS/IAQ LITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS IAQ:CARPET EMISSIONS [8] Howe!l v. Shaw Industries. Inc.. 93-CV.2068 (U.S. District Court. Eastern District, Pennsylvania) (filed April 19, 1993) ...............•-.•••-•-••••-••••-•••-••••.••-•••••••••••••••• 4 WORIa'LACEt HANDICAP DISCRIMINATION [9] Hinman v. Yakima School District No. 7. 1993 Wash. App. LEXIS 153 (Washington Court of Appeals) (decided April 20, 1993) .........................................•--••••••••••-•5 WORKPIACE: COLLECTIVE BARGAINING [10] Newark Valley Central School District v. Public Employment Relations Baard 1993 N.Y. App, Div. LEXIS 3729 (Supreme Court of New York, Appellate Division) (decided April 15, 1993) .................................................................................................... ...... 5 [11] In re: Department ofHealth and Human Servicrs/SSA and Loca13172. American Federation ofGotxnsmrnr Employees. AFL-CIO, 1993 WL 106970 (Federal Service Impasses Panel) (decided April 7. 1993) ......................................................... 5 OTHER DEVELOPMENTS (12] "It's Ronald McDonald vs. Joe Camel in the Smoking Debate," B.A. Epstein, St. Petersburg Times, April 12. 1993 .........................................................................................6 (131 SEC Approves Omission of McDonald's Shareholder Proposal About Smoking Policy ...........6 [14] Restaurant Chain Operators Keep Eye On McDonald's Experiment .......................................6 [15] MCS Sufferers Want Perfumes Banned under ADA .................................................•.••••••••---••6 [16] Shopping Mall Goes Smoke Frcc .............................................................................................7 [17] Survey on Corporate Health Practices Released ............................................. .......................... 7 [18] Hotel Space for Nonsmokers ...................................................................................................7 (19] Smoking Rights Advocates Decry Use of Tobacco Tax Funds .................................................7 SCIENTIFIGTECHNICAL ITEMS RECENT/UPCOMING MEETINGS [20] "Indoor Environment '93: Defining Strategies for Effective Indoor Air Management," Baltimore. Maryland, April 2d-23. 1993 ................................................................................. 7 [21 j Indoor Air Quality Congress '93, Boston, Massachusetts, June 15-16, 1993 .....................•--•••8 LUNG CANCER [22] Letter to the Editor Regarding "Commentary: Environmental Tobacco Smoke and Lung Cancer." C.W. Heath, The Lancet 341: 526. 1993 .................................•.•-••-••••••••..8 RESPIRATORY DISEASES AND CONDITIONS - CHILDREN [231 "Chronic Sidestream Smoke (SS) Effects on Airway and Pulmonary Artery Reactivity to Serotonin in Developing Rats." J.M. Bric. K.E. Pinkerton, and J:P: Joad, Journal ofA!largyand Ct'rnicalImmunology91 (1 Part 2), 1993 [See Appendix A] ....................9

Contents Continued, Issue 46 [24] "Risk Factors for Acute Wheezing," A.L. Duff„E. Pomeranz, G.W. Price, L.E. Gelber, A.H. Farris, F.G. Hayden. A.E. Plata-Mills, and P.W. Heymann,. Annals ofAllergy 70: 47, 1993 [See Appendix A] ......................................................................9 OTHER HEALTH ISSUFS [25] "Evaluation of Individuals Attributing Hypersensitivity Symptoms (HS) to Indoor Air Pollution (IAP)," P. Kuhnl, G. Golling,$. Eberlein-Konig, and B. Przybilla, Journal ofAllargy and Clinical lmmunology 91 (1 Part 2). 1993 [See Appendix A] .................................................................................................... ........9 [261 "Spontaneous Resolution of Severe Chronic Glue Ear in Children and the Effect of Adenoidectomy. Tonsillectomy. and Insertiornof Ventilation Tubes (Grommets)." R. Maw and R. Bawden, Britrsh Merlical Journal306: 756-760. 1993 [See Appendix A] ......... 9 [27] "Social Differences in Swedish Infant Mortality by Cause of Death. 1983 to 1986," M.L. Nordstrom, S. Cnattingius, and B. Haglund. Artterican fournal ofPu6lic Health 83:,26-30, 1993 [See Appendix A] ...............................................................................9 ETS EXPOSURE AND MONITORING (281 "Development of Pulmonary Cytochrome P450 (CP-450) Isoenzymes: Protein Expression. Activity and Response to Environmental Tobacco Smoke (ETS)'in Postnatal Rats." A. Gebremichael. C.G. Plopper, A.R. Buckpitt. and K.E. Pinkerton, Toxicologist 13: 49, 1993 [See Appendix A] ........................................................................... 10 [29] "A Time Series Model for Cigarette Smoking Activity Patterns: Model Validation for Carbon Monoxide and Respirable Particles in a Chamber and an Automobile," W. Ott. L. Langan, and P. Switzer, Journal ofF.xposurt Analysis and Environmental Epidemiology 2(Suppl. 2): 175-200. 1992 [See Appendix A] .................................................................................................... ...... 10 INDOOR AIR QUALIZY [30]' "Air Movement. Comfort and Ventilation in Partitioned Workstations," F.S. Bauman,,R.S. Helm, D. Faulker, E.A. Arens, and W.J. Fisk, ASHRABJournal (March): 42-50. 1993 [See Appendix A) .................................................... 10 [31) "Will the Mouse Bioassay for Estimating Sensory Irritancy of Airborne Chemicals (ASTM E 981-84) Be Useful for Evaluation of Indoor Air Contaminants?" J.S. Tepper and D.L. Costa, Indoor Environment 1: 367-372, 1992 [See Appendix A] ........... 10 SMOKING POLICIES AND RELATED ISSUES (3211 Letters to the Editor Regarding "Issues and Answers Concerning Passive Smoking in the Workplace: Rebutting Tobacco Industry Arguments." J.L. Repace and A.H. Lowrey, Tobacco Contsoll: 208-219. 1992 ...................................................................10 STATISTiCS AND RISK ASSESSMENT [33] "An Individual DecisiomModel For Environmental Exposure Reduction,"'N. Duan and W. Ott, Journal ofF.xposurt Analysis and Enviranmental Epidemiology 2 (Suppl. 2): 155-174. 1992 (See Appendix A] .........................................................................11 IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS AUSTRALIA [34] Parliament House Smoking Policy Debated in New South Wales .......................................•-11 [35] Smoking Bans Adopted it•. Railway Stations and on Trains .................................................... 1 1 [36] Local Council Adopts Smoking Ban ......................................................................................1 1 CANADA [37] North York Considers Tougher Smoking Restrictions ........................................................... 12 PHILIPPINES [38] Manila Adopts Street Corner Jails to Enforce Smoking Laws ................................................. 12 TA1wAN [39] Legislature Considers Tobacco Hazards Control Act ............................................................. 12

Contents Continued, Issue 46 UNITED KJNGDOM [40] More Action Considered by Local Governments on Smoking Issue ....................................... 12 ETS-RELATED LITIGATION INVOLVING CIGARETTE MANUFACTURERS AUSrxALIA (411 Tobacco Inrrirate ofAustrralia Ltd. v. Austra4an Federation of Conrymn Organuatrora Inc. (Australian High Court) (appeal filed April' 1. 1993) ................................. 12 OTHER DEVELOPMENTS AUSTRALIA [42] Restaurant Smoking Policies Stir Debate ..................................................••••.••--•••--•-.-•••-•-••--.13 [43] Landmark Shopping Complex to Ban Smoking ....................................................•....•••--•••-... 13 (441 Chinatown Restaurants Experiment With Smoking Restrictions ...........................................13 BELGIUM (45] Tobacco Information Centre Begins Courtesy Campaign on Smoking .................................. 13 CANADA [46) IAQ Becomes Marketing Tool for Commercial Building Managers ....................................... 13 (47) Train Smoking Bans Announced ........................................................................................... 13 INDIA [48) Doctors Call for Declaration About ETS ............................................................................... 13 JAPAN [49] Nonsmoking,Businessman Fined for Assault on Airline Cabin Crew ..................................... 14 UNITED KINGDOM (50] Antismoking Activists Seek ETS Legislation ...................................................••-•••••-••••••-•-••••• 14 (51] Unusual Coalition Seeks to Overturn Railway Smoking Ban ................................................. 14 APPENDIX A .................................................................................................... ............................... Article Summaries APPENDIX B .................................................................................................... .............Anderson Expcrt Designation APPENDIX C .................................................................................................... .................................... ASH Handout

APRIL 30. 1993 1 REPORT ON RECENT ETS AND IAQ DEVELOPMENTS IN THE UNITED STATES REGULATORY AND LEGISLATIVE MATTERS U.S. CONGRESS [1 ] Updates on Federal ETS/IAQ Legislation; Hearing Held on H.R 881 In the four months since the 103d Congress convened, a number of measures relating to ETS/IAQ have been introduced. They indude "PRO-IQDS" (H.R 710, S. 261), "PRO-FEDS" (S. 262), the Traficant "Ban on Smoking in Federal Buildings Act" (H.R. 881), and the "Indoor Air QualiryAct of 1993" (S. 656). A House measure on indoor air is expected to be introduced by Representative Joseph Kennedy II (D-Mass.) at any time. In addition, OSHA reform legislation has been intro- duced in both the House and Senate (H.R. 1280, S. 575). Although this legislation does not require IAQinvestiga- tions or the development of an IAQ standard, the House version of the bill would set a threshold for a finding of significant risk for suspected carcinogens in the workplace at one in a million. Only the Traficant measure has been the subject of Congressional hearings. Hearings were held on H.R. 881 on February 23 and March 11. See issues 42 and 43 of this Report, March 5 and 19, 1993. And again, on April 22, 1993, the House Public Buildings and Grounds Subcommittee convened to take testimony on the bill. Testifying at this hearing were Dr. John Hoyt of the Society of Critical Care Medicine; Dr. Alfred Munzer of the Coalition on Smoking OR Health; Dr. Gio Gori; and Gray Robertson of Healthy Buildings International (HBI); Lawrence Rogers, Director of the Department of Labor's Office of Workers' Compensation Programs; David Zeigler, Acting OSHA Administrator; and Dr. Douglas Dockery of the Harvard School of Public Health. The OSHA officials did not provide any new infor- ination regarding OSHA's plans for an ETS regulation, but they did testify that concerns about the alleged health effects of ETS were not likely to lead to in- creased liability exposure for the federal government. Specifically, Lawrence Rogers observed that relatively few workers' compensation claims have been filed against the federal government on the basis of alleged ETS-related injuries, and that such claims should actually decrease in the future in light of the restrictive smoking policies that have already been adopted in federal workplaces. Representative Traficant repeatedly asked Rogers about the issue of increasing future ETS compensation awards, but Rogers refused to modify his opinion. Rogers did agree, however, to provide for the record calculations of the costs associated with handling claims filed through the federal workers' compensation program. Dr. Gio Gori and Gray Robertson appeared at the hearing on behalf of the Tobacco Institute. Gori testified about problems with the EPA Risk Assessment on ETS, and Robertson discussed the role of ETS in IAQ Subcommittee member John Tucker (D-Cal.) remarked that HBI's approach seemed reasonable from both sides of the workplace smoking debate. Represen- tative Bill Emerson (R-Mo.), another member of the subcommittee, submitted into the record a legal analysis prepared by Covington & Burling, which suggests that liability exposure is unlikely to increase based solely on the EPA Risk Assessment on ETS. The hearing conduded without an indication from the subcommittee when the bill would be considered fmher. U.S. ENViRONMENTAL PROTECTION AGENCY (EPA) [2] "The EPA Report: Why the Tobacco Control World Will Never be the Same," David M. Burns, Tobacco Control2(1): 3-4 Declaring the EPA Risk Assessment on ETS as "the beginning of a new era in tobacco control," a doctor who participated in the review and approval of the risk

2 assessment claims the scientific community has reached a consensus on these three points: • "ETS exposure causes lung cancer. •"Levels of ETS exposure that commonly occur in the work environment and other public places result in a risk of lung cancer several hundred times greater than the risk from any other carcinogen currently allowed in the occupational environment. •"The practical approach for reduction of ETS exposure to levels that generate risks comparable to other regulated environmental carcinogens is to eliminate smoking completely from indoor environments." These points appear in an editorial in the most recent issue of Tobacco ControZ a journal devoted to anti- smoking positions. The author of the editorial is David Burns, an associate professor of medicine at the University of California in San Diego and a consultant to the EPA Science Advisory Board committee that reviewed and approved the risk assessment. "The EPA and its staff are to be congratulated for the production of a truly outstanding scientific document and for having the political courage to persist in the effort to complete its review in the face of a determined effort by the tobacco companies to alter its conclusions and prevent its release," Burns asserts. He urges the "tobacco control community" to use the risk assess- ment to shape public policy and eliminate smoking from all public environments. [3] EPA to Study Carpet Emissions According to a recent press report, EPA will begin formal testing to determine whether carpets cause neurological effects in laboratory mice. The study will reportedly "parallel" research already conducted by Anderson Laboratories in an attempt to duplicate the laboratory's findings. Results from the first phase of the three-phase project are expected to be completed and ready for peer review in late spring. EPA will apparently accept public comment at that time. The carpet industry reportedly will not be participating in the project. See Indoor Air Quality Update, April' 1993. Anderson Laboratories has reported that it tested more than 100 carpets submitted by individuals who ETS/IAQ REPORT, ISSUE 46 had health complaints that they attributed to the carpets. Mice exposed to the carpets reportedly showed sensory irritation, pulmonary irritation, neuromuscular effects. In some instances, the animals died. sAnderson named expeR witness in 8ahura. lhm 8. STATE AND LOCAL GOVERNM£NTS [4] ETS-Related State and Local Legislative Activi- ties • California California Assemblyman Curtis Tucker, Jr., is report- edly planning to introduce antismoking legislation in the state assembly that would establish statewide smoking restrictions and preempt tougher local laws on smoking. Critics of the measure say it would benefit the tobacco industry. According to a spokeswoman for the American Heart Association, the bill is "a piece of Swiss cheese, and we've seen all the pieces before." Evidently, a similar measure was introduced in 1991, but failed to dear an Assembly committee after opponents leaked a document alleging that the Assembly Speaker had suggested the strategy of trading some restrictions for statewide preemp- tion at the behest of tobacco companies. See San Francisco Chronicle, April 13,1993. • Local Governments in Kansas According to a news report, the Overland Park Citizen Advisory Council on Environmental Issues is propos- ing a ban on smoking in restaurants and businesses. A public hearing will be held July 7, 1993, after which the matter could be considered by the full City Coun- cil. The proposal is opposed by the Kansas Restaurant and Hospitality Association. An Association spokesman was reported to say that restaurants have spent thou- sands of dollars to ventilate smoking areas and to make sure nonsmokers are adequately accommodated. "We just don't get complaints," he was quoted to say. See The Kansas City Star, April 21, 1993. • Local Governments in California According to a news report, the Moorpark City Council is considering a smoking ban in nearly all enclosed public places. The Council has delayed a decision until all businesses in the city could be notified and residents alerted. A public hearing is scheduled for May 19. The proposed ban would prohibit smoking in elevators, buses, taxis, restrooms,

APRIL 30; 1993 retail stores, restaurants (with the exception of some outdoor seating and indoor cocktail lounges), theaters and all areas of public assembly. Employers must inform employees that smoking is prohibited in all enclosed facilities without exception. The Mayor was quoted to say, "If you read the body of information that's out there now on smoking, it s overwhelming. I can't in good conscience continue not to be affected by these overwhelmingly disturbing reports that are coming from the medical community." See Los Angeles Times, April 25, 1993. Another news report states that the Fresno City Council has voted 4 to 3 to ban smoking in most restaurants. Citing recent studies on the alleged health risks of ETS, the Council strengthened a 1987 ordi- nance that prohibited smoking in most public build- ings and required restaurants to set aside 50 percent of the dining areas for nonsmokers. Smoking will con- tinue to be permitted in bars, bowling alleys and billiard rooms. See LosAngrles Times, Apri122, 1993. • Hawaii A bill is awaiting the signature of Governor John Waihee (D). The bill prohibits smoking in all group child care homes, group child care centers and family child care homes during their hours of operation. SerS.B. 831, 17th Legislative Session - 1st Reg. Sess. (1993). • Local Governments in Texas According to a news report, Dallas school district trustees banned smoking throughout the school district starting in the fall, 1993. The policy prohibits the use of any tobacco product in schools, district buildings, and other school property, including vehicles and sports facilities. According to the report several of the trustees said that the release of the recent EPA Risk Assessment made any delay of the ban "unsafe." One trustee was quoted to say, "To hold students hostage in a building with passive smoke is an incorrect thing to do." See The Dallas Morning Neu,,4 Apri122, 1993. [51 IAQ Related State and Local Legislation • New York According to a news report, a bill was introduced on April 23, 1993, that would give currently voluntary ventilation standards the force of law in all public and private nonresidential buildings with 25,000 square feet or more floor space. Buildings would either have to be upgraded to 3 allow more fresh air or have to have sources of pollution reduced. See Nnrnday, Apri123, 1993. ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS [6] Broin: Lorillard Renews Motion for Sanctions Lorillard has renewed its motion for sanctions against eight plaintiffs who still have not made complete responses to the written discovery served by Lorillard in June 1992. A hearing has been scheduled for May 11, 1993. In other proceedings in the trial court, Judge Robert Kaye granted defendants' motion to compel discovery of plain- tiffs' medical records on April 20. The depositions of plaintiffs Gary Hayes and Valerie Gibson, scheduled for Apri12G and May 17, have been rancelled. On Apra 23, 1993, as scheduled, the Third District Court of Appeal heard oral argument on plaintiffs' appeal of the trial court's order dismissing the class action allegations of plaintiffs' complaint. The court's decision could be announced at any time. The appeals court still has not indicated whether it will entertain oral argument on defendant's petition for certiorari. The certiorari petition seeks review of the trial court's denial of a protective order concerning notices to depose senior executives of six defendants. At issue in this case are the claims of 30 flight attendants allegedly injured by occupational exposure to ETS. In addition, the husband of one of the flight attendants daims loss of consortium The 30 attendants purport to represent a class of approximately 60,000 other attendants. The injuries alleged by the putative class representatives include lung cancer, breast cancer and unspecified respiratory ailments. Plaintiffs further allege that occupa- tional exposure to ETS on board aircraft causes at least 22 diseases and a reasonable fear of contracting such diseases. The defendants are purported to be the six major U.S. cigarette manufacturers (plus related enti- ties), UST, Inc., United States Tobacco Co., Dosal Tobacco Corp., the Council for Tobacco Research, The Tobacco Institute, and three other trade associations. Broin, et aL v. Philip Morris, et aL (Circuit Court, Dade County, Florida) (filed October 31, 1991).

4 [7] ZwiUman: Plaintiff Says He Will Dismiss Case Contacted by telephone during a hearing on April 16, plaintiff Wolf Zwillman said he will voluntarily dismiss this case with prejudice. This development moots the motion to withdraw filed by plaintiffs' counsel, the court said. As of this writing, an order of dismissal had not yet been entered. This originally was a smoking-and-health case filed pro se by Wolf Zwillman for himself and as the per- sonal representative of his wife, Marjorie, a smoker who allegedly died in 1989 of lung cancer. ETS daims were added in an amended complaint. In March 1993, the court granted defendant's dispositive motions, giving plaintiff leave to reassert some of its claims against defendants Brooke Group, Ltd., and The American Tobacco Company: Brooke Group is the successor corporation to Liggett & Myers. Zwillman v. Brooke Group Ltd., et al. (U.S. District Court, New Jersey) (filed February 15, 1991; second amended complaint adding ETS claims filed February 13, 1992). ETS/IAQ LITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS IAQ: CARPET EMISSIONS [81 Howell v. Shaw Industries, lnc., 93-CV-2068 (U.S. District Court, Eastern District, Pennsyl- vania) (filed April 19, 1993) Purporting to represent a class of more than 100,000 persons, three plaintiffs have sued the largest carpeting manufacturers in the United States and their trade association for damages allegedly caused by toxic emissions from carpeting. Asserting claims for breach of warranty, negligence, failure to provide adequate warnings to consumers, false advertising, and violations of state and federal laws, the complaint names as defendants Shaw Industries, Inc., Beau Lieu of America, Inc., World Carpets, Inc., and The Carpet and Rug Institute. The class which plaintiffs purport to represent includes all individuals and entities in the United States that have purchased from defendants "carpeting ... containing volatile organic compounds" since ETS/IAQ REPORT, ISSUE 46 January 1, 1980. Within that class is a"personal injury subclass" of individuals who allegedly have "suffered physical and/or psychological injuries from exposure to the carpeting," plaintiffs claim. According to the complaint, the carpeting manufac- tured by the defendants contains toxic chemicals such as benzene, styrene and "4-PC," which have allegedly caused personal injuries and property damage to thousands of consumers throughout the United States. The plaintiffs claim that the defendants have concealed information regarding the purported dangers of chemical emissions from carpeting and have misled the public by disseminating assurances that carpeting is environmentally safe. Although the named plaintiffs' specific injuries are not averred, the complaint includes the following injuries as "reported health effects of carpeting and other indoor air pollutants": respiratory illness, head- aches, sleeplessness and fatigue, nausea, vomiting, skin rashes, irritation of the eyes, nose and throat, development of immune system problems and aggravation of previous conditions. The complaint further avers that carpet factory workers have a higher than normal incidence of lymphocytic, bladder, bowel and thyroid cancers. The plaintifls seek compensatory damages, punitive damages, injunctive relief, and a medical monitoring fund. The suit was filed byattomeys Joseph C. Kohn of Philadelphia and Barry F. Greenberg of Bridgeport, PA. During the recently conducted Indoor Environment '93 conference in Baltimore, Maryland, the subject of carpet emissions attracted media attention and partici- pant interest. The keynote speaker, U.S. Representative Al Bernard Sanders (I-Vt.), who is working with Representative Joseph Kennedy II (D-Mass.) on federal IAQ legislation, focused primarily upon toxic carpet emissions during his luncheon address. A subsequent session, featuring a dialogue between researcher Rosalind Anderson, PhD., whose tests of carpet samples produced convulsions and death in ~ mice, and representatives of the carpet industry, was well attended. Anderson has been named as plaintiffs' indoor air quality expert in Bahura v. SE'lY/tnvrstors, the IAQ lawsuit involving EPA's national headquarters building. According to court records, she is expected to testify that testing on building carpets caused neurological damage to mice and that those results can be "directly I

APRIL 30, 1993 correlated" to humans. A copy of the court filing in which she is designated is attached as Appendix B. >EPA wiN try to dupUcate Anderson's fidinas. ltem 3. slndoor Environment'93 conference detais. ftem 20. WORKPLACE: HANDICAP DISCRIMINATION [9] Hinman v. Yakima School District No. 7, 1993 Wash. App. LEXIS 153 (Washington Court of Appeals) (decided April 20, 1993) An appeals court in the state of Washington has denied summary judgment to the defendant school district in a case involving a guidance counselor's handicap discrimination claim which was based upon her alleged sensitivity to ETS. The state statute on which plaintiff's claim is based prohibits employment discrimination because of "the presence of any sensory, mental, or physical handicap." According to the appellate court, plaintiff Helen Hinman has a history of asthma which is aggravated by ETS. Her office was located some 35 feet from the school smoking lounge. Measures taken to keep the smoke confined to the lounge and to limit Hinman's exposure were ineffective, and Hinman eventually took medical leave due to asthma. The school district asked her to return to work and promised that the smoking lounge would be moved. The lounge was not moved and Hinman was hospitalized for ventilation and treatment of her asthmatic condition. She finally asked for and received a transfer to another building. Hinman recovered industrial insurance benefits for what the Department of Labor and Industries deter- mined was an occupational disease, i.e., aggravation of chronic bronchial asthma, caused by workplace exposure to ETS. The issues before the court of appeals in the handicap discrimination case were whether Hinman's claim was out of time under the relevant statute of limitations and whether the exclusivity provision of the industrial insurance act barred her handicap discrimination claim. Answering both questions in the negative and finding a genuine issue of material fact as to whether Hinman sustained injuries different from the physical injury allegedly caused by deliberately discriminatory acts, the court of appeals remanded the case for trial. 5 At trial, Hinman will have to prove that the school district failed to provide her with a safe and healthful workplace and did not reasonably accommodate her handicap. The court futther ruled, should Hinman prevail at trial, that her industrial insurance benefits may be deducted from her discrimination damages if necessary to prevent double recovery. WORKPLACE: COLLECTIVE BARGAINING [10] Newark Ya11ry Central School District v. Public Employment Relations Board 1993 N.Y. App. Div. LEXIS 3729 (Supreme Court of New York, Appellate Division) (decided April 15, 1993) The Appellate Division of the New York Supreme Court has reversed a decision of the supreme court which ruled that banning smoking by bus drivers on school buses even while students are not present was not a matter for collective bargaining. The school district petitioner in the case had established a smoking policy in March 1990 by which the Public Health Law would be promoted and bus drivers would not be permitted to smoke at any time on school buses. The school district refused to negotiate the issue and the drivers filed an improper practice charge, alleging a violation of the Civil Service Law. The appellate court ruled that the provisions of the Education and Public Health Laws about smoking preempted any collective bargaining agreement when students are present on the buses, and also determined that there was no preemp- tion when studenu are not present. Thus, the court held that the school district was required to negotiate this part of its policy. [I 1] In re.• Department of Health and Human Ser- vices/SSA and Loca13172, American Federation of Government Employees, AFL-CIO, 1993 WL 106970 (Federal Service Impasses Panel) (decided Apri17, 1993) Union workers filed a request for assistance with the Federal Service Impasses Panel when their employer refused to increase the ventilation in a new office location from 5 to 10 cubic feet per minute (CFM) of outside air per person. The panel refused to grant the union request for relief in spite of evidence that ASHRAE now recommends a rate of 20 CFM for office space. "In our view," the panel stated, "[the

6 union] has failed to demonstrate a need to change the current ventilation rate of 5 CFM." Because there was a nonsmoking policy in the office, the employer was complying with the "minimum Federal rate," and no one had yet complained about the air quality, the panel did not believe it was necessary for the employer to spend $12,500 to raise the ventilation rate. OTHER DEVELOPMENTS [ 12] "It's Ronald McDonald vs. Joe Camel in the Smoking Debate," BA. Epstein, St. Petersburg Times, April 12, 1993 Dr. Bruce Epstein, a St. Petersburg pediatrician, urges parents to force restaurant owners to ban smoking in their facilities for the sake of the health of children. Epstein cites the EPA Risk Assessment on ETS to bolster his argument about the alleged health effects of ETS exposure. He concludes, "We can no longer allow eating, which is life-sustaining, and smoking, which is life-destroying, to co-exist in the same room." [13] SEC Approves Omission of McDonald's Share- holder Proposal About Smoking Policy According to a press report, McDonald's Corp. won permission from the Securities and Exchange Commis- sion (SEC) to omit from its proxy statement a share- holder proposal that the board adopt a smoke-free policy at corporate headquarters and smoke-free policies for all new franchisees by 1995. Apparently, the SEC agreed with McDonald's assertion that the shareholder proposal dealt with matters relating to the corporation's ordinary business operations. Under SEC rules, such matters need not be included in the issuer's proxy materials. See BNA Pensions d Benefits Daily, April 22, 1993. McDonald's and two other fast-food chains have been sued in U.S. District Court in Connecticut under the Americans with Disabilities Act (ADA) to force the adoption of smoking bans as a reasonable accommodation of persons allegedly disabled by asthma and lupus. Staron v. McDonald's Corp., Staron v.Burgrr IGng Corp., Staron v. Wendy ~ Old Fashioned Hamburgers of Nrw York, Inc., see issue 45 of this Report, April 16, 1993. ETSIIAQ REPORT, ISSUE 46 [14] Restaurant Chain Operators Keep Eye On McDonald's Experiment According to a trade publication, the operators of fase-food restaurants are waiting to see what McDonald's will decide to do about smoking following its test of a smoke-free policy in some 40 of its restau- rants. The director of marketing for the Atlanta-based chain, Chick-fil-A, is quoted in the article as saying, "Someone as big as McDonald's creates the standards." The National Council of Chain Restaurants was reportedly scheduled to consider the issue of smoking at a March 31, 1993, meeting. Reports suggest that concern about potential lawsuits by employees and customers may be fueling consideration of smoking policies by restaurant operators. The executive vice president of operations for Hardee's Food Systems, Inc., however, observed that this is not a priority issue because customers have not been complaining about smoking in its restaurants. See Nation 's Restaurant News Newspaper, March 15, 1993. According to other reports, approximately 50 of the 3,700 Wendy's fast-food restaurants went smoke free last year; Wendy's official policy is to provide separate smoking and nonsmoking areas, according to a com- pany spokesperson. See New York Times, April 3, 1993. At Indoor Environment '93, held last week in Balti- more, John Banzhaf claimed the Chuck E. Cheese fast- food chain has instituted a smoking ban. [15] MCS Sufferers Want Perfumes Banned under ADA According to an article appearing in a recent issue of The Philadelphia lnquirer, a number of communities may soon follow the lead of San Francisco and Oak- land in adopting policies to ban perfumes and other fragrances from government public meetings. Santa Clara and Santa Cruz officials are also reportedly considering such a ban in order to comply with what are deemed vague requirements under the Americans with Disabilities Act (ADA), which are intended to protect the disabled from discrimination. The movement in San Francisco to ban fragrances was apparently spearheaded by John Cailleau who suffers from AIDS and claims he developed MCS following years of exposure to solvents and new carpet fumes and a violent reaction when he was exposed to

APRIL30, 1993 an overbearing perfume in 1990. Cailleau believes that the ADA should apply to those with MCS. He has joined with like-minded individuals in a group known as the Environmental Health Network and hopes to take his campaign nationwide. The group has reportedly received inquiries from Arizona, Hawaii, Oregon and Minnesota. See The Philadttlphia Inquirer, April 12, 1993. [16] Shopping Mall Goes Smoke Free A shopping mall in Connecticut is reported to be the first there to adopt a total smoking ban. According to press reports, Westfarms mall in Farmington intro- duced its ban gradually and, until this month, permit- ted smoking in customer lounges. A spokesperson for the International Council for Shopping Centers was reported to say that smoke-free malls are a national trend in response to consumer concerns about ETS. See The Hartford Courant, April 15, 1993. [17] Survey on Corporate Health Practices Released According to a survey recently released by the U.S. Public Health Service, some 59 percent of 1,507 workplaces with 50 or more employees prohibit or severely restrict smoking. Apparently, this represents a doubling of the number of workplaces imposing smoking restrictions since 1985. Twelve percent of those businesses surveyed reportedly adjust health insurance rates based upon whether an employee smokes. The survey reportedly focused upon a variety of healch-promoting issues and found that self-insured companies and those with 750 or more employees were the most likely to offer wellness programs. See UPI, April 13, 1993. A survey released by the Bureau of National Affairs in 1991 reported that total bans on smoking had been established by 34 percent of compa- nies in the survey, compared with seven percent of firms in 1987 and two percent in 1986. See issue 7 of this Report, September 13, 1991. (18] Hotel Space for Nonsmokers Some hotels in the United States are reportedly setting aside more nonsmoking rooms. According to a press report, Marriott has converted 60 percent of its rooms into nonsmoking rooms, which is up from 22 percent in 1990. Hilton has 50 percent nonsmoking rooms, up from 10 percent in 1987. Most hotels, however, still maintain more smoking rooms than nonsmoking rooms, reportedly on account of foreign travelers who smoke at higher rates than Americans. See USA Today, April 13, 1993. [ 19] Smoking Rights Advocates Decry Use of To- bacco Tax Funds Californians for Smokers' Rights, a Sacramento-based smoking advocacy group, reportedly complained to the governor of California that tobacco tax funds are being misspent on baby showers, pool parties, parade floats and racing cars. Defenders of the programs say that they are public outreach programs that bring messages about the purported dangers of ETS exposure, among other matters, to teenagers and low income women who are pregnant. According to a health official quoted in a press report, "We aren't doing a lot of traditional, ho-hum stuff (with the cigarette tax money), and the tobacco companies are going nuts." See The San Francisco Chroniclr, Apri123, 1993. SCIENTIFIC/TECHNICAL ITEMS RECENT/UPCOMING MEETINGS [20] "Indoor Environment '93: Defining Strategies for Effective Indoor Air Management," Balti- more, Maryland, April 21-23, 1993 Although several sessions of this conference were devoted exclusively to ETS, many other IAQ issues were dealt with during sessions that were divided into five tracks. The estimated 600 participants, who induded environmental lawyers, building managers and owners, IAQ consultants, government officials, and industrial hygienists, could choose among tracks designated as Programs & Policy, Issues in Evaluation & Mitigation, Building Management, Safety & Health, and Litigation & Liability. The opening session featured an address by Bob Axelrad, Director of the Indoor Air Division of the EPA. His remarks included reference to the EPA Risk Assessment on ETS, and he particularly focused upon the alleged health effects for children. A session entitled "ETS: Recent Health Effects Research" was led by Steve Bayard, Project Manager of the ETS risk assessment and'John Banzhaf, executive

8 director of ASH. During this poorly attended session, Bayard defended the purported validity of the risk assessment, and Banzhafs presentation stressed antismoking monologue, which included an assertion that the greatest risk to smokers comes from their exposure to ETS and not from their inhalation of mainstream smoke. The handout provided to conkr- ence participants by Banzhaf is attached as Appendix C. It includes information about the ETS risk assess- ment and cases which ASH asserts put those permit- ting smoking on their premises at risk of incurring liability for ETS-related injury. Officials of state and federal agencies discussed the programs and studies they are currently conducting with regard to IAQ issues, and attorneys who are litigating SBS cases gave practical information about avoiding such lawsuits. Helen Eisenstein Zukin, who has litigated such cases for a number of years, predicted that an "explosion" of SBS litigation was unlikely because the cases are burdensome and expensive for the plaintiffs who file such daims. Victor Schwartz, an attorney specializing in products liability issues, and Banzhaf addressed issues during a session designated simply as "Environmental Tobacco Smoke." Schwartz rebutted Banzhaf s assertions about the coming tide of ETS litigation by challenging the ETS risk assessment for its "pages and pages of assumptions" and by noting the difficulties plaintiffs claiming injuries based on ETS exposure would have in proving causation. ASH attorney Kathleen Scheg shared a podium with a representative of the Building Owners and Managers Association (BOMA) to address "IAQ and the Americans with Disabilities Act" (ADA). Scheg concentrated on ETS and the ADA and declared that a complete ban on smoking is the only reasonable accommodation that can be made under that Act to protect the rights of the alleged 100 million impaired Americans for whom ETS poses a significant health threat. The speaker from BOMA discussed the difficulties building owners face in resolving all IAQ problems for purposes of removing barriers to entry for the disabled, but echoed Scheg in denouncing ETS and in recommending total smoking bans. Susan Rosmarin, representing the IAQ Model Law Task Force, was supposed to present to conference participants a completed "conceptual outline" which ETS/IAQ REPORT, ISSUE 46 would form the basis for the draft of a model law on IAQ that will eventually be made available to state and local governments. See issue 44 of this Report, April 2, 1993. However, Rosmarin indicated that difficulty has been encountered in the drafting process due to an attempt to accommodate the interests of a range of business, health and consumer groups. She did discuss the broad param- aers being considered by the subpand drafting the model law. There was no mention of source control. Additional sessions considered issues related to multiple chemical sensitivity, IAQ and worker productivity, microbial contamination, and IAQ and psychological factors. During the session on worker productivity, the results of two studies were reported which indicated, to the researchers' surprise, that there was no observ- able correlation between poor IAQ and productivity. These studies were presented by Dr. Jan Stolwick and Edward Chu. [21] Indoor Air Quality Congress '93, Boston, Massachusetts, June 15-16, 1993 According to advance materials, the 1993 IAQ Congress will address solutions for IAQ improvement. Topics indude minimizing legal risks, applying new methods and discovering new systems for improving IAQ. Health aspects, problem diagnosis and problem mitigation will also be covered. The conference is sponsored by the Environmental Engineers and Managers Institute, The Demand-Side Management Society and the Association of Energy Engineers. LUNG CANCER [22] Letter to the Editor Regarding "Commentary: Environmental Tobacco Smoke and Lung Can- cer," C.W. Heath, The IQncet 341: 526,1993 The Lancet has published a response by Gio Gori to this editorial. As discussed in Issue 43 of this Report, March 19, 1993, the author said that the EPA Risk Assessment on ETS provided a "firm regulatory basis for increased societal action to eliminate ETS." Gori s response appears in The Lancrt 341: 965, 1993. Gori proposes that Heath's editorial is not "well informed," and suggests that the editors consider the ETS risk assessment itself. He then criticiaes a number of the positions detailed in the risk assessment.

APRIL 30, 1993 Gori writes that EPA's claim that ETS is equivalent to the smoke inhaled by smokers "falls short of objective verification," and suggests that EPA "categorically exdudes" the possibility of a threshold. He also calls the reported ETS exposures "vanishing" and the epidemiology "incondusive." Moreover, Gori calls the EPA's use of 90% confi- dence intervals and "one-tailed" statistical tests a "questionable gambit." He also criticizes EPA's use of meta-analysis, its decision rcgarding confounders, and its failure to include two recent epidemiologic studies, which, he proposes, "invalidate the Agency's condu- sions even by inflated statistical standards." Gori concludes by stating that "Clark Heath's attributions of robust science are perplexing," and criticizes some of Heath's particular statements, including one concerning the possibility of OSHA regulation. Gori calls for attention to scientific credibil- iry, and proposes that "[a]lthough the EPA report may yet prove an effective policy instrument, the Agency's claim of scientific support seems ill-founded." RESPIRATORY DISEASES AND CONDITIONS - CHILDREN [23] "Chronic Sidestream Smoke (SS) EEhects on Airway and Pulmonary Artery Reactivity to Serotonin in Developing Rats," J.M. Bric, KE. Pinkerton, and J.P. Joad, Journal ofAllergy and ClinicalImmunol- ogy 91 (1 Part 2), 1993 [See Appendix A] This abstract reports on an experiment in which young rats were exposed to sidestream smoke and tested for airway reactivity. The authors propose this system as an animal model for increased airway reactivity and asthma prevalence reported in children who live with smokers. Their data, however, suggest statistically significantly decreased airway reactivity in rats exposed to sidestream smoke. [24] "Risk Factors for Acute Wheezing," A.L. Duff, E. Pomeranz, G.W. Price, L.E. Gelber, A.H. Farris, F.G. Hayden, A.E. Platts-Mills, and P.W. Heymann, AnnaG ofAlkrgy70: 47, 1993 [See Appendix A] In this abstract, the authors report on an investigation of the prevalence of three purported risk factors (viral 9 infection, ETS exposure, and allergy) in acutely wheezing children. They report a higher prevalence of smoke exposure in study subjects under the age of two. OTHER HEALTH ISSUES [25] "Evaluation of Individuals Attributing Hyper- sensitivity Symptoms (HS) to Indoor Air Pollution (IAP)," P. Kuhnl, G. Golling, B. Eberlein-Konig, and B. Przybilla, Journal of Allergy and ClinicalImrnunology 910 Part 2), 1993 [See Appendix A] This abstract reports on an investigation of persons with a self-reported hypersensitivity to "indoor air pollution." The authors report that "common" allergic diseases alone; psychosomatic effects alone; and a combination of the two contributed to the claimed hypersensitivity in different segments of the sample studied. [26] "Spontaneous Resolution of Severe Chronic Glue Ear in Children and the Effect of Adenoidectomy, Tonsillectomy, and Insertion of Ventilation Tubes (Grommets)," R. Maw and R. Bawden, British Medical Journal306: 756-760, 1993 [See Appendix A] This paper is another report from a large study on chronic otitis media with effusion ("glue ear"), con- ducted in Great Britain. The authors report that long- term resolution of glue ear was best with combined removal of the adenoids and tube insertion. However. they also claim a longer time to resolution in children whose parents smoked. [27] "Social Differences in Swedish Infant Mortality by Cause of Death, 1983 to 1986," M.L. Nordstrom, S. Cnattingius, and B. Haglund, American Journal of Public Health 83: 26-30, 1993 [See Appendix A] The authors of this study investigated mortality in more than 355,000 infants born in Sweden between 1983 and 1986. They report statistically significantly elevated risk estimates for sudden infant death syn- drome in infants whose mothers smoked.

10 ETS ExPOSURE AND MONITORING [28] "Development of Pulmonary Cytochrome P450 (CP-450) Isoenzymes: Protein Expression, Activity and Response to Environmental Tobacco Smoke (ETS) in Postnatal Rats," A. Gebremicbad, C.G. Plopper, A.R. Budcpitt, and K.E Pinkerton, Toxicologist 13: 49, 1993 [See Appendix A] This abstract reports on the experimental exposure of rats to sidestream smoke, and on data collected con- cerning enzyme activity. The authors report "signifi- cantly higher" activity in exposed rats of one of the two enzymes measured. [291 "A Time Series Modd for Cigarette Smoking Activity Patterns: Modd Validation for Carbon Monoxide and Respirable Particles in a Chamber and an Automobile," W. Ott, L. Langan, and P. Switzer, Journal of Exposure Analysis and Environmental Epidtmiologgy 2(Suppl. 2): 175- 200, 1992 [See Appendix A] The authors present a detailed mathematical model for calculating "pollutant" levels over time in the presence of smoking. They also apply the model to a "microenviron- ment," that of an er.ciosed automobile, in which they report that ETS levels can become "relatively high." INDOOR AIR QUALfIY [30] "Air Movement, Comfort and Ventilation in Partitioned Workstations," F.S. Bauman, R.S. Helm, D. Faulker, EA. Arens, and W J. Fisk, ASHRAEJournal (March): 42-50,1993 [See Appendix A] Based on experiments conducted in an environmental chamber, the authors of this study report that office partitions do not always present a barrier to effective air circulation or ventilation eflicienry. [311 "W'ill the Mouse Bioassay for Estimating Sensory Irritancy of Airborne Chemicals (ASTM E 981-84) Be Useful for Evaluation of Indoor Air Contami- nants?" J.S. Tepper and D.L Costa, Indoor Environmens 1: 367-372, 1992 [See Append'a A] This "Opinion" article reviews information on a mouse bioassay, which is intended to indicate the ETS/IAQ REPORT, ISSUE 46 irritancy of an airborne substance by a change in the animal's breathing pattern. The authors review the applicability of the assay with respect to human exposures, such as sick building syndrome. SMOKING POLICIES AND RELATED ISSUES [32] Letters to the Editor Regarding "Issues and Answers Concerning Passive Smoking in the Workplace: Rebutting Tobacco Industry Argu- ments," J.L. Repace and A.H. Lowrey, Tobacco Control 1: 208-219, 1992 The journal Tobacco Control recently published two letters concerning this article. As discussed in Issue 35 of this Report, November 20, 1992, the authors purport to present a summary of tobacco industry positions on ETS. They then present rebuttals to each claimed position, for "regulatory officials and employers unfamiliar with advances in ETS research." The authors, James Repace, an EPA employee, and Alfred Lowrey, have published several articles relating to the alleged health effects of ETS exposure. The first letter in the current correspondence is from Sharon Boyse, a scientist with the British-American Tobacco Company, the second letter is a response from Repace and Lowrey. The letters appear in Tobacco Control 2: 56, 1993. Boyse refers to Repace and Lowrey's claim that the tobacco industry takes scientific data out of context. She "would argue that the industry does not do so," and suggests that Repace and Lowrey "could be accused of doing so in this article, in the enthusiasm of their attempt to discredit the scientific acumen of the tobacco industry." Boyse characterizes the Repace and Lowrey paper as "riddled with statements that simply cannot be justified by the current scientific data." Boyse discusses in some detail three of the largest studies of spousal smoking and lung cancer in non- smoking women, describing their reported results as a "situation of conflicting data ... typical of the ETS story." She then inquires: "Why do Repace and Lowrey fail to disclose these facts, unless it is because they can be accused of exactly the same bias that they assign to the tobacco industry?" Noting that approximately 80% of the spousal smoking studies and 80% of the studies including estimates of workplace exposure do not report statisti-

APRIL 30, 1993 cally significant increases in lung cancer risk, Boyse questions "how the authors can criticise either the tobacco industry - or ... independent scientists ... - for holding to the opinion that the case has not been proven." She concludes with the suggestion that "[i]f this evidence applied to anything other than tobacco smoke, it would never have become a major public issue." In their reply, Replace and Lowrey claim that Boyse's letter provided "several textbook illustrations of how the tobacco industry quotes scientific studies and methods out of context and ignores contradictory studies" concern- ing ETS. They claim that the tobacco industry puts undue emphasis on statistical significance, which they suggest reflects a "cavalier attitude toward public health." Repace and Lowrey advocate the "total weight of evi- dence" approach, and invoke the argument of "biological plausibility." Moreover, they daim that, if the data from the "highest" exposure categories reported in 17 of the spousal smoking studies are considered, statistical signifi- cance is achieved. Repace and Lowrey further accuse Boyse of a "shame- less quote-out-of-context" concerning the Wu-Wil- liams, et al., (1990) study of spousal smoking in China. They refer to the authors' condusion that an"efl•ect" of ETS was "obscured" in their study because of high indoor air pollution; however, as Boyse had pointed out, Wu-Williams, et al., reported a statistically significantly negative risk estimate for spousal smoking. In conclusion, Repace and Lowrey claim that "even while vehemently denying the practice of the selective citation and the out-of-context quote, the tobacco industry cannot refrain from their use." They write: "Perhaps for those who market tobacco, such practices have become as addictive as nicotine." STATISTICS AND RISK ASSESSMENT [33] "An Individual Decision Model For Environ- mental Exposure Reduction," N. Duan and W. Ott, Journau of Exposure Analysis and Environ- mental Epidemiology 2(Suppl. 2): 155-174, 1992 [See Appendix A] This paper presents a detailed mathematical model to illustrate ways that an individual can reduce personal exposure to a given substance. The authors use benzene, 11 purportedly from ETS and active smoking, as an example in their discussion. They call for increased availability of exposure and cost data for the general public. IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS AtJSTRALIA [34] Parliament House Smoking Policy Debated in New South Wales According to a press report, the members of State Parliament plan to debate the issue of banning smok- ing in the New South Wales Parliament House on April 27, 1993. Ser Sunday Telegraph, April 25, 1993. [35] Smoking Bans Adopted in Railway Stations and on Trains According to Transport Minister David Hamill, Brisbane's major railway stations will become smoke free beginning on July 1, 1993. The ban will'report- edly apply to platforms and subways at Central, Roma St., Brunswick St., Toowong and Ipswich. Ser Courier Mais: April 15, 1993. In a related story, Hamill also reportedly announced that smoking will be banned on long-distance Qld trains from July 1. The decision to adopt the ban was apparently a result of Qld Rail's concern for the health of staff and passengers and concerns about liability following recent ETS cases. See TownsvilLe Bulktin, Apri18, 1993. Meanwhile, CityRail staff reportedly planned to conduct a three-day campaign to crack down on passengers violating smoking and other regulations in the Sydney, Newcastle and Wollongong areas. See Sydney Morning Heralca; April 23, 1993. [36] Local Council Adopts Smoking Ban Beaudesert Shire Council has reportedly banned smoking in its buildings as part of a move to curb

12 compensation and injury payouts. See Gold Coast Bulletin, April 28, 1993. CANADA [37] North York Considers Tougher Smoking Restrictions The North York Council has reportedly endorsed a new Board of Health report on ETS. According to a press report, the endorsement will likely lead to a board request that the council adopt a stronger smoking bylaw which will further restrict smoking in public and workplaces. See The Toronto Star, April 15, 1993. PHILIPPINES [38] Manila Adopts Street Corner Jails to Enforce Smoking Laws Manila City has reportedly begun to jail persons caught violating tough nonsmoking and other laws in street-corner jails where they can be seen by passersby. Street jails can apparently be found in the Sampalic district and on Malate, Tondo and Magsaysay Streets. According to police, the concept appears to be working as smoking in public places has been reduced. Since a government crackdown began in January on the orders of Manila's mayor, over 11,500 people have been arrested for violating smoking, prostitution, jaywalking and littering ordinances. See Xinhua, April 23, 1993. TAIVe/AN [39] Legislature Considers Tobacco Hazards Control Act The legislature has reportedly begun to deliberate the merits of a proposed "Tobacco Hazards Control Act,' which would, among other matters, restrict tobacco smoking. See BNA Inttrnational Trade Reporter, April 7, 1993. UNITED KINGDOM [40] More Action Considered by Local Governments on Smoking Issue South Derbyshire Council is reportedly considering segregating smokers from nonsmokers at its offices in ETS/IAQ REPORT, ISSUE 46 Swadlincotc. A committee will apparently seek a report and recommendations on the matter. See Burron Dailjr MaiL March 27, 1993. Numerous changes to the smok- ing policy already in effect at Argents Mead Council offices were reportedly considered at a recent meeting of the Health and Leisure Committee. And after a lengthy discussion, committee members decided to keep the present system which permits smoking in specially designated rooms. See Hincklry Trsnrs; April 1, 1993. Meanwhile, a total ban on smoking has evidently been adopted in Croydon Council's Taberner House offices. According to press reports, the ban may be extended to more than 10,000 other council staff in other locations such as schools, senior citizen homes and works depots. See Crwydon Advertiser, April 2, 1993. ETS-RELATED LITIGATION INVOLVING CIGARETTE MANUFACTURERS AUSTRALIA [41] Tobacco Institute ofAustralia Ltd v. Australian Federation of Consumer Organisations Inc. (Australian High Court) (appeal filed April 1, 1993) AFCO has filed an application for special leave to appeal from the March 11, 1993, decision of the full federal court. The application for leave to appeal challenges the award of costs and "such other parts of the judgment as senior counsel may advise should be induded in the Application for Special Leave." In support of its challenge, AFCO asserts that the case involves a substantial public interest, that the proceed- ings were brought solely in the public interest, and that TIA refused AFCO's offers of settlement and compro- mise. TIA has entered an appearance in the case. The March 11 decision: (i) declared language in a 1986 TIA advertisement misleading and deceptive; (ii) denied AFCO's request for injunctive relief; (iii)) refused AFCO leave to introduce new evidence; (iv) refused TIA leave to argue a constitutional free speech issue; and (v) awarded AFCO fewer costs than origi- nally awarded by the trial judge in the case.

APRIL 30, 1993 OTHER DEVELOPMENTS AUSTRALIA [42] Restaurant Smoking Policies Stir Debate Eleven clubs reportedly answered a Canberra Times survey on smoking bans recently and most expressed concern about such policies unless all clubs and pubs are required to abide by the same rules. According to a paper presented at a Licensed Club Association direc- tors' seminar, however, the industry should adopt smoking bans to fulfill legal obligations in light of recent court cases showing that the courts are finding a legal link between ETS exposure and ill health. See Canberra Tirnrs, April 11, 1993. Meanwhile, a new dub, called Smoko, which is just for smokers and their friends, has reportedly formed in the southern suburbs. See Brisbane Sunday Mai,: April 18, 1993. In Sydney, however, the Galileo restaurant in the Observatory Hotel has reportedly just become the first top dining room to ban smoking completely. See Sydney Morning Hrrald April 4, 1993. [431 Landmark Shopping Complex to Ban Smoking According to a press report, Sydnry's landmark MLC Centre is the latest commercial and shopping complex to adopt a smoking ban. The policy will reportedly com- mence on May 31 to coincide with "World No Tobacco Day." Sce Sydney Morning Herald April 4, 1993. [44] Chinatown Restaurants Experiment With Smoking Restrictions According to press reports, seven of the most popular restaurants in Sydney's Chinatown area will offer smoke- free zones for an 8-week trial period. The experiment is reportedly part of the state's campaign to minimize ETS exposure in a particular ethnic community. Sydnry's smokers will also be asked to refrain from smoking in nondesignated areas in the Queen Victoria Building public eating areas or toilets. The move is apparently part of a long term plan to gradually ban smoking in the building. See Daily Tilrgraph Mirror, April 15, 1993; Sydney Morning Htralc4 April 16, 1993. 13 BELGIUM [45] Tobacco Information Centre Begins Courtesy Campaign on Smoking The Belgian Centre for Information and Documenta- tion on Tobacco has reportedly started a courtesy campaign which includes in its materials the blue and green, smoking and nonsmoking elephants, which were used recently in a campaign by French hoteliers. See Le Sois, April 23, 1993. CANADA [461 IAQ Becomes Marketing Tool for Commercial Building Managers According to press reports, high vacancy rates in commercial office buildings are forcing landlords to pay attention to IAQ issues which are of concern to their tenants. Some building managers have hired environmental consultants to conduct regular IAQ tests in their properties. Test results are being used as a promotional device that is apparently being noticed by prospective tenants when the results are positive. According to the president of Purdy's Wharf Develop- ment Ltd., a twin-tower complex in Halifax, more new tenants have been signed in the first quarter of 1993, than in all of 1992, since the company began promot- ing its superior IAQ during the last six months. See Mackan i April 19, 1993. [471 Train Smoking Bans Announced VIA Rail has reportedly announced that smoking will be banned on trains traveling in the Quebec Ciry-Ot- tawa-Windsor corridor beginning on June 1, 1993. Apparently, bans will not be imposed on other VIA routes because some of those trips take longer than four hours to complete. See The Citizen, April 15, 1993. INDIA [48] Doctors Call for Declaration About ETS During a public conference recently held in New Delhi, doctors called for the designation of ETS as a carcinogen. K.L Chopra, chairman of the Heart Care Foundation of India, reportedly stated that ETS, to which nonsmokers are exposed, has higher concentra-

14 ETS/IAQ RE['ORT, ISSUE 46 cions of toxic substances than the mainstream smoke inhaled by smokers. The vice chairman of the founda- tion called for smoking to be banned in government offices. Ser Xinhua, April 11, 1993. JAPAN [49] Nonsmoking Businessman Fined for Assault on Airline Cabin Crew A nonsmoking Japanese businessman was reportedly fined $12,000 for attacking three Qantas cabin crew members after he was forced to sit in a smoking section. According to a federal prosecutor, the man did not speak English and became frustrated when the crew could not understand his demands to have his airline seat changed. See Herald Sun, April 17, 1993. UNITED KINGDOM [50] Antismoking Activists Seek ETS Legislation According to a press report, the Association for Nonsmokers' Rights stated at a recent Glasgow symposium on national health that education about ETS is a waste of time unless it is accompanied by legislation offering protection to nonsmokers from ETS exposure. The association is apparently calling for the adoption of new laws to address the issue. Ser Edinburgh Evening News, April 3, 1993. [51] Unusual Coalition Seeks to Overturn Railway Smoking Ban Lord Harris of High Cross has reportedly been joined by Cockney comedian Chubby Oates and FOREST in a fight to reverse the British Rail decision to close the smoking compartment on commuter trains to London. Apparently, Lord Harris recently participated in a "smoke-in" on the 8:24 Tonbridge to London train and regularly protests the ban in the House of Lords. FOREST reportedly presented a Chubby Oates cabaret on Apri129, in London's West End, evidently in recognition of Oates' lobbying activities on behalf of smokers' rights. See Sunday Telegraph, April 4, 1993.

APRIL 30, 1993 APPENDIX A The numbers assigned to the following article summaries correspond with the numbers assigned to the synopses of the articles in the text of this Report. RESPIRATORY DISEASES AND CONDITIONS - CHILDREN [23] "ChronirSidestream Smoke (SS) Effects on Airway and Pulmonary Artery Reactivity to Serotonin in Developing Rats," J.M. Bric, K.E. Pinkerton, and J.P. Joad, Journal ofAllcrgy and Clinical Immunology 91 (1 Part 2), 1993 "Since children raised in the homes of smokers exhibit increased airway reactivity and a higher inci- dence of asthma, we previously exposed developing rats to SS in an attempt to establish an animal model for this effect. However, the SS-exposed rats did not become hyperresponsive to methacholine. This study was designed to determine if SS-exposed rats develop increased reactivity to another bronchoconstrictor, serotonin.... [R] ats were exposed to filtered air (FA) or to SS for 6 hr/day, 5 days/wk from 2 days of life to I 1 wks of life. Then, their lungs were removed and studied in an isolated, buffer perfused system where lung resistance (RL) and pulmonary artery pressure (Pr,,) were measured while increasing doses of seroto- nin were injected into the pulmonary artery. In contrast to our expectations, airway reactivity to seroconin was markedly decreased in SS-exposed rats. However, the serotonin-induced increase in PPA was not altered by previous SS exposure. After serotonin, lung weight/body weight ratio in the SS-exposed group did not differ form that in the SS-exposed group did not differ from that in the FA-exposed group. We conclude that serotonin may play a role in environ- mental tobacco smoke-induced airway problems." [24] "Risk Factors for Acute Wheezing," A.L Duff, E. Pomeranz, G.W. Price, LE. Gelber, A.H. Farris, F.G. Hayden, A.E. Platts-Mills, and P.W. Heymann, Annals of Allagy 70: 47, 1993 "A cross-sectional analysis was performed on 100 acutely wheezing children (WH)...and 58 controls (CON) to evaluate multiple risk factors for wheezing. Patients were evaluated for inhalant allergy...for A-1 tobacco smoke exposure...and for viruses. Some risk factors appear to be more prevalent in different age groups of wheezers. Viral pathogens were more preva- lent in WH <2 when compared to WH >2 and to CON <2. Smoketxposure was found in 79% WH <2 compared to 21% WH >2. Inhalant allergen sesitization was more significant in WH >2 yrs than in WH <2. Sixty-six percent of all WH were exposed to two or more risk factors. Multiple risk factors may be associated with an individual's acute wheezing episode, but based on the age of the patient, some risk factors may be more contributory." OTHER HEALTH ISSUES [25] "Evaluation of Individuals Attributing Hyper- sensitivity Symptoms (HS) to Indoor Air Pollution (IAP)," P. Kuhnl, G. Golling, B. Eberlein-Konig, and B. Przybilla, Journal ofAllergy and ClinicalImmunology91 (1 Part 2), 1993 "Air pollution as well as allergy have found much interest in the general public, and there are increasing numbers of patients attributing HS to IAP, especially to 'chemicals'. Frequently, in dinical practice such an interpretation of symptoms can neither be proven nor rejected, although the complaints appear bizarre not rarely. To approach this issue, we... recruited individu- als complaining of HS attributed to IAP...71 patients were investigated in detail by a thorough allergological examination. In addition, a structured psychological evaluation was performed by a trained psychologist.....Among the 65 patients...different groups took shape: 17 (26%) had 'common' allergic (or other hypersensitivity) diseases (CAD) not yet treated adequately, e.g. allergic rhinoconjunctivitis or asthma. In 19 (29%) there were CAD superimposed by strong psychosomatic effects. An exclusive psychoso- matic cause of the complaints was found in 19 (29%). Imonly 10 (16%) there were indications of actual HS to indoor pollutants other than allergens from biologic sources; all these patients were also suffering from CAD. So, patients presenting with HS related to IAP by themselves are a heterogenous group. If a conclusive diagnosis of CAD cannot be made or seems insufficient with regard to the complaints, an additional psycho- logical evaluation is indispensable. The role of indoor pollutants for the development of symptoms in some patients with CAD is being further evaluated."

A-2 [26] "Spontaneous Resolution of Severe Chronic Glue Ear in Children and the Effect of Adenoidectomy, Tonsillectomy, and Insertion of Ventilation Tubes (Grommets)," R Maw and R. Bawden, Brisrsh MedicalJourna1306: 756-760,1993 "The study was designed to show the outcome of chronic glue car not submitted to any surgical treat- ment compared with that treated by adenoidectomy and adenotonsillectomy. Insertion of a ventilation tube in only one ear enabled us to assess this procedure both alone and in combination with adenoidectomy and adcnotonsillectomy....This report presents the long term findings up to 12 years after inclusion in the study." "Our study shows the long term spontaneous resolu- tion of severe glue ear in children. They had a history of hearing loss for an average of 18 months. Fluid was present in both cars at three examinations over three months and was confirmed by a validated otoscopist and by tympanometry. Nevertheless, without any treatment the condition improved as time passed." "Assessment of the effect of possible prognostic factors showed that children with parents who smoke and, in the case of surgical intervention, children who are younger at onset of hearing loss have a less satisfac- tory outcome otoscopicallyand tympanometrically: Because surgery reduces the postoperative duration of the fluid the earlier it is performed the shorter is the overall duration of the condition. Unlike in other studies we did not find any perceptible effect due to sex." "These results agree with our other previously reported short term data in which the effect of adenoidectomy was related to the age of the child and, to a lesser extent, to the degree of nasopharyngeal obstruction caused by the adenoids. More recently we have shown morphological differences in the nasophar- ynx and base of the skull in children with glue ear, and these are probably related to age and growth." "This study was designed to evaluate the effect of adenoidectomy and adenotonsillectomy compared with no surgery and thus the data on effectiveness of treatment with ventilation tubes are somewhat a by- product. During the follow up a mean of 2.48 tubes were required to maintain adequate hearing ability in those treated with tubes alone compared with a mean of 1.52 in the children also receiving adenoidectomy. The two ears may not react identically with respect to ETSIrAQ REPORT, ISSUE 46 insertion and reinsertion of tubes. In this study the overall need for reinsertion may have been higher, particularly in the no surgery group, than if bilateral tubes had been used instead of one tube." "Owing to the spontaneous resolution seen before and after operation all children with glue ear should be examined with pneumatic otoscopy and tympanometry on at least two occasions over three months before the decision to operate is made." "Finally, parents of children with glue ear should be advised to stop smoking." [27] "Social Differences in Swedish Infant Mortality by Cause of Death, 1983 to 1986," M.L Nordstrom, S. Cnattingius, and B. Haglund, American Journal ofPublic Health 83: 26-30,1993 "Infant mortality varies with other characteristics as well, such as maternal age, parity, and smoking habits. For a better understanding of how the social' gradient in infant mortality works, it is important to adjust the class-specific risks obtained for the influence of such possible confounders. The aim of this study is to investigate social differences in infant mortality in Sweden by cause of death, adjusting for the effects of maternal characteristics." "All live single births in Sweden between 1983 and 1986 to mothers 15 to 44 years old with Nordic citizenship were studied. The causes of death were classified into six major groups. Mother's education was used as a social indicator." "There were 355 601 births and 2012 infant deaths. Only for sudden infant death syndrome were signifi- cant social differences found, with crude odds ratios of 2.6 for mothers with less than 10 years of education and of 1.9 for mothers with 10 to 11 years, compared with 1.0 for mothers with 15 years or more. After adjusting for age, parity, and smoking habits, these ratios were no longer significant." "This led to further analysis of the effects of mother's education and smoking habits on sudden infant death syndrome. If the mother smoked between I and 9 cigarettes per day, the risk for sudden infant death syndrome was 1.5 times higher than it was among nonsmokers, with adjustment for maternal'age and parity. If the mother smoked 10 cigarettes or more per

APRIL 30, 1993 day, the risk was 2.4 times higher. Adjusting also for length of education did not give better estimates." "In the present study, the risk for sudden infant death syndrome was significantly influenced by the mother's smoking, which must be assessed as a potentially preventable risk factor." "During this period in Sweden, social dass, as measured by length of mother's education, played a minor role as a risk factor for all causes of infant death. The increased risk for sudden infant death syndrome among infants to mothers with short education was substantially related to differences in maternal age, parity, and smoking habits. It seems reasonable to assume that the relatively minor importance of mater- nal education on infant survival was a consequence of a generally high standard of living; of high medical, technical, and economic developments; and of the nationwide, free prenatal and child health care system." ETS EXPOSURE AND MONITORING [28] "Development of Pulmonary Cytochrome P450 (CP-450) Isoenzymes: Protein Expression, Activity and Response to Environmental To- bacco Smoke (ETS) in Postnatal Rats," A. Gebremichael, C.G. Plopper, A.R. Buckpitt, and IGE. Pinkerton, Toxicologist 13: 49, 1993 "CP-450 activity is known to be influenced by different factors such as age and exposure to a variety of environmental pollutants. Various ETS constituents are either metabolized by or are inducers of CP-450 monooxygenases. These studies were to determine whether age and exposure to ETS would affect the activity and/or protein levels of pulmonary CP-450 isoenzymes. Conditioned side stream cigarette smoke was used as a surrogate for ETS. Rat pups were exposed to ETS or filtered air from birth to 100 days of age. Exposure was for 6 hrs/day, 5 days/week from postna- tal day until euthanasia. CP-450 IAl and CP-450 IIB activities were measured in lung microsomes....CP-450 IAI activity in ETS exposed group was significantly higher than the control at all ages while CP-450 IIB activity was t.he same as in the control group." A-3 [29] "A Time Series Model for Cigarette Smoking Activity Patterns: Model Validation for Carbon Monoxide and Respirable Partieles in a Chamber and an Automobile," W. Ott, L. Langan, and P. Switzer, Journal of Fxposure Analysis and Envi- ronmental Epidemiology 2(Suppl. 2): 175-200, 1992 "Human activity pattern-exposure models require accurate submodels for the exposures in the typical microenvironments that people occupy (automobiles, residences, workplaces, etc.) to predict the distribution of exposures across the population. Many of these microenvironments contain environmental tobacco smoke (ETS). Thus, a flexible, accurate model is needed for representing ETS in today's human activity pattern-exposure models...and other total human exposure models to be developed in the future." "Smokers ordinarily engage in a sequential smoking `activity pattern' over time: one cigarette is smoked after another, with a recovery period between each cigarette. A person living with a smoker in a home is exposed to a time series of concentrations resulting from a succession of cigarettes reflecting the smoking activity patterns of the smoker. In this paper, we derive theoretical equations for the concentration time series in a well-mixed microenvironment when a person engages in a specified smoking activity pattern. Equa- tions also are derived for the minimum, maximum, and mean for the case of a uniform smoking activity pattern (the 'habitual smoker') and for the case of multiple smokers. The time series of concentrations on which these equations are based are evaluated experi- mentally in a chamber and a moving automobile." "Solutions to the mass balance equation provide a theoretical basis for calculating all parameters of the model - air exchange race, source strength, and sink terms - in a single experiment. Application of the experimental methodology requires monitoring instruments that operate with high time resolution (minutes or seconds). The air exchange rate is deter- mined from the exponential decay of concentrations in the microenvironment. The source strength is deter- mined from the equilibrium concentration with continuous smoking. The sink term for pollutants that adhere to surfaces, such as particles, is determined by

A-4 subtracting the particle decay rate from the decay rate for a pollutant that has no surface sinks, such as CO. In most cases, an effective air exchange rate is mea- sured, which includes the effect of the mixing factor. In the small microenvironments considered in this paper (a chamber, an automobile), the pollutant appears to be reasonably well-mixed." "Measurements of cigarette smoke in an automobile with a smoker present show that the concentrations of common environmental tobacco smoke (ETS) pollut- ants can become relatively high. When driving at 20 mph with the windows closed, a single smoker raised interior CO concentrations to nearly 20 ppm and particle concentrations to over 2 mg/m3 by the third cigarette. In our automobile experiment, the blood carboxyhemoglobin levels of both the active and passive smoker (as measured in breath) increased significantly after smoking occurred. Our model shows that the combination of a small mixing volume and restricted air infiltration make the automobile a microenvironment in which very high concentrations can occur from smoking. It is not uncommon to find air conditioned vehicles driving on U.S. highways in summer with active smoking and closed windows. If the surrounding traffic is congested and slow, the concentrations contributed by the other vehicles will add to the high concentrations already present from cigarette smoking inside the vehicle." "Knowing only the air exchange rate the volume of a motor vehicle, it should be possible to estimate the concentrations of ETS pollutants from any cigarette smoking activity pattern using this model, provided that the cigarette emission rate for the pollutant is known. From the model, the mean concentration can be calculated quite easily for the idealized case of the habitual smoker....Because of the simplicity of the basic assumptions in the modd, it is likely that many of these findings can be generalized to other microenvironments." INDOOR AIR QUALITY [30] "Air Movement, Comfort and Ventilation in Partitioned Workstations," F.S. Bauman, R.S. Helm, D. Faulker, E.A. Arens, and W.J. Fisk, ASHRAEJournal(March): 42-50, 1993 "Today's office designs, technologies and work processes make it increasingly difficult for conventional ETS/IAQ REPORT, ISSUE 46 HVAC systems to satisfy the environmental needs of office workers - especially as those workers more openly express personal preferences about air quality and comfort." "In an open-plan office workplace, the design and configuration of furniture and partitions can, in certain cases, influence the thermal and airflow conditions in workstations. Some researchers believe that partitions separating workstations may obstruct airflow, resulting in poorly ventilated workstations." "This article presents the major results of a study examining the comfort and ventilation conditions in workstations surrounded by partitions and ventilated by a conventional ceiling supply-and-return air distri- bution system. The study investigated a wide range of partition configurations and environmental parameters in an attempt to bring greater thoroughness to the testing methodology and to yield a more dearly substantiated condusion on the role of partitions in air circulation." "The overall objectives of this study were: to evaluate the conditions under which partition designs can improve or degrade air movement, ventilation perfor- mance and worker comfort; and to evaluate the effects of an airflow gap near the bottom of partitions on air movement, ventilation performance and worker comfort." "Although members of the building engineering community continue to express concern over the potentially detrimental effects of office partitions on air movement, comfort and air quality, the results of this study based on an extensive series of experiments in a controlled environment chamber do not support this contention." "A ceiling-mounted supply-and-return air distribu- tion system supplying air to the test chamber over the range of 0.2 to 1.0 cfm/ft2 was able to provide uniform ventilation rates into all three partitioned workstations. The range of tested air supply volumes represented rates that were both below and above the manufacturer's recommended minimum levels for acceptable diffuser performance. Variations in solid partition height produced only small differences in overall thermal performance and had no measurable impact on ventilation performance." "While the existence of an airflow opening at the bottom of office partitions can, in some cases, produce slight increases in air velocities near the floor, there are

Al'RIL 30, 1993 no significant improvements in comfort conditions or deviations from uniform ventilation within the worksta- tions compared to results obtained for solid partitions." "Test parameters that were found to have a more substantial impact on air movement and comfort included heat load density and distribution, supply air temperature and supply diffuser location." "Comparison of the results of this study with future field-based research in large partitioned offices is necessary before general conclusions can be drawn. However, it is important to know, based on the research presented here, that office partitions do not necessarily present a significant barrier to effective circulation or ventilation efficiency." [31] "Will the Mouse Bioauay for Estimating Sensory Initanry of Airborne Chemicals (ASTM E 981-84) Be Usefvl for Evaluation of Indoor Air Contaminants?" J.S. Tepper and D.L Costa, Indoor Environment 1: 367-372, 1992 "The potential for adverse health effects resulting from exposure to indoor airborne contaminants is drawing increased attention from both the lay public and various regulatory bodies concerned with public health.... Unfortunately, the reported health effects are often of vague character appearing in selected individu- als and are difficult to associate with any exposure." "The largest data base that may relate to this symptomatology from which one could derive expo- sure-response relationship in humans, lies in the industrial health literature supporting the development of threshold limit values-time weighted averages (TLVs-TWAs).... (S]ensory irritation is a response common to many airborne substances and has served as a tool in assessing some health risks associated with such exposures." "The experience with establishing TLVs-TWAs in the workplace suggests that a screen capable of detecting irritancy may be valuable in the assessment of problems associated with indoor air exposures. In this regard, the American Standard Test Method (ASTM) E 981-84, a mouse bioassay for estimating the irritancy of inhaled chemicals, merits consideration. As with any screening method, its primary purpose should be the ability to A-5 predict human responses. Ideally, this method also would be sensitive to a broad spectrum of contami- nants and would aid in the characterization of product emissions. Additionally, the screen should detect and discriminate between a variety of pulmonary and systemic ailments and be useful for both acute and chronic quantitative health assessments. ASTM E 981- 84 meets many of these criteria, but as with any biological model, it has limitations. This article identifies some major strengths and limitations of the ASTM E 981-84." "The test method (ASTM E 981-84) provides a quantitative estimate of the sensory irritant potential of an inhaled chemical. Irritancy is detected by a charac- teristic change in the breathing pattern of mice, which results in a reduction in the breathing rate during exposure to a test atmosphere. This characteristic response in mice has been demonstrated to qualita- tively predict nose, throat and eye irritation in humans for 51 chemicals. A quantitative relationship has been established between the published TLVs-TWAs for 26 irritant chemicals and the concentrations at which these chemicals reduce the respiratory rate by 50% (RDO in mice. This statistical relationship indicates that 3% of the RD50 can be used to suggest interim TLVs- TWAs, if toxicity is primarily based on sensory irritation." "The mouse bioassay (ASTM E 98-84) has clearly been a valuable tool for the assessment of inhaled irritants, particularly in the establishment of interim exposure limits (TLVs-TWAs) in the absence of other toxicity data. The large existing TLV-TWA data base provides support to the idea that product emissions and ambient indoor environments testing positive with this methodology are likely to be irritant hazards in an office or a domestic indoor air environment." "There is a strong desire to adopt a screening method that rapidly and reliably assesses the discomfort/ adversity of potential 'sick-building' situations. While the ASTM E 981-84 may well provide a means to address such issues, the validation of the method is based on irritancy alone and does not include many subjective complaints often raised in the sick-building situation, such as headache and malaise. tllthough these symptoms often occur together, anecdotal reports suggest that subjective complaints may exist without irritation."

A-6 STATISTICS AND RISK ASSESSMENT [33] "An Individual Decision Model For Environ- mental Exposure Reduction," N. Duan and W. Ott, Journal ofExposureAnabris and Envinonmen- ta! Epidemiology 2(Suppl. 2): 155-174,1992 "Environmental exposures for human subjects are usually attributable to multiple sources. For example, human subjects can be exposed to benzene, a known carcinogen, from industrial emissions, motor vehide exhaust, gasoline fume from gas pumps, mainstream tobacco smoke (MTS), environmental tobacco smoke (ETS), certain consumer products, etc." "Given the multiplicity of sources, exposure reduc- tion can be achieved in a variety of ways. We can focus on reducing the emissions form one of the sources. For example, benzene exposure reduction has traditionally been focused on reducing industrial emissions. Alterna- tively, we can reduce the emissions from several sources simultaneously. For example, we can reduce benzene emissions simultaneously from industrial point sources, ETS, consumer products, etc. Since there are many options for exposure reduction, choices have to be made." "The choice among exposure reduction programs should' be based on the joint consideration of two factors. First, we need to consider the effects of the candidate programs, i.e., how much exposure reduc- tion is achieved under each program. Second, we need to consider the costs for the candidate programs. We discuss below a decision model to illustrate the optimal exposure reduction program that achieves the most exposure reduction for a given cost." "Since many important local sources are within individuals' direct control, individuals should be recognized as key decision makers in exposure reduc- tion. They can exercise their control over many local sources to achieve exposure reduction at a lower cost than centralized environmental regulators can achieve. Furthermore, their perceptions and preferences can also have important implications for how regulators would manage global sources. An important compo- nent of environmental management should be based on enabling individuals to make appropriate exposure reduction decisions for themselves." "How can a target individual (or his proxies) reduce his personal exposure to a given pollutant? The target ETS/IAQ REPORT, ISSUE 46 individual has direct control over many local sources: he can quit or reduce smoking to reduce his benzene exposure from MTS, he can change his use of con- sumer products, he can modify his home microenvi- ronment, etc. He has indirect control over some local sources such as ETS: he might be able to reduce his benzene exposure from ETS in his workplace by demanding that a better ventilation system be installed, or he might lobby for local ordinances restricting ETS in workplaces. He has very limited control over global sources, such as lobbying through the political process to influence how industrial point sources are regulated." "The individual decision model to be described below illustrates how to determine the optimal exposure reduction program for a target individual! Depending on the composition of the optimal exposure reduction program, the target individual might or might not have direct control over its implementation. If the optimal program indicates changes in the local sources over which he has direct control, he can implement the optimal program directly by implementing those local changes. If the optimal program indicates changes in global sources or local sources over which he does not have direct control, he needs to lobby for the changes that are beneficial for him. Therefore, the individual decision model should sometimes be viewed as a guideline for the target individual to decide how to cast his vote, or how to voice his concerns." "The individual decision model described in this paper should be considered as a prototype to imple- ment NRC's recommendation on public education. The implementation of this model requires a substan- tial amount of data, induding the exposure compo- nents and the cost factors, and several algebraic ma- nipulations. We do not expect an average person to implement the model in its exact form. However, we believe the principle underlying this model can be used by the average person to arrive at reasonable decisions." "The task facing John Doe, the exposure reduction decision maker, is not generically different form the task for John Doe, the consumer purchasing an automobile. The decision theory in this paper is analogous to the standard decision theory in microeconomics. Although we do not expect the average consumer to obtain optimal economic deci'- sions in its exact form, we do expect the average consumer to make reasonable economic decisions."

APRIL 30, 1993 "The major difference between John Doe, the exposure reduction decision maker, and John Doe, the consumer, is in their access to the data necessary in making decisions. The average consumer has ready access to.the cost data in the market place, and usually has reasonable access to the relevant features of con- sumer products - for example, the gas mileage for automobiles, or nutrition contents in processed food. On the other hand, John Doe, the exposure reduction decision maker, has much less access to the relevant data. The exposure data, if accessible at all, are usually presented in a cryptic form unintelligible to an average person. The average person is unaware of many major exposure sources affecting him and knows little about the options available for reducing those exposures."' "The key component of the individual decision model described above is the need for individual consumers to access the relevant exposure and cost data. It is crucial to implement a public health policy based on risk communication programs that dissemi- nate the data required for the individual consumers to make appropriate exposure reduction decisions. While we do not expect the average consumer to make perfect exposure reduction decisions, we believe they can be as successfitl in making reasonable decisions as they can in making economic decisions, if they are given sufficient acccu to the necessary data for making those decisions."

IN THE SUPERIOR COURT FOR THE DISTRICT OF COLUMBIA CIVIL DIVISION JOANNE BARURA, et. al,. * CIVIL ACTION NO. Plaintiffs, * vs. S.E.W. INVESTORS, a/k/a/ S.E.W. PARTNERS, et a~l. * * * N Defendants * * * * * * * * * ~tQR 2 0 * st~~. C... D: me Ri~fut * PLAINTIFFIS SECOND AMENDED DESIGNATION OF EXPERT WITNESSES * * Plaintiffs, by their undersigned counsel, hereby designate, pursuant to Rule 26(b)(4) of the Superior Court Rules of Civil Procedure, the following additional person as an expert witness. Plaintiffs incorporate, in this Second Amended Designation, Plaintiff's Amended Designation of Expert Witnesses previously filed with the Court. 1. Rosalind C. Anderson, Ph.D. - Dr. Anderson's resumd, which sets forth her background and qualifications, is attached hereto as Exhibit A and incorporated by reference herein. She currently holds the position as President, Anderson Laboratories, Inc. ("Anderson"). Dr. Anderson is expected to testify as follows: Based on tests conducted by Anderson and her review of other data, Dr. Anderson will state it is her opinion that the air in the Waterside Mall is currently contaminated, and more probably than not was contaminated for some time in the past. She will further state that the contaminents may have O• j Cb ISSUE 46 j~j?APPENDIX B ~ ~

adversely affected the muscular, neurological and respiratory systems of the Plaintiffs. Dr. Anderson will testify that when tested the air in the building adversely affected the muscular, neurological and respiratory functions of mice, and the detrimental effects on mice directly correlate to detrimental effects on humans. The contaminants were measured by the American Source Test Material Consensus E-981 Method. This is an accepted consensus standard. Dr. Anderson will further state that based on the tests conducted by Anderson, and other data she has reviewed, it is her opinion that the air in the Waterside Mall Complex, currently is unacceptable, as defined by ASTM standards and worse than other public buildings around the country and in the D.C. area. Dr. Anderson will testify that tests conducted by other consultants in the Waterside Mall Complex did not measure the effect of contaminants on EPA occupants. Specifically, these tests did not measure the toxic effect of complex mixtures at different concentrations. Consequently, the test results often did not reflect that the building was contaminated. If the results were measured via the ASTM E-981 Standard, they might have indicated that this building was and is contaminated. Dated: March 1, 1993 ll~et4 t4~-, Robert W. Kat D.C. Bar No. 1413 (SIGNATURES CONTINUED ON NEXT PAGE] ~ ~ ~ - 2 - O CA a C.7 W

Gordon, Feinblatt, Rothman, Hoffberger & Hollander 233 East Redwood Street Baltimore, Maryland 21202 410/576-4291 Attorneys for Plaintiffs CERTIFICATE OF SERVICE I HEREBY CERTIFY that on this day of /4-1 r'`1 1993, a copy of the foregoing Plaintiffs' Second Amended Designation of Expert Witnesses was mailed, first-class, postage prepaid, to: Gregory A. Krauss, Esquire Carr, Goodson & Lee 1919 Pennsylvania Avenue, N.W. Washington, D.C. 20006; James W. Greene, Esquire Bromley, Greene & Walsh 1050 17th Street, N.W. Washington, D.C. 20036; Edwin Sheridan, Esquire Doherty, Sheridan & Gramalbi 8408 Arlington Boulevard, Suite 200 Fairfax, Virginia 22031; Marc L. Fleischaker, Esqurie Arent, Fox, Kintner, Plotkin & Kahn 1050 Connecticut Avenue, N.W. Washington, D.C. 20036-5339; 3

L31256.550 S:5 Mark Proctor, Esquire Levin, Middlebrooks, Mabie, Thomas, Mayes & Mitchell, P.A. P.O. Box 12308 226 South Palafox Place Pensacola, Florida 32581; and Bernard J. DiMuro, Esquire DiMro, Ginsberg & Lieberman, P.C. 921 King Street Alexandria, Virginia 22314 Jonath N. Portner ~ 4

ISSUE 46, APPENDIX C Background for "Indoor Environment '93": Excerpts From the ASH Special Report on ETS ACTION ON SMOKING AND HEALTH 2013 H St., N.W. • Washington D.C. 20006 •(202) 659-4310 INVOLUNTARY SMOKING: The Factual Basis for Action "INVOLUNTARY SMOKING" or "PASSIVE SMOKING," sometimes even called "RESPIRATORY RAPE" - it all means the same thing: being forced to inhale other people's tobacco smoke. Today we know that this substance, now called "Environmental Tobacco Smoke" (ETS) or "secondhand smoke," is the deadliest danger to which we are exposed. Indeed, it kills more Americans than all forms of air pollution, water pollution, food additives, and radiation combined; more than all automobile accidents, guns, AIDS, and illicit drugs - a staggering 53,000 innocent victims each and every year! This document presents the major findings of the Environmental Protection Agency (EPA) Report on passive smoking, and other recent studies and information in a form which can be used to convince business leaders, legislators, agency officials, judges, and others of the need to protect the majority of Americans who don't smoke (including all children) from the deadly effects of ETS. This, the experts and the agencies tell us, can only be done by restricting smoking in all public places; there is no safe lower level for the dozens of dangerous chemicals in tobacco smoke which drift and are recirculated, and' cannot be filtered out or otherwise eliminated by even the finest ventilation systems. Portions of the complete 16-page ASH Special Report are being distributed free to attendees of "Indoor Environment '93." Complete copies are available from ASH. $2/each Table of Contents of Entire Report PAGE 2 presents the official findings of five government agencies that~ ETS causes lung cancer in nonsmokers PAGE 3 answers commonly asked questions about how we know that ETS causes lung cancer in nonsmokers PAGE 4 explains how ETS is the third major U'.S. killer, how it kills over 50,000 Americans each year PAGE 5 answers the tobacco industry's major arguments concerning ETS studies, and provides three questions which should be asked of any witnesses defending ETS PAGE 6 describes how ETS creates very serious health hazards for all children, and cites the major studies PAGE 7 explains how courts protect children: from ETS through court orders and through custody decisions PAGE 8 notes what major newspapers and organizations are saying and doing concerning public smoking PAGE 9 indicates the legal theories under which owners and employees are being held' liable for permitting smoking, and cites some of the major legal decisions PAGES 10-14 reprint of the complete verbatim text of! the EPA Report's "Summary and Conclusions" PAGE 15 reprints additional important information from the EPA Report, including additional citations PAGE 16 tells what you can do to protect yourself and others, and where to get additional information What We Know About ETS Todav. Environmental tobacco smoke (ETS) is a "Group A Carcinogen" like asbestos and benzene - one of the few substances known to cause cancer in humans and for which there is no safe lower limit. Each year it kills:  an estimated 53,000, Americans:  more people than alli the victims of automobile accidents, including those caused'iby drunken drivers;  more than twice as many people as all homicides, including homicides caused by firearms;  more than twice as many people as AIDS;  more than ten times as many people as all the illicit drugs we target in our "war on drugs" ETS presents even greater dangers to children. Each year, even at the levels found in a home where onlw one parent smokes, it is estimated to cause in infants:  150,0001300,000 lower respiratory infections like pneumonia and bronchitis  7,500-15,000 hospitalizations  200,00011,000,000 asthma attacks  8,000-26,000 new cases of asthma  increased middle ear effusion  respiratory symptoms of irritation  significantly reduced lung function  a large increase in the risk of death from S.I.D,S. LEGAL ACTION AND EDUCATION ON THE HAZARDS OF SMOKING• PROTECTING THE RIGHTS OF THE NONSMOKING MAJORITY 878fl5'73G

SH - SPECIAL REPORT ON INVOLUNTARY SMOKING Page 3 How we know ETS causes lung cancer Q: How do we establish that a sub- stance causes cancer? A: Usualh•, because the cancer-causing effects are so small, scientists subject laboratory animals to doses hundreds or thousands of times the equivalent of human exposure. Then we see if there is an increase in the incidence of cancer. In some cases we have been able to observe the effects of very high doses directly on~ humans; e.g., uranium workers exposed to radon. In both cases, because we have never found a safe level below which a carcinogen doesn't cause cancer, we must assume - until proven otherwise - that it can~ cause cancer in any concentration. Q: Does this mean we usuallv have no studies showing that a chemical causes cancer at the levels at which it is nor- mally encountered? A: That's right - such studies are usual- 1y not available. For example there are no studies showing that radon at typical levels found in homes causes cancer. The same is true for most of the other carcinogens regulated by various agen- cies. Fortunately, these normal-level (so called' "'epidemiological")' studies are available for ETS, and show what hap- pens at typical ETS levels in homes. Q: Is there anyy evidence, in the ab• sence of these epidemiological studies, which shows that ETS causes cancer? A: Yes, many different types: FIRST, more than 40 individual chemicals present in ETS have indepen- dently been found to cause cancer, and there is obviously no reason to believe that they lose their cancer-causing prop- erties when mixed with other toxins in ETS. SECOND, thousands of studies have demonstrated that mainstream tobacco smoke - which contains virtually the same chemicals as ETS - causes cancer in the lungs of smokers, as well as in animals such as mice and rats. THIRD, numerous studies showw that nonsmokers absorb large amounts of these chemicals into their bodies - in some cases the equivalent of a pack a day - even if they are seated in no- smoking sections, and that they retain the chemicals for long periods of time. THUS, this evidence even by itself is far stronger than that under which most carcinogens are regulated. As the U.S. Surgeon General said in his 1986 Report: "In examining a low-dose expo- sure to a known carcinogens it is rare to have such an abundance of evidence on which to make a judgment, and given this abundance of' evidence, a clear judgment can now be made: exposure to [ETS] is a cause of lung cancer." Q: How were the epidemiological studies [listed on page 15]' done? A: The studies examine comparable groups of people to see if the one regu- lhrh• exposed to ETS had higher rates of'lung cancer than the one which was not. In virtually all cases, those ex- posed to ETS had higher lung cancer rates than those who were noo exposed. Moreover, where it was possible to measure the amounts of the exposure, those with the most exposure generally had the highest rates of lung cancer. Q: How do we know that other things didn't cause the higher rates? A: Individual! researchers and EPA scientists looked for these other factors, but found none which could'expiain the higher rates in the many different stud- ies in so many different countries. Also it is unlikelV that any of these other causes would have increased di- rectlv in proportion to ETS exposure.. cancer deaths in nonsmokers: A: The evidence today is far stronger and more conclusive than with regard to virtually any other chemical. In 1986 the National Academy of Sciences - an~ official and impartial body established'bv Congress - unani- mously concluded that ETS caused lung cancer in humans. The same vear the U.S. Surgeon General reached the same conclusion. [see page 2] Indeed, numerous other scientific and medical organizations reached exactly the same conclusion even prior to the EP A Report, and none has ever reached the opposite conclusion. (see page 2] Q: Could the EPA have been biased? A: The EPA Report was prepared by a large number of scientists with the help of consultants from many different independent organizations. It was then subjected to scrutiny - including publie hearings open to all critics and objectors - by a Science Advisory Board (SAB)') composed of other scientists. Even though almost half of the mem- bers of the SAB, including its chairman, admitted to having direct financial ties to the tobacco industry, the SAB never- theless unanimously agreed with the EPA that ETS caused cancer M humans. Besides, alleged bias by the EPA czn't explain why every other scientific bodv both here and abroad which examined the issue reached the same conclusion. "ETS is a human lung carcin- ogen, responsible for approxi- mateh• 3,C00 lung cancer deaths annually in U.S. non- smokers." (EPA Report at f-l.]i Q: How strong is the evidence that ETS causes lung cancer and lung Q: Is 3000 a large number of deaths? A: Yes. It is more than 3C times those estimated to be caused by all EPA-regu- lated cancer-causing chemicals. [see box below] Annual Cancer Deaths Asbestos ............ 15/yr Vinyl chloride ....... <?7 /vr Airborne radionuclides . . 17/yr Coke-oven emissions . . < 15L-r Benzene ............. 8/yr Arsenic ............. <51yr Smurcr: Rep,ca. Rn2i.Anii.+.a. \'l:. \c;. :r9: This is a special isue of the ASH S»to4ing.nd Health Review (fSSN ' 1C3 6-9077:C1. Copyrighted by Action on Smoking and Health (ASH)4 _C1: H'.Sn. \D; ;,u'ase.. DC 2CCC6. (2:-_'1 659-43iC. ASH is a national nonprofit, tax-exempt organitation concerned o,ith the problems of smoking, and the rights of nonsmokers. ASH' is entire!. supported'bv tax-deductib!e contributions.,and regu!ar, contributors receive the ASH Review. Printed portions of the ASH Rrt+xm ma.• be reprinted n•itfi credit to ASH..

,.,~4SH VJ- SPECIAL REPORT ON INVOLUNTARY SMOKING ETS is the third major U.S. killer The EPA Report concluded that ETS causes approximatelv 3000 nonsmoker deaths annually from lung cancer, but that's only the tip of the iceberg. Actually, other studies noted by the EPA strongly suggest that ETS causes 53;000 U.S. deaths each year, making it the third major killer - after active smoking (by smokers) and alcohol! It is not surprising that passive smok- ing causes diseases other than~ lung cancer, or that lung cancer was the first disease definitively linked to ETS. The same thing happened with regard to active smoking. "amestimated 53,000 Americans die each year from' exposure to tobacco smoke of~ others." Dr. Antonia C. Nbvello, U.S Surgeon General Annual Deaths, Passive Smoking Heart Disease ......... 37;000 Lung Cancer ........... 3,700 Other Cancers ......... 12,000 TOTAL .......... - 53,000 SOCRCe_ Glantz,. et al .. Passtve Smoking and: Hean D,sease.,Circulatson• 1991:63.1.1-11. see, also N'ells. An emmateof adult monalrtv in the CS.S from passive smo'asng• Ennr !ht 199_:2 639, . The original Surgeon' General's report' concluded that smoking caused lung cancer in smokers. Only later did we realize that it also causes heart attacks,, and cancer at many other sites. This also appears to be happening with ETS. The EPA Report stated: "While this report focuses only on the respiratory health effects of passive smoking, there also may be other health effects of concern. Recent analyses . . . suggest that ETS exposure may be a risk factor for cardiovascular disease. . . . If it' is, the totaDpublic health impact from ETS will be greater than that discussed: here." A recent analysis of almost a dozen epidemiological studies concluded'' that ETS increased the risk of heart attack among people living with smokers. In addition' the principal author [Glantz) noted that since smokers are much more densely packed in an office than the,v are in' most houses, "we are almost cenainly underestimating the risks" of workplace smoking. The epidemiological studies upon which the article was based are believed to be particularly reliable because they generally show a "dose-response" effect, with higher exposure causing a higher risk of heart attack. This tends to show that it is the ETS - and not some otherr factor - which is causing the deaths. The studyy also outlines at least five ways in which ETS contributes to hearth attacks. First, the transportation of oxygen to red'''blood cells is immediatelv hampered by the carbon monoxide (CO) in~ ETS. The CO replaces the oxygen which is ordinarily carried by the red'' blood cells. Second, other studies show that the blood not onlv does not carry the oxygen as well, but also that the oxygen a-hich does get to the heart isn't used bv the heart muscle to do work as efficiently. Third, there's evidence that ETS makes bloo& platelets abnormally "sticky,"' and thus more likely to aggre- gate and form~ blood clots. Fourth, while increased platelet aggre- gation plays a direct role in' heart at- tacks, it also contributes to the develop- ment of atherosclerotic plaques, the fatty deposits on the walls of coronarn•. arteries which often lead to heart at- tacks. Fifth, components of ambient tobacco' smoke may damage the delicate inner walls of'~ coronary arteries, and initiate or accelerate development of these plaques. In the next column are the major epidemiological studies linking ETS to heart attacks. Immediatelti•y following are studies which suggest that ETS causes cancers other than lung cancer. Page 4 BGTLPR. The relationshep of pasuve.smoklmR tovanous hesith outcomes among Seaeath'-Dar Ad,entssts in Caiafornua. )e.enth VCorld Conf<renet on Tobacco andHealth 199:J16'. • GAR- IaND, rr al... Effects of Pasn.e SYnoksng on Ischemrc Hun Disease Monahrv of.\onsmoken. Ans J Ep~demsol 19g5:1:1.6a5- 65C • GIIUIS. ec al.. The Effecs of E'nstronmensa) Tobacco Smoke in T+ro Urban Carssmnnmes in the West of Scaiand.. Euro J Resp Dn 19fa.65(Suppl 1331:It1.i26. HE. tinmen'npass.se smoking and coronarv heart diseue. Chung-Hus-YuFanpl-Hsurh. Tu{hm 19/9: !3 ~19d2  HEISING. nal I. Hean. Disease 5lonabn• vn \cnsmokers Lnng With Smokrrs.. Am JEpudrmioi 19gg.L'.',915-9'_?  HOIF, et a1_:Passsve smokusg and car~'~ore- spsntorv hultksn a general population in the vta oi Sectland: Br\fed:J. 1919199a?3-427 • HUMBLE. Passive smoiang and nenn• 3'rar.cardsovasndar dJstast monahrv among nonsmofunS ss.es m Evans Countyr Georgra, Am J Public Hcahb 190:: g: 599- 6:1 • LEE. et al... ReliuonsWp of Passsve Smokmg to Rssk of Lung Cancer and Other Smokmg-Assoctatrd Dnrasas. Be J of Cancer 1916.54.97-1:5 • HIRAYAMA. T. liungCancer tn 0 Annual Deaths, Various Causes Active Smoking' . . . . . . 434,000 Alcoholic Beverages2 ... 105,C00 Passive Smoking' ....... 53,CC0 Auto Accidents' ....... 43,500 Homicides'' ........... 24,020 AIDSS .............. ,,,334 Fires' ................ 4,'00 Radon, to nonsmokerss . . . 4,000' Cocaine & Crack' ....... 2,483 Heroin & lvlorphine'` . . . . 1,976 1~.• C:S. Centers forDnnse Concroli 1911 • 2• C.S Cenaers for Daease Control; 1911? . 3• l'S,Sursros Grneu:-.199C • e.• `it1'SaieraCounal. 1991 . S• USStn J,rdKUrv.Conun. Rpt. !991 e 6: Cs. CentersforDsrase.Concrnl_ 1991 . 7• IS. Nst'8 SafttrCeunn,i. 199t Repsce. Rnk' Ans!.-_ V No 1, t99;, :7 . 9. •Nat•I Inst, on Drug Abwe. 199: .1: .. Nail Inst on Dn.g Abuse. 199:. Jlpan: Effects of Numtsnn and Passne SmokSng, in Lung Cancer-Causes and Prevenvon, M. \lsadll.• et al..eds.. pp 175-195.\'erla9 Cheme lnt1„Ne.• York, 19te. MARTIV:,M, . J Increased. Incsdenct of Hean Acuek's u+ ;tiensrnok'ang Women \tarrsed to Smokers. Paper presented at anmual m.nmgnr American Publu: Health Assocsatmn, 1916 . . SYEEDLSND..K.. Passrve Smokrng and tke risk of hrandusease. JA\fA.f1992116-9..99. SWEND- SEN; et al. Effee<s o/ passsve smokmg Ihe mudt,pie nsk iaanr sntenentson tnall Aen J.Eptdemso11917a:6-713-'93 CANCERS: StaTTERY. n al- Ggarenclmoksng and Eaponrre, toPasss.e Smoke are Risk Faesors in Cerwcal Cancer. JANA. Vol. 261 (17), 1593-159g. \Lr 1991) • HIRAYA.MA. T... Cancen. \4orsalrv in Nonsmok.ng.lYbmen With Smoking Husbarsds BassJ ona Large-Scale Coh'on Siudv in Japan: Prev \1hdJ :3(6}:6g:.d9C.. tios-. 1914 . GI W S. n al., The Effect of EnvsronmentA Tobacco Smmoie.,n Ti.ro. L'rban Communsnes mthe \Sestoi Seotland. Eur. J..Resp. Dn. 65(Suppl. 133) 1984 • REYNOIDS, et al.. Pasnvr Smoking and.Caneer Inndrnee~Prespecuve Evdence from th'e AtamrdlCaunm Srnds" Paper pneunted atthe Socsrn-ior Ep,dem,oioga Research. Amherm. \Sass.. jiuse 1987 . Mll1FR.. 0 H Cancer. Passsae )moksng and Nonampi6ved and Empioved. N",vrs. Vl'ev J Neu M:.: 632e3i., 1994 . • SANDLER, n ai. Passne imokms. - Aduiihoo.i and:.ancrr Rui. Am j Epidem.oi 121. PN1 1913 This is a special issue of thr.tSHSrrtoking.rtdHr.lth'Revuav ((SSN' 104(~907X0): Copynghted!by Action on Smoking and Health (ASH).?013 H St., NV:'. VL'asN:, DC ?0006. (.:2)'6594310 ASH is a national nonprofit tax-exempt organization concerned o•nh,thc problems of smoking and the rights of nonsmokers. ASH ii enureh 8'7805'738

0SPECIAL REPORT ON INVOLUNTARY SMOKING Page 5 Answering tobacco industry arguments on ETS studies The tobacco industn• (TI) purports to find scientific flaws in the evidence that tobacco smoke causes cancer in non- smokers. However, since they also find flaws in the overw helming evidence that tobacco smoke causes cancer in smok- ers, it is reasonablie to doubt their im- partiality and their scientific credibility on both issues. Nevertheless, here are some of their major arguments, and brief answers prepared by ASH. TI: The EPA was biased. ASH: It is very doubtful that the scien- tific body which reviewed an& agreed with the EPA's conclusions was biased against tobacco, as almost half of its members admitted to having direct financial ties to the tobacco ind'ustn•. Since the more than a dozen govern- mental, scientific, and medical bodies which have reviewed the issue all agreed that~ ETS causes cancer, and no indepen- dent body has ever reached the opposite conclusior., it is far more likely that the tobacco industry's position is the one motivated by bias and self interest. TI: Studies showing increased inci- dence of lung cancer from exposure to ETS in the home don't prove that ETS in the workplace or in public places likewise causes cancer. ASH: There is no reas= to believe that chemicals shown to cause cancer in one location would suddenly lose their cancer-causing properties in another. Although no studies done in schools show that asbestos causes cancer, we don't allow children to go to school where asbestos is in the air. TI: The EPA unscientifically relied on studies which were not statistically significant. ASH: "Statistically significant," in this context, means that an individual study proves to at least a 95°!o probability that ETS causes lung cancer. While we sometimes needithis very high degree of.f certainty before taking action, lower standards (e.g., 90%) are often used, and have been accepted by courts. After all, shoul& nonsmokers be subjected to a substance if we are only 90% (rather than 95%)~ certain that it causes lung cancer? TI: The EPA unfairly combined dif- ferent studies. ASH: Many studies all pointing im one direction often prove causation to a far greater certainty than any single study. Flipping a coin and having it come up heads 56 out of 100 tries only proves to about a 90% (not 95%) certainty that the coin is imbalanced. But if it keeps coming up heads more often than tails in study after study of 100-200 flips, the odds of that happening by chance be- come so small we can say a•ith~virtual certainty that something other than chance i's causing it to favor heads. Here, looking at different combina- tions of the larger and better studies, the EPA says the odds of the results occurring, by mere chance range be- tween 1 in 10,OC0~to I in 1,00C,CCJ,CCO: In other words, the EPA judged the overall statistical significance of the studies to be at least 99:999^°!! For additional information and argu- ments refuting the tobacco industry's challenges to the EPA Report, see the EPA Report; excerpts from it on pages 11-14 of this document; and Repace & Lowrev, "Issues and answers concerning passive smoking in the workplhce: re- butting tobacco industry arguments,"' Tobacco Control 1992; 1:208-219. ETS CAUSES CANCER The following organizations have all concluded that Envi- ronmental Tobacco Smoke (ETS) causes lung cancer and lung cancer deaths among nonsmokers: American Cancer Society American Heart Association American Lung Association American Medical Association American Public Health Association Environmental Prot~ection Agency National Academy of Sciences National Cancer Institute National Institute for Occu- pational Safety and Health U.S. Public Health Service U.S. Surgeon General World Health Organization TI: The answer to ETS problems is better ventilation, not smoking bans. ASH: Many studies and scientific bodies have concluded that the risks from~ ETS remain higher - even in buildings with the best ventilating systems - than we would accept in other circumstance. For example, air pollution levels in many public places were foun& to ex- ceed federal outdoor air quality criteria, even in the "no smoking"' sections. Repace & Lowrey, "Indoor Air Pollu- tion ...," Science, Vol'. 208, 5/2/80. Even separate smoking rooms don't provide acceptable levels of protection since tobacco smoke is recirculated. No filter can remove the cancer-causing gases, and most of the cancer-causing particles are too smaR to be 'rapped. Repace & Lowrey, "An Indoor Air Quality Standard . .," NY State J. Med., 85:381-83 (1985). -his is a speaal issue of thc ASH Smoking and Health Revrw (15S` 1Z16-9Z7XC). C°pvngnted by Action on Smoking and Heaith, (ASH). 2-1 3 N' St.• NT. u un-• DC 10006, (2C2) 659-4310. ASH is a national nonprofit, tax-exempt orgaiuzation concerned ..-ith the problems of smoking and the rights of nonsmokers. ASK' is entire:p supported by tax-deductible contributions. and regular contributors receive the ASH Rrvtew. Printed pontor» of thc ASH Re-.new may be repr med with eredit to ASH.

1,~4SH ~(J SPECIAL REPORT ON INVOLUNTARY SMOKING What others are saying and doing about ETS "EPA Report Sparks Antismoking Plans: Plaintiffs' Suits May Prod Firms To Bar Smoking - The [EPA] is counting mainly on plain- tiff's lawyers, rather than regulators, to drive businesses to ban smoking on their premises, and the lawyers are eager to comply. As a result of the EPA's report linking 'passive' tobacco smoke to lung cancer and other ailments, a new wave of tobacco-related! lawsuits is likelv, legal specialists say. These are expected to include workers' com- pensation claims [andJ damages suits by customers who experience ad- verse reactions." Wall Street Jour- nal~ 1/7/93 "Already,, 56% of organizations sur- veyed are completely smoke-free; by the year 2002, another 40% a•: l have enact- ed a smoke-free policy. ~'~nly 4% said they expected to cont:n;:e allowing smoking during the next 10 years." International Facility Management Association "It's just a matter of time before smok- ing is completely banned in the work- p15ce. It will happen in 10 years - may- be less." National Alliance of Business "WV Our Kids Are Breathing. Easier: Our Restaurant is Now a Smoke-Free Environment - Since we are a restaurant concept catering to families, we are always concerned about health risks affecting children. One of' those risks is the effect of second-hand~ smoke. Recent health advisories have studied the effects of second-hand smoke and„ because of the results, we have determined it is a risk we cannot afford to take. therefore, our restaurant is now a smoke-free environment." ShowBiz Pizza Time, Inc. [ChuckEChecse] "Employers that continue to allow smoking in the workplace, even under the most restrictive circumstances, may be more vulnerable than ever to litiga- tion by nonsmokers."' Employee Bene- fit News, 3/93. "'More and more the owners or opera- tors of public facilities like the Orioles are sending tobacco smoke the way of flaking asbestos - and for the same reason. It kills innocent people." Baltimore Sun, 1/10 "When I learned that second-hand; smoke is a known carcinogen with no safe level of exposure, and that air-con- ditioning simply recirculates it, I decid- ed I did not want my family, my cus- tomers or my employees to breathe tobacco smoke. Ten months ago I made all four of my restaurants no smoking.. . yet [my restaurants'] sales are about the same. I've had a few guests upset about my policy, but most of thems after hearing the reas= whv„ decided to stay." Pasadena [CA] Res- taurant Owner "If indoor smoking isn't curbed, some people who think they've been put at risk by secondhand smoke may wind up taking their complaints to court." Raleigh News & Observer, 1/10 "An increasing number (;of restaurants) are in the process of banning smoking. There is not a chain in the country that is not considering it today." National Restaurant Association "McDonald's Corp., the world's largest restaurant operator, is considering ban- ning smoking in its nearly 9,000 U.S. outlets .. McDonald's . . has been a kind of corporate weather vane on social policy issues." Washington Post, 2/19/93 "As a result of the EPA ruling, Grey- hound Lines Inc. says it plans to reas- sess a smoking policy that had alreadv Page 8 "The Heat is on: Anti-smokers Promise an All-Out War This Year, and They're Going After Restaurants - Even before the EPA declared secondhand smoke a Class A carcinogen - along with asbestos and benzene - the nation- wide movement to ban virtually all smoking in restaurants had roared to a blaze. Three years ago, only three localities had outlawed smok- ing, either in restaurants or all workplaces. By [1/1/93J, the total was up to 47 (including]IFlagstaff, Ariz., Stockbridge,,'•vIass., and Madir son, Wisc." Restaurant Business, 2/10/93, grown increasinglyy restrictive in recent years. 'Given the EPA findings, we will seriously consider abandoning smoking for all of our locations.'" Wall Street Journal, 1J7/93 "No one would grant his neighbor the right to blow tiny amounts of asbestos into a room or sprinkle traces of' pesti- cide onto food. By the same logic, smokers have no right to spew even more noxious clouds into the air around them."' New York Times, 1/16 "Lawmaker Would Punish Drivers Who Smoke With Kids in the Car - Anyone caught smoking in a car carrying kids under 16 .. would be fined S50 under legislation proposed .. by state Rep. Peter Daley. The Washington County [PA] Democrat says the bill was spurred by a Janu- ary report from the [EPA) docu- menting the health risks to children from secondary smoke. 'The major focus of that report was the fact that secondan• tobacco smoke causes serious health problems for thousands of American children.' Dalevv said." U:P.I, 3/3/93. Ttiis is a special issue o6 the ASH S»sokieg .nd Healih Retxw QSSN 10a6•907a0). Copyrighted by , Action on Smoking and Health (ASH); 2C13 H St.. NW. Wash.. DC 20006, (202) 6i9.4310. ASH is a national nonprofit. tax•esempt orgutization concerned a•ith thc problems of smoking and the rights of nonsmokers. ASH is entireh• su.nnnrted h- tisaicduitihlc cnntrihutinn.. snd rec.tl,r .nntrihutnrc reocivethcASHRrts>u, n•,n,rcl n-.,n.ACH Rrtv+rm- k•----ni -•^ , ^dil ,n ACiY 8'7805'740

an W- SPECIAL REPORT ON INVOLUNTARY SMOKING Legal liability for permitting smoking Even without the new evidence now available in the EPA Report, workers have long been able to recover com- pensation for injuries cause& by expo- sure to tobacco smoke. So far, they have been successful under a variety of legal theories and doctrines: • common law and negligence: when an employer fails to provide a rea- sonabh• safe and healthful work- place, even in the absence of a statute; • workers' compensation: designed to compensate workers for job-related injuries and health problems;, • unemployment insurance: protects workers who lose their jobs through no fault of their own; • disability: to protect workers made unable to work;, an& even • discrimination:' unfair retaliation against nonsmokers In addition, a number of rulings held that persons who are sensitive to tobac- co smoke are "handicapped persons." That meant that entities covered by the law at the time - governments and large recipients of federal funds - had to make a reasonable accommodation to protect such people. Since the new Americans With Dis- abilities Act (ADA) imposes the same obligations on virtually all businesses, many more legal actions under this theory are likely to be filed and to be successful. Already, ASH has filed an ADA complaint against an airport, and ADA lawsuits have been filed against McDonald's and other fast-food outlets. The EPA Report is likely to make it much easier for employees to prove the harmful effect of ETS in all of the types of cases outlined above. It is also likely to open the door for new types of suits- For example, a child brought into the smoking section of a fast-food restau- rant or other public place could sue the owner if'~he or she suffered an asthmatic attack or other medical problem as a result. In such a suit, the carelessness of the adult who brought the child into the smoking sectiom is not a valid legal Cases of Particular Interest Smoke drifting up from a first- floor smoking area into a second- floor classroom was enough to trigger chronic lung disease in x teacher who was awarded 529;999,' A waiter who suffered a heart attack as a result of'' working in a smoke-filled bar received 595,000.= A secretary was held to be "envi- ronmentally disabled" because she could not work where she was exposed' to tobacco smoke. Her employer paid her S50;000' plus 5500/mo for the rest of her life,, even though she was free to work in any other smoke-free office.' Pointing out that smoking was banned in one room because it adversely affected a computer, a judge, even' prior to evidence of lbng-term health hazards from ETS, ordered a smoking ban in the office of a smoke-sensitive employee.a An Army employee sensitive to tobacco smoke was a "handicapped person" under the Federal Rehabili- tation Act, and his employer was required to make a reasonable ac- commodation to his handicap.5 A government employee had' no righr to smoke, and' could be fired for smoking even one cigarette on his own time off the job.b iL Schd)Irr v.,Los Angeles Cmhed School: Diancs PAS 656. PAS 175:. LA6:7f".9, CGhf Workeri Comprnutmn Appeals Bnard, 3/2^•/92: • 2. Lbht v. Staue Compensauon Innuanee Fund. Cat-N' Fiddle Restaurant (C+li[. tY'orkrrs' Compensation Appeals Board 199:): . • 3. Piarod, v\fens Systems Ptotecuon Baard'697 ~Fad 7)1(91h Car. 1912). •+. Shsmp v. Nea- Jersey BeB. Telepltone Company, 366 A1d +08 (1976);. • 5. Plenen v Departmens of the Atmv, L'5. \feat SVitems Protection Board Nos. CH"-75211:1::99, CH:1527 29:1 (1981):.• see also t',ckenv.The t'emons Admsmnuurm..S+B F. 5upp 85 (19829. • V"eer v: Oldae wPersonnrl \1ana8ement (\li'nr Si•ssrms ProtecttanBo+na- Dallas ReBtonal OIlrce. Dockn ~o DA 831L861:~j l l 1986/. • 6: . Gwendori v: Cnv on Oklahoma Gsv, 116F2d 539. !1-th.. C,.r. 19871 ~. Page 9 defense for the business. Similar legal actions could' also be brought on, behalf of young children who suffered medical problems as a result of exposure in the smoking sec- tions of airplanes on overseas flights. Some of the legal precedents involving exposure to tobacco smoke are dis- cussed or cited on this page. COMMON. L1>tr: Hemss) v. SmBer183. Cal.i Rpsr 159. (App 19121:: • Smmh v. VC'enern Eleevrc Compan. 6+3, 5 W . :d Ato. App. 1983) NEGLIGENCE: 'scCarslip, v. Depanmenc of Socul Hrauti Senices. 11: Wash. d 812, 759P.2d 351 (19/81 a'ORSMEN'S COMPEN5ATION= Brookss v Tnm.)Conid Aulma ee al Caldornu tYorkm~en:'s Compensumn Apprals Board.: Case No 76 SF 257-975 (.197'1; • Schober v V ountarn 3ell Telephone N.\f.: App 63: P,d./2+1 i198!l: • Bncheiorv. Fresno. Couniv (C+ldornul d196:): •!n she Matter of the Com~penunon oi SlarkneV['.' Anchse...OreBon VCorkers' Compenutton.Board. WCB CaseNo. B.L7248- CGsm tio. D69:SC8..WCDNo Nonr 5 5,N ..5i3-r6-56P (198570 • In the V aosrr of she Compensaaon oi . Stan-.1. Dou-nev. Oregon `t'ork'ersCcc.pensauon Board WCB Case No 63-:19C1. Clarm ~No D6:5:9:. DEl! 'a'CD ~Fae No. C15179G. SSN'593=3+2883 (1985):,• Jland R Eler. No :853 , 28:..fh 1-..VC-orien' Comp, Bd.: Dec 1988, (N-ESTLA>C.,k1WC- AD\bN.datahase. 1929 Vsl 1917:+): • JohSnnesrn v 1r. York . Gn Department oi . HouunB Presenatwn and Devrlnpmem .1 L4 , A.D: 2d 753; 3+6.I:.Y.S 2d +^. (196'fr •';wahi.v. ti`nconnn Bri;. Inc...(Wtsconsm .abor and Indunrtai. Re- Commauon, a.:anm. No. 88:..:676. 199C)', • Bem w Stassacfsusens Turnpske Authornv tRepon oi Ad•ssmussrauve JudBe of thc Depar-mer.toi Induanall. Acodent (Dunne Solomon) Board: No. :392s-:86.. Octeber :.., 1991); • Servrnv The Chdd Cmter (}t'orkers' Compenut.on Board of ILsdiana Appitcatson \umben 11:+9C- Janusn 6. 199]'i , L".VES'IPLOYME\T INSIIRANCE:Hahman._N YSDepan- ment oi La6or. F.A. Russo Incorp; 5.5 A. e1:=3:-H65. Appeal' e'-33:526, Rrferee 76.)29•83 (19761-, • Stn- s-C-P. Clarr. and Campanv. et, a).. Industnal Communon oi.Idilio DOE 615-CB (19711)- • Aleaander v Cnemplmvmen:Ins. AppealsB,1. ::+ CG1. App. ~f 97, G1. Rptr 411 .(198C), ,• Ennu and SeroehmannBro.s.... Pennsvlvanu tlnemplovment . Compensauon: Board: of Reac- AppealNo 8-83-SR-2+. Deas,on Nc 82135::G (198ri: • >1eCrocklm v Emplovment Developmem Depar.mrnte: lI 15e C.1. App.?d 1:67. 2:5Cal Rp:r 156'lCa: App. - vsn.. Deve., 198+i. • Laph'arn v. Commo-alth Cnemplo,m.rnr Compenu- eson Board. 519 A.2d 11:1 (Pa. Cm.ish:.l98'1. DISCABMINATiON AGAINST NONSMOKERSo Tar, Wa..vArerABenev on ApnB Initial Derermmauen..EOC CGSe Equai Opporrunases Comm.- Cim of \fsdison. R-fsconssn (19.^,:.. • Department of Fatr Empiovment andHousmBv. Frrmna . Coun,. CaidornuFasn Empiovmenu and Hkusm6 Commns- C+se No. FEP81,/: C8::C9ph (196+). • Depanrnent of FiuEmpi-nsand'HousmB v. Cou- oi..FresnoDepartmem ct, SOC41St-cesCastNof FEP62-L'C9~'e+p.F'_^83-BS.C9.::+srr N_16+3 FEP8L83.C9::85p. FEP8:-63 C9:19ere N*2165] tl9s>':.  Counn-of.Fresnov: Fav Empl6vment.and Houstn8 CSmm:s- aonobshe Swm.of Caldornu: • Brooks ana Capo. RruilPannen. . m IAteren. Ct ob App. State of Caldornu. Fifth App Dsss. 266 0). App. Sd 15+1, 277.Ca1. Rptr 555: J+nua- 23. 1991): FEDERAL REHABILITATION ACT CASES fDISABILITYAND HANDICAP):Flamk'en. v. Off- or Personnd %tanaeemen.t. L'S. \Ierrt SvarmsProtem- Board: Da;las F:eid Othce No. DAH31L1---1i (J91:11 • R4tuc•Cnned 5tasn Ponai,5enae (Equal. EmplovmentOpporrsmrtrCommusucn. Appeall 1b :1853426. 19671. This is a sperui issue of the ASH Srraoking and'Health Revmw (ISSN 1Ci6-9C7XC). Coprrtghted br Action on Smoking and Health (ASH);,_:13 H':=t.. NXV:,V'ash.- DC 2=26„(2i,3) 659-j*31C. ASH is a nationalinonprofit& tir-exempt orgamzauon concerned with the problems of smoking and the rtghts of nommoke;s. ASH is entirciY supported by taad6duetible contributions- and regular contributors receive the ASH Revsew: Printed portions of thc ASH Resnew mav be reprinted s'nh ereaic to ASH..

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