Tobacco Documents Online

Major risk factor combinations, 'i 0-year incidence of first major coronary events, men age 30-59 at entry, Pooling project 189 87808265 .~ ° N .     . . . . .  None SM CorH Only o( 3 Only SMBC C8H AII3 or (No SM) SM&H Risk Factor Status at Entry SM = smoker. C- cholesterol, H - hypertension

2 40 10 COLD mortality ratios for men and women, by number of cigarettes smoked per day, 87808268 British Physicians' Study Nonsmoker 1-14 15-24 25+ Cigarettes per day

87808264 Lung cancer mortality ratios in ex-cigarette smokers, by number of years stopped smoking - British Physicians' Study 20 16.0 2 Nonsmokers Current Smokers 5.3 1-4 5-9 10-14 ~ Number of years off cigarettes r

Environmental tobacco smoke (ETS) is a complex mix of over 4,000 air contaminants found in both the vapor and particle phase. Some of the ETS contaminants are associated solely with the combustion of tobacco (e.g. nicotine and tobacco specific nitrosimines) while others are emitted by a number of other sources in the outdoor and indoor environment (e.g. carbon monoxide and respirable suspended particles). Given this complex mix it is necessary to identify an air contaminant or class of air contaminants for monitoring that would be indicative of the presence and amount of ETS in an indoor space. Such a contaminant or class of contaminants are called tracer, marker or proxy compounds. The appropriateness or usefulness of a marker compound for the identification and quantification of ETS in indoor environments is evaluated by the following five criteria: S.the marker compound would be unique or nearly unique to the tobacco so that other outdoor or indoor sources are small in comparison, 2.the marker compound should be in present in sufficient quantity in the tobacco such that when it is emitted it will be in room air concentrations that can be easily detected even when the smoking rates are low, 3.the emission rate for the compound should be similar for a variety of tobacco products, 4.a fairly consistent ration of the marker compound(s) to individual contaminants of interest or categories of contaminants (e.g., suspended particulates) should exist under a range of environmental conditions for a variety of tobacco produces, 5.measurement methods for monitoring the marker compound would be available which will permit the assessment of concentrations of the marker compound in indoor spaces or personal exposure levels in an easy, accurate and cost effective manner. The first four criteria are listed in the NAS report on ETS (9). It should be clearly stated that the above criteria for selecting a suitable marker compound are the ideal criteria and that it practice no single contaminant or class of contaminants have been identified which meet all the criteria. There is in fact no single marker which is universally accepted or recognized as representing ETS. Selection of a suitable marker for ETS reduces to satisfying as many•of the criteria as is practical and recognizing the limitations of the selected marker compound. Over the last several years several marker air contaminants have been used to represent ETS concentrations in both chamber OD 55 ~I CID 0 GD N Vi C

.COLD deaths smokers vs. nonsmokers Deaths per 100,000 persons 500 400 Smokers 300 200 100 0 Nonsmokers 35-44 45-54 55-64 65-74 75-84 Age group ~ m Q m 0 GO N 24 1 0~ ~

Coronary heart qisease deaths, smokers vs. nonsmokers Deaths per 100,000 men 500 1000 996 2500 422 1 2025 800 2000 400 200 600 542 1500 400101 1000 200 150 ~ 100 2W ® ~ 500 0 0 im- _'- 0 Ages 45-54 Ages 55-64 Ages 65-74 =Nonsmokers M Smokers

prohibited or restricted to given location(s) then representative location(s) should be selected for monitoring which would be indicative of the occupants exposure. Toward this end one or two samples in each location may be sufficient. This assumes that the contaminants in the.space are reasonably well mixed. If the goal is to determine the exposure in the work station of an occupant who is concerned about his or her exposure then sampling near or at that persons work station is necessary. Frequently, there are severe limitations on the availability of air sampling equipment resources.for the collection and analysis of collected air samples. Such situations require careful attention to the selection of a representative location for collection of samples. The period of time over which a sample is collected can vary from as little as one minute to as much as two or more weeks depending on the sampling methods employed and the purpose of monitoring. The portable piezoelectric particle mass monitors provide short term RSP measurements over a 24 second or two minute period while passive nicotine monitors can provide integrated measurements from one day to over two weeks. Recording short-term measurements would necessitate several repeated measurements to insure the measurement of a representative concentration in the space since the ETS contaminants can vary considerably in time. Short-term measurements should also be accompanied by the recording of such information as the occupancy and smoker density to determine how representative the measurement would be of a variety of smoking rates that could be expected to be encountered in the space. Long-term measurements need to be interpreted in light of the actual time the spaces were occupied and time smoking occurred. Both short-term and long-term sampling of spaces is useful for a variety of purposes including concentration modeling of spaces, determining compliance with smoking policies, investigating ETS related complaints from occupants and determining exposures associated with health and comfort effects of ETS. MEASUREMENT METHODS FOR RSP ETS related and non-ETS related RSP encompasses a very broad range of particles of varying chemical composition and physical properties. In general terms RSP refers to particles less than 2.5 um with no distinction as to chemical composition or size distribution. Over the e-years there have been a large number of measurement methods developed to measure particles in the RSP size range. These methods have utilized the physical properties of the particles (impaction, light scattering, etc.) to obtain measurements ont he size distribution and mass of the particles in the RSP size range. These monitoring methods vary considerably interims of complexity, application and cost. The RSP sampling methods as with sampling methods for other air contaminants were developed for outdoor and workplace monitoring with relatively few instruments developed specifically for indoor 59 - - - - - - - - - - - - -

studies and in a number of microenvironments where people spent their time. Carbon monoxide, nitrogen oxides, acrolein, benzene, toluene, tobacco specific nitrosamines, vapor and particle phase nicotine, isoprene, pyridine, particle phase nicotine and cotinine, respirable suspended particles, polonium-210 and benzo(a)pyrene are among the many air contaminants that have been used or proposed for use as indicators of the presence of ETS. Tables in chapter 6 show the range of concentrations measured in a number of indoor environments were smoking occurred. All the markers used to date have some problems associated with their use, for example, carbon monoxide, nitrogen oxides, etc. have many indoor and outdoor sources other than the combustion of tobacco, while such compound as nitrosamines, benzo[a]pyrene, etc. are sufficiently difficult to measure (concentration sin smoking environments are low, cost of collection and analysis of samples, etc.) such that their use is very limited. At the present time respirable suspended particulate matter (RSP) and vapor phase nicotine are widely and most commonly used as markers of the presence and concentration of ETS for a variety of reasons associated with their ease of measurement, existing knowledge on their emission from tobacco combustion and their relationship to other ETS contaminants. This chapter will focus on the use of RSP and nicotine as markers for ETS and the methods available for their measurement in indoor environments. The use of RSP as a marker for ETS is based upon information obtained from a number of chamber and field studies and available air sampling methodology (9, 10), including the following: l.Tobacco combustion has a major impact on the mass of suspended particle matter in occupied spaces in the size range of ,2.5 um (respirable suspended particle mass - RSP) (9, 10). RSP is a major component of ETS and is detectable above background levels in occupied environments even under conditions of low smoking rates (see Chapters 6 & 7 of this report). 2.RSP contains a number of the tobacco related compounds of health concern. 3.RSP emissions are major component of the air contaminants emitted into the environment from tobacco combustion with relatively little variation in emissions across different brands of cigarettes when considered on a gram of tobacco consumes bases. 4. A number of methods are available to accurately and inexpensively measure RSP levels on a short-term (minutes) or long-term (hours) integrated bases with minimal expense. 5.There are outdoor particle health standards established by the U.S. Environmental Protection Agency (EPA) which provide a Go 56 Q O 00 tJ G1 M~

CSAPTER S MEASURING EXPOSURE TO ENVIRONMENTAL TOBACCO SMOEE BRIAN P. LEADERER JORN B. PIERCE FOUNDATION L718. DEPARTMENT OF EPIDEMIOLOGY AND PUBLIC EEALTS YALE UNIVERSITY SCHOOL O! MEDICINE 290 CONGRESS AVENUE NEW 8AVEN, CONNECTICUT INTRODUCTION Assessing exposure to ETS can be done by direct and indirect methods. Direct.assessment of exposure includes the use of biomarkers and personal air monitoring. Indirect methods include use of questionnaires and modeling. Modeling is based upon measurement of air contaminant concentrations in enclosed spaces, the factors controlling the concentrations and an assessment of the time people spend in those spaces. Direct assessment of exposure includes the use of biomarkers and personal air monitoring. In recent years there has been a growing interest in the analysis of physiological fluids for specific compounds that are indicative of exposure to ETS. Thiocyanate (1), carboxyhemlobin (2), nicotine and cotinine (3), hydroprloine (4), N- Nitrosoproline (5), aromatic amines (6), genotoxicity (7) and protein or DNA adducts (8) measurements in physiological fluids have all been considered as indicators of exposure to either active or passive tobacco smoke. while these biomarkers are indicative of exposure they may not be directly related to potential for development of the adverse effect under study and can show considerable variability from individual to individual sue to differences in uptake, distribution and metabolism. Some of these markers may not be specific to ETS exposure (e.g., carboxyhemoglobin) while others (e.g., thiocyanate) may be useful for active smoke exposure but not sensitive enough for ETS exposures. Biomarkers are indicators of exposure not measures of dose. Cotinine and nicotine measures in the blood, urine and saliva have been widely used as indicators of exposure to ETS (e.g. g) and are valuable in determine total or integrated exposure to ETS across all environments that na individual spends his time. A biomarker of exposure however, does not provide an exact measure of ETS exposure in any one environment of provide information on the environmental factors impacting the 53

applications. The discussion of measurement methods for RSP presented here will cover only those methods which have relatively wide application, as determined by cost, ease of use and accuracy, in measuring RSP in indoor spaces. Table 1 presents a summary of the RSP measurement methods which are applicable for use in monitoring RSP levels indoors. The table lists the measurement method, sampling times, sampling rates, concentration range, accuracy, manufacturer and cost for each monitor as well as comments concerning the use of the monitor. Many of the instruments are gravimetric providing an integrated measure of particle mass concentrations over several hours to several days, while other systems utilize light scattering or piezoelectric resonance to provide a short-term measure of particle concentration. The gravimetric measurements require the weighing of filters before and after particle collection in a humidity and temperature controlled environment to determine the mass concentration. The gravimetric measurement also results in a particle mass sample which could, depending on the filter media use and handling and storage of the collected sample, be subjected to detailed chemical analysis to obtain additional source information. Gravimetric particle mass - measurement methods are considered a standard method on particle measurement. The actual size distributions measured by the instruments vary considerably with the optical scattering instruments measuring a broad particle size range (0.1 - 10.0 um) while other monitoring systems (e.g. gravimetric methods) utilize cyclones or impactors to collect the mass of particles below 3.5 or 2.5 um. Only some of the monitors actually measure RSP, particles less than or equal to 2.5 um. Selection of a method for monitoring RSP depends in large part on the purpose for taking the measurements. If the application calls for integrated particle mass measurements in spaces over a period of days with chemical analysis of filters then the integrated gravimetric measurements utilizing the Harvard or NBS samplers may be the methods of choice. These systems are not as portable as the other systems listed in Table 1. If six to twelve hour particle mass concentrations of spaces or personal samples (sampler worn by a subject) with possible subsequent filter analysis then the standard industrial hygiene personal pumps with particle preselectors may be the method of choice. In using any gravimetric method care must be taken to insure the sampling times are sufficient to collect adequate particle sample for accurate determination of mass concentrations. In addition, pump flow rates and filter selection and handling are important. If the sampling application calls for short-term measurements in one or several locations over variable time frames with lightweight portable equipment which is easy to use then the piezobalance or light scattering monitoring systems might be the methods of choice. It should be noted that all the methods listed in Table 1 have been used with good success in chamber and 60 Q~ ~ ~ C m N C11 6^