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MAY 10, 1996
[35] Hatcher v. Evans, 1996 WL 187511 (U.S.
Court of Appeals, Tenth Circuit) (decided
April 18, 1995)
The Tenth Circuit Court of Appeals has dismissed
prisoner Robert Hatcher's claim that of(icials at the
James Crabtree Correctional Center violated his Eighth
and Fourteenth Amendment rights by failing to
provide an ETS-free environment. The court dismissed
Hatcher's claim because "the identical issue with regard
to prior and present confinement had been raised and
decided in plaintifl's civil rights claim filed in the
Eastern District of Oklahoma."
OTHER DEVELOPMENTS
[36] Toxic Fungus Uncovered in Department of
Transportation Headquarters
Toxic mold has reportedly been discovered in the
fitness center shower facilities of the Department of
Transportation's (DOT's) headquarters building in
Washington, D.C. Recent press reports indicate that
the mold has been identified as stachybotrys
chartarum, a fungus which is apparently seldom found
in buildings.
In April 1996, DOT officials declared their head-
quarters a sick building following a three-month
investigation of the structure by a panel of indoor
environmental consultants. The special investigation
was reportedly launched in December 1995 after a
team of Occupational Safety & Health Administration
(OSHA) IAQ experts was unable to determine the
cause of health complaints, including headaches and
nausea, experienced by Federal Railroad Administra-
tion employees.
Stachybotrys chartarum can reportedly irritate the
skin and mucous membranes, interfere with normal
body metabolism and reduce resistance to infections.
Melissa Spillenkothen, assistant secretary of transpor-
tation for administration, was quoted as saying that
fitness center conditions appeared to be "uniquely
associated with the extensive presence of
long-standing water." The fitness center has report-
edly been closed and its HVAC system shut down
until a special filtration system can be installed to
treat the air in the facility.
13
In other parts of the building, industrial hygienists
have reportedly discovered a more common fungus
called .:~pergillus fumigatus, which can apt arently
trigger allergic reactions, asthma and lower-respiratory
infections. DOT employees will evidently continue to
be relocated to different parts of the building as HVAC
system improvements and cleanup continue. See The
Washington Post, May 4, 1996.
[37] Smokeless Cigarette Test Marketed in Tennessee;
Critics Express Concerns about Health Effects
According to a recent press report, R.J. Reynolds'
(RJR's) new Eclipse cigarette, a mostly smokeless
product, has been greeted with interest in its test
market of Chattanooga, Tennessee. One city tobacco
shop employee reportedly said that his shop has
received many phone calls about the new cigareLtes.
RJR has reportedly distributed free cartons of the
cigarettes to area smokers.
RJR reportedly plans to advertise that Eclipse ciga-
rettes produce 90 percent less smoke than regular
cigarettes. Apparently, the cigarette burns only 25
milligrams of tobacco when the carbon tip is lighted,
then glass fibers stop the fire, allowing the remaining
tobacco to be heated instead of burned.
Meanwhile, another press report indicates that four
leading tobacco critics were invited to a six-hour
briefing about Eclipse at RJR's North Carolina head-
quarters in late April. Their concerns reportedly
included whether the glass fibers could be inhaled, if
the smoke contains carcinogens and whether the
product could increase heart disease by putting more
carbon monoxide into smokers' blood than existing
"light" cigarettes. See The Atlanta Constitution, May 6,
1996; AP Online, April 27, 1996.
[38] Study on Effects of Carpet Chemicals To Be
Released
According to a press report, the Consumer Product
Safety Commission will soon release a report focusing
on the effects of chemicals emitted from carpet and
carpet padding. The study was reportedly undertaken
to analyze contradictory information found in studies
conducted by Anderson Labs, a University of Pitts-
burgh researcher and the U.S. EPA. See Building
Environment Report, March 1996.
SHB
14
[39] Shareholders Reject Request for Smoking Bans
in Restaurants
Shareholders in Wendy's International Inc. fast food
restaurants have reportedly rejected a request to ban
smoking in company-owned facilities. According to a
press report, the company's chair indicated at the
April 30, 1996, annual meeting that smoking bans
should be left to legislators instead of restaurateurs.
Apparently, only about 200 of Wendy's 4,300
locations across America are smoke-free, either
because of local laws or franchise owner preference.
See Reuter Newswire, April 30, 1996.
In a similar action, shareholders of PepsiCo Inc., have
rejected a proposal to ban smoking at the company's
Pizza Hut and Kentucky Fried Chicken restaurants. At
the company's May 1, 1996, annual meeting, company
officials were quoted as stating, "In today's competitive
quick-service environment, where consumers have
many restaurant choices, a flat ban on smoking that
targets only our restaurants puts us at a competitive
disadvantage." Apparently smoking is already prohib-
ited at company-owned Taco Bell outlets. SeeAP
Online, May 1, 1996.
[40] Philip Morris Shareholders Reject Proposal To
Stop Challenging Studies Linking ETS to
Health Hazards
Recent press reports indicate that among four share-
holder proposals defeated at the annual meeting of
Philip Morris Cos. in late April was a request for the _
company to quit challenging studies that link health
hazards to ETS. Other proposals rejected at the
meeting included spinning off the tobacco division
from the rest of the company and reducing nicotine in
its tobacco products. See Businesswire, April 25, 1996;
Reuters, Ltd., April 25, 1996.
[41] Dodgers Baseball Player's Cancer Blamed
on ETS
The Georgia surgeon who removed a cancerous tonsil
from Los Angeles Dodgers outfielder Brett Butler on
May 3, 1996, has reportedly suggested that Butler's
tumor may have been the result of exposure to ETS.
According to a news release, Robert Gadlage, M.D., an
ear, nose and throat specialist, told a May 8 press
conference that the greatest risk for throat cancers is
ETS/IAQ REPORT, ISSUE 123
exposure to nicotine products. He apparently
downplayed the 38-year-old center fielder's past use of
chewing tobacco while alluding to Butler's childhcod
ETS exposure from his parents' cigarettes. "We can see
someone who smokes two packs a day, three packs a
day for 50 years who never gets this. Then there's
somebody with minimal exposure like Brett," Gadlage
said. See AP Online, May 8, 1996.
[42] Recent Books on Cigarette Companies
Mention ETS
Stanton Glantz's recently released book, The Cigarette
Papers, which discusses the Brown & Williamson
documents he obtained in 1994, contains a chapter
titled "Environmental Tobacco Smoke and the Non-
smokers' Rights Movement." In the chapter, Glantz
and co-authors discuss industry "awareness of the
importance of the passive smoking issue" in the early
1970s. They also contend that the industry in general
has "actively sought to mislead the public about the
dangers of passive smoking."
ETS issues, such as EPA's risk assessment, are also
discussed in another recently published book, Ashes to
Ashes, by Richard Kluger, which focuses on the history
,f the Philip Morris Co.
SCIENTIFIC/TECHNICAL ITEMS
UPCOMING SCIENTIFIC MEETINGS
Appendix B lists upcoming scientific meetings
discussed in this and past issues of this Report.
[43] Society for Epidemiological Research Annual
Meeting, Park Plaza Hotel, Boston, Massachu-
setts, June 12-15, 1996
The agenda for this event indicates that two poster
sessions will relate to ETS and a contributed paper will
focus on the relationship between ETS and coronary
heart disease.
SHB
MAY 10, 1996
[44] ASHRAE Annual Meeting, Marriott River
Center, San Antonio, Texas, June 22-26, 1996
The technical program for this meeting indicates that
sessions will include those on enhancing IAQ with
added substances, IAQ issues in correctional and
institutional facilities, and respirable particulates.
Presented by the American Society of Heating, Refrig-
erating and Air Conditioning Engineers.
[45] Annual Summer Toxicology Forum, Given Bio-
medical Institute, Aspen, Colorado, July 8-12, 1996
Preliminary information about this conference
indicates that topics of discussion will include those on
cancer and cardiovascular disease prevention, neurotox-
icity and toxicological risk evaluation. The meeting is
sponsored by the Toxicology Forum.
[46] 13th International Symposium on Contamina-
tion Control, The Hague, Netherlands,
September 16-20, 1996
Organized under the auspices of the International
Committee of Contamination Control Societies,
preliminary information about this event indicates that
topics of discussion will include filtration technologies
and particle measurement.
LUNG CANCER
[47] "Pulmonary Carcinogenicity of Cigarette
Sidestream Smoke in A/J Mice," H.P. Witschi
and K.E. Pinkerton, The Toxicologist30(1, Part
2): 1036, 1996 [See Appendix A]
In a meeting abstract, the authors report data on lung
tumor incidence and multiplicity in mice exposed to
sidestream smoke. They claim that both endpoints were
statistically significantly increased in exposed animals
and conclude that under "appropriate conditions,"
sidestream smoke "produces lung tumors in mice."
CARDIOVASCULAR ISSUES
[48] "Cardiovascular Disease and Occupational
Exposure to Environmental Tobacco Smoke,"
D.M. Aviado, American Industrial Hygiene
Association journal57: 285-294, 1996 [See
Appendix A]
This article is based on the author's written submis-
sion to OSHA on its proposed rule on indoor air and
indoor smoking. In it, the author concludes that the
available data do not support additional regulation of
ETS based on cardiovascular disease.
15
[49] "Prevalence of Coronary Artery Disease and Its
Risk Factors in the Urban Population of South
and North India," R. Begom and R.B. Singh,
Acta Cardiologica L(3): 227-240, 1995 [See
Appendix A]
According to the authors of this study, South Indians
have a significantly higher coronary artery disease
(CAD) prevalence than North Indians. They claim
that primary smoking is significantly more common in
South Indian males than in North Indian males and,
furthermore, that ETS exposure is "significantly higher
in South Indiarr females which may be the cause of
higher CAD among them."
[50] "Characteristics of Leisure Time Physical
Activity Associated With Decreased Risk of
Premature All-Cause and Cardiovascular Disease_
Mortality in Middle-Aged Men," N. Haapanen,
S. Miilunpalo, I. Vuori, P. Oja, and M. Pasanen,
AmericanJournal ofEpidemiology 143: 870-880,
1996 [See Appendix A]
Although ETS exposure is not discussed, the authors
of this cohort study of more than 1,000 middle-aged
Finnish men report that a low level of physical activity
is a risk factor for both cardiovascular disease mortality
and all-cause mortality.
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[51] "Dietary Antioxidant Vitamins and Death from
Coronary Heart Disease in Postmenopausal
Women," L.H. Kushi, A.R. Folsom, R.J.
Prineas, P.J. Mink, Y. Wu, and R.M. Bostick,
New England Journal ofMedicine 334:
1156-1162, 1996 [See Appendix A,
Although ETS is not mentioned, this paper discusses
the potential role of dietary factors in cardiovascular
disease. The authors conclude that the risk of heart
disease is lower in women with higher dietary vitamin E
intake, but that use of vitamin E supplements had little
relationship to cardiovascular disease risk. See also the
article by Stephens, et al., in this section and the articles
in the Other Health Issues section by Hennekens, et al.,
Omenn, et al., and Greenberg and Sporn.
[52] "Cigarette Tar Does Not Promote Arterioscle-
rotic Plaque Development," A. Penn, K. Keller,
L.C. Chen, A. Nadas, and C.A. Snyder, The
Toxicologist30(1, Part 2): 1377, 1996 [See
Appendix A]
The authors of this study have previously presented
data suggesting that sidestream smoke inhalation in
animals promoted the development of arteriosclerotic
plaques. In this abstract, they report no increase in
plaque size in cockerels injected with mainstream
smoke "tar" and conclude that the vapor phase of
smoke is associated with reported adverse effects.
[53] "Randomised Controlled Trial of Vitamin E in
Patients with Coronary Disease: Cambridge
Heart Antioxidant Study (CHAOS)," N.G.
Stephens, A. Parsons, P.M. Schofield, F. Kelly,
K. Cheeseman, M.J. Mitchinson, and M.J.
Brown, The Lancet 347: 781-786, 1996 [See
Appendix A]
Treatment with vitamin E supplements reportedly
lowered the risk of nonfatal myocardial infarction in
patients with coronary atherosclerosis in this clinical
trial. ETS was not mentioned, but this study is of
interest because it addresses potential dietary con-
founders. See the articles by Kushi, et al., in this section
and the articles by Hennekens, et al., Omenn, et al.,
and Greenberg and Sporn in the Other Health Issues
section, which also discuss dietary vitamin supplements
and disease risk.
ETS/IAQ REPORT, ISSUE 123_
RESPIRATORY DISEASES AND
CONDITIONS -- ADULTS
[54] "Effect of Active and Passive Smoking on
Ventilatory Function in Elderly Men and
Women," C. Frette, E. Barrett-Connor, and J.L.
Clausen, American Journal ofEpidemiology 143:
757-765, 1996 [See Appendix A]
Based on data from nearly 1,400 men and women,
the authors of this study conclude that reported ETS
exposure is not associated with pulmonary function
decrements and call for additional research on this
question. The study also claims that active smoking has
a "deleterious effect" on lung function.
RESPIRATORY DISEASES AND
CONDITIONS -- CHILDREN
[55] "The Attack of Asthma," E. Friebele, Environ-
mental Health Perspectives 104: 22-25, 1996
[See Appendix A]
The author of this article explores the apparent
paradox of the simultaneous reported increases in
asthma prevalence and decreases in many factors, such
as air pollution and ETS exposure, allegedly associated
with asthma.
In related press coverage, the Centers for Disease
Control has apparently ieported that the rate of
reported asthma deaths among young people doubled
between 1980 and 1993 and that from birth to age 4
and for ages 15 to 24, blacks were six times more likely
than whites to die of asthma in 1993. Researchers
indicated that a number of factors may contribute to
these data. See The New York Times, May 3, 1996.
[56] "Fungus Spores, Air Pollutants, and Other
Determinants of Peak Expiratory Flow Rate in
Children," L.M. Neas, D.W. Dockery, H.
Burge, P. Koutrakis, and F.E. Speizer, American
Journal ofEpidemiology 143: 797-807, 1996
[See Appendix A]
Summer episodes of particulate pollution, excessive
aerosol acidity and variation in fungus spore counts are
reportedly acutely associated with an increased inci-
dence of cough and cold episodes, as well as decreases
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MAY 10, 1996
in lung function in children living in State College,
Pennsylvania.
[57] "The Impact of Lung Development on Respira-
tory Disease Later in Life," L.I. Landau,
Monaldi Archives of Chest Diseases 3: 167-1 0,
1995 [See Appendix A]
The author of this article briefly discusses congenital
and environmental factors that may potentially affect
pre- and postnatal lung development. It is maintained
that childhood respiratory symptoms are not the cause
of subsequent lung disease but a reflection of abnor-
malities of lung development through intra-uterine and
early postnatal life. Maternal smoking is discussed.
[58] "Breastfeeding as Prophylaxis Against Atopic
Disease: Prospective Follow-Up Study Until 17
Years Old," U.M. Saarinen and M. Kajosaari,
Lancet 346: 1065-1069, 1995 [See Appendix A]
A prophylactic effect of breastfeeding against the
development of atopic disease is reported by the
authors of this long-term Finnish study; although ETS
is not discussed, the article suggests another factor that
could be considered in studies of atopy and allergy.
17
[60] "Molecular Epidemiology: Insights into Cancer
Susceptibility, Risk Assessment, and Preven-
tion," F.P. Perera, Journal of the National
Cancer Institute 88: 496-509, 1996 [See
Appendix A]
This review paper discusses the emerging field of
molecular epidemiology. Although ETS is not men-
tioned, this area is of relevance because of increasing
interest in the use of biomarke:s to attempt to link
exposures to health endpoints.
REPRODUCTIVE AND DEVELOPMENTAL
ISSUES
[61] "Neuroendocrine Cell Expression in Fetal Lungs
After Maternal Exposure to Aged and Diluted
Sidestream Cigarette Smoke (ADSS)," K.P.
Allamneni, C.G. Plopper, and K.E. Pinkerton,
The Toxicologist30(1, Part 2): 235, 1996 [See
Appendix A]
According to this meeting abstract, maternal exposure
to aged and diluted sidestream smoke, a surrogate for
ETS, is associated with an increase in the number of
specialized airway cells in the offspring.
OTHER CANCER
[59] "Relation of Breast Cancer with Passive and
Active Exposure to Tobacco Smoke," A.
Morabia, M. Bernstein, S. Heritier, and N.
Khatchatrian, American Journal of Epidemiology
143: 918-928, 1996 [See Appendix A]
This Swiss case-control study purports to be better
designed than previous studies to address the potential
relationship between active smoking or ETS exposure
and breast cancer risk because its comparison (control)
group excludes women with ETS exposure. The study
reports risk estimates of 2.2 to 4.6 for active smoking
and 3.2 for "passive smoking," which the authors
concede is contrary to their expectations.
Press coverage on this study continues to appear, with
one article noting that other breast cancer researchers
"remain skeptical" about its conclusions. See The New
York Times, May 5, 1996.
OTHER HEALTH ISSUES
[62] "Risk Factors for Chronic Otitis Media With
Effusion in Infancy: Each Acute Otitis Media
Episode Induces a High but Transient Risk,"
O.P. Alho, H. Oja, M. Koivu, and M. Sorri,
Archives of Otolaryngology and Head-Neck
Surgery 121: 839-843, 1995 [See Appendix A]
Acute otitis media episodes of nearly 2,000 Finnish
children were assessed in this cohort study. The
authors report that recent previous acute otitis media
episodes are a risk factor, as are male gender and
autumn day care attendance. ETS exposure reportedly
was associated with a "modest" effect related to
previous episodes.
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18
[63] "Epidemiology in the Assessment of Small
Risks," D. Coggon, Transactions of the Institu-
tion of Chemical Engineers 73 (Part B, Suppl.):
S36-S38, 1995 [See Appendix A]
In this article, the author comments on the limita-
tions of epidemiology, particularly when risk is less
than 20 percent. He suggests that advances in areas
such as DNA adducts may lead to improvements in the
study of weak associations.
[64] "The Epidemiology of Haemophilus influenzae
Type b Disease in the Republic of Ireland," J.
Fogarty, A.C. Moloney, and J.B. Newell,
Epidemiology ofInfections 114: 451-463, 1995
[See Appendix A]
Day care center attendance and chronic illness are
both identified as reportedly significant risk factors for
primary Haemophilus influenzae Type b disease in Irish
children by the authors of this case-control study.
Parental smoking was among a number of factors
assessed as potential risk factors.
[65] "Inequality in Income and Mortality in the
United States: Analysis of Mortality and Poten-
tial Pathways," G.A. Kaplan, E.R. Pamuk, J.W.
Lynch, R.D. Cohen, and J.L. Balfour, British
Medical Journal312: 999-1003, 1996 [See
Appendix A]
According to this study, variations in the inequality
of the distribution of income are associated with
variations in health endpoints and mortality across
the states. See also the editorial by Link and Phelan in
this section, which discusses sociodemographic status
and health.
[66] "Editorial: Understanding Sociodemographic
Differences in Health -- The Role of Fundamen-
taI Social Causes," B.G. Link and J.C. Phelan,
American Journal ofPublic Health 86: 471-473,
1996 [See Appendix A]
This editorial explores the nature of the reported
relationship between socioeconomic status and health,
noting that characteristics of the society as a whole
may be linked to disease risk. See also the research by
Kaplan, et al., on socioeconomic issues discussed in
this section.
ETS/IAQ REPORT, ISSUE 123
[67] "Lack of Effect of Long-Term Supplementa-
tion with Beta Carotene on the Incidence of
Malignant Neoplasms and Cardiovascular
Disease," C.H. Hennekens, J.E. Buring, J.E.
Manson, M. Stampfer, B. Rosner, N.R. Cook,
C. Belanger, F. LaMotte, J.M. Gaziano, P.M.
Ridker, W. Willett, and R. Peto, New England
Journal of Medicine 334: 1145-1149, 1996
[See Appendix A]
The use of beta carotene supplements was associated
with neither an increase nor decrease in the incidence
of cancer, cardiovascular disease or death from all
causes in this clinical trial. See also the study by
Omenn, et al., and the editorial by Greenberg and
Sporn in this section, and the articles in the Cardiovas-
cular Issues section by Kushi, et al., and Stephens, et
al., which discuss dietary vitamin supplementation and
disease risk.
[68] "Effects of a Combination of Beta Carotene and
Vitamin A on Lung Cancer and Cardiovascular
Disease," G.S. Omenn, G.E. Goodman, M.D.
Thornquist, J. Balmes, M.R. Cullen, A. Glass,
J.P. Keogh, F.L. Meyskens, B. Valanis, J.H.
Williams, S. Barnhart, and S. Hammar, New
England Journal of Medicine 334: 1150-115 5,
1996 [See Appendix A]
According to this paper, administration of a combina-
tion of beta carotene and vitamin A in this intervention
Ctudy was not associated with any benefit in terms of
lung cancer and cardiovascular disease in smokers and
asbestos-exposed workers. See the articles by Kushi, et
al., and Stephens, et al., in the Cardiovascular Issues
section and the articles by Hennekens, et al., and
Greenberg and Sporn in this section, which also discuss
dietary vitamin supplements and disease risk.
[69] "Antioxidant Vitamins, Cancer, and Cardiovas-
cular Disease," E.R. Greenberg and M.B. Sporn,
New England Journal of Medicine 334:
1189-1190, 1996 [See Appendix A]
The authors of this editorial state that the two trials
reported in this issue of the Journal "put to rest" claims
that beta carotene supplementation can reduce cancer
and cardiovascular disease risk. They note, however,
that epidemiologic studies of diet and disease risk
suggest some influence of diet. See the articles by_
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MAY 10, 1996
Kushi, et al., and Stephens, et al., in the Cardiovascular
Issues section and the articles by Hennekens, et al., and
Omenn, et al., in this section, which also discuss
dietary vitamin supplements and disease risk.
GENOTOXICITY AND MUTAGENICITY
[70] "Formation of Tobacco Smoke-Induced
Hemoglobin Adducts in Rats," C.G. Gairola,
S.R. Myers, M.T. Pinorini-Godly, and S.
Subramaniam, The Toxicologist30(l, Part 2):
503, 1996 [See Appendix A]
Three hemoglobin adducts are recommended as
biomarkers of tobacco smoke exposure in this meeting
abstract reporting results of a study in which rats were
exposed to sidestream smoke.
"Formation of 8-Hydroxy-2'-Deoxyguanosine in
Heart, Liver, and Lung Tissue Due to Environ-
mental Tobacco Smoke Exposure," D.J. Howard
and C.A. Pritsos, The Toxicologist 30(1, Part 2):
357, 1996 [See Appendix A]
This meeting abstract reports increased levels of a
purported marker of oxidative stress in tissues from
mice exposed to "ETS" in an experimental situatinn.
INDOOR AIR QUALITY
[72] "The Impact of Heavy Metals from Environ-
mental Tobacco Smoke on Indoor Air Quality
as Determined by Compton Suppression
Neutron Activation Analysis," S. Landsberger
and D. Wu, The Science of the Total Environ-
ment 173/174: 323-337, 1995 [See Appendix A]
In this study, the authors discuss a methodology for
measuring heavy metals, including cadmium, arsenic
and antimony, and conclude that ETS is an important
source of these metals in indoor air. _
19
[73] "Separating the Impact of Exposure and Person-
ality in Annoyance Response to Environmental
Stressors, Particularly Odors," G. Winneke, M.
Neuf, and B. Steinheider, Environment Interna-
tional22: 73-81, 1996 [See Appendix A]
This paper addresses the relationship between
personal variables, e.g., in intensity of response to
environmental stimuli, with reports of annoyance.
SMOKING POLICIES AND
RELATED ISSUES
[74] "Cigarette Smoking in China: Prevalence,
Characteristics, and Attitudes in Minhang
District," Y.L. Gong, J.P. Koplan, W. Feng,
C.H.C. Chen, P. Zheng, and J.R. Harris,
Journal of the American Medical Association 274:
1232-1234, 1995 [See Appendix A]
According to the authors of this survey, in which
more than 7,000 citizens residing in the Minhang
District were questioned, more than 88 percent of
respondents believe that ETS exposure is harmful.
[75] "Resident Smoking in Long-Term Care Facili-
ties -- Policies and Ethics," G. Kochersberger
and E.C. Clipp, Public Health Reports III:
66-70, 1996 [See Appendix A]
Based on data from a survey of administrators of 106
Veterans Affairs (VA) nursing homes, the authors
report that "smoking is relatively common among VA
long-term care patients." The potential conflict
between nursing home reform measures regarding
issues of patient autonomy as defined in the Omnibus
Budget Reconciliation Act of 1987 and administrative
concerns about patient safety are discussed as they
relate to smoking restrictions and policies.
SHB
