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SHOOK, HA~°ZDY& BACON REPORT ON RECENT ETS AND IAQ DEVELOPMENTS October 22, 1993 ~ ~ ~ ~ ~ ~ SHB ~ ~ ~ 0+

REPORT ON!RECENT ETS AND IAQ DEVELOPMENTS - IN THIS ISSUE - IN THE UNITED STATES REGULATORY AND LEGISLATIVE MATTERS • Conferees remove PRO-KIDS amendment from HHS appropriations bill; Lautenberg decries removal of PRO-FEDS and PRO- KIDS amendtnents, p. 1. • House committee submits report on Traficant bill, p. 1. • ASH invites supporters to file ETS exposure complaints with 1OSHA, p. 2. • SSPC 62 to Meet in Philadelphia Prior to. IAQ'93 Meeting, p. 5. ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS  Two new cases, Benrz and! Williams;, are discussed beginning on, p. 7. • Ninth, Circuit affirms dismissal of Schultz case, p. 8. ETS AND IAQ LITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS • California court, denies summaryjud'gment, in Portenier and! sets case for trial, p. 9. • Texas appeals board.denies workers' com- pensation benefits to ETS claimant who allegedly had! lung cancer, p. 9. • California court temporariNy removes child from custody of smoking mother, p. 10. • Florida appeals court invalidates city's policy of refusing to hire smokers, p. 10. OTHER DEVELOPMENTS • Massachusetts launches Tobacco Control Program, p. 13. • Freedom Air fails to attract sufficient numbers of fliers, p. 13. ISSUE 58 SCIENTIFIC/'TECHNICAL ITEMS •"O'ccupational Risk Factors for Lung Cancer Among Nonsmoking Women: A Case- Control Study in Missouri (United States)," p. 14. • "Cigarette Smoking and Sudden Infant Death Syndrome: Some Salient Points in the Debate,"' p. 16. •"Tobacco Smoke im Shopping Malls and Restaurants," p. 16. IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS • Developments in Hungary, Ireland, Malay- sia an&the United Kingdom, p. 17. LITIGATION!NbT INVOLVING CIGARETTE IVIAN U FACTURERS • In Australia, Burswood casino seeks costs of $250,000, p. 18. • Roundup of pending litigation in Australia„ p. 18. LEGAL ISSUES AND DEVELOPMENTS • Asthmatie threatens lawsuit; Australian sports organizations issue smoking restric- tions, p: 19. OTHER' DEVELOf'MENTSIMEDIA COVERAGE • British Airways, Qantas and Singapore Airlines announce smoking bans for interna- tional flights, p. 20. • "Gasping for Breath; Are Exhaust Fumes Suffocating our Children?° p; 21.

- TABLE OF CONTENTS - Issue 58 October 22, 1993 IN THE TJNITED STATES REGULATORY AND LEGISLATIVE MATTERS 103D CONGRESS [1] Conferees Remove PRO-KIDS Amendment From HHS Appropriations Bill; Lautenbcrg Decries Removal of PRO-FEDS and PRO-KIDS Amendments .............................................. 1 [2]1 Committee Submits Report on Traficant Bill .......................................................................... 1 U.S. OCCUPATIONAL SAFETY AND. HEALTH ADMINISTRATION(OSHA). [3]': ASH Invites Supporters to Filt ETS Exposure Complaints With OSHA, ............... ........................................ 3 [4] Secretary Reich Tells AFL-CIO Indoor Air Is a Priority .................. [I5] Witnesses Address Poor IAQ During OSHA Reform Hearing ...................... _........................ 3 U.S.ENVIRONMENTAL PROTECTION! AGENCY (EPA) [I6] ETS Riik'Assesrmrnt Litigation: EPA Files Motion for Leave to File Reply Brief imExccss of Page Limit and Attaches Proposed Reply Brief in Supportof Motion to Dismiss . ............... 3 [7] Confirmation Hearings Hcld!for EPA Nominees ............................................•-..-•••--•-•.•.-.--.••• 4 [8] Companion Bill lntroduced'to Streamline EPA Risk Assessment Procedures .......................... 4. [9] Top Science Advisor's Role in Jeopardy ................................... .................... ............................ , (101 Science Advisory Board Given New Role ....................................................•••-.•--••-.-.--.-.•••••-•.. 5 AS H RAE [11] SSPC 62 to Meet in Philadelphia Prior to IAQ '93 Meering ................................................... 5 STATE AND.LOCAL G~OYERNMENTS [12] Florida Publishes Changes to C1eamIndoor Act Rules ............................................................. 5 [13] Privacy Legislhtion .............................................................. ...... ..... .......... ..... ..... .... ................ . 5 [14] Other ETS-Related State and Local'Legislation ....................................................................... 6 ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS [15)I Benrz I?roSrPrisoner Case Filed in Oregon ............................................................................7 [16]1 Bluirt: Defendants'.'Responses to the Complaint to brFiied ........................ ............................ 7 (17] Broin: Depositions ofScnior Executives Taken ..............................................................••••-..---7 [18] Butlerr Deposition of Plaintiff Ava Dean Butler Postponed ..................................................... 8 [19] Dunn:,R'eply Briefs in Supporrof Defendants' Dispositive Motions to be Filed ...................... 8 [20] Schultz- Ninth Circuit Affirms Judgment in Favor of Philip Morris ........................................ 8 [21] Williams: Case Filed in Louisiana ...........................................................................---.............. 8 ETS AND lAQLITIGATION NOT INVOLVING CIGARETTE MANUFACTURERS VIWORK7aLACE: ASSAULT AND BATTERY [22] Porrenier v. Republic Hogg Robinson (Superioo Court, Los Angeles,Counry, California)~ (filed June 6, 1991) ................... ..............................°....-...................-....-..---.......................... 9. AMERICANS WITHIIIfiABILITIES ACT (ADA) [23) Pcterson v. Utah,Dtparrmcnt ofHealth (U1S. Department of Health and Human Services) (filed July 14, 1993)', .................................................................................................... ........... 9 WORKPLACE: WORKERS'COMPENSATION [24] Appt!lantlCrosf-Rrsp, o»dtnt v. Rtspondtnr/Cross-Apprllant, 1993 WL 406384 (Texas Workers' Compensation Commission) (decided October, 1, 1993) .................. -...................... 9 WORKPLACE: IAQ [25] Babura v. SE"W Jnvrstors (Superior Court, District of ColUmbia) (filed September 14, 1990) .. 9 IAQ: CARPETEM15SIONS~ [26]' Nowd1 v. Shaw lndustrits, lr+c., 93-CV-2068 (U.S. District Court. Eastern District. Pennsylvania) (filed April 19, 1,993) ......................................................................................,1'0 CHILD CUSTODY(27] INaronc v. Tanner (Superior Court„Sacramcnto, California) (temporary custody order entercd October 13, 1993) ................................................................................................... 10~

Contents Continued, Issue 58 WORKALACE:CCAASFS INVOLVING SMOmRS'RIGHTS [28] Kurtz v. City ofNorth Miami, 1993 Fla. App. LEX]S 10307 (Court of Appeal, Third District, Florida) (decided October 12, 1993) ...............••••••••••-••--••••••••••-•••••-•••••••-••••• •Â•--•••-••• 10 HOSPITAL: PATI.ENTS'RIG~HT TO SMOKE [29) Arbogastv. Ptttrson„ 1993 Ohio App. LEXIS 4883 (Court of Appeals, Ninth Districr, Summit County„Ohio) (decided October 6, 1993), .............................................................. 1 1 PRISON: PRISONERS' RIGHT TO SMOKE [30] Prison Inmattrv. Polk County(Di'stricrCourt, Polk County, lowa) (filed September 1993)',... 11 [31] R'rynolds; Jr: v. Bucks, 1993 U.S. Dist. LEXIS 14058 (U,S. District Court, Eastern District„Ptnnsylvania) (decided October 1, 1993) ..................•...••--..••••••••.•-••..--•.••-••••••••. CASES FILED BY NbNSMOKING PRISONERS. [32] LY/ilson v. Hambrick, 1993 U.S. App. LEX1S 25454 (U.S. Court of Appeals, Sixth Circuit) (decided September 30. 1993) ..................................---.........-...-.............................. 1 1 [33] Brown v. Thornburgh„ 1993 U.S. App. LEXIS 26732 (U.S. Court of Appeals, Sixth Circuit) (decided October 12: 1993) ..................................................................................... 12 S1CKBUILDING SYNDROME [34] Klockn v. ThrAd'D Limited Pcrrnsrahip, 1993 Ohio App. LEXIS 4913 (Court of Appeals, First District, Hamilron County, Ohio)! (decided September 22, 1993) .................. 12 LEGAL ISSUES AND DEVELOPMENTS [35]1 California Bar Considers Resolution on Workplacc Smoking ................................................ l .. [36]1 "'Sick' Buildings Rarely Are, but Perceived Probl6ms Must be SolLcd,"' J. Wojcik, Business Insurance, September 13, 1993 ................................................................................. 12 [371' "Exposure to Tobacco Smoke is More Than Offensive, It is Cruel an&Unusual Punishment,"' J.S. Kinsler, Valparaiso University Law Review, 1993 ....................................... 12 OTHER DEVELOPMENTS [38] Massachusetts Launches Tobacco Control Program .............................................................. 13 [39) ASH Offers Long Distance Service to Raise Funds ...................................................•.....••...-. 13 [40) Toyota Test Markets Air Cleaner .......................................................................................... 13 [41] Freedom Air Fails to Attract Sufficient Numbers of Fliers ..................................................... 13 SCIENTIFIC/TECHNICAL ITEMS UPCOMING SCIENTIFIC MEETINGS [I42) IAQ'94: Engineering Indoor Environments, Sa Louis„Missouri„October 30-Novcmber 2, 1994: .................................................................................................... ............................. 113 (43) Eleventh ORNL Life Sciences Symposium, IhdoorAir and Human Health Revisited (Bringing Selected Advances in Medical Science to the Indoor Air Quality Community),, ' Knoxville, Tennessee, March 28-31, 1994 ............................................................................. 13 LUNG CANCER [44] "Occupational Risk Factors for Lung Cancer Among Nonsmoking Women: A Case- Control Study in Missouri (Llnited States)t" R.C. Brownson, M.C:R. Alavanja, and J.C. Chang, Cancer Causes and Conrrol4: 449=454, 1993 [See Appendix A] ................................. 14 [45] 1 "Towards Truth, Through Falsification," A. Flew, Indoor Environment 2: 125-128, 1993 [See Appendix A] .................................................................................................... ............. 14 [46] Letters to the Editor Regarding Trichopoulos, D:, Mollo, F.. Tomatis, L., Agapitos, E., Delsedime„L., Zavitsanos, X., Kalandidii A., Katsouyanni, K-, Riboli, E., and Saracci; R.,. "Active and Passive Smoking and Pathological Indicators of Lung Cancer Risk in an Autopsy Study,"' Journal ofthr Amtrican MedicalAssociation 26$: 1697-1701, 1992 ............. 14 [47] Editorial Regarding Letters to the Editor on Trichopoulos, et al.: "Smoke and Letters." D. Rennie, Journal oftheAmerican MtdicalAstociation 270(14): 1742-1743, 1993 .................••• 15 OTHER HEALTH ISSUES [48] "Risks for Premature Rupture of Amniotic Membranes," E.E. Ekwo, C.A. Gossclink, R. Woolson, and A. Moawad, lntrrnationalJournal ofEpidcmiology:22(3); 495-503,1993 [See Appendix A) .................................................................................................... ............. 15

Contents Continued, Issue 58 [49) "Cigarette Smoking and Sudden Infant Death Syndrome: Some Salient Points in the Debate," B. Haglundi Acta Paediatrica Suppl. 389: 37-39, 1993 [See Appendix A] I ............... 16 [50]! "Brea,st-Feeding and Materna]iSmoking,in the Etiology of Crohn's Disease and Ulcerative Colitis in Childhood," A. Rigas, B. Rigas, M. Glusman, Y.-Y Yen, S.J. Lan, E. Petridou, C.-C. Hsieh, and D. Trichopoulos, AnnaG ofEpidtmiology3:,387-392, 1993' [See Appendix A] .................................................................................................... .............. 16 ETS EXPOSURE AND MONITORING [5111 "Tobacco Smokc in Shopping Malls and Restaurants," G: Lofrorh, Indoor Environment 2: 173-178, 1'993 [Scc Appendix A] I .......................................................................................... 16 [52]1 Letters to the Editor Regarding "Relationship Between Environmental Tobacco Smoke Exposure and Carcinogen-Hemog]obin Adduct Levels in Nonsmokers," S.K. Hammond, J. Coughlin„P.H'. Gann, ML Paul„K. Taghizadch, P.L. Skippcr, and S.R. T.annenbaum, Journal of the Narional Cancn Inttitute 85 (6) i 474-478, 1993' ............................................... 16 INDOOR AIR QUALITY [53] "Windows and Environmental Satisfaction: A Survey Study of an Office Building," M. Boubckri and F. Haghighat, Indoor Envi.rommenr2: 164~172; 1993 [See Appendix A]..... 117 [54] "Acute Pulmonary Function Impairment in School Staff Working in a'Sick Building': A PilorStudy," M. Dahlqvist and R. Alexandersson, IndoorEnrrironment2: 179-185„1993 [See Appendix A) .................................................................................................... .............. 17 [551 "Smoking Habits, Atopy;,and'Ptevalcncc of Sick Building Syndrome Symptoms Among Office Workers in Norway," K. Lcnvik, Environmrnrlnternarional 19: 333-340';, 11993 [Sec Appendix A] .................................................................................................... ............. 17 IN EUROPE & AROUND THE WORLD REGULATORY AND LEGISLATIVE MATTERS HUNGARY [56] Parliament Leaves Smoking Policy Decisions to Employ,crs ................................................... 17 I RELAN D ..................°-........ _...._.......................... 1 [57] Irish Cancer Society Calls For Smoking Bans ........._. MA1AY9tA [581 New Bill Would Broaden Smoking Restrictions .....................................................--..•••••---... 17 UNITEDICINGDOM [59], Environment Minister Recommends Smoking Bans ............................................................. 18 ETSIIAQLITIGATION'NOT INVOLVING CIGARETTE MANUFACTURERS AusTRA>_.IA [60] Burswood Seeks Costs of 5250,000 ....................................................................................... 18 (611 Roundup of Pending Litigation in Australia ...................................................................•..-... 118 LEGAL ISSUES AND DEVELOPMENTS AusTRALIw [62] Asthmatic ThreatensLawsuit and Sports Organizations 1,ssurSmoking Restrictions ............. 19 [63] "Tobaceo Litigation: Impact and Future Directions," E. Arocca, fournal ofLav and Medicine, October 1993 .............................................................. .......................................... 19 CANADA [64] Court Grants Right to Appeal Decision in Challenge to Tobacco Products Control Act ....... 19 OTHER DEVELOPMENTS AusTRAL1A [65] PoIIIGauges Tolerance of7ndoor Smoking .......................................................................•.--. 20 (66) AMA President Supports Claim AbouoETS and Child Abuse ..............................................Z0 EUROPEAN. COMMUNITY [67] Europe AgainsrCancer Week: October 11-17 .......................................................................20 UNITED KINGDOM [68]! Survey Gauges Popularity of Nonsmoking Areas ................................................................... 20,

Contents Continued, Issue 58 WoRl.n A1RUNE I*TEws (69] British Airways, Qantas an&Singapore Airlines Announce Smoking Banss for International', Flights .................................................................................................... .... 20 MEDIA COVERAGE JAPAN [701 "Japan Aiming to Relinquish Smoking Title," The Nikkei R7rrk'ly; September 27, 1993 ........ 21 UNITEID KINGDOM [71) "Gasping for Breath; Are Exhaust Fumes Suffocating our Children?" The Indepr.ulenr. October 10, 1993 ........................................................................................21' APPENDIX A, .................................................................................................... ................................ Articl6 Summaries APPENDIX B .................................................................................................... .............. Upcoming Scientific Meetings APPENDIX C .................................................................................................... ............ ASH's OSHA Complhinn Form

OCTOBER 22, 1993 1 REPORT ON RECENT ETS AND IAQ DEVELOPMENTS IN THE UNITED STATES REGULATORY AND LEGISLATIVE MATTERS 103D, CONGRESS [1] Conferees Remove PRO-KIDS Amendment From HHS Appropriations Bill; Lautenbcrg Decries Removal of PRO-FEDS and PRO- KIDS Amendments A House-Senate conference committee has removed the PRO-KIDS amendment from the appropriations bill'i for the Department of Health an& Human Services. (H.R 2518). The amendment would have restricted smoking to separately-ventilated areas in federally- funded facilities serving children younger than 18. It had been added to the appropriations billiby the Senate on September 28', 1993, by a vote of 95-3. The version of the appropriations bill passed by the House did not contain the PRO-KIDS amendment. The conference committee had been, appointed to reconcile tliis and'1 other differences between the House and Senate versions of the bill. The conference com- mittee completed its work on October 5 and submitted' its recommendations in a written repora The House approved the conference committee's report on October 7, and the Senate followed suit on October 18. The floor debatepreceding,the Senate'ss approval of the conference committee report featured'a speech by Senator Frank Lautenberg (D-N.J.), the primary sponsor of the PRO-KIDS legislation.. Lautenberg is also the primary sponsor of a bill known as PRO-FEDS (S. 262), which would restrict smoking in all federal buildings to separately-ventilated areas. Like the PRO-KIDS legislation, the PRO-FEDS measure was added to a House appropriations measure by the Senate, and then removed by a House-Senate conference committee. See issues 55 and 57 of this Reporty September 10 and October 8, 1993. In his October 18 speech on the Senate floor, Lautenberg expressed his "d:ispleasure"' at the fate of his antismoking provisions and vowed to continue in his efforts to pass them. "I believe that both my PRO-FEDS and PRO-KIDS amendments were dropped for substan- tive reasons and not procedural reasons, despite what I feel is overwhelming support for both of them in the Senate„" Lautenberg said. "I want to let-all of my col- leagues know that I will soon return to the Senate floor to offer both of these amendments to appropriate vehicles and I ask for a rollcallivote on both of them. I make this statement so that none of my colleagues will be surprised to see me on the floor trying to protect our children and Federal workers and visitors from the deadly carcinogen called secondhand smoke." During his remarks, Lautenberg referred to the EPA Risk Assessment on ETS and submitted the EPA's July 11993 brochure on ETS into the record. He also submit- ted into the record a press report about the efforts being made by Congressmen to kill his amendments. According to a press report, Lautenberg plans to contact individual secretaries of various federal depart- ments to obtain support, for his PRO-FEDS legislation. He also reportedly plans to contact Senator Wendell. Ford (D-Ky.) to encourage him to adopt a smoking policy for the Senate. Ford chairs the Senate Rules Committee, which purportedly has the authority to ban smoking without a legislative initiative. See Roll' Ca14 October 4, 1993. [21 Committee Submits Report on Traficant Bill On October 15, 1993, the House Committee on, Public Works and~ Transportation filed its report on a bill introduced by Representative James Traficant, Jr., (D-Ohio) that would'restrict smoking in federal, buildings (H.R. 881). As part of the background description of the legislation, the report cites the EPA Ri'sk Assessment on ETS. The report also traces the bill's progress through subcommittee hearings and' summarizes relevant testimony. 20 2 4 7 0Z.5 G 7

2 Quotations from the report follow. "The Committee believes that Congress should not impose a total ban on smoking. H.R. 881, as amended, allows for smoking in separately venti• lated~ areas. The bill, as amended, addresses the issue of ETS in the Federal office workplace, as well as the competing rights of non-smokers versus smok- ers. The committee encourages the heads of Execu- tive Departments and Federal agencies to:survey their employees to ensure full and open~participa- tion in making a reasonable determination regard- ing the issue of smoking areas." •"The conclusions of the EPA report may result in an ~ increasing number of claims against the Federal government by non-smokers who have been exposed to ETS. Independent of the EPA report, the fact remains that a number of workers' compen- sation claims have been successfully pursued by non-smoking Federall employees who have been temporarily or permanencly impaired by exposure to ETS in the workplace." •"As a result of the conclusions of the EPA report, many states, municipalities and private businesses have taken measures to~ban smoking,from their publfc buildings and facilities. California, New Jersey, Ohio, Maryland, Michigans Utah and Idaho are examples of the states which have banned smoking in its [sic] public facilities. Cities whi& have taken similar measures include Denver, Sacramento and Houston. In addition, numerous airports, shopping malls and restaurants, su&as McDonald's have taken measures to limit or eliminate public exposure to tobacco smoke." •"The Congressional Budget Office has reviewed H'.R. 881, the Ban~on Smoking in Federal Build- ings Act, as ordered by the Committee on Public Works and Transportation on June 17, 1993. CBO estimates that implementing the bill would result in no significant cost to the federal government if no special smoking rooms are designated, and up to $50 million over f ve years if separately ventilated smoking rooms are provided in some or relatively large federal buildings." •"Based on information from the General Services Adininistration, we estimate that providing separate ventilation for a speciallsmoking room would cost ETS/IAQ REPORT, ISSUE 58' between $7,500 and $'12,500 for construction, plus $250~to $750 per year, for additional energy costs. Thus, over five years, construction, and energy costs would total between $8,000 and $15,000 per room."' The measure has been referred to the House Com- mittee on Government Operations, where it is sched- uled to be considered on or about November 12. U.S. OCCUPATIONAL SAFETY AND HEALTH AD1v1INISTRATION (O!SHA)' [3] ASH Invites Supporters to File ETS Exposure Complaints With OSHA In an effort to increase pressure on OSHA to ban, smoking in the workplace, ASH is sending,its support- ers an OSHA complaint, form to be filled out by anyone who is exposed to ETS in the workplace. Language preprinted on the form by ASH asserts that, the complaints "must be investigated" and' alleges that workplace exposure to ETS violates the general duty clause of the OSH Act. Copies of the complaint form and ASH's transmittal letter are attached to this Report as Appendix C. Supporters are encouraged to complete the form andl return it to ASH, which promises to forward the com- plaint to the appropriate OSHA office. Supporters also are encouraged to make a financial contribution to ASH. "Our hope is that this new projecn will finally force OSHA to address the smoking,issue," ASH says in the transmittal letter for the complaint form. "We also believe io will help prompt OSHA to issue an across- the-board rule banning smoking„rather thantrying to deal with~ each individual complaint." In ongoing efforts to force a regulation banning workplace smoking, ASH has sued' OSHA in the U.S. Court of Appeals for the District of Columbia four times. The first three cases, filed in~ 1989 and 1991, have been dismissed. The fourth case, filed~ in Decem- ber 1992', is pending. In addition to the December 1992 lawsuin, three of the petitions ASH has filed directly with OSHA remain pending. ASH most recently petitioned OSHA on July 1'2, 1993; the petition asks OSHA to issue an emergency temporary standard banning smoking in the workplace. 2~~247~,~ )Fi~

OCTOBER22, 1993'. OSHA still has not announced whether or how it will dealwith~ ETS in the workplace. In January 1993, then-Labor Secretary Lynn Martin directed the agency to prepare a report on issues related to ETS exposure so that her successor could determine the most appropri- ate rulemaking option. [I4] Secretary Reich Tells AFL-CIO Indoor Air Is a Priority According to press reports, Labor Secretary Robert Reich touched on the subject of indoor air quality while addressing a recent AFL-CIO convention in San Fran, cisco. "Often it is unhealthier to breathe the air inside the workplace than outside the workplace," Reich is quoted as saying. "We have better laws goveming,dean air and water outside the workplace than inside the workplace. But where is it most Americans spend most of their time? In the workplace." Reich spoke in support of OSHA reform, a matter which was considered by convention delegates, who voted to approve a resolution in favor of the Comprehensive Occupational Safety and Health Reform Act (H'.R. 1280, S~: 575). As part of its resolution, the AFL-CIO is calling for stronger standards on indoor air quality. See Daily Labor Repom October 7, 1993;' Government Employee Relations Reporr, October 111, 1993. [5] Witnesses Address Poor IAQ During OSHA Reform Hearing Witnesses testifying before the Senate Subcommittee on Labor on October 5, 1993; addressed workplace IAQ problems while commenting upon proposed OSHA reform legislation (H.R 1280, S.575). Donald Hales, a shop steward for the American Federation of Government Employees Local No. 2367 at the U.S. Military Acad'emy,, West Pointy New York, testified that poor IAQ caused by inadequate ventilation is a problem~that needs to be addressedby OSHA. In addition, Deanne Clarke, a flight attendant who claimed she experienced neurological damage due to a carbon monoxide leak, discussed the indoor air on airplanes. Neither witness linked poor IAQ to ETS. 3 U.S. ENVIRONMENTAL PROTECI i.Oid AGENCY (EPA)~ [6] ETS Risk Assessmenr Litigation: EPA Files Motion for Leave to File Reply Brief in Excess of Page Limit and Attaches Proposed Reply Brief in Support of Motion to Dismiss. On October 19, 1993, EPA tendered to the court a 20-page reply brief in support of its motion to dismiss plaintiffs' complaint. The brief was attached to a motion for leave to exceed the ten-page limit estab- lished by local rule. As of this writing, the court had not ruled om the motion, which is opposed by plain, tiffs. The deadline for f ling the reply brief was October 20, 11993. In the proposed reply brief, the EPA challenges each of the arguments made by the plaintiffs in opposition to the motion to dismiss. The EPA argues that its risk assessment does not constitute "agency action" or "final agenry action." In so arguing, the agency emphasizes that it "did not conduct any original scientific research in preparing,the ETS Report. Rather, EPA examined and compared the results of existing studies of ETS.... When EPA concurred and conclud'ed! in its Report that ETS is a knowm hurnan carcinogeny the Agency was not saying anything different than many others had alread'y said before." In addition, the EPA argues that the court lacks jurisdic- tiom because plaintiffs' claims are not ripe for review. The EPA challenges the plaintiffs' due process claiM by arguing that the Guidelines for Carcinogenic Risk Assessment and for Exposure Assessment do not prescribe substantive rules of decisioniand thus d'o not create a constitutionally-protected interest. The agency also criticizes the case law upon which the plaintiffs rely in support of their claim that an adverse effect on company business constitutes a deprivation of due process. The EPA concludes by stating, "the ample opportuni- ties that the plaintiffs have already had'to comment on, the ETS risk assessment suggests that additional process would be of little value. The balance of factors _ easily swings toward EPA." Scheduled' briefing on the motion to dismiss is now complete; the court has not yet entered an order on the 20Z470Z_S[;,q

4'. oral argument requested by plaintiffs. (The EPA didl not request oral argument.) The court also has not ruled on either of the pending motions for leave to file amicus briefs. Plaintiffs' complaint in this case seeks a declaration that EPA's decision to designate ETS a Group A carcinogen, together with the risk assessment on whi& the decision is based, is unauthorized, arbitrary and capricious, violates procedures required by law, and amounts to a denial of due process. Plaintiffs also seek a permanent injunction requiring EPA to withdraw the Group A designation and the underHying risk assess- ment. Flue-Cured Tobacco Cooperatrve Stabilization Corporation, etaL, v. EPA, No. 6:93CV370 (U.S. District Court, Middle District, North Carolina) ~ (filed June 22, 1993). [7] Confirmation~ Hearings Held for EPA Nominees On October 20, 1993, confirmation hearings were conducted by the Senate Committee on Environment and Public Works for the nominee to become EPA Assistant Administrator for Air and Radiations Mary Nichols, and the nominee for Assistant Administrator for Administration and Resources Management, Jon Cannom Nb vote was taken on the nominations, and the record was left open for the submission of answers to questions posed during the hearing. Nichols is a former California state official and attorney. She criticized the previous administration's director of the Office of Air and Radiation and the Office of Management and: Budget for creating, procedural roadblbcks M implementing environmental legislation. Cannon testified that he will bring a strong emphasis on management of resources if he is confirmedL [S] Companion Bill Introduce&to Streamline EPA Risk Assessment Procedures A Senate bill that would coordinate the dcvelopment implementation of environmental' policies at the EPA (S. 110) now has a companion bill in, the House of Representatives: H.R. 3111, which was introduced on September 21, 1993, by New Jersey Representative Dick Zimmer (R)~ After its introduction, the House bill' was referred to three committees. t i WtAll tcr.i•ux i, ib5 UL 58 The Senate bill was introduced' in January 1993 by New York Senator Daniel Patrick Moynihan (D). No hearings have been held on the bill;, it has not been marked up or voted out of committee. Further details regarding S. 110 appear in issue 41 of this Report, February 19, 1993. The House measure, "Environmental Risk Reduction Act of 1993;" is virtually identical to the Senate bill, although in the findings section, the Senate measure refers to "pollution prevention and toxic use reduction" as preferred techniques for environmental protection; while the House measure speaks simply of "risk reduction." Both measures would create a Committee on Relative Risks, which would rank the relative risks of environmen- tal problems, and a Committee on Environmental Benefits, which would estimate the quantitative benefits of reducing particular risks. These committees would be independent of the EPA's Science Advisory Boardi The House measure also would require a Committee on Communicating Risk, whichwould "provide expert advice on communicating to the public information on risks in a manner that provides the public accurate and understandable information about those risks." Where the Senate measure would authorize appropriations to carry out the bill in the amount of about $1 billion, the House bill designates "such sums as may be necessary." [9] Top Science Advisor's Role in Jeopardy According to EPA sources, the position of EPA Science Advisor is in doubt due to indecision over the role of the advisor in the Clinton~administration. The current holder of the position, William. Raub, was hired last year after recommendations were made to boost the reputation~of EPA science. Raub has reportr edly been frustrated by the failure of top EPA staff to decide the status of the position under Administrator~ Carol Browner. Although~ Raub apparently would like to remain at the EPA, his one-year detail from the Department of Health and Human Services concludes at the end of November; thus, he may be forced to begin making plans to leave the agency. According to SAB members, the loss of Raub would be a serious blow given his high regard in the scientific community. See Insi& EPA, October 15, 1993. 2024 % 0-2,5'70 i

OCTOBER 22, 1993 [10] Science Advisory Board Given New Role According to a press report, the EPA's Science Advisory Board (SAB) will be charged with examining future societal and business trends that may have an environmental impact and require EPA action during the next century. An announcement about the "fu- tures" project is expected to be made at the SAB's October 27, 1993, annual meeting. The project is apparently a response to Congressional and public criticism that the EPA lacks a long-term strategic plan. An October 8, 1993, draft plan for the project reportedly indicates that eachi of the SAB's 10 committees will be required'to conduct short-term five year projections and longer 20-year projections. Each committee will also be instructed'to choose a limited number of future developments for in-depth evaluation of their, environmentallconsequences and to draw implications for future EPA responsibilities. Issues that may be addressed include (i) the role of nuclear power and renewable fuels in the long-termm energy mix; (ii) the impact of future technologies on, travel and work patterns; (iii) the impact of urbaniza- tion on pollution; and (iv) the existence of more effective approaches to managing environmental problems. See Ifusde EPA, October 15, 1993. ASH RAE [11J SSPC 62 to Meet in Philadelphia Prior to IAQ '93 Meeting A special working,meeting of SSPC 62, the commit- tee responsible for revising ASHRAE Ventilation Standard 62-1989, is scheduled to begin on November 5, 1993, in Philadelphia. The three-day meeting is scheduled to conclude just prior to the commencement of ASHRAE's annual conference, Indoor Air Quality '93, which will be held November 7-10, also M Philadelphia. Standard 62-1989 suggests ventilation rates to ensure adequate indoor air quality. The voluntary standard assumes the presence of smokers, and the ventilation rates are recommended to deal with ETS and other substances in the indoor air. SSPC 62 was formed in 1992 to review and revise the standard. A draft revision was circulated in January 1993; committee members currently are debating suggested changes to that draft. 5 For more information about the Indoor Air Quality '93 meeting, see issue 49 of this Report,,Jlune 11, 1993. STATE AND LOCAL GOVERNMEN?I'S [12] Florida Publishes Changes to Clean Indoor Act Rules The Florida Depanment of Health and Rehabilitative Services (HRS)1has published a notice of change to the rules it has been considering to implement the Florida Clean Indoor Act. The Act is addressed solely to indoor smoking, and the proposed rules essentially designate the procedures to be followed byenforce- ment personnel and the types of citaeions and fines that can be assessed for violations of the Act. The changes, published! on October 1, 1993, were made in response to comments made during a public hearing in August 1993. The latest version of the proposed'rules omits any reference to public announce- ments made in transportation terminals about the state's smoking policy, a matter over which HRS has no enforcement authority or jurisdiction under the statute. The changes also redesignate a: type of violation~ under the statute involving smoking in private offices where smoking is permitted and the office doors are left open. According to an HRS spokesperson, the proposed rules have been challenged and their adoption is on~hol& pending the decision of an administratir-e hearing officer. [13] Privacy Legislation •Pennsylvania A bi111 that would prohibit employment discr~imination against persons who use lawfull products has been reconsidered in the House. On October 13, 1993, the bill was read a third time, amended, and passed the House. The bill now is under consideration in the Senate. See H.B. 956, 176th Gen. Assembly, Reg. Sess. (1993-94); ThrAssociated P'ress;,October 14, 1993. •Ohio On October 6, 1'993~ a bill was introduced that would _ include the use of tobacco products outside employ- ment within the unlawful discriminary employment practices of the Ohio Civil Rights Law. Sce H.B. 517, 120th Gen. Assembly, Reg. Sess. (1993-94). 202470 25 ~ 1

6 •Illinois On October 13, 1'993, a bill was introduced'that would amend'the Right to Privacy in the Workplace Act by prohibiting,employment discrimination based on lawful activities away from work. SeeS.B. 1126, 88th Gen. Assembly, Reg. Sess. (1993-94). [14]I Other ETS-Rclated State and Local Legislation •Local Governments in Arizona Tempe. City Counciltnan Frank Plencner has proposed amordinance that would ban smoking in restaurants, the workplace, Tempe Diablo Stadium, city buildings and city vehicles. His proposal, along with one made earlier that would' ban cigarette vending machines, will be forwarded to the City Council. At least four of the seven council members must agree to place the propos- als on an agenda for a regular council' meeting. See The Arizona Republic/The Phoenix Gazette, October 11, 1993. •California H.B. 291 was signed' by Governor Pete Wilson on October 11, 1993. The measure, which goes into effect January 1, 1994, places into law an executive order issued by Wilson last winter that bans smoking in state-owned and! state-leased buildings. The legislation also expands the Governor's ban to include state- owned cars, state universities„legislative buildings and state appellate courts. The measure prohibits smoking wiihim five feet of entrances to state buildings. See Sacramento Bee, October 13, 1993; United'Press International October 12, 1993; and The San Francisco Chronicle; October 13, 1993. •Local Governments in California Long Bcach. According to la news report, the City Council has decided'to place its antismoking ordinance before voters in the April 12 municipal election. The ordinance, which would prohibit smoking in restau- rants, had been suspended by a petition drive for the referendum. In the meantime, the council has drafted an interim ordinance that would restrict smoking to one-fifth of the total space in restaurants and bars. If the council gives final approval, the restrictions would' take effect in November and remain in effect if voters reject the stricter measure in April. See Los Angeles Times; October 13 and October 14, 1993. Ojar: The City Council is considering,a variety of approaches to strengthen its smoking ordinance, ETS/IAQ FtEPORT, ISSUE 58' including a possible smoking ban on~ciry sidewalks, in Libbey Park and all other public places except bars and tobacco shops. The current law, adopted in 1987, allows smoking in most public places, but requires no- smoking areas in public facilities and businesses. See LosAngeles Times; October, 12, 1993. West Hollywood According to: a news report, restaurant owners have launched a petition, drive to force the City Council to rescind a restaurant smoking ban that took effect October 6. Councilman Paul Koretz, the Council's primary advocate of the ordinance,,was reported to say that "growing evidence" of adverse health effects of ETS on restaurant workers made the ordinance necessary. See Los Angeles Times, October 14, 1993. Westlake Village. The City Council has given prelimi- nary approval to a smoking ban in~ most workplaces and indoor public areas. The measure will ban~smoking indoors except in private homes and clubs, bars, hotel~ and' motel rooms, tobacco stores, and private and designated smoking rooms. Smoking rooms would be requiredito be separately ventilated. See Los Angeles Times, October 15, 1993: •Maryland The Attorney General of Maryland has issued an opinion which states, in part, that localigovernment restrictions on smoking in public places are not preempted by state or federal law. The opinion was issued at the request of a state legislator who wanted too know if Prince George's County Council could' lawfull'y enact antismoking legislationL •Local Governments in Maryland Montgomery County. The County Council introduced' legislation on October 5, 1993, that would prohibit smoking in~counry government workplaces. County Executive Neal' Potter allcgedly requested the legisla- tion based! on the EPA Risk Assessment on ETS. See The Washington Trmes;, October 6, 1993. Talbot County. Opponents of an ordinance banning smoking in all restaurants and most workplaces have submitted 2,254 signatures in an effort to put the issue to referendum next year. The County Councillhad passed the measure August 10, 1993, but when restaurant owners realized the bill had been changed to ban smoking in all dining areas, they opposed the ordinance. See Baltimore Sun,,October 9, 1993. 20247n2s7z

OCTOBER 22, 1993 •Local Governments in Massachusetts Newton. An ordinance has been passed that requires most restaurants either to ban cigarettes or to have separately-ventilated rooms for smokers by July 1994. The ordinance covers taxicabs and buses, theater lobbies and some outdoor public places, such as semi- enclosed bus stop shelters. A news report claims that antismoking forces were assisted by the release of the EPA Risk Assessment on ETS. See The Boston Globe, October 6, 1993. •Local Government in Missouri St. Charles County. On October 12, 1993, County Executive Eugene C. Schwendemann vetoed a bill that would have banned smoking in county government buildings. Schwendemann stated that he vetoed the measure because it was unfair, and he pointe& out that the County already had a policy governing smoking that permits smoking in designated areas. See St. Louis Post-Dispatch, October 12,,1993. •Local Governments in North Carolina Cabarrus County. The County Board of Health~has votedto ban~smoking in all governmenrbuildings, including city buildings in Concord, Kannapolis, Harrisburg and! Iwlt. Pleasant. It will not affect pri- vately-owned public places. The ban was proposed by board member Dr. David Lockhart, who allegedly relied on the EPA Risk Assessment on~ ETS: See Charlotte Observer, October 2, 1993. ETS-RELATED LITIGATION AGAINST CIGARETTE MANUFACTURERS [15] Bentz: Pro Se Prisoner Case Filed in Oregon American Tobacco and American Brands were served recently in a case filed in the United States District Court for the District of Oregon. PlaintiffiTravis Bentz, a prisoner in an Oregon jail who filed the case pro se, alleges he has an unspecified irreparable injury an& has incurred a "reasonable fear of contracting one or more of the known fatal effects" from ETS expo- sure. He further alleges that cigarettes are "unreason- ably dangerous to consumers, bystanders, and the general public." He seeks $12 million in actual dam- ages, $500,000 in noneconomic damages and $1 million in punitive damages. Additional defendants in the action are Eagle Tobacco Corp. an&Ultratech 7 Co,-p. Bentz v. Eagle Tobacco Corp., et al. (U.S. District Court, Oregon) (filed September 27, 1993). [16] Bfuitr.Defendants' Responses to the Complaint to be Filed Defendants are stillischeduled to submit their responses to the complaint, on November 1, 1993. Plaintiffs in this action allege Willie Ruth Bluitt was a nonsmoker who died~ of lungcancer caused by workplace exposure to environmental tobacco smoke. Defendants in the action are the six major U.S. cigarette manufactur- ers. Bluitr v. RJ.Rrynolds Tobacco Co., et at (U.S. District Court„ Eastern District, Texas) (filed August 30, 1993)~ [17] Broirx Depositions of Senior Executives Taken Plaintiffs deposedsenior executives of some of the defendants between October 11 and October 15, 1993. William Campbell!, president of Philip Morris Incorpo- rated, was deposed on~October 11; Lawrence Ricciardi, president of RJR Nabisco, Inc. and Michael Rosenbaum, a vice president of Brooke Group Inc., were deposed on October 12; Farrell Delman, president of the Tobacco Merchants Association, and Andrew Tisch, president~ of Lorillard Tobacco Co,, were d'eposed on October 14; and Martin~Orlbwsky, executive vice president of Lorillard Tobacco Co:, was deposed on October 15. The Ricciar&and Delman depositions were limited to: jurisdictional issues. A representative of the Council for Tobacco Research is presently scheduled to be deposed on November 4. At issue in this case are the claims of 28 flight atten- dants allegedly injured by occupational exposure to ETS. In addition, the husband of one of the flight attendants claims loss of consortium. The 28 attendants purport to represent a class of approximately 60,00&other atten- dants. Plaintiffs' class action allegations have beeni dismissed by the trial court; plaintiffs' appeal of that dismissal is pendingin the Florida Court of Appeal. Injuries alleged by the putative class representatives include lung cancer, breast cancer and unspecified' respiratory ailments. Plaintiffs further allege that occupa- tionallexposure 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-

6 ties); UST, Inc., United States Tobacco Company, Dosal Tobacco Corp.,, the Council for Tobacco Research, The Tobacco Institute and three trade associations. Broin, et al., v. Philip Morris, et aL (Circuit Court, Dade County, Florida) (filed' October 31, 1991'). [18] Butler. Deposition of Plaintiff Ava Dean Butler Postponed The October 20, 1993, deposition of plaintifff'iva Dean Butler and the October 21 deposition of one of the barbers in the shop formerly owned by plaintiff Burl Butler have been postponedL Both were post- poned due to Mr. Butler's recent hospitalization. Plaintiffs contend that Burl Butler, a barber in Laurel, Mississippi, developed lung cancer as a result of his exposure to environmental tobacco smoke. The defendants in this case consist of the six major U.S. cigarette manufacturers and several local retailers. Butler v. R.J: Reynolds Tobacco Company, et al. (Circuit Court, Hinds County; Mississippi) (filed October 21, 1992). [19] Dunn: Reply Briefs in Support of Defendants' Dispositive Motions to be File& Reply briefs in support of defendants' pending motions are currently due on October 27, 1993. The cigarette manufacturing defendants, The Tobacco Institute and'the Council for Tobacco Research have filed a joint motion to transfer venue from the Circuit Court of Delaware County, Indiana, to the Circuit Court of Grant County, Indiana. The holding com- pany defendants - American Btand's,, Loews Corp. and RJR Nabisco Holdings Corp. - have separately filed motions to dismiss for lack of personal jurisdic- tion. The court is presently scheduled to hear argumentt on the motions on December 2. Plaintiffs in this case contend that Mildred Wiley was a nonsmoker who died of lung cancer as a result of workplace exposure to environmental tobacco smoke. Her husband, Philip Wiley, is also asserting a loss of consortium claim. Defendants in the case are each of the six major U.S. cigarette manufacturers, parent companies of three of the manufacturers,,The Tobacco Institute, and the Council for Tobacco Research. Dunn v. RJR Nabisco Holdings Corporation; etal. (Superior ....,,.....,~...-...... > .,.,v._ iu Court, Delaware County, Indiana) (filed May 28, 1993). [20] Schultz Ninth Circuit Affirms Judgment in Favor of Philip Morris On October 5, 1993, the Ninth Circuit Court of Appeals affirmed' a judgment in favor of Philip Morris, the only defendant in the case to have been served. The U.S. District Court for the District of Arizona had granted Philip Morris' motion to dismiss, which was based on Rule 11i of the Federal Rules of Civil Proce- dure. In affirming the judgment, the Ninth Circuit held that plaintiffs "numerous frivolous filings indicate that he initiated this action to harass and cause unnec- essary delay in the proceedings." - The instant action was the first of several' Greg Schultz initiated invoHving claims of unspecified injuries resultingfrom exposure to ETS M prisom Schultz v. Philip Morris, et al. (U.S. Coun of Appeals, Ninth Circuit) (filed August 31„ 1990). . [21] Williams Case Filed' i~n ILouisiana. George Covert represents plaintiffs Cornealius Williams and Cynthia Johnson Williams in a case filed on October 8, 1993, in the District Court, of East Baton Rouge Parish, Louisiana. Defendants named in the complaint, are R.J'. Reynolds, Philip Morris and Johnson's former employer, McCarty Corporation. Plaintiffs allege that Mr. Johnson has laryngeal cancer, that was diagnosed in December 1992. While he allegedlysmoke& unnamed brands of cigarettes manu- factured by R.J. Reynolds (from 1966-1968)'and by Philip Morris (from 1968-1992), plaintiff's al'so allege that Johnson was injured by ETS exposure during an unspecified period of his life. As in, the recent Chutsz case, the ETS allegation in Williams is only made in passing and is not well'developed. (Plaintiffs' claimss against McCarty Corporation are based on Johnson's alleged~ exposure to asbestos fibers while working as a pipefitter.)' Plaintiffs seek $712,000 1in actual damages and unspecified dollar amounts in damages for personal injury, mental anguish and loss of enjoyment of life on behalf of Mr. Johnson. Plaintiff Cynthia Johnson Williams seeks an unspeci6ed! dollar amount in damages for her loss of consortium claim. IX/ilGams v:

OCTOBER 22, 1993 R.J. Reynolds Tobacco Company„ etal. (District Court, East Baton Rouge Parish, Louisiana) (filed October 8; 1993). ETS AND IAQ LITIGATION! NOT INVOLVING CIGARETTE Iv1ANUFACTURERS WORKPLACE: ASSAULT AND BATTERY [22]', Portenier v. Republic Hogg Robinson (Superior Court, Los Angeles County, California) (filed June 6, 1991) A Superior Court Commissioner has reportedly denied defense motions to dismissxhis lawsuit, which was filed by an insurance broker's employee who has alleged liability on the basis of assault and battery due to ETS exposure in the workplace. Trial has been set for April 26, 1994. The Commissioner's ruling rejects the employer's argument that the claim was subject to the exclusivity provision of the state workers' compensation~ act. The emplbyer's attorney has reportedly stated that the decision willl not be appealed. Trial' in the case has been set for April 26, 1994. See Los A'ngeles Daily Journal October 14, 1993: Plaintif'fAndrea Portenier, who began working for. Republic Hogg Robinson~ in January 1987, apparently informed her employer in March 1990, that ETS was causing health problems and that she should not be exposed to ETS in the workplace. The company reportedly offered to accommodate Portenier by (i)~ assigning a nonsmoker to work for her, (ii) relocating her work station,,and (iii)' offering her a position in a nonsmoking building. AMERICANS WITH DISABILITIES ACT (ADA) [23] Peterson v. Utah Department of Health (U.S. Department of Health and Human Services)' (filed July 14, 1993) The U.S. Department of Health and Human~ Services (HHS)' has decided to investigate the complaint of a man who claims that he has a genetic lung disease and is being subjected to discrimination by Utali's policy of permitting passage through smoking sections in places of public accommodation to reach designated non- smoking areas. HHS advised complainant Calvin Petersomby letter dated July 17, 1993, that it had jurisdiction~over the complaint under both~ the Rehabilitation Act of 1973 and the ADA, and that it would initiate an investiga- tion to determine whether the State was required to modify its policy "to accommodate the breathing disabledi» WORKPLACE WORKERS' COMPENSATION [24] AppellantlCross-Respondent v. Respondent/Cross- Appellant, 1993 WL 406384' (Texas Workers' Compensation Commission) (decided October 1, 1993) . A panellof ad'ministrative appeals judges has denied workers' compensation benefits to a woman who claimed that her lung cancer had been caused by workplace exposure to ETS: The woman, now de- ceased, claimed that she had been exposed to ETS for 23 years while working for her employer and'that she had'no other exposure to ETS. A hearing,oflicer had initially denied the claim, and the appeals panel determined there was suflecient evidence in the record to support that determination. According to the panei, there were conflicts in~ the evidence regarding,tlie amount of ETS in the work- place and in the opinions of the expert medical wit- nesses. Because it was for the hearing officer to judge questions of credibility and to resolve evidentiary conflicts, the panel deferred~ to his discretion. The panel referred to the EPA Risk Assessment on ETS, but evidently did not find' it persuasive. 9 WORKPLACE: IAQ N O[I25j B S£Wl t (S i Co t N h ors uper or ur ., a ura v nves .h District of Columbia) (filed September 14, 1990), ~ ~ Following a three-hour pretrial conference held on ~ October 15, 1993, Superior Court Judge Rufus King >Q II1 said'that trial would begin on October 25, 1993. 1;ol

ii& The case involves employees of the EPA who have sued various parties involved in renovating the EPA's headquarters. Plaintiffs allege health problems due to poor, indoor air quality. According,to the parties' joint pretrial statement, the trial is expected to take five to six weeks and will involve the claims of only five of the original 19 plaintiffs. The plaintiffs have listed more than 175 witnesses, including Representative Joseph Kennedy III (D-Mass.) and! Dr. Rosalyn Anderson,,who conducted the controversial carpet emissions tests that resulted in the neurological impairment or death of test mice. Plaintiffs are expected to show a videotape of mice exposed to the indoor air at the Waterside Mall building. The plaintiffs have made a pretrial demand of $'9,400,000~ The defendants have listed 41 witnesses, including Dr. Philip Witorsch, and have made no offer of settlement. Two of the defendants' expert witnesses, Dr. Herman Staudenmayer and Dr. Edlvard C. Kirby, will testify that there is a psychological explanation for many of the plaintiffs' alleged injuries. During,the pretrial conference, the judge expressed his view that trial would'only take four weeks, and he told the attorneys they needed'to pare their witness lists. IAQ: CARPET EIvIISSIONS [26] Howell v. Shaw Industries, Inc., 93-CV-2068 (U.S. District Court, Eastern District; Pennsyl- vania) (filed April 19, 1993). Granting a defense motion to transfer, the trial court has ruled that this case should be tried in Georgia rather than Pennslyvania. The carpets at issue in the case are manufactured in Georgia, and most of the liability witnesses and documentary evidence are in that state, the court stated: The new venue for the case is the Northern District of Georgia. See BNA Product Liability Daily, October 22, 1993. The plaintiffs in this case, purporting,to represent a class of more than 100,000 persons, are seeking damages for injuries allegedly caused by carpet emis- sions. Plaintiffs' theories of recovery include breacL of warranty, negligence, failure to provide adequate warnings to consumers, false advertising, and violations of state and federal laws. The defendants are the largest ETS/IAQ REPORT;,ISSUE 58 carpeting manufacturers in the United States and their trade associations. CHILD CUSTODY [27) Masone v. Tanner (Superior Court, Sacramento, California) (temporary custody order entered'October 13, 1993) According to numerous press reports, a California! Superior Court judge has temporarily taken custody of an eight-year-old asthmatic child from her mother, who is a smoker, at the request of the child's father. The child is living wizL her paternallgrandmother until the court decides whether to remove the child perma- nently frorn~her mother's home. The mother, Susan Tanner, reportedly claims that she does not smoke in the child's presence, while the father, Steve Masone, reportedly claims that a urine test of the child showed she is being exposed to significant levels of ETS. Evidently, custody has been disputed for a number of years, and the court has ordered psychiatric evaluations of both parents before she makes a permanent custody award. Masone is also reportedly preparing to file for custody oEhis stepson who is living with Tanner. J'ohn Banzhaf is quoted in many of the press reports about the case, and reference is frequently made to the EPA Risk Assessment on ETS by those articles discuss- ing the issue of smoking and child custody. See Sacramento Bee, October 7 and 14, 1993;! The Neur York Times, October 116, 1993; USA Today, October 15, 1993; Time, October 25; 1993: WORKPLACE: CASES INVOLVING Sh90):ERS' RIGHTS [28]I Kurtz v. City ofNorth Mrami, 1993 Fla: App. LEXIS 10307 (Court of Appeal, Third District, Florida) (decided October 12, 1993) The Florida Courr of Appeal has determined that a city regulation~ requiring job applicants to sign an affidavit stating that they have not used tobacco for at least one year prior to application is unconstitutional'. The court's ruling reverses a trial court decision that upheld the City of North Mami's policy of refusing to hire smokers. See issue 31 of the Report, September 25, 1992.

OCTOBER 22, 1993 PlaintiffArlene Kurtz had applied for a position as clerk-typist; she was informed'she would not be hired after she told an interviewer she could not sign the required affidavit. Kurtz sued the ciry for violation of her rights of privacy, equal protection and due process. The appellate court held that Kurtz had' an overriding privacy interest under the Florida Constitution ~ in not disdosing information about personal matters of a lawful nature which bore no relation to the job for which she had applied. "Although the City may, and indeed perhaps should, provide a smoke-free working environ- ment, we conclude that the City's interests are not sufficient to reach the private lawful'conduct of potential' employees," the court said. Kurtz was represented by lawyers employed by the AmericanCivili Liberties Union, North Miami's ciry manager has reportedly stated! that the City will likely appeal the decision to the Florida Supreme Court. See Daily Labor Report, October 18, 1993. HOSPITAL: PATIENTS" RIGHT TO SMOKE [29] Arbogast v. Peterson, 1993 Ohio App. LEXIS 4883 (Court of Appeals, Ninth Disuict, Summit County, Ohio) ~ (decided October 6, 1993) An Ohio appellate court has upheld a ban on smoking by patients at a psychiatric hospital. Patients of the facility challenged the policy on the grounds that it had not been properly implemented and that it violated their equal protection rights. The court held that the policy was a matter within the "executive charge" of the institution's managing officer and thus was not subject to regular promulgation procedures. The court also found that the purpose of promoting health and safety at the hospital was legitimate and that a ban on patient smoking was a reasonable means of implementing that purpose. PRISONr PRISONERS' RIGHT TO SMOKE [30] Prison Inmates v. Polk County (District Court, Polk County, Iowa) (filed September 1993) According to a press report, some 32 iinmates in Polk County, Iowa, have filed a lawsuit, against the county to overturn a smoking ban instituted in the trailers in 11 which they are housed. In support of the lawsuit, the inmates have apparently filed statements in which they claim that the ban is causing them to be "uptight" and that "fights break out over nothing at all." According to prison officials, the ban was imple- mented in response to recent court rulings regarding ETS, and a ban on smoking in the main jail is also being planned. The county has filed a motion to dismiss the case, arguing that smoking is not an activity protected by state or federal law. See Associated Press,. October 3, 1993. [31] Reyno!'ds, Jr. v. Bucks, 1993 U.S. Dist. LEXIS 14058 (U.S. District Court, Eastern District,. Pennsylvania) (decided October 1, 1993) A district court judge has ruled that prison inmates do not have a constitutional right to smoke. The four prisoners who filed the lawsuit allegedlthat the ban on smoking recently implemented at the Berks Counry Prison in Pennsylvania, is a form of punishment depriving them of their right to due process under the Fifth and Fourteenth Amendments and their Eighth Amendment right to be free of cruel and unusual punishment. The court cites the 1990 Draft EPA Risk Assessment on ETS to support its holding that there are legitimate governmental interests to justify the smoking ban. The court also states, "Given the known health risks associated with smoking, and the fact that more and more office buildings, stores, restaurants, and public accommodations prohibit smoking; it cannot be said that a smoking ban conflicts with society's standards of decency. Although the lack of nicotine may be painful for some prisoners, the pain is neither unnecessary nor wanton." CASES FILED BY' NONSMOKING PRISONERS [32] Wilson v. Hambrick, 1993 U.S. App. LEXIS 25454 (U.S. Court of Appeals, Sixth Circuit) (decided September 30, 1993). The Sixth Circuit Court of Appeals has permitted a woman ~ incarcerated at a fed'eral' prison in Lexington, Kentucky, to pursue her claim that her Eight Amend- ment rights are being violated by her exposure to ETS.

12 Plaintiff Angela Wilson had alleged in her pro se complaint that the smoking policy at the prison was nor being enforced and that she was being housed in a smoke-filled environment with inadequate ventilation. She alleged that ETS caused her to suffer hypertension, sore throat, eye and skin irritation, headaches, cough- ing and other breathing difficulties. She further alleged that she had been allergic to ETS since childhood and that the prison warden refused her request to move her away from smokers. Citing HeIling v. McKinney, 113 S. Ct. 2475 (6/18/ 93), the appeals court determined that the U.S, Supreme Court's decision in that case is broad enough to apply to an assertion that a prison smoking policy is not being enforced and ETS "hovers" in the complainant's living area. Accordingly, the court reversed, in part, the lower court's ruling that the complaint was frivolous. The court of appeals dis- missed'every defendant from the action other than the prison warden, saying that if the facts alleged againso the warden were true, Wilson~ could support her argument that the warden was deliberately indifferent to Wilson's reactions to ETS. [33]'' Brown v. Thornburgh, 1993 U.S. App. LEXIS 26732 (U.S. Court of Appeals, Sixth Circuit): (decided' October 12, 1993). The Sixth Circuit Court of Appeals has determined that a pro se federal prisoner may pursue her claim~that she has a medical'need for a smoke-free environment and'that she is being exposed to high~levels of ETS in violation of the Eighth~Amendrnent. Ptisoner Shirley Lynn Brown, like Angela Wilson (see previous item) ~ is incarcerated at a Federal prison in Lexington, Ken- tucky. The court simply cites Helling v. McKinney, 113 S. Ct. 2475 (1993), to support its holding. The case has been remanded for further consideration. SICK BUILDING SYNDRO?vIE. [34] Klacke v. The Au'D' Limited Partnership, 1993 Ohio App. LEX1S 4913 (Court of Appeals, First District, Hamilton County, Ohio) (decided' September 22, 1993) An Ohio appellate court has determined that plain- tiffs who have alleged that their injuries were caused by the building in which they worked and conducted ETS/IAQ REPORT, ISSUE 58 business may pursue their complaints as a class action. According to the court, "the claims of the representa- tive parties are typical of the claims of the class." The plaintiffs are apparently alleging that noxious fumes, bacteria, fungi, dust and other irritants in the defendant's building caused their problems. LEGAL ISSUES AND DEVELOPMENTS [!35] California Bar Considers Resolution on Work- place Smoking According,to a: press report, the California State Bar's Conference of Delegates was scheduled to consider whether to adopt a: resolution favoring the prohibition of workplace smoking. The resolution, introduced by the National Lawyers Guild, was reportedly one of 1700 resolutions slated for consideration during the October 8, 1993, meeting of the policy-making body for members of the state's voluntary bar groups. See The Recordrr,,October, 7, 1993. [36] "`Sick' Buildings Rarely Are, but Perceive& Problems Must be Solved," J. Wojcik, Business Insurance, September 13, 1993 This article advises building owners and employers too take the "sick building" complaints ofbuild2ng occu- pants seriously to avoid litigation. Among the items discussed are "sick building syndrome," pending Congressional IAQ legislation and a number of the cases raising claims based on IAQ problerns: The author also addresses potential sources of poor IAQ including ETS. Several experts consulted by the author dispute allegations of injury caused by "sick buildings„" and suggest that the problem may be one more of psychology than of chemistry. [37] "Exposure to Tobacco Smoke is More Than Offensive, It is Cruel and Unusual Punish- ment," J.S. Kinsler, Valparaiso University Law Review, 1993 This article, written before the U.S. Supreme Court decided Helling v: McKinney, examines the issue of ETS exposure in prisons and'conclud'es that such a condition of confinement violates the Eighth Amend- ment proscription against cruel and unusual punish-

OCTOBER 22, 1993 ment. The author makes numerous references to the EPA Risk Assessment on ETS, and claims "any debate concerning ETS's dangers ended with the issuance of the 1993 EPA Report." OTHER DEVELOPMENTS [38]I Massachusetts Launches Tobacco Control Program Using the revenue from a 25-cent sales tax on ciga- rettes, the State of Massachusetts has launched a $91 million program that seeks to reduce tobacco use in the state by 50 percent by 1999. The program, known as the Massachusetts Tobacco Control Program (MTCP), includes a$14I million multimedia advertising cam- paign targeted primarily at young people. Some of the ads attempt to increase awareness of the alleged health effects of ETS exposure. One of the program's three priinary objectives is to give local communities "the funds and tools necessary to enact their own anti-tobacco ordinances," according to a press release. The other primary objectives are (1i) to increase awareness about the alleged health effects of tobacco use and (2) to provide services that will help smokers quit smoking and give them access to tobacco information. The 25-cent sales tax was approved in a statewide referendum in November 11992. See PR Newswire, October 14, 1993. [39] ASH Offers Long Distance Service to Raise Funds A brochure recently produced by ASH offers a long distance phone service tliatASH is using as a means of raising furtds. Stating "[y]ou can help ASH take more legal action to protect non-smokers' rights by simply switching your long distance carrier," ASH indicates that a percentage of each long distance telephone billlwill benefit the activities of ASH. The service, knownias the "Affiniry Fund," daims to offer overallI savings over most programs offered by AT&T, MCI and Sprint. [40] Toyota Test Markets Air Cleaner Toyota is reportedly test marketing an air purif er for, its 1992-1993 Camry sedans. The air purifier purport- edly reduces the amount of airborne pollen, tobacco smoke, dust and microscopic particles inside the car. 13 Thc a:v purifier operates independently of the heater and air conditioner and' is controlled by a two-speed switch on the console. The device reportedly removes, filters and returns interior air through color-keyed vents mounted on the rear window shelf between the rear speakers. See Chicago Tribune, October 17, 1993. [41 ] Freedom Air Fails to Attract Sufficient Numbers of Fliers According to a press report, the airline service launched for smokers has failed to attract enough passengers to become viable. After three Chicago to Los Angeles flights, owner Ted Hall reportedly can- celled the Freedom Air service, saying he could not afford regular flights and the costs of advertising needed to get off the ground. Hall had reportedly hoped to get some support from the tobacco industry. See International Herald Tribune, October 11, 1993'. SCIENTIFIC/TECHNICAL ITEMS UPCOMING SCIENTIFIC MEETINGS [42] IAQ'94: Engineering Indoor Environments, St. Louis, Missouri, October 30-Nbvember 2, 1994 An announcement and~ callI for papers have been issued by the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE)lfor this IAQ symposium on engineering indoor environments. According to the announcement4 the symposiumlwill "provid'e builders, designers, building owners and building managers with the latest scientific and practicall information on indoor environmental issues," and will. "encourage recommendations on procedures for design- ing, operating and maintaining buildings to ensure acceptable indoor environmental quality." The confer- ence will include panel discussions on specific topics of current interest and original scientific presentations. [43] Eleventh ORNL Life Sciences Symposium, Indoor Air and Human Health Revisited (Bringing Selected' Advances in Medical Science to the Indoor Air Quality Community), Knox- ville, Tennessee, March 28-31, 1994 Oak Ridge National Laboratory will host this sympo- sium sponsored by the U.S. Department of Energy, EPA,.

14 and the Hazardous Waste Remedial Actions Program. According to promotional materials, the symposium will focus on "health effects ranging from normal sensory response to poor indoor air qualiry to effects that seriously degrade the quality of life or are life threatening." Sessions will deal with sensory, allergy/respiratory (including bioaerosols), neurotoxicity and cancer issues. LUNG CANCER [44] "Occupational Risk Factors for Lung Cancer Among Nonsmoking Women: A Case-Control Study in Missouri (United States)s" R.C. Brownson, M.C.R. Alavanja, an&J.C. Chang, Cancer Causes and Control4: 449-454, 1993 [See Appendix A] Although this paper does not present risk estimates for spousal smoking,and lung cancer, it is of interest because it is based upon the same studypopuladon as the 1992 Brownson, et ali, paper on spousal smoking. See issue 35 of this Report, Nbvember 20, 1992. The current paper presents statistically significantly elevated lung cancer risk estimates for several indices of occupational exposure. Occupationall exposures were not consideredl as potential confounding factors in the Brownson, et al., spousall smoking report. [451 "Towards Truth, Through Falsification," A. Flew, Indoor Environment 2: 125-128; 1993 [See Appendix A] In this editoriali the author uses the conclusions of government, agencies about spousal smoking and! lung cancer to illustrate his position that some public policies may be based upon material that is "not, truly scientific." He calls for continued scientific criticism in order to detect andreject "substitutes" for scientific "truth." [46]I Letters to the Editor Regarding Trichopoulos, D., Mollo, F., Tomatis, L., Agapitos, E., Delsedime, L., Zavitsanos, X.., Kalandidi, A., Katsouyanni, K., Riboli, E., and Saraccii, R., "Active and Passive Smoking and Pathological Indicators of Lung Cancer Risk in an Autopsy Study," Journal of the American Medical Associa- tion 268: 1697-1701, 1992 The Journal of the American Medical Association recently published six letters concerning a paper by l=.1 J/11qCZ K'J:.l'OK1 „1JSUt. 58 Trichopoulos, et al., which reported on data from an autopsy study conducted in Greece. The authors claimed that their data on cellular changes in the lungs of women reportedly exposed to ETS supported a "link" between~ ETS exposure and hing cancer. See issue 32 of this Report, October 9, 1992. Letters in response to Trichopoulos, et ali, by Nathan~Mantel4 Christopher R.E. Coggins and Thomas J. Steichen, David J. Doolittle, Kathryn Goldin, and Peter Lee were published, as was a response by Dimitrios Trichopoulos and his coauthors. The letters appear at Journal'of the American Medical Association 270(1i4). 1689-1691, 1993. Mantel's letter comments on the apparent contrast between the claims of Trichopoulos, et al., regarding lung cancer risk, based on data from, 30 women, and the risk estimates derived from larger epidemiologic studies of spousallsmoking. Mantel notes than with small'~ numbers of cases, "RR values can be highly erratic."' He comments on the "inconsistency" of the results reported by Trichopoulos, et al., for instance, that the reported risk estimate for nonsmokers ex- ceeded the risk estimates for former and current smokers. Coggins and Steichen, of the R.JI Reynolds Tobacco Co., state that the work of Trichopoulos, et al., "contains a number of major flaws, collectively render- ing the information presented as scientifically question- able." They comment on the imprecise nature of the data (which was acknowledged in the original''1 paper)4 the small'sample size, the possibility of uncontrolled confounding, the nature of the tissue changes invesri~ gated, the possibility of problems associated, with, the use of surrogate respondents, and the study's apparenti omission of possible effects of air pollution (for whichi Athens is known) in the interpretation of the data. Another R.J. Reynolds scientist, David J. Doolittle, reports that his company has conducted a number of experiments using cultured cells and laboratory animals to study possible effects of ETS, and has "initiated a series of planned human studies on this topic:" Doolittle notes that the Trichopoulos, et al., study's conclusion was based on only 30 persons, in~contrast to press reports' suggestions that hundreds of people had been studied. He also suggests that Trichopoulos, et al., failed to present their data in a fashion amenable to independent analysis by other scientists.

OCTOBER 22, 1993 Goldin's brief letter inquires whether the association claimed in the Trichopoulos, et al., study would have been stronger if subjects with cancer or lung disease had not been exduded from the analysis. Peter Lee's letter questions the use of "epithelial, possibly precancerous lesions" (EPPL) as a "supposed index of lung cancer risk," commenting on inconsisten- cies in~ the data reported by Trichopoulos, et al. He writes: "One must ... doubt whether an elevated EPPL is of any prognostic importance, especially when, as for the increase reported for spousal smoking, it is marginally statistically significant." Lee also suggests that the data used in the `1'richopoulos, et al., study could be subject to bias from misclassification4 smoking status and from "unrecorded risk factors," including dien Trichopoulos, et al., respond to Mantel's letter by stating that it is "difficult to imagine" that misclassification could operate in their study, and that Mantel fails to identify any bias or to consider additional issues that were not addressed by the authors in the original article. In response to the Coggins and Steichen~ letter, Trichopoulos and colleagues state that confound- ing is not related to study size, state their opinion that surrogate respondents know an individual's smoking, status, and indicate that their analysis took air pollution into account by an adjustment for urban/rural residence. Trichopoulos, et all, respond''ito Doolittle by stating that "it, is unavoidable that some readers would require more, some less, and some different information." They also indicate that another paper on the study will be forth- coming. Trichopoulos, et al., agree with Goldin that their "results would have been more dear-cut" if subjects with respiratory disease had been induded in the analysis. Finally, in response to Lee's letter, Trichopoulos, et al., state that "Lee cannot explain in noncausal terms why both active and passive smoking predicted EPPL" in the study: They also say that his misclassification argument is "very weak" because of the different "psychosocial conditions" in an autopsy study compared'to a case- control study. [47] Editorial Regarding Letters to the Editor on Trichopoulos, et al.: "Smoke and Letters," D. Rennie, Journal of the American Medical Associa- tion 270(14): 1742-1743, 1993 This editorial focuses on four letters on the Trichopoulos, et al., autopsy study by tobacco industry 15 personnel or consultants, that were published by the Journal of thr American Medical Association. See preced- ing,item. The author of the editorial, Drummond Rennie, M.D., the journal's Depury Editor (West), notes that critical letters are commonly published in journals in what is essentially a part of the peer review process. However, Rennie states that the industry- related letters are "different." Rennie characterizes Nathan Mantel and Peter Lee as "energetic letter writers on behalf of [the] industry." He proposes that "writing letters to the editor seems to be a prominent tactic of the tobacco industry," noting,that no letters critical of the work of Trichopoulos, et ali, were received from "independent" researchers. While acknowl- edging that the ind'ustry has the right to respond to a published study, Rennie suggests that the letters may be judged by "number," instead of by "weight„" by "the people setting public policy on smoking," Rennie concludes by stating that the Journa4 "in~the best traditions of editing," will continue to publish such letters, "despite our fears about the political use to which the resulting citations may well be pur."' OTHER HEALTH ISSUES [48] I "Risks for Premature Rupture of Amniotic Membranes," E.E. Ekwo, C.A. Gosselink, R.. Woolson, and A. Moawad, International Journal ofEpidemiology22(3); 495-503, 1993 [See Appendix AJ This study considers two aspects of premature labor: premature rupture of amniotic membranes (PROM), and preterm labor without such~ rupture. [The amni, otic membranes surround the developing fetus in the uterus.] While the authors report extensively on risks for PROM associated with urinary tract and cervical, infections, they also present data on smoking in the household and the two indices of preterm labor. PROM was reportedly not statistically significantly associated with smoking in the household, although preterm labor reportedly had an odds ratio of 1.9 (95 percent CI, 1.1-3.3).

16 [49] "Cigarette Smoking and Sudden Infant Death Syndrome: Some Salient Points in the Debate," B. Haglund, Acta Paediatrica Suppl. 389: 37-39', 1993 [See Appendix A] This brief commentary focuses on maternal smoking during pregnancy and'sudden infant death syndrome (SIDS), with the author proposing that maternal smoking is an important preventable risk factor. With regard to "passive smoking," generally estimated from the father's smoking habits, the author suggests that further research is needed. [50] "Breast-Feeding and Maternal Smoking in the Etiology of Crohn's Disease and Ulcerative Colitis in Childhood," A. Rigas, B. Rigas, M. GIassman,. Y.-Y. Yen, S.J. Lan, E. Petridou, C.-C. Hsieh, an& D. Trichopoulos, Annals ofEprdcrniology 3: 387- 392„ 1993 [ISee Appendix A] The authors of this retrospective study„which was based on information abstracted from medical records, report no statistically significant associations between maternal smoking and either Crohn's disease or ulcerative colitis (two inflammatory bowel'diseases) in children. One of the authors of this study is Dimitrios Trichopoulos, author of one of the first studies purporting to link spousal smoking and lung cancer in womeni ETS EXPOSURE AND MONITORING [51 ] "Tobacco Smoke in Shopping Malls and Restau- rants," G. Lofroth, Indoor Environment 2: 173- 178, 1993 [See Appendix A] This study examines nicotine concentrations and mutagenicity of air samples in several public places in Sweden. The author suggests that measured levels of these "indicator components" of ETS from "nonsmok- ing" areas may have been due to the design of the ventilation system, for instance, to the placement of an exhaust fan in the nonsmoking section of a restaurant. ETS/IAQ REPORT; ISSUE 58 [52]i Letters to the Editor Regarding "Relationship Between Environmental; Tobacco Smoke Exposure and Carcinogen-Hemoglobin Adduct Levels in Nonsmokers," S.K. Hammond, J. Coughlin, P.H. Gann, M. Paul, K Taghizadch, P.L. Skipper, and S.R. Tannenbaum, Journal'of the National Cancer Institute85(6)c 474-478, 1993 The Journal of the National Cancer Institute recently published two letters concerning the Hammond's et al., study, which reported higher levels of 4- aminobiphenyl-hemoglobin adducts in women report- edly exposed! to ETS. The authors claimed that their data suggest that ETS exposure is related to levels of a: known carcinogen in nonsmokers, as 4-aminobiphenyl ('4-ABP) has been associated with an increased risk of bladder~ cancer in other studies. See issue 44 of this Report. The letters were written by Mark J. Reasor, and by S. Katharine Hammond and severaliof her coauthors, and appear at Journal of thc Nntional'Cancer Institute 85(20): 1693-1696, 1993. In his letter, Reasor states that "investigators fre- quently draw conclusions that are not supported by the data presented in~ their studies or by the scientific literature." He suggests that such conclusions, once they appear in the scientific literature, may be cited as "definitive." Reasor suggests that such an "error of critical appraisal" occurred in the Hammond, eo al., paper. He criticizes the conclusion of Hammond and colleagues for the foll'bwing reasons: that the presence of hemoglobin adducts is an index of exposure whose "relevance to human cancer is far from clear"; that detectable "background" levels of adducts were mea- sured in botli "exposed" and "unexposed" study subjects; that the conclusion of Hammond, et al., suggests a relationship between adduct levels and lung carcinogenicity that is "misleading and without scientific foundation"; and that the small data set involved in the study limits one's ability to draw conclusions from it. In their reply, Hammond, et al., claim that their study "clearNy shows" exposure of nonsmokers to:the carcinogen 4-ABP from ETS, and suggest that a study on ETS exposure and bladder cancer be conducted. The authors also claim that adduct levels can be used to assess cancer risk. They suggest that nonsmokers are exposed~to 1'0-201 percent as much 4-ABP as are

OCTOBER 22, 1993 smokers, an exposure they call' "not insignificant." Hammond, etal.,,also claim that their results are "meaningful" for the evaluation of the suggested ETS- lung cancer relationship, invoking claimed measure- ments of higher concentrations of certain substances in sidestream smoke as comparedito mainstream smoke. II~TIDOOR AIR QUALITY [531 "Windows and Environmental Satisfaction: A Survey Study of an O'ffice Building," M. Boubekri and F. Haghighat, Indoor Environ- ment 2: 164-172, 1993 [See Appendix A] Indoor air qualiry, lighting, and thermal comfort are among the indoor environmental attributes examined in this study. The authors report that occupant satisfac- tion may be related to workers' access to a: given attribute„such as a window. [54] "Acute Pulmonary Function Ilmpairment in School Staff Working in a`Sick Building': A Pilot Study," M. Dahlqvist and R. Alexandersson, Indoor Environment 2: 179-185, 1993 [ISee Appendix A] In this study„ respiratory symptoms and' pulmonary function are examined in 17 workers in a "sick" Swedish~school. The authors report that smallldecreases in~pulmonary function in these individuals are prob- ably related to microbial'growth, associated with the operation of the ventilation system. [551 "Smoking Habits, Atopy, and Prevalence of Sick Building Syndrome Symptoms Among Office Workers in Norway," K. Lenvik, Environment Internaszona119: 333-340, 1993 [See Appendix A] Based on questionnaire responses from approximately 1,300 Norwegian office workers, the author of this paper reports that gender and atopy were statistically significantly related to SBS symptom reporting. The author also indicates that his study does not support claims that ETS is associated with the sick building syndrome. 17 IN EUROPE & AROUND THE WORLD REGULATORY'AND LEGISLATIVE MATTERS HUNGARY [56] Parliament Leaves Smoking Policy Decisions to Employers The Hungarian Parliament has reportedly aecepted a law that allows employers to decide whether to regulate smoking in their individual workplaces. If smoking restrictions are imposed, smoking,areas must be provided. I RELAi+1 D [57] Irish Cancer Society Calls For Smoking Bans Asserting that ETS exposure causes 1501ung cancer deaths a year in Ireland', the Irish Cancer Society is reportedly urging the Irish government to ban smoking in all public places and to introduce legislation aimed at banning smoking in the workplace. The call' for legislation was made at the start of Europe Against Cancer Week, which began October 11, 1993. During the week, Irish antismoking activists were expected to launch a campaign emphasizing the alleged health effects of ETS exposure on children, operate a toll-free heloline to answer questions about ETS exposure, and air a television advertisement about ETS. See The Irish Times, October 12, 1993. > Other actrvrties dwnng Europe Against Caneer Week, Aem 67. MALnYs1A [58], New Bill Would Broaden Smoking Restrictions According to a press report, the Malaysian government will introduce a bill that would ~ require nonsmoking sections in many restaurants and would ban smoking in elevators, hospitals, schools and! taxis. Smoking is already banned in movie theaters, buses and government build- ings, but many Malaysians reportedly ignore the laws. 20247f]i2 ;H,`3

18. Prosecutions under the law, which carries a $1,960 fine or two years in jail, are apparently rare. See The Wall Street Journa4 October 15, 1993; Japan Economic Newswire, October 14, 1993. UNITED KINGDOM [59] Environment Minister Recommends Smoking Bans Lady Denton, the Environment Minister, has report- edly urged pubs, restaurants, cafes and bus and rail waiting rooms to: ban smoking, after the European Commission claimedion October 11, 1993; that ETSS causes 4,000 lung cancer deaths each year in Europe. In connection with Europe Against Cancer Week, October 11-17, the United Kingdom reportedly announced a goal that 80 percent of public placess should' have smoking policies in effect by 1994. See The Daily Telegraph, October 12, 1993; Press Association News. f le, October 11, 1993. > Other activities during Europe Against Cancer Week;,item 67. ETS/IAQ LITIGATION' NOT INVOLVING CIGARETTE MANUFACTURERS AUSTRALIA [60] Burswood Seeks Costs of $250,000 After successfully defending itself against criminal charges relating to its smoking,policy; Burswood' Resort (Management) Ltd. is now seeking $250,000 in costs from the Crown Law Department. The Crown's prosecutor has called the claim phenomenal and unreasonable, but Burswood'said the expenditures were appropriate. See WestAustralian, October 16, 11993: Burswood, a casino, was charged in the case with failing to take effective measures to control levels of ETS at its facility. The claims were dismissed by the court on September 1'7, 1993. Department of Occupa - tional Health and Safety v. Burswood Resorr (Manage- ment) Ltd. (Magistrate's Court, Perth) (decided September 17, 1993). [61] Roundup of Pending Litigation in Australia • Gregory v. StateElectricity Commission of Victoria (Victoria County Cout) (filed February 26, 1993). ETS/IAQ REPORT,,ISSU'E 58' Plaintiff alleges that exposure to ETS in a mess room and in commission vehicles aggravated his asthma. • Kelly v. Handelson's Pty: Ltd.(District Court, New South Wales) (filed Apri127, 1989). Smoker suing for wrongful dismissal over workplace smoking policy dispute. Set for hearing October 27-28, 1993. On October 21„the cout denied a later application by Handelson's to amend its defense to include the "dangers of ETS:" •Mansfield v. H'erald and Weekly Times (Victoria County Court) (filed November 19, 1992): Journali'st claims ETS caused caneer of the vocal chord's. Inter- mittent exposure since 1968 alleged. • McBride v. IPS Friendly Society (Victoria County Court): (filed November 30, 1992). Claim is that ETS, dust and fumes in the workplace caused injuries to chest, lungs and respiratory system. • Renda v. Public Transportation Corporation (Victoria County Coun) (filed November 30, 1992). Bus driver claims ETS at depot caused respiratory tract infections, chronic asthma and breathing difficulties. • Margaret Scobell (workers' compensation claim, New South Wales) and (Supreme Court, New South Wal'es) (1993). Fifry-five-year-old smoker claims workplace ETS aggravated chronic bronchitis. Ten year exposure alleged. Settlemenr offer pending. • Stewart v. The State of Victoria (Victoria County Court) (filed October 30, 1992)'. Court emplbyee alleges ETS caused impaired respiratory function, emphysema and asthma. Exposure allegedly occurred between January 11990 and June 1992. • Tagell v. The Victorian Office of Corrections (Victoria County Court) (filed June 24, 1992). Prison emplbyee alleges ETS aggravated':his asthma and causedidizzy spells, breathlessness, fatigue, stress and anxiety. Exposure since 1983 alleged. • Tracry v. David Syme d' Co: Limiud (Victoria County Court) ~(filed August 16, 1993). Electrician daims ETS caused severe respiratory dysfunction due to aggravation of pre-existing obstructive lung disease and asthma. • Vaiano u Public Transport Co. (Victoria County Court) (filed September 1992). T''hirry-six-year old claims workplace ETS caused throat cancer. Exposure since 1980 alleged.

OCTOBER 22, 1993 • Waters v. Roads Corp: (Victoria County Court) (filed November 1i992). Fifty-two-year-old claims ETS caused acceleration of bronchial asthma and respiratory impairment. Exposure since 1963 alleged. This is the same John Waters who, along with his solicitor Eugene Arocca, instituted a media campaign in mid-October that resulted in the creation of nonsmoking areas in Australian Football League venues. LEGAL ISSUES AND DEVELOPMENTS AUSTRALIA [62]I Asthmatic Threatens Lawsuit and Sports Organizations Issue Smoking Restrictions According to press reports, John Waters, a chronic asthmatic who is a Collingwood fan, threatened to file a multi-million d'ollarlawsuit against the Australian Football'League (AFL) and'the Melbourne Cricket Ground (MCG) for failing to set aside nonsmoking, sections. During the second week of October 1993, Waters' attorneys reportedly sent a.warning letter to the AFL claiming that cigarette fumes in the public stands at the MCG could cause Waters to suffer a life- threatening asthma attack. Allegedly, Waters has been unable to attend games at his team's home ground this season because of alleged risk to his health. He claims that he asked! at the start of the season~ that nonsmoking areas be set up at the MCG so he could attend games, but his request was not honored. In response to the threatened'.lawsuit, the AFL appar- ently announced'that it would segregate smokers and nonsmokers at Waverley Park, while the Collingwood dub has begun to discuss the situation. Meanwhile, Illawarra's two biggest crowd-drawing sporting dubs are reportedly not planning,to stop people smoking on their grounds unless forced by law to do so. Executives of the Steelers and Wolves apparently said they would monitor the threatened legal' action against the AFL dub in Melbourne, but are not considering any policy changes at this time. Also monitoring the situation are sporting officials in Sydney. See Canberra Times, Herald-Sun, and Telegraph-Mirror, October 14, 1993; Illawarra Mercury and Daily Teltgraph Mirror, October 15, 1993. 19 1631 "Tobacco Litigation: Impact and Future Direc- tions," E. Arocca, Journal of Law and'Medreine, October 1993 This artide, written~ by an attorney with plaintiffs' solicitors Maurice Blackburn &' Co:, discusses ETS issues in the context~ of workplace, hospitality industry, prisoner and'child custody litigation. The Scholem case is high- lighted, and the EPA Risk Assessment on ETS is cited and quoted. The author states that he is "confident" the release of the risk assessment "should jolt occupational health and safety authorities into using their existing powers to enforce smoke-free workplaces." According to the author, it is his understanding that ETS litigation may soon be brought in Australia directly against the tobacco industry. "As mentioned,"' he states, "the impetus for passive smoking litigation has been significantly boosted by the report of the United States EPA." The author briefly discusses the AFCO'v. TIA litigation and claims, "The success of Australian plaintiff lawyers in passive smoking litiga- tion has gained world renown." The article concludes by expressing the hope that persistent litigation will have an~impact upon the public and that legislators and the courts willl "take an active role imsaving lives and safeguarding the interests of those parts of the public which remaM uninformed about the dangers and effects of cigarette smoking." CANADA [64] Court Grants Right to Appeal Decision in Challenge to Tobacco Products Control Act The Supreme Court of Canada has reportedly granted Imperial Tobacco Ltd. and RJR MacDonald Inc. the right to appeal: a lower court decision whicL upheld'the validity of the country's Tobacco Products. Control Act. For further details about the litigation, see issue 57 of this Report, Octooer; 8, 1993. The Act, inn addition to banning tobacco advertising, would require package warnings about ETS. The court is reportedly ~ expected to rule by the end of November 1993 N whether the tobacco companies must comply with the ~ ~ new law while their appeal is pending. See Canadian Press Newswire, October 14, 1993;' The Globe and r~ Mai4 October 15, 1993..

20 OT HER DEVELOPMENTS AUSTRALIA [65] Poll Gauges Tolerance of Indoor Smoking A recent Saulwick Age Poll reportedly shows that Australians are still "largely tolerant" of smoking, with the majority allowing people to smoke in their homes. Ap- proximately 83 percent said smokers should ask permission before smoking. See Sydney Morning Herald' October 9, 1993. [661 AMA President Supports Claim About ETS and Child Abuse According to a press report, the president of the Austra- lian Medical Associations Dr. Brendan Nelson, has welcomed statements made during a conference on asthma that exposing children to ETS can be considered a form of childabuse. SeeHobanMercury; October: 12; 1993. EUROPEAN COMh+IUNITY [67]' Europe Against Cancer Week October 11-17 During Europe Against CancerWeek, events took place throughout the continent to increase social awareness of the alleged'.healthI effects of ETS exposure. A major conference launched the week, offeringdelegates the opportunity to explore the issues and launch ASH's Breathing Space Campaign. A leaflet titled "No More Smoke Between Us," produced by the European Cancer Leagues„was distributed to:the public. A press briefing also took place;,guest speakers included David Pollbck, director of ASH, and Martin Jarvis, principal scientist of the Health Behaviour Uhit at the Imperial Cancer Research Fund. Pollock urged "passive smokers" to become "less passive." He stated' that "we want non-smokers to become more militant." See Press Association Newsfile, October 11', 1993; The Guardian, October 12, 1993. UNITED KINGDOMI [68] Survey Gauges Popularity of Nonsmoking Areas According to a newspaper article, 95 percent of Britons responding to a recent government survey said they believed nonsmoking areas should be provide& in eating places. Sixty-six percent said they would favor nonsmok- ETS/IAQ REPORT, ISSUE 58 ing areas in pubs. The survey was commissioned by the Department of the Environment. At present, approximately one-third of the restau- rants, bars and other public places in Britain reportedly do not have designated areas for nonsmokingers. See United Press Internationa4 October 11, 1993. WORLD AIRLII*IE NEWS [69] British Airways, Qantas and Singapore Airlines Announce Smoking Bans for International Flights On January 1, 1994, British Airways will commence a three-month trial smoking ban on all flights between Britain and'Australia/Niew Zealandi and Qantas Air.vays will do the same on one flight a day between Sydney and London. Some flights between Britain and Australia are said to last for up to 24 hours. Meanwhile, Singapore Airlines has announced that it wilt permanently prohibit smoking on flights to Australia and the Indian sub-continent beginning December 1, bringing the airline's nonsmoking services to about 70 percent of totall flights. British Ainvays attributed its trial ban to declining demand for smoking seats. The ban will become perma- nent if passenger response supports it, according to a company spokesman. The airline alteadyprohibits smoking on selected flights to and from California and Hong Kong and on all European flights of less than 90! minutes. In addition to the announcement concerning its London route, Qantas said it will begin prohibiting smoking on various flights from between Australian capital cities and Singapore. In all, Qantas reportedly is increasing its nonsmoking internationalI services by 72 flights a week. See Sacramento Bee, October 10i,1993; The Straits Times; October 11, 1993; Press Association Newsle and! The Reuter Library Report,, October 15, 1993; and Age and Xinfiua General News Service„ October 16 1993. Otherr airlines with smoking bans on international flights include Cathay Pacific, Air Canada and China Airlines. The International Civil Aviation Organisation has set a target of 1996 for a worldwide smoking ban on international! flights. See issue 32 of this Report, October 9, 1992.

OCTOBER 22, 1993 MEDIA COVERAGE JAPAN [70] "Japan Aiming to Relinquish Smoking Title," The Nikkei Weekly, September 27, 1993 While the Japanese continue to be "the world's heaviest smokers," antismoking activism "has been gainingmomentum recently," according to this article. Many Japanese companies reportedly are establishing designated smoking zones, and the article predicts that train stations in all major Japanese cities should be smokefree "some day soon." The article also briefly discusses antismoking activity in the Uhited States and! France. The anicle asserts that the Japanese, on~a per-capita basis, smoke 2,510 cigarettes a year„comparedlwith 2,200 for South Koreans, 2,100 ~ for Americans, 1,700 for the French, and 1,200 for the British. UNITED~ KINGDOMi [71] "Gasping for Breath; Are Exhaust Fumes Suffocating our Children?" The Independent, October 10, 1993 The author reports that "tick by tick, the evidence is accumulating from little-noticed scientific studies all over the world that one of the main factors behind the epidemic is the growth in the use of private cars." Appar- ently, 4,000 of the world's top chest physicians met in Florence this month and concluded that "air pollution from car exhausts at least exacerbates asthma." The author also reports that "there are several suspect triggers in the modern lifestyle" and that "passive smok- ing is perhaps the best established." However, Dr. Mart}n Partridge, chief medical adviser to the National Asthma Campaign is quotedas stating that "if you stopped all smoking, this would have a relatively small effect on the disease. Something - or some things - even bigger is to blame." 21 Ozone and nitrogen dioxide are the alleged culprits in car exhaust, and Professor Robert Davies of St Bartholomew's Hospital reports that the "evidence has built up so strongly over the past few months that 'there is now no doubt that air pollution exacerbates asthma.'"

OCTOBER 22, 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. LUNG CANCER [44] "Occupational Risk Factors for Lung Cancer Among Nonsmoking Women: A Case-Control Study in Missouri (.United States)," R.C. Brownson, M.C.R. Alavanja, and J.C. Chang, Cancer Causes and Control4: 449-454, 1993 "We recently conducted a large case-control study among nonsmoking women in Missouri. Since the study included information on occupationall risk factors, we were able to evaluate lung cancer risk in nonsmokers in relation to specific occupational pursuits and exposures." "For subjects who screened eligible and agreed to the full interview, the telephone-administered question- naire consistediof sections on residential history, passive smoke exposure, personal health history; family health history, and reproductive history." "Following the telephone interview, a second ques tionnaire on dietary and occupational factors was provided to each subject when study staff visited the subject's home to place radon detectors for another phase of the study." "We initially examined numerous potential con- founding factors. Results presented are adjusted for those factors that appeared'to confound the occupa- tional associations (i.e., age, active smoking [for exsmokers]„and history of previous lung diseases)." "Slight elevations in risk were noted for several job categories including shoemaking, shipbuilding,, foundry work,, rubber industry, housing construction, and beautician. Work in the dry cleaning business showed excess risk for all subjects (OR = 1.8) and for lifetime nonsmokers (OR = 2.1):° "Several specific exposures in the workplace resulted in elevated risk of lung cancer among nonsmokers. Increased risks were observed for asbestos exposure (OR' = 3.5, CI = 1.2-10.0) and for pesticide exposure (OR = 2.4, CI = 1.1-5.G)."' A-1 "Our study of nonsmoking women confirmed certain occupational associations that have been identified in predominantly male- and smoking-series of lhng cancer cases." "[R]isk due to asbestos exposure was much larger among ex-smokers (even 15 or more years after cessation) than among life-time nonsmokers." "Our study also indicated elevated risk of lung cancer among nonsmokers who were occupationally exposed to pesticides." "Our study has several major strengths. These include the large sample size - one of the largest series of nonsmoking,lung-cancer cases to date. In addition, we conducted a pathology review of cases."' "In summary, this study id'entified'several occupa- tional associations for lung-cancer among nonsmoking women that merit further study. Currently, the study is being expanded to include more former and current smokers as well as nonsmokers. This expansion may shed further light omthese and other occupational associations." [45] "Towards Truth, Through Falsification," A. Flew, Indoor Environment 2: 125-128, 1993 "Only when and' in as much as hypotheses have survived and continue to survive such criticismy remaining still unfalsified, do we become rationally entitled to feel confident that, even~ if these have nott yet reached the final truth„then they do at least constitute the nearest approaches presently available." "In contrasting science with~ politics we have to recognize and~to remember that there is not always and everywhere a sharp, clear line separating detached and neutral, scientists from invoHved and committed lobbyists." "Readers of Indoor Environment will no doubt be only too aware that in this and other countries various authorities which, ought to know better have been and still are proclaiming in the name of science, and offering as the bases of public policy, much, of what by these criteria is not truly scientific. Take, for instance, the question of the harmfulness or otherwise of environmental tobacco smoke (ETS). All persons and organizations campaigning against smoking have a compelling reason for wanting to establish that ETS is.

A-2 harmful; and the more extensive and substantial that harm the better. For this is precisely the discovery whic6 they need iM order to undermine principled libertarian ~ opposition to the introduction of laws against smoking andJor restrictions upon the produc- tion and sale of tobacco products." "The motive here, and the consequent temptations to error, may well be ideally disinterested and benevolent - a desire to prevent people suffering and dying from smoking related diseases. These temptations are never- theless temptations to commicwhat should be seen as serious scientific offences. Many of those who ought to have known and done better have in fact succumbed." "Thus in Australia in 1986 the National H'eal'th and Medical Research Council concluded - on~ the basis primarily if not exclhsively of 19811 studies by Hirayama and by Trichopolous [sic] et al. - that the case against 'passive smoking' was 'strongly suggestive',,even `compelling': But the Council quoted'only the original and incorrect calculations of risk ratios from Trichopolous, making no mention of his acceptance of Heller's systematic recalculations. And', about errors in Hirayama's paper, it, saidl nothing whatever." "In the same year, the Surgeon Generallof the United! States, in a report on The Health Consequences of Involuntary Smoking, gave the corrected values butt attributed! them to 'Trichopolous et al., 1983', where they do not appear, rather than to Heller, who is not so much, as mentioned. In discussing Hirayama, the Surgeon Generall similarly neglected to mention the monumental miscalculations which were pointed out by Lee and later admitted by Hirayama himself. On the contrary: for the Surgeon General's response to Lee"s criticism was apparently to maintain that 'the calcula- tions were later confirmed'." "[;1Xf]here.as we can take it as established that active . smoking is one of the possible causes of lung cancer, as well~as of some other afflictions, the conclusion of the latest and most comprehensive critical survey of the research findings on ETS is 'that the epidemiological evidence has not convincingly demonstrated that ETS increases the risk of mortality'." "The overriding aim of all scientific inquiry is to discover both what the facts truly are and the true reasons why they are what they are. Both because there are so many possible interests and inclinations tempting ETSIL,Q REPORT, ISSUE 58 and misleading people to adopt and defend beliefs which, although~congenial to them, are not in fact true, and because even the most dedicated and' disinterested investigators are still liable to make mistakes, it be- comes exceedingly difficult to ensure that what we have got is indeed the truth. Yet to the extent that we really are sincerely devoted to the discovery an& assertion of truth, we cannot accommodate any substitutes, however seductively appealing. Why criticism is needed in the present context, and what it is for, is to detect such substitutes and, consequently, to reject them." OTHER HEALTH ISSUES [48]1 "Risks for Premature Rupture of Amniotic Membranes," E.E. Ekwo,,C.A. Gosselink, R. Woolson, and A. Moawad, IMrernarional Jourrral of Eprdemiologv22(3): 495-503, 1993 "The objective of this study was to test the hypothesis that diverse risk variables including infections during the index pregnancy independently increase the risk of preterm premature rupture of amniotic membranes (PROM) and preterm delivery without PROM. A case-control design was used to study women 15-45 years oldl who had preterm PROM„ full-term PROM or preterm without PROM and were singly matched by age race and'pariry to controls who deli'vered full- term infants." "Univariate conditional logistic regressiom analysi's indicated that odds for preterm PROM delivery were 9.0 (CI: 2.09-38.8) times that for controls for women with intra-amniotic infection. Likewise, the odds for preterm PROM birth were all significantly increased among women with cervical gonococcus, urinary tract,, and cervical'chlamydia infections during the index pregnanry." "Other potential risk factors for pregnancy outcomes were next examined univariately.... The odds of preterm~RROM birth were 4.2 times that of controls among women living in households where she alone smoked cigarettes and'was 2.1 times higher if she resided in~households where she and other household members smoked. The risk of exposure to passive cigarette smoke did not differ significantly from that of their controls. Vaginal' bleeding during index preg- nancy also proved to be an important risk factor."

OCTOBER' 22, 1993 "Analysis showed the odds for preterm delivery without PROM increased three-fold that of controls among women with previous preterm birth and 1.8 times among those with previous cervical surgery. Their odds were increased 1.9 times that for controls among those with household exposure to passive smoking by other family members and 2.5 times among those living in households where they anA others smoked." "Whether passive exposure to cigarette smoke in- creases the risk for preterm delivery with or without PROM is still uncertain. Our data did not demonstrate an additive effect of passive and active smoke exposure. Further studies using quantitative methods for deter- mining passive exposure are needed." [49] "Cigarette Smoking and Sudden Infant Death Syndrome: Some Salient Points in the Debate," B. Haglund, Acta Paediatrica Suppl. 389: 37-39, 1993 "The overall impression given by the available literature is that maternal cigarette smoking is associ- ated with SIDS with ORs ranging between 1.5 and' 5." "It is a well known fact that smokers differ from non- smokers in many ways.... A competing,hypothesis for the smoking effect is thus that if we could controli for such behavioral characteristics in the analysis the effect of smoking would be reduced." "Although it appears to be most likely that maternal'! smoking is not a confounding factor, it is important tol be aware of different possible interpretations of the associations betweenlSIDS and smoking as long as the causal pathway remains unknown." "In most of the literature, maternal smoking is discusse& only as a gestation-related factor to SIDS. However, some attempts have been made to differenti- ate between prenatal and postnatal exposure to smok- ing. The smoking habits of fathers have been used as an indicator of passive smoking by the infant. The results are contradictory: McGlashan reports a signifi- cant relative risk (RR = 1.7) as well as a dose-response effect if the fathers smoke, while Lewak etl al. and Bergman & Wiesner found no association between smoking by the father and SIDS. AS the correlation between the smoking habits of mothers and fathers is likely to be rather high, the conflicting,results could, to A-3 some extent at least, be due to different methods. Better data and further analyses are needed in order to make it possible to differentiate between the effects of prenatal and postnatal exposure to smoking.° "Maternal smoking is one of the most important prevent- able risk factors for SIDS. The causal pathway is admit- tedly unclear, but the available literature shows unequivo- cally that SIDS is associated with smoking. Further epidemiologic research on the role of passive smoking and the separate effects in different subpopulations may result in new hypotheses on the etiology of SIDS." [50]I "Breast-Feeding and Maternal Smoking in the Etiology of Crohn's Disease and Ulcerative Colitis in Childhood," A. Rigas, B. Rigas, M. Glassman, Y.-Y. Yen, S.J. Lan, E. Petridou, C.-C. Hsieh, and D. Trichopoulos, Annals ofEpiderni- ology 3: 387-392, 1993 "Crohn's disease and ulcerative colitis are the two most common inflammatory bowel diseases; In spite of extensive overlap in their symptomatology, the two conditions appear to represent distinct pathologic and perhaps etiologic entities." "We have undertaken a medical records-based; case- control study of Crohn's disease and ulcerative colitis in children andladolescents up to 17 years old, to examine the role of maternall smoking,and breast-feeding in the occurrence of these diseases. Childhood inflammatory bowelldisease is likely to be more strongly related to these factors than adult disease, and the respective exposure information may also be more reliable, since ohe intervening,period is relatively short." "Among mothers of patients for whoml maternal smoking information was available, the proportion of smokers was 1 ll (24%) of 45 for the Crohn's disease group, 5 (26%) of 19 for the ulcerative colitis group, and 15 (20%) of 74 for controli patients." "With respect to Crohn's disease ... only breast- feeding has a dose-dependent statistically significant negative association that could be interpreted as reflect- ing a protective effect of breast-feeding on, Crohn's disease risk. Birth order and maternal age at birth were not significantly or suggestively related to Crohn's disease. The multiple logistic regression-derived relative risk (RR) with respect to maternal smoking was 0.8 with a 95% confidence interval (CI) of 0.3 to 2.5."

A-4: "With respect to ulcerative colitis ... again only breast-feeding appears to have a dose-dependent negative association that borders to nominal statistical significance. Birth order and maternal age at birth were not significantly or suggestively related to ulcerative colitis and the logistic regression-derived RR for maternal smoking was 1.4 (CI: 0.4 to 5.1)." "The results of this study are essentia111y 'negative' with regard to birth order, maternal age at birth, birthdate seasonality, and! maternal~ smoking, but they indicate that breast,feeding is inversely associated with both Crohn's disease and ulcerative colitis, with an~ overall RR of about 0.5 and duration-dependent trends in both instances. However, since inflammatory bowel diseases are rare in children, firm conclusions can only be drawn by pooling series of published studies." "Two recent studies explored'the effect of environ- mental tobacco smoke during childhood on the risk of inflammatory bowel disease. Persson and coauthors reportedlthat the RR of Crohn's disease among those exposed to environmental tobacco smoke during childhood was 1.5 (CI: 1i.01to 2.3) while the corre- sponding RR for ulcerative colitis was 0.98 (Ch• 0.6 to 1.5). Sandler and coworkers found that the RR of ulcerative colitis among persons exposed to environ- mentalltobacco smoke during childhood was 0:501(CI:: 0:25 to 1.00), whereas it was 0! 53 (CI:, 0.24 to 1.14) among active smokers." "Our results do not support a: role of exposure to environmental tobacco smoke during childhood on the occurrence of either ulcerative colitis or Crohn's disease among children and~ adolescents. In fact the RR point estimates for [maternal] smoking were below I for Crohn's disease and above 1 for ulcerative colitis. Al- though the confidence intervals in the present study are reNatively broad and the large number of unknown values with respect to maternal smoking justifies some concern about the validity of the corresponding estimates, it may be worth noting that our findings are in agreement with epidemiologic expectations. A demonstrable effect of passive smoking is biologically more plausible when the corresponding RR for active smoking is in the order of 10 and less plausible when the corresponding RR is in the twofold to threefold range." ETS/IAQ REPORT, ISSUE 58 ETS ExPOSUIiEE AND MON.TOPJNG [51] "Tobacco Smoke in Shopping Malls and Restau- rants," G: Lofroth, lndoor Environment 2: 173- 178; 1993 "The present study deals with the contribution from~ tobacco smoking in some public places. Measurements were made with respect to nicotine, whick is an indicator for tobacco smoke, and'e the mutagenic response of the organic extract of particulate matter, which is widely used for the characterization of com- bustion~emissions. The investigation covers a compari- son between two shopping malls with different smok- ing policies, a lunch restaurant with both a smoking and a nonsmoking section and some other restaurants and public places without any particular smoking policies." "Both~the shopping malls studied ha& tobacco smoke in the air as shown by the presence of nicotine. The mutagenic activity of the airborne particulate matter was in both~malls higher than the activity of outdoor ambient air showing that tobacco smoke contributed to this type of air pollution.... ln a general compari- son, the nonsmoking,mall had less tobacco smoke in the air than the smoking mall showing that smoking restriction decreases the contribution to air pollution from this source." "Carbon dioxid'e measurements ... showed~ that the concentrations were 600-800 ppm indicating,that the malls were reasonably well ventilated."' "The special study on the nicotine concentrations in the pedestrian area, inside a shop and in an, office in the rear end of the shop showed a clear decreasing gradient from the street to the shop to the office. This strongly implicates street air as the origin of the tobacco smoke measured as nicotine:... Following these studies, ic has been announced that smoking,will be prohibited in the pedestrian areas as of the begin- ning of 1993 with reference having been made to opinion polls showing that about 80% of the visitors wanted a smoke-free mall." "The restaurano with a large smoking section and a smaller nonsmoking section had tobacco smoke in both sections. This can be explained by the fact that ventilation air entering the building through doors, l~

OCTOBER 22, 11993 window slits and other openings is removed by an exhaust fan located in the middle of the nonsmoking section; air is thus drawn from the smoking section into the nonsmoking section before it eventually is exhausted at the roof level." "Subsequent measurements of carbon, dioxide in the restaurant have shown concentrations of 1,200-1,800 ppm which indicate that the ventilation rate is inad equate." "This study shows that passive exposure to tobacco smoke can occur to a variable extent in a variety of places. Tobacco smoke can also be encountered in situations where tobacco smoke is not expected to be present, as exemplified with a shopping mall advertised to be a: nonsmoking mall and; with a nonsmoking section in a restaurant. The shopping malls have return~ air ventilation systems, and this probably [aggravates] the tobacco smoke contribution, as has been found in an earlier study of office buildings." INDOOR AIR QUALI1l'' [53] "Windows and Environmental Satisfaction: A Survey Study of an Office Building," M. Boubekri and F. Haghighat, Indoor Environ- ment 2: 164-172, 1993 "There are many factors that contribute to environ- mentallquality. A simplistic approach to achieve environmental comfort would be to optimize all the attributes, which could be achieved only if cost is of no bearing on design decisions. As this is generally not the case, there is a need: to know which factors are consid- ered important by the occupant with respect to comfort and satisfaction in the workplace."' "[O]ur objectives in this study were the following: (1)~to examine office workers' perception of the impor, tance of workplace attributes and the impact of the nearness of windows to workers on sucli perception; (2) to explore the relationship between the perception of the importance of workplace attributes and! workers' satisfaction with them and whether the nearness of windows has any bearing on this relationship; an& (3) to determine if some workplace attributes are more susceptible to affect general environmental satisfaction than others and whether the nearness of windows has any effect." A-5 "In examining the relationship between the percep- tion of the importance of the seven attributes and satisfaction with thems it appeared that the importance of a workplace environmental attribute to a worker was related to how much they have of that particular attribute....[T]he importance of windows was much greater for~ those who did not have them immediately adjacent to their workstations. The relationship between the perceived importance and possession of'an attribute at a workstation tend'ed to be negative, but only when the attribute was not available to the worker. Conversely, the imponance of an attribute diminishes for those who possess it." "As to the third objective of this study,, tests of correlation between individ'ua] satisfaction with each attribute and general satisfaction with their workplace environment, the only difference concerned attributes possessed differently by the two groups, namely view and lighting. These two attributes affected overall environmentalisatisfaction in the group deprived of windows. Indoor air quality and privacy were the two factors commonly namedl by the two groups and which had a strong impact on general satisfaction." "In general„the importance of a workplace attribute and worker satisfaction depended largely on the location of the workers' workstation in relation to a window, and thus onwhatthe worker has or does not have....[A]n attribute considered important by one group of workers may not be as important to the other."' "For, the researcher ... there is an need to be aware that potential differences between groups within the entire sample could significantly affect the outcome of the analysis. With such knowledge, the researcher or evaluator can and should design the . . . questionnaire accordingly. As demonstrated by this study, such groups could be characterized by the nearness of workstations to windows or perhaps by other character- istics such as age or gender." [54] "Acute Pulmonary Function Impairment in School Staff Working in a`Sick Building': A Pilot Study," M. Dahlqvist and R. ~ Alexandersson, Indoor Environment 2: 179-185, ~ 1993 "This study was initiated because occupants in a school had' increasingly sought medical attention for airway symptoms compatible with the sick building syndrome. The purpose of this pilot study was to ,~ w N

A-6 examine any possible acute effects on pulmonary function during a working week." "In the present paper, respiratory symptoms and pulmonary function in 17 subjects in a Swedish school' with mechanical ventilation have been determined before and after a working week once ca& in winter and summer and once again in winter 1 year later.... [T]he dominating symptoms were irritated mucous membranes (eyes, nose and throat); headache and/or sleepiness. Thirteen out of 15 subjects exhibited a fall in forced vital capacity during a working week when examined in wintertime. This decrease was found' among nonsmokers as well as smokers. Pulmonary function was unaltered during a working week in summertime.... Symptoms from lower airways were related to the pulmonary function impairmenr."' "In the present study, reductions in FVC were found in school staff during a working week on 2 winter occasions. The prevalence of symptoms from~mucous membranes and other subjective symptoms were also observed and almost unaltered on the 2 occasions. The affected building was relatively newly built and, since the opening of the facillry,,various occupants had reported symptoms compatible with the sick building, syndrome." "Deficient ventilation has been claimed to cause a higher prevalence of these nonspecif c symptoms. Repeated checks of the ventilation in the building had' resulted, however, in measurements of the airflows in~ accordance with the planned constructed values. Furthermore, the ventilation system was carefully inspected at the time of the study, and! no growth of moldi was visible in the ducts and! filters. Although the odor on the ground floor was the most unpleasant one, the concentrations of viable airborne moU spores did not, differ between the three Eloors.... However, a high ventilation rate may not always solve the problem with sick building syndrome, which, is why the acute transient decrease in pulmonary function on, the 2 winter occasions therefore is suggested to depend on the ventilation system being in an operating mode. This is further supported by the findings that the studied group had less complaints and no pulmonary function impediment during a working week when the ventilation system was shut off on the study occasion 2 months after measurement 1." ETS/IAQ REPORT„ISSUE 58 "Since the measurements of mold~ in this study were not carried out with personal sampling; a possible relation between the acute pulmonary function deterioration and mold concentration could not be evaluated': However, stationary sampling disdosed growth of mold on all three floors in the studied building at concentration levels of 332-453 cfuW, which is higher than the approximate normal limit for mold spores of 174 cfu/m'." "Although the acute restrictive pulmonary function impairment in the present study may not indicate any marked limitation of the physical work capacity in the daily life of the subjects, theprognosti:c significance of these small changes in pulmonary function requires a! longitudinal study with a follow-up time of more than 1 year." "In conclusion, this study on occupants in a: facility built on a damp bedding has shown acute transient pulmonaryfunction deterioration. The findings are probably caused by the moist environment with a growth of microorganisms or other unmeasured expo- sures, quantitatively related to the microorganisms, and this seems to be associated to the microorganisms, and this seems to be associated with the ventilation system being,in an operating mode, since there were no find- ings during warmer weather conditions when the ventilation system was shut off." [55] "Smoking Habits, Atopy, and Prevalence of Sick Building Syndrome Symptoms Among Office Workers in Norway," K. Lenvik, Environment International'19: 333-340, 1993 "Further studies are needed in order to assess the influence of personal factors on the prevalence of SBS symptoms. This paper deals with the relationships between~the personal factors sex, sensitivity of the individual, smoking habits, and prevalence of SBS symptoms. This analysis is part of ongoing investiga- tions regarding,possible relationships between occupa- tional, environmental and personal factors, and the prevalence of SBS symptoms." "Employees in ten private and public nonindustrial buildings were asked about their working situation and about 'sick building syndrome' symptoms by question- ~ naires.

OCTOBER 22, 1993 "The study was conducted at the request of the health personnel in the buildings. Thus, the buildings were already suspected of being `sick'." "Information was asked for on 223 items. This paper deals with the items reltvant to the specific problem discussed. Information was requested nor only on typical SBS symptoms, but also on colds and sinus trouble." "[T]he prevalence of symptoms shows that sex significantly influences the reporting,of symptoms. In both sexes, the prevalence of symptoms is higher among atopic individuals than among nonatopics." "For most of the symptoms, sex also correlated to the reported prevalence. Sex was the best explanatory variable for the general symptoms headache (OR = 3.00) and heavy head' (OR = 3.50) and for the symp- toms dry hands (OR = 6.28), dry face (OR' = 5.10); and itching face (OR = 3.84)'. For the following symptoms, statisticall'y significant correlations were found only to aropy; sinus trouble (OR = 3.98), cold (OR = 2.39), poor concentration (OR = 1.83), stuffy nose (OR = 4.07) and dizziness (2.71). Since skin diseases are common symptoms in atopy, it is not surprising that these are strongly relate& to atopy (OR = 3.05).... There was no significant correlation between any of the symptoms and smoking alone. Itching of the eyes was strongly dependent upon an interaction between atopy and smoking.. When con- trolled~ for atopy, there was a significant correlation between eye problems and smoking habits among the atopics (OR = 1.76)s while sex was found to be the best explanatory variable (OR = 2.41) among the nonatopics." "The highest prevalence of atopy was found among, exsmokers. The lowest prevalence was found among individuals who have never smoked. Since atopics are more susceptible to SBS symptoms than nonatopics, this shows that nonsmokers consists [sic] of two groups which are diametrically opposed to each other regard- ing sensitivity to SBS symptoms." "To conclude, among the nonatopics, no differences were found in the prevalence of the various symptoms among smokers as compared with nonsmokers. Among atopics, the prevalence of the symptoms was higher among the smokers than among the nonsmokers, A-7 although the difference was not staristically signifi- ~ cant. "Some reports indicate that SBS is correlated to passive smoking rather than personal smoking habits. This study d'oes not show such an association. Smoking, in areas where several people congregate, including indoor working,areas, was prohibited in~ Norway by law in 1988. In principle, no smoking and no exposure to ETS should occur in working areas. However, 32.2% of the females and 36.3% of the males reported that tobacco smoking takes place in their own office, and about 11.8% of males and 13.2% of females reported discomfort from tobacco smoke. Even if tobacco smoking,does occur, it may not be heavy enough to cause obvious problems."

OCTOBER 22„ 1993 B-11 APPENDIX B UPCOMING SCIENTIFIC MEETINGS • October 30-November 2, 1993 IAQ'94: Engineering Indoor Environments, ASHRAE and other sponsors, St. Louis, Missouri [In This Issue] • December 16-17; 1993 The National Environmental Tobacco Smoke Conference: Public Battles, Private Choices, IAQ Publications, Washington, D.C. [Issue 55, Item 34] • November 7-10, 1993 Indoor Air Quality '93: Operating and Maintain- ing Buildings for Health, Comfort and Productiv- ity, ASHRAE, Philadelphia, Pennsylvania [Issue 49;. Item 34] • November 11-13, 1993 Contemporary Concepts of Indoor Air Quality, Hacettepe University, Ankara, Turkey [Issue 49, Item 36] • December 15, 1993 Indoor Air Qualiry: An Overview for People Who Need to Know, AIHHM, San Antonio, Texas [Issue 57, Item 35]I Same program to be hel& March 4, 1994, Orlando, Florida; April 13, 1994, Minneapolis, Minnesota; May 5, 1994, Chicago, Illinois; June 17, 1994„Oklahoma.Ciry,,Oklahoma; July 14, 1994, Anchorage, Alaska • March 28-31, 1994 Eleventh ORNL Life Sciences Symposium, Indoor Air and Human Health Revisited (Bringing Se- lectedAdvances in Medical Science to the Indoor Air Quality Community), Knoxville, Tennessee [In This Issue] • May 5-7, 1994 Second Annual IAQ Conference and Exposition, NCIAQ, Tampa, Florida [Issue 49, Item 35] • May 22, 1994 Indoor Air Quality Symposium, American Indus- trial Hygiene Conference and Exposition, Anaheimi„ California [Issue 57; Item 34]I • October 18-20, 1994 Indoor Air Quality in Asia, Beijing, China [Issue 54, Item 42] I

ACTION ON SMOKING AND HEALTH 2013 H St., N.W. • Washington D.C. 20006 •(202) 658-431D Dear ASH Supporter: Now YOU, can help ASH fight, to eliminate smoking ini the workplace and at the same time help all nonsmokers! Several federal health agencies have conclusively determined that separate smoking sections do not provide adequate protections especially in resfiaurants where the smoke drifts into-t'he no-smoking section. So ASH stepped up the pressure on the Occupational Safety and Health Administration, (OSHA) with its latest legal petition filed July, 12„ 1993. We now have four proceedings (including a suit in the U.S. Court of Appeals) against OSH'A,,seeking to force the agency to protect workers and those whoi frequent workplaces by issuing an, across-the-board rule banning workplace smoking. BUT YOUR HEALTH CAN'T WAIT! SO WE'RE URGING THAT WORKERS EXPOSED TO SMOKE ACT NOW TO PROTECT' THEMSELVES, WITHOUT HAVING TO WAIT FOR A RULING ON ASH'S LAWSUIT. To help ASH, simply file an easy 2=page complaint with OSHA. The form is enclosed, and the complaint can be filed anonymouslc!! (Be sure to read the instructions careful,ly before you~ file.). And' even if YOU'RE not exposed to tobacco smoke where YOU work, encouraging people you know who do work in offices, restaurants, airplanes, retail stores and': even malls to file OSHA complaints can help clean the air YOU are forced to breathe. ASH IS UNDERTAJ:ING A MAJOR NEL'',' OFFENSIVE TO PROTECT NONSMOKERS BY HELPING THEM FILE OSHA COMPLAINTS: Our hope is that this new project will final'ly force OSHA to address the smoking issue. 'Ale also believe it wil] help prompt OSHA to issue an across-the-board rule banning smoking, rather than trying to deal with each individual complaint. TO HELP COORDINATE THE OFFENSIVE AGAINST OSHA,,ASH HAS HAD TO HIRE A NL'WATTORNEI` AND A NEVG' LEGAL SECRETARY. However, we believe this substantial increase in cost is warranted by the real chance of achieving a total victory for all nonsmokers - a complete ban on all workplace smokin+!~ That's why I'm writing to ask vou to do TV1'O things: 1. file a complaint with OSHA if your workplace is not smokefree„ or help persuade at least one person you know to do so; 2. make an extra contribution of 540, S30 or whatever you can afford to help ASH meet these sub- stantially increase& expenses. ISSUE 58'* APPENDIX C LEGAL ACTION'AND EDUCATION ON THE HAZARDS OF SMOKlNA • PRf1TF(:TIN(: TNF RIRMTG OF THF N(1NCGA(YK1Nf: uA.l(1RITV

Taking on a major federal agency AND the mighty tobacco industry is no small task, but ASH's track record proves it can handle the challenge:  ASH: used legal action to force the FCC to make broadcasters provide free time for antismoking messages - this led directly, to the ban on ciCarette cotnmercials.  ASH used legal action to make the CAB issue airplane smoking rules - which led to the smoking ban on~ domestic flights.  And ASH successfully use& legal action to get the ICC to require interstate buses to ban smokin . All of these - and the manyv other ASH victories - were possible only because of the suBporn of concerned citizens like you. This time the tobacco industry is hoping you won't care enough to back the fight to protect YOUR rights and YOUR health; Then they can use their stranglehold on OSHA to prevent it from acting. This despite overwhelming evidence that workplace smoking kills tens of thousands of people each year - evidence the industry is trying desperately to~ discredit. ASH is fighting and winning for you, but we urgentlyy need your help. Please consider filing a - complaint or persuading a worker you know to file one. And please send us your contribution nov%, $40 will go a long way in our vitali life-saving work. Show that you care enough about your health, and the health of your loved ones, to support ASH's fight on YOUR behalf. Coordinating the filing of hundreds of different complaints willi be both challenging and time- consuming; particularly since the forms must be filed with dozens of individual offices at many different locations. Indeedy under federal law, some must even be filed with state agencies which act in conjunction with OSHA. ASH IS READY TO UNDERTAKE THIS DAUNTING TASK - THIS MAJOR ESCALATlOti OF THE BATTLE FOR YOUR RIGHTS AND YOUR HEALTH - IF YOU~ ARE PREPARED TO SUPPORT US. Please don't wait. The quicker we receive your complaint form~ and your contribution,, the more quickly we can move forward to help protect you~ ind'ividually, as well as all nonsmokers generally.: Your comolaint formi must be received at ASH by December 1, 1993 in order for us to process and mail it. Sincerely; n F. Banzhaf III Executive Director P:S.: By completing and mailing the encl'osed OSHA complaint along with your check for S40 to help cover the costs of this major new program, you can help limit smoking in your workplace, and' in all the restaurants, stores, and other people's workplaces you visit. PLEASE ACT NOW: ASH m ust, receive vour complaint by December 1. 2()24'702i9'.7 ~....e .~ ..e.w. rw

Nbtice of Alleged Safety or Health Hazards U.S. Department of Labor Occupationai Satety ano healtn Aosn,nstrat.on MOD Date 1 . Employer Name 3. Site Location ~(Sveet, Cny. Szate. ZI P) 4. Maihnp Address (/I ditlereru) (Street, CAy, State, , ZIP) , 1. Cornpla na Numoer' 5. Manapemern OHicial 6. Telephone Number 7. Type ot Business * 8. Hazard Descripoon. Describe briefly the hazard(s) which you believe exist. IhGude the approximate number ot employees exposed1o or threatened by each hazard: This constitutes a"formal complaint' as that term is defined by OSHA.1 By, law•, all complaints meeting the requirements for a formal complaint must be investigated? This formal complaint is brought under and pursuant to the 'general duty dhuse' of the OSH Aa3 which requires that 'each employer shall4urnish to each,of his employees employment and a place of employment which are free from recognized hazards that arc causing or aro likely to cause death or serious physical harm to his employees..' Complainant alleges he or she is being exposed; in violation to the general duty alause of the OSH Aa„to levels of chemical},-knowm as secondhand tobacco smoke or Environmental Tobacco Smoke (ETS)ifound by the Environmental Protection Agenq• (EPA), National Institute for Occupational Safety and Health (N`1OSH)l U.S. Public Health Service (USPHS), National Research Council of the Nitional'iAcademyy of Sciences„National Cancer lnstitute, Ihternational Agency for Cancer Research (IACR), World Health Organiiation (1,%7HO), American Medical Assoeiation, Amerinn Cancer Society, and the American iLung Association to cause lung cancec (and'deaths from lung cancer), as well as numerous other health hazards„even in otherwise healthy adults - and thus is likel~- to eause death or serious physical harm to employees, including complainant. This complaint further alleges that this forced exposure to a substance the EPA hu dusiLed as an 'Group A Carcinogen' (in the same utegory, as benzene, asbestos, and arsenic),4 and N1OSH'has classified as a'potentiall occupational urcinogen,"5'subnantially exceeds the official exrosure recommendatioru of the U.S. Public Health Service, and the official federal guidelines for exposure to ETS promulgated by the EPA6' and NlOSH,7. Both require that, if any smoking is permitted in an indoor work: area, it be restricted to separate rooms which are individually ventilated and are negatively pressurized. Complainanralsoalleges that exposure to ETS is a'recognized hazard,' as tharterm is defined by. OSHA,8 because it is a eonditiomwhich by common know•ledge is hazardous (see above findings), and is detectable by means of the senses - and that complainant has dearly detected the exposure by smelling,the distinct odor of ETS and9or by seeing the particles of ETS in the air. NOTES: U'To meet the formality requirements outlined in Section 8(f)of the Act and in 29 CFR' 190111 1 a compltint shall: (1) Be reduced to writing either on a Notice of Alleged Safety or Health Hazards (OSHA-7 Form) or in a 1enc; (2) Allege that an imminent danger or a violation threatening physical harm,(.e., a hanrd covered by a nandud or by the general duty dause) exists in the workplace; (3) Set forth with reasonable particularity the grounds upon which it is based. This does not mur. thac the complaint must specir). a pa.zicull standard; it need only specify a condition or practice tkr, is hazardous and, if uncommon, why it is hanrdbus;,and (4) Be signed by a: lean one employee or employee represenar.ive:" Chapter IX - Complaints and Referrals, A.2.d-, OSHA Field Operations Manual at 201 (7-29-92)j (I.) Chapter DC - Complaints and Rcferralt, A.7., OSHA Field Operacions Manual aa 203 (7-29-92). (D, ~J 29 USC SI 654(a)(1). •(4.) 'Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders,' E1'A/60016-90/006F (1993). (5:.)''En6ronmenta'.! Tobacco Smoke in the.CV,orkplace,'Pub. 91-108. (6:J'Secondhand Smoke,' 402-F-004, July. 1993. •[7:)'EnvironmentallTobacto.Smoke in the.Vi,'orkplaee,' Pub. 91.108. •[8.]I Coruolidited'Fsgineering Co., 12 OSAI-IRC 490:(1974)!2 OSCH 1253, see generally 61 Am Jur 2d'Plint and'Job Saferv S 36: (For Additi,onal' Citations and Information, vrrite or call Action on Smoking, and' Health (ASH)„2013 H St., N.W., Wash. D:C. 20006, (202)' 659.4370.] COMPLAINANT: Add bePow in your own words additional details about the type, amount, and circumstances of exposure, any immediately evid'ent health consequences, and' approximate number of workers exposed (if knov,,n)': Hazard~ Location. Spec 1y the pan cui0r building or works,te where me alleged violation exms ZOZ,4/ F)r[...).7(7

tO:Hasthns conddton.been broughDtothe attention of (Mark."X" in all that apply) D Employer E] Otner Government Agency (specify). 11. Please rnd cate your desrre: 0 Do not reveal my name to the Emplbyen 13 My name may be reveai the Employer 12: The Undersigned. (Mark "X" in one box), 0 Employee O Federal Safety and Health Commdte le D Representative of Employees 0 Other (specily), .,. .(>elievestllat a violaUohiofan OCCupat)dnal'.Safety or Health standard exrstswhiCh is a lob satetyor heatthhazard at, theestabtlshment named on this lorm. 13. Complainant Name (Type or print name) 15. Address (Street• Gty; State, ZIP): 18. If you are an authorized representative of employees allecled1by this complaint. please state the name of the organization that you represent and your title: Organization Name: I Your Titte: OFFICIAL USE ONLY 19. Reporting,I I21., Optional Complaint - Number fleatlbn Ident . 22. Establishment, 23. Site Address 24 Employer.ID (Siate'S option)i 25. Crty'Code 6. County Code t Name Change? 13 ~ Change) l Receipt 27. Received by: 28: Send OSHA-7~' 29 Dale 3p. Time AM 31_:Superv,sor(s),ASSrgned (nfOrmatlbn Q Yes Q No PM. ~a. b Industry 3: Ownership- 32. Primary SIC 33. Ownership (Mark "X"'m one bcx)', a.OPrrva.te Sector b. ~ Locat!Government'. c_[I State Governmenl~ d'~ [11FFederallAOency/Cooe.~ Complaint 34• Evaluated by: 35. Subject an¢ Severity EvalUatibn -= Distriinihation Q 36. IS This a Va1id'COmplalnt? Immment, ~ Yes E]INd Danger Serious Other 37. Formality Safety QI Q E) - Q Formal QlNOnlormal Heattn QI QI ~ . • . -, 38. Q Migranl Farmworker Ca:mp Complafnt 39. Send'Letter: Action a. Q No InspecliOn - for Invatid Complaints c. Q OSHA-7' lw ' Signature VJan Letter u Too Vague or Unsubstantiated D Complete or G Partial - .. 0 Recent, tnspection or Obteeuve Evidence d. OlNOntormal Complaint Notditation toEmQloyer _ (Date of Inspect/on) 0 IGompla+nant i C Explanation of 11(t) D Not,in OSHA'S Junsdiction e QlComp:arnant Notiflcauon VJith Letter d _. b. O,No~InspeOtion- for Nbnlormal Complaints 0 NameNb1 Revealedt7 Ezplanationot 1~1(C), p No Imminent Danger or No Standard f ~I Acknowteogement to Compta nant (pauonal) 0 No Direct Relation to S&H ~ O Not Enough IntormauoniTO Evaluate o. ElIOtner (speaty) F: - - - 0. Date Letter Sent 41. Date Response Due (For letters c Dr d) 20. Previous Actwity'~ O YesQ NO 42., Inspectron Planned) ~~ It Yes. 0 Yes 0 No Prronty. 4.3:. Transter to (Jame)i45: Transter to (Category) a. O Federal OSHA/Reportrng ID II J ~ b. Q State OSHIReporlmg ID 1 ' 11 1 46. Optionali Information II No. Reason 44. Transter Date c C]'Otne Federet Agency/Cooe )i I o. 0 S+ate/Local Govemment, e D Othe Type I ID: Value T'ype ID I Value - I 47'. Tota; Entnes Close Complalnt 49. Comments. 48. OICtose Complaint entet Type' Number 11 Yes C"E FILE COPY OSHA-7 (Rev 1184) 2(~24'7(l;~ ,:99

Page 1 FILING YOUR COMPLAINT WITH OSHA ABOUT WORKPLACE SMOKING Please read this side of the sheet FIRST. C Filing complaints with OSHA can help limit smoking in your workplace. It can also encourage OSHA to issue a general rule limiting smoking in all workplaces, including restaurants, stores, and' other public places. This page provides general information about filing OSHA smoking complaints. The next page provides more specific inforrnation about filling out the enclosed OSHA complaint form, and mailing, it to ASH for filing. Q. WHO IS ELIGIBLE TO FILE COMPLAINTS WITH OSHA? A. With a few exceptions, employees may file complaints with the Occupational, Safety and Health Administration (OSHA) if they believe they are exposed to chemicals likely to cause death or serious physical harm. The exceptions include government emplbyees, and individuals (like persons working in mines) subject to~ special safety rules. Q. WHO SHOULD FILE A SMOKING COMPLAINT WITH OSHA?' A. Any worker eligible to fil'e an OSHA complaint (see above)' who is exposed to Environmental Tobacco: Smoke (ETS) anywhere in the workplace and who believes that it may cause lung, cancer or other serious diseases should file a complaint to protect his or her own health. Q. IS FILING A COMPLAINT DIFFICULT? A. No. ASH has added to the OSHA complaint form the legal and technical language we believe is appropriate under the circumstances. You may adopt any or all of this language without the need to~ recopy it. Filling out the remainder of the form is not difficult, and the other side of this sheet provides additional assistance and instructions.. Q. CAN I FILE THE COMPLAINT ANONYMOUSLY? A. Yes, by checking a box on the form which says "'Do not reveal my name to the Employer." If you check this box in response to Question l li, federal law provides that your name shall not appear in; the copy provided to the emplb}~~er "'or on any record! published, released, or made available pursuant to section (g) of [29 U.S.C. § 651]."' Q. WHERE OR WITH WHOM DO I FILE MY COMPLAINT? A. Because the office where the complaint must be filed depends in a complicate& way on the address of your employer,, you, can simply send your complaint to ASH. ASH will determine which of the more than 1001 offices should receive it,, and send it to that: office. Q. WILL ASH REPRESENT ME OR ACT AS MY ATTORNEY? A. No. ASH cannot represent the hundreds or thousands of individual nonsmokers who may wish to file complaints, but such representation is not necessary. Any employee may file a complaint with~ OSHA, an& OSHA's procedures are geared to processing complaints filed by workers who do not have attorneys. Q. WHAT WI LL OSHA DO WITH MY COMPLAINT? A. OSHA employees may call you~ for additional information, make an inspection; of the premises, andlor seek to negotiate informally with your employer to lirnit smoking. It is also possible that OSHA may refuse to act on the complaint, a decision which will probably strengthen ASH's law suit in the U.S. Court of Appeals seeking to force OSHA to take action regarding workplace smoking.

Page 2 FILING YOUR COMPLAINT WITH OSHA ABOUT WORKPLACE SMOKING Please read this side of the sheet only after reading the other side. OSHA instructions state that a worker should "complete items 2'through 18'[of the form] as accurately and~ completely as possible. Describe each haza4 you think exists in as mu& detail as you can. If the hazards described in! your complaintt are not all in the same area, please identi fy where each hazard can be found in the worksite." ASH suggests that you fill out the form with a sharp-pointed pen, print your answers clearly, and~ be sure to answer each question 2-17. Do NOT put anything in the space for question 1 or questions 18-49, nor in the box marked "MOD Date." Question 2"Ernployer Name": the name by which~ your company is generally known; for example, how it is listed' in the telephone book or on its own stationary Question 3 "Site Location": the street address of your workplace, plus information like floor, department,, or section of the building if relevant _ Question 5 "Management Official": the name of any person, or persons you know whoo exercise some management control or authority there Question 7 "Type of Business": a general description, such as "insurance office," "restaurant," • "bank," "school," "factory," "beauty parlor,"' "bowling alley,"' etc. Question 8"Hazard Description": To help satisfy OSHA's requirements, ASH has added legat and'technical language which we believe is applicable to virtually all workers exposed to ETS. Cross out any which you feel is NOT applicable to your own situation. Then add more specific information about the.type, amount, and circumstances of your exposure, any immediately evident healthi consequences, and the approximate number of workers exposed (if known). The following are brief sampl'es of the kind of information you may wish to add: Approximately 10 nonsmokers are subjected to smoke from three smokers in an office; complainant sufj;erx sinus attacks. " "l am forced to breath dense smoke in the restroom and it makes me nauseous. " "About 50 employees are exposed to smoke in hallway, but there are no immediate obser-vable s}mptoms. " "Smoke drifis inzo my oj'~f cc from the smoking room, and several of us smell it. " Question 10: check the appropriate box only if you know that the problem has been brought to the attention of the employer or a government agency Question 11: check the FIRST box if you do NOT want your name revealed' to your employer Question 12: If you are filing the complaint on~ behalf of yourself, you should check the first box marked "Employee" Question 18: DO NOT PUT ANYTHING in the space for this question Once you have completed the form and signed and dated it, please return the ORIGINAL in the enclosed courtesy envelope by December lst. ASH will forward valid complaints to the appropriate office. There is no cost or other obligation for this service, and' ASH is NOT acting as your attorney or authorized representative. ..... M K,a......• 7

SPECIAL CONTRIBUTION YES! I want to help ASH fight to eliminate smoking in the workplace. I am sending my contribution of: Q'5100 Q S40 Q S30 1 Q Other Card#' ~. Q~ Q'~ Exp.Date: Signature: Please return this form, along with your check (ff applicable) in the enclosed buslness reply envelope.. Return your completed OSIIA complalnt form separately In the courtesy envelope marked ASH - OSIiA COIvfP1AINT., I I I I II I I III I rI I I III I I I I I I I Ii I I IlI I I III I I u I I „I I I I I I I I I I II I I I Action on Smoking and Health, 2013 H Street N.'W. Washington, D. C. 20006 ------ ,~

ETS/IAQ REPORT FAx COMMUN!ICATION SHEET NOTE.• If you would like additional information, on one of the stories contained in this issue, or if you have information or ideas that we could incorporate into future issues, please complete and FAX this form. To: Mark W: Cowing, Esq. From: Shook, Hardy & Bacon Company/Title FAX 816-421-5547 Telephone: Date: I would like additional'information~that may be available on the articles in Issue numbered as,follows[indicate the bracketed number next to the article headline]: " ] [ ] [ ] [ J' [ ]I I [ I [ I [ I [ I Name FAX # Address Overnight Delivery Regular Mail (Ifpref rence is norindicated,infiirmation will'be sent by regular mail.) Please provide non-confidential reference information you believe could be of use in compiling future issues of this Report. 3.18'.93 SHB