Tobacco Documents Online

TESTIMONY OF JAMES' L. REPACE IN THE MATTER OF SENATE' BILL 1440, THE NONSMOKERS' RIGHTS ACT' OF 1985. BEFORE THE U.S. SENATE SUBCOMMITTEE ON CIVIL SERVICE, POST OFFICE AND GENERAL SERVICES, COT4ITTTEE ON GOVERNMENTAL AFFAIRS WASHIINGTO'N„ D.C. September 30, 1985 § MR. CHAIRMAN, AND SENATORS: My name is James L. Repace. As a scientilst whoihas worked for a deca!de on the health physics of environmental tobacco: smoke., and as a policy analyst i n a fedieral regul atory agency, 11 woul d lli ke to share~ wi't you the ri sk assess- ment results and risk management op ions which I have developed in my work. My qualifications are discussed in an appendix to my statement. STATEMENT OF JAMES L. REPACE ON THE HEALTHIIMPACT OF TOBACCO COMBUSTION PRODUCTS 0N NONSMOKERS It has long been known that high levels of outdoor alir pollutioni from! factory chimneys and automobiles could cause acute illness and even death duri ng ai r pol l ution epi sodes a~nd that el evated 1 evel s of outdoor ai r polliuti on were responsible for chironic morbidity and mortality.6 These: serious heal'th effects from air pollution have lied to fede al standards for the regulation of outdoor exposure, lievels, and considerable progress.has been made i'n curtailing outdoor ai r polll uti on. Hbviever, Ameri cans spendl an average of 90% ofi' thei r l i ves ilndoors. Therefore the~ levels of' indoor air pollution assume great importance i n determilni ng total human exposures to many ai r pol l!utants.G.14,,15' Indoor air.pollutilon from tobacco combustion products is not only chemically related to the smoke: factory chimneys andlotfier sources of outdoor air pol- O lution, but generally occurs at far higher level's indoors than does factory smoke ~ and automobile exhaust outdoors 6 Because one-thi'rd of the U adult population: S ~ . . . ~. ~ ~ G-1

-2- smokes, andl because ventilation rates are primarily diesilgned to conserve energy rather than to~preserve indoor ai'r quality5,6,8,1'4„16 the smoke fromi burningi cigarettes, pipes, and! cigars overwhelms the capability of typical building ventilation systems, inflicting substantial air pollutiion burdens upon nonsmokers -- far in excess of those encountered inismoke-free indoor environments, outdoors, or i'n vehicles on busy commuter hilghways.6,S,15 For more than 20 years, reports of the Surgeon Genera1 -- which now amount to a: stack more than a foot high! -- have, indicted the smoke whichi the smok r inhales (called mainstream smoke) as cause of cancers in many organs of the human body.3'+5 we now, know that the smoke which the nonsmoker inhales (calied side- stream smoke) i's even more carcinogenic than an equal amount of'mai'nstream smoke.3 C7 early„ there i s good reason to bel i eve that nonsmokers are exposed to the ri sk of smoking-reTated diseases from repeated exposure to tobacco combustilon products.3 In a recent official' position paper18 in which it was stated'that environ- mental tobacco smoke appears to be carcinogenic, The Amerilcan Association for Cancer Riesearth stated that gpvernment shouldl"enact and enforce! legislation that restricts smoking i'n public pTaces". In another recent medical journal pap r,17 three offilcials concerned with smoking and health from Canada's Mational Department of Health and'Welfa~re examined the evidence that exposure to tobacco smoke in the workplace Is harmful' to nonsmokers. They concluded that "passive smoking Is an occupational health, hazard to nonsmokers'. This raises two essential questions pertinent to Senate Bi11 1440: First: What are the risks to nonsmokers from breathing envlronmental tobacco smoke in, the workplace? And secondly: What are, the options for management of those risks? G-2

-3- C) To answer the risk assessment question, Or. Alfred Lowrey, of the Naval Research Laboratory and I used the principles of quantitative risk assessment. After five years of work, and based ini part on our 13'previous sci'entific publica- tions on the health physics of environmental tobacco smoke, we pub1lished!estimates that in the United States, exposure of nonsmokers to indoor air pollution from tobacco combustion products causes a minimum of'about 500, but more 11ilkely 5000 lung cancer deaths per year, with an average loss of life-expectancy of about 1'1 years per vi'ctim.3 To place this into perspective, 5000 lung~cancer deaths per year i s nearlyone-thi rdl of' the annualllung cancer; nartal ity in nonsmokers., There have been no credible scientific attacks on our previous work, although the Tobacco Institute has publicized some failed8 attempts. Insofar as our publltshed! ri sk assessment i s concerned, i n an accompanyi ng edi tori al , the ed'i tor-i'n-chi ef' of the journal stated: "'Diue to the controversial nature of the paper by Repace and, Lowrey, added measures were required to assure adeqpate peer review and'the documentation, of underlying information, including assumptions".1'9 In summary, he concluded that "... Repace andlLowrey make a convincing case for public health hazards of public smoking."19 To explore risk-management options, we assessed the risks associated withi five common types of control measures for tobacco smoke. We found that in the typical! U.S. office workplace, under average condiitions of occupancy and ventilation, the tobacco-smoke-caused lungi cancer risk to the nonsmoking office workers appears to be, depending upon the ventil'ation, 250 to 1000 times the level of' acceptable risk using standard federal guidelines for carcinogens in air or water or food.2• 7 . Q We then explored the risk reduction achievable by various controll options. CA We found that separati on of nonsmokers wi thi n a gi ven space offers only a ~ PON N' ~ ~ G~-3'

-4!- sl!iight reduction in'risk.5•8 We found that increases in ventilation rates or air cleaning potentially offered much greater reductions in risk, but because such i ncreases requi re respecti vely large amounts of energy and capital, they do not appear to be very cost-effective.2•7 We found that if smokers andi nonsmokers are separated in dilfferent enclosed spaces but not' on different venti',llation systems, as for example in a large building, the background concentrationiof smoke recirculated into the nonsmokers offiices via the venti'llating system would probably be reduced toonly a few times the acceptable risk lieve1,1•2 but this option does not appear to offer the most cost-savings. Separation of smok rs and nonsmokers into different spaces with different ventilatilon systems offers mortprotection than the previous option, but at a potentially higher cost. We found that a ban on smoking in the workplace,appeared to offer the most cost-effective approach of'all.1•2,2m In summary: it appears that the typicaT nonsmoking federal worker in: workplace where smoking is unrestricted faces a large lung cancer risk from , environmentall tobacco smoke. It also appears tfiat there are a variety of' reasonable and cost-effective controll measures which, can provide mitigation of' tfiat ri sk. REFERENCES: 1-15. Listed onipage 6. 16. ASFiRAE Standardl 90-80, Energy Conservati on i'n New Bwi l di ng Oesi'gn, Ameri can Society of Heatiing„ Refrigerating, and Air Conditioning Engineers, Atlantal, 1980. 17. Collishaw NE, Kirkbride J, and Wi'gl'e OT: Tobacco smoke in the workplace: an occupational- health, hazardl. Cain Med Assoc J 1'984;, 131: 11199-12104. 18. Loeb LA, Ernster VL, Warner KE, et al.: Smoking and lung cancer, ain overview. Cancer Res 1984; 44: 5940-5958. 19. Moghissl A: Health risks of passive smoking. Envirom International 1985; , 11:1. 20. Office of'Technology Assessment: Smoking-related deaths and financial costs. 1985. G:-!+.

APPENDIX -5'- J.L. REPA'CE: CURRICULUM Y1TAE: For the past six yeam, I been a poJ!icy analyst iin the air pol!icy offi'ce at the U.S. Environmental Protection Agency, Washington, DC. However, my testimony here thi s morni ng wi l l be as a pri'vate ci'ti'zen,, and shoul d not be i nterpreted as representing official U~.S. E~nvironmental Protection Agency pol!ilcy., Prior to: EPA, 11 worked for 1b'years as a, research physicist at the Naval Research Laboratory, at RCA Sarnoff Laboratory, and at two New York hospitals. I earned a Master's degree in physics.from the Polytechnic Institute of Brooklyn. I am a technical advisor to the Nati'onal A'cadiemy of Sciences Committee, on Passive Smoking. I'am a contributor to ani Lnternational Agency For Research on Cancer monograph on Sidestream Srnoke, concerning modeling and measurement of' nonsmokers' exposures., I am executive secretary of the Indoor Air Quality Ciommfittee of the. Air Pml]ution Controll Association. I am a member of' the Interagency Technical Working Committee, on Smoking, Heart, Lung and Blood Diseases. I have been a member of a Natilonal Institute of Health special study committee to review, grant proposals on passi've smoki'ng and lung cancer. I have, testified as an expert witness on the subjiect of'passive smoking at a U.S. House of Representatives hearing on Indoor air pol!lution research. I have been a consultant to both the World'Healthi Organization and the National Acadenpr of Sciences Cbmeittee on Ai rl i ner Cab1 ni Ai r Quality, on the question of' passive smokiing oni passenger ai rcraft. I was a: consultant on, the Involluntary Smoking Chapter of the 1984 Svrgeon. General "s Report on Smoking and Chronic Obstructive Lung Diseases. I served as a consultant to the Federal Trade Commission i'n the area of tobacco, smoke and air, cleaners. Three of my papers are cited in the 1984: Surgeon Generall's Report on, Smoking and' O' Lung Di'sea.se, and' my work is extensi'vely d'i scussed i n two books: "Indoor Ai r UT Quality" by B:. Meyer, Addison Wesley, 1983,, and i'n "I'ndbor A1r Quality" by Walsh, ~~ Dudney, b Copenhaver, CRC Press, 1984. APh N W' G-5

-6- SELECTEIDPUBLICATI'ONS', J.L.REPACE. 1. "Passive smok4ng has no place in the workplace'. J.L. Repace,, Guest Editorial, CANADIAN MEDICAL ASSOCIATION JOURNAL, 133I: 737-7'38' ('1985). 2. "An Indoor air qualtty standard for ambient tobacco! smoke based'on carcino- genic risk. J.L., Repace and A.H. Lowrey, NEIV' YOR~K' STATE JOURNAL OF MEDICINE,, 8'5 : 381-383 (19'85') . 3. "A'quantitative estimate of Nonsmokers' Lung Cancer Risk From Passilve Smoking", J.L. Repace and A.H. Lowrey, ENVIRONMENT INTERNATIONAL 1!L: 3-22'(11985).. 4. "Consistency of research data on passive smoking an6 1'ung cancer" J.L. Riepace, THE LANCET (ii'): 3 March: 1'984, p. 506. 5. "The Problem of'Passive~Smokiing", J. L. Repace, BULLETINIOF THE NEW YORK ACA'DEM'Y' OF MED~ICLNE57: 936-946 (1981). 6. "Indoor Air Pollution, Tobacco Smoke, and Public Health", J. L. Repace and A'. H.. Lowrey, SCIENCE 208: 4I64-474 (1980)1. . 1. "Effect of ventilatilon on passive smoking risk in a model workpliace'. Proceedings of an Engineering Foundation Conference on Management of Atmospheres In Ti'ght1y Enclosed, Spa es, Santa Barbara,, Oct. 17-21, 1963, American Society of Henting,,Refrigerating„ and Air Condytiioning,Engineers, ASHRAE Special Publliicati on„ 1984. 8. "Tobacco Smoke, Ventil,lation„ and!Indoor Air Quality", J. L. Repace and A. H. . Lowrey, ASHRAE TRANSACTIONS 88: Part I1,8915-914 (1982). 9. 'The Dosimetry of Passive smoking"', J.L. Repace, Proceedings of The 5th Worldl Conference on Smoking b' Health, Winnipeg, July 10-15', 1'.983. 10. "'Modeli'ng Exposure of'Monsmokers To Ambient Tobacco Smoke"', J.L. Repace and A.H. Lowrey, Proceedings of the 7bthi Annual Meeting of'ttie Air Pollutilon Control Association,, Atlanta, June 20-24, 1983. 11. "Risks of Passive Smaking', J.L. Repace, in To: Breathe Freely, a book by the Center for Philosophy and! Pub]'ic Policy, l9nivers 'ty o f Rary and, in, press. Pub1ished as al Center Working Paper in 1983. 12. 'Nonsmokers and'.ciigarette smoke: a modified perception of risk", F. G. Bock, reply by J. L. Repace and A. H. Lowrey, SCIENCE 215: 197' (1982). 13. "Effect of'ficegative Ion Generators on Ambient Tobacco Smoke"', J.L. Repace, D.B. . Seba, A.H. Lowrey, and T.W. Gregory, J'OURNAL OF CLINICAL ECOLOGY 2: 90-94 (1984)1 14. "Indoor Air Polluti'on', J. L. Repace„ ENVIRONMENT INTERNATI'0'NAL 8: 21-36 (1982)1. C 15. tV °7ota1l Human Exposure to Air Pollutilon"„ Ji. L. Repace, W. R. Ott, and L. A. Wallace, Proceedings of the 73rdiAnnual Meeting of the Air Polluti'on Control ~ Association, June 22'-27, 1980; Montreal.. ~ ~ ~. C C G-6

-7- , SEL'ECTED PRESEMTA'TIONS, J.L. REPACE, 1983 - 1985 "Tobacco Smoke and the Nonsmoker"', lnvited talk, Session on Nonsmokers' Air Environment, 5th World Conference on Smoking & Health, Winnipeg, Canada, 1!3 July, 1983.. Testimony on Passive Smoki'ng, Hearing before the Svbcommittee on Energy Development and'Appllcations and the Subcommittee on Natural Resources, Agriculture Research an& Environment of the Commfittee on Science and Technology, U.S. House of Representatives, Washington, D.C. August 2, 1984. Invitedlparticipant, Internationall Conference on Assessment of'Passive Smoking, sponsored by the International Agency for Research on Cancer, at the American Health Foundation, Va1halla, NY. 8-9 December 1983. "Workplace Passive Smoking"'', Invited talk presented at the, National Safety Management Society Conference, Hotel Sheraton4ashingxon,-Washiington DC, April 23-26, 1984. "Passilve Shioki'ng"', invited talk presented at the 19th A'nnual! Meetin% of the U.S. Publ'ilc Health Service Professional Association, Scottsdale, Arizona, 4-8 June 1984. "A Proposedl'Indoor Air, @Quality Standard for Ambient Tobacco Smoke": paper presented at Third International Conference on Indoor Air Quality and! Indoor Climate, • Stockholm„ Sweden, 20-24 August 1984. "Risks of Passive Smoking" Guest Lecturer at Pierce Foundation Laboratory, Yale Uni'versity, New Haven, CT, 17 December 1984. . Invited Talk oni "Risk Assessment'of Passive Smoking", Interagency Technical Working Committee on Smoking, Heart, Lung,,and!Blood Diseases, National Institutes of I Health, Bethesda, MD, 16 January 1985. Invited Talk on "Risk Assessment of Passive Smoking"', Interagency Task Force on Envi ronmental Lung Cancer, U.S.EPA, Washington, DX. 7 February 1'985.. Panelist, Special Study Section for Review of National Cancer Inst1'tute Grant Appli- cations ('RFA-84!-CA-14) for Passive Snaki ng Research, Arl i ngton VA. 1'S Marchi 1985. Invited Talk on "Cancer Risk fromWorkplace Smoking", Conference on Smokingiand the Workplace, Society for Occupational and Environmental Health, Washingtoni DC, 10 April 1985. Invited participant, Planning, Workshop on Research Programi for Passive Smoking on Aircraft, sponsored by the World Health Organization, Geneva, Switzerland, N Aprili 17-19, 19815. . Invited Talk on ".Risk Assessment of Passive Smoking", University of'California, ~ Berkel ey/Sani Franc1 sco, Program i n Bi o-Engi'neeri ng, Sain Franei sco, CA, 30 Apri'1 19815. ~ Invited Tal k on Model i'ng of Si destream Smoke on Passenger Ai rcraft. Nati onal ~ Academy of Sci'ences Committee on Ai'rliiner Cabin Air Quality. Woods Hole„ Mass. ~ July 25, 1985. ~ OA G-7