Tobacco Documents Online

ETS and Lung Cancer "The absence of a threshold for respiratory carcinogenesis -in active smoking, the presence of the same carcinogens in mainstream and sidestream smoke, the demonstrated uptake of tobacco smoke constituents by involuntary smokers, and the demonstration of an increased lung cancer risk in some populations with exposures to ETS leads to the conclusion that involuntary smoking is a cause of lung cancer." The Health Consequences of Involuntary Smoking (U.S. Surgeon General, 1986) OtiLZ OLSZS

Bayard

ETS and Lung Cancer "Examination of smoke from the different sources shows that all three types contain chemicals that are both carcinogenic and mutagenic. The amounts absorbed by passive smokers are, however, small, and effects are unlikely to be detectable unless exposure is substantial and very large numbers of people are observed. The observations on nonsmokers that have been made so far are compatible with either an increased risk from 'passive' smoking or an absence of risk. Knowledge of the nature of SirlclStrcnam anrm mainstrnar~ Smnlsn7 nf thn matorials ahsnrhorl rle er'nrs I%..v a9 v o.. I I%.. III n~ .~v III II1v~ v v~ .~~v ~~~ a~~~ ~ v v1 a/vv %..vl if Iy 'passive' smoking, and of the quantitative relationships between dose and effect that are commonly observed from exposure to carcinogens, however, leads to the conclusion that passive smoking gives rise to some risk of cancer." --~ There is sufficient evidence that tobacco smoke is carcinogenic to humans. - IARC Monographs on the evaluation of the carcinogenic risk of chemicals to humans. Vol 38 Tobacco Smoking, 1986. Zt'LZ OLSTS

Uniqueness of ETS for EPA 1. Wealth of human studies at true environmental levels. (3 cohort and 21 case-control) A. Smaller expected relative risks B. Use of meta analysis to combine results C. No need to use mathematical models for low-dose extrapolation 2. Knowledge that ETS contains the same chemical constituents as mainstream cigarette smoke - known human carcinogen - and that the lung is exposed to both forms. jSLZ 0L5ti5

Health Eftcts of Passive Sr.:oking: Lung Cancer in Adults and Respiratory Disorders in Children Prepared By: U. S. EPA OFFICE OF RESEARCH AND DEVELOPMENT OFFICE OF HEALTH AND ENVIRONMENTAL ASSESSMENT Human Health Assessment Group At the Request of (major fundingJ: OFFICE OF AIR AND RADIATION OFFICE OF ATMOSPHERIC AND INDOOR AIR PROGRAMS Indoor Air Division PROJECT MANAGER Steven Bayard, Ph.D. PRIMARY AUTHORS Ch. 2-5, App. B Kenneth Brown, Ph.D. Appendix A Charles G. Humble Appendix C Douglas Crawford-Brown, Ph.D. Appendix D Todd Thorslund, Sc.D. ALSO HERE TODAY EPA Research on ETS Joellen Lewtas, Ph.D. Ch. 5 Apama Koppikar, M.D., Ph.D. LELZ OLSiS

Ste ven Ba yard, Ph. D. Presentation before the Science Advisory Board on The Health Risks of Passive Smoking December 4 - 5, 1990 9ELZ OLSTS

IARC GROUP 1 AGENTS KNOWN HUMAN CARCINOGENS IARC MONOGRAPHS SUPPLEMENT 7,1987 50 AGENTS Melphalan 8-Methoxypsoralen (Methoxsalen) plus ultraviolet radiation Mineral oils, untreated and mildly-treated MOPP (combined therapy with nitrogen mustard, vincristine, procarbazine and prednisone) and other combined chemotherapy including alkylating agents Mustard gas (Sulphur mustard) + 2-Naphthyiamine + Nickel and nickel compounds' Oestrogen replacement therapy Oestrogens, nonsteriodal' Oestrogens, steroidal' Oral contraceptives, combinedi Oral contraceptives, sequential The rubber industry Shale-oils + Soots Talc containing asbestiform fibres -Abo.. TosvaQ+ccv prvVVCts, .s7rl~iokeie~3J '~ Tobacco smoke Treosulphan + Vinyl chloride 'This evaluation applies to the group of chemicals as a whole and not necessarily to alt individual chemicals within the group (see also Methods, p. 38). +Identitied in ETS ~f1LZ 0LST5

CONCLUSION ETS is causally associated with Lung Cancer (EPA Group A) based on: 1. Consistency of Response 2. Association 3. Consistent Dose - Response Trend 4. Effects Remain After Adjustment for Bias 5. Broad-based Evidence 6. Biological Plausibility 7. Collateral Evidence SS` Z 0Z S rS

ETS and Lung Cancer "The weight of evidence derived from epidemiologic studies shows an association between ETS exposure of nonsmokers and lung cancer that taken as a whole is unlikely to be due to chance or system atic bias." pg. 245 "Considering the evidence as a whole, exposure to ETS increases the incidence of lung cancer in nonsmokers." pg. 10 . ETS: Measuring Exposures and Assessing Health Effects (National Research Council, 1986) jiILZ OLSTS

CONCL USIONS A. L UNG CANCER IN ADUL TS 1. ETS is a Group A or known human carcinogen. (Hazard idei iti f icatioi i or 'viieig h t-of-evidence) 2. ETS causes on estimated 3,700 lung cancer deaths per year among non-smoking adults aged 35 and over. The confidence limits are 1,700 and 6,000 (quantitative assessment). 8ELZ 0LSt5