Tobacco Documents Online

ACCOMMODATION IN THE HOSPITALITY INDUSTRY • Accommodation -- Definition and Purpose: Consistent with the theme of preserving freedom for the individual, the accommodation program attempts to strike a balance between those who wish to smoke and those who do not want to be exposed to ETS. Adults should have the freedom to smoke, subj ect to appl icable laws and ordinances and tempered by the basic responsibility to act courteously toward people who are bothered by tobacco smoke. Nonsmokers annoyance in the presence of tobacco smoke is to be minimized; at the same time, nonsmokers are expected to be tolerant of an individual's freedom to smoke. Thus, the accommodation prvgram relies on a delicate balance - one that does not discriminate unfairly against either smoker or nonsmoker and one which does not accord any special rights to either. • The approach recognizes that workplaces and restaurants are infinitely varied and that smoking policies need to be designed to fit the specific requirements of individual locations. In some locations, smoking restrictions may be unnecessary; in others, minimal changes, e.g., simple separation of smokers and nonsmokers, may sensibly accommodate the interests of both. An accommodation approach recognizes that complaints about exposures to ETS can be ~ addressed in a number of ways. Simple increases in outdoor air ~ ventilation levels to those specified by building codes, the simple O relocation of workstations or the separation of smokers and CT~ ~ nonsmokers historically have been effective in addressing complaints W ~ 00

about ETS. They require few additional costs from the employer. In addition, scientific data indicate that these common solutions are effective in providing acceptable indoor air quality and minimizing nonsmoker exposure to ETS. • Why accommodation? Twenty-five percent (25%) of all adults are smokers. Its reasonable to assume a good number of your patrons will be smokers, just as it is reasonable to assume that a good number of your employees or patrons will be nonsmokers. It simply makes good sense as an employer, manager or restaurateur to accommodate the interests and preferences of both smokers and nonsmokers. The accommodation approach provides the framework for addressing indoor air qua•lity needs for both smokers and nonsmokers. An accommodation program is designed to provide the employer, the manager or the restaurateur with a number of options which can be used to achieve acceptable indoor air quality. Improving indoor air quality can maximize satisfaction with the indoor environment and therefore minimize customer complaints. • Why not simply ban smoking? This appears to be an easy, quick and inexpensive solution to complaints about indoor air quality. It is true that ETS, because it is easily seen and smelled, is often blamed for indoor air quality problems, and smoking bans have been proposed as a so-called "solution" to complaints about indoor air quality. Smoking, however, is only one part of the much larger - 2 -

issue of indoor environmental quality. Smoking bans do not improve fresh air ventilation nor do they ensure acceptable indoor air quality by preventing the potential build-up of a myriad of invisible airborne substances. There is really only one way to effectively address overall indoor air quality and that solution emphasizes proper ventilation. The employer or manager realizes that adequate ventilation should always be provided in any enclosed workspace regardless of whether or not smokers are present. • A case in point: the majority of indoor air quality problems in "sick-buildings" have been traced to inadequate fresh air and poor air distribution. Results from four large databases on sick- building investigations in North America (comprising more than 2,000 buildings) indicate that only two to four percent of complaints from occupants in buildings investigated have been related to tobacco smoke exposures, even though some individuals initially reported annoyance or irritation in the presence of ETS. By contrast, more than half of the buildings investigated were found to have inadequate ventilation. These data suggest that even a total smoking ban would not likely materially affect complaint rates in 96 to 98% of so-called "sick" buildings. • I mentioned earlier that because workplace environments are infinitely varied, smoking policies need to be designed to fit the requirements of each individual workplace. The question of 3

the feasibility of implementing one or more options is best determined on individual or case-by-case basis. One option, consistent with the accommodation approach, involves the designation of a smoking area where smoking and nonsmoking areas share a common ventilation system. The scientific literature indicates that this simple separation of smokers and nonsmokers can adequately minimize nonsmoker exposure to ETS. One recent study reported that the use of a designated smoking area reduced nonsmoker exposure to ETS by as much as 95%. Another study from a smoking restricted office building reported that ambient nicotine levels in nonsmoking areas were virtually undetectable, suggesting that smoking had a negligible impact on the nonsmoking areas of the building. Canadian researchers, in a series of reports, presented results on levels of ETS constituent measurements in offices where smoking was regulated and unregulated. They reported no significant differences in average ETS constituent levels between nonsmoking offices that received recirculated air from designated smoking areas and nonsmoking offices that did not receive recirculated air. They concluded: "The results indicate that the provision of a designated, but not separately ventilated smoking area can effectively eliminate or drastically reduce most components of environmental tobacco smoke from nonsmoking offices." • What is the amount of ETS to which the average nonsmoker is O exposed in public places, the office or a restaurant? There are a ~ O CT~ C4 _ 4 _ CR ~

! number of published studies in the scientific literature that have reported on the measurement of various airborne ETS constituent levels. Given the infinite variety of workplaces, public places and restaurants sampled, it is virtually impossible to generalize over all of these studies. However, studies indicate that typical nonsmoker exposure to ETS under realistic conditions in public places, offices and restaurants, is minimal. A number of studies suggest that typical measurements of ambient nicotine range from an exposure equivalent of 1/100th to less than 1/1000th of 1 filter cigarette per hour. This means that a nonsmoker would have to spend from 100 to 1,000 hours or more in a public place, an office or a restaurant where smoking is permitted in order to be exposed to the nicotine equivalent of smoking a single cigarette. In a study by G. Oldaker, et al., entitled "Results from Surveys of Environmental Tobacco Smoke in Offices and Restaurants" (Indoor Air Quality, 1990), researchers reported results on 156 ETS measurements in offices and 170 ETS measurements in restaurants. They estimated average exposure equivalents of 2/100th of a cigarette per 8 hour work day in an office and 3/1000th of a cigarette equivalent for a 1 hour meal in a restaurant. • The argument that ETS exposure increases the risk of lung cancer in nonsmokers is based on an interpretation of data from epidemiologic or population studies of nonsmoking women who were married to smokers. There are currently 33 published epidemiologic

studies on the issue of spousal smoking and lung cancer. Fourteen of those studies also assessed reported exposures to ETS in the workplace (i.e., the office). Twelve of the 14 workplace studies report associations between ETS and nonsmoker lung cancer which do not achieve statistical significance. If the data from all the studies are pooled together, the result suggests no increase in risk due to exposure to ETS in the workplace. • Many of you no doubt have heard about a recently published review in the Journal of the American Medical Association entitled "Involuntary Smoking in the Restaurant Workplace: A Review of Employee Exposure and Health Effects" by Michael Siegel. The author concluded that ETS "is a significant occupational health hazard for food-service workers." It is important to note at the outset that the author did not undertake an original study but rather reviewed some of the available published data on ETS exposure levels in bars, restaurants, offices and residences, and studies on disease rates in food-service workers. The author looked at data on ETS measurements from four review articles found in the published literature. He "averaged" the data for the reported concentrations of various ETS constituents and then compared those levels in restaurants, offices, and homes. He concluded that carbon monoxide levels are 1k times higher in restaurants than in offices, that nicotine concentrations are about 1.6 times higher in restaurants 6

than in either residences or offices and particle levels are generally 2 times higher in restaurants than in offices. It is not surprising that both carbon monoxide and particle levels are reportedly higher in restaurants than they are in either offices or residences. That is because carbon monoxide derives mainly from combustion sources due to cooking or to the infiltration indoors of automobile exhaust, the latter because of a restaurant's probable proximity to street-level traffic. Particle matter (i.e., dust) in the air is generated by cooking and from human activity, e.g., from the dust raised from simple walking. Studies that have looked at actual constituents of carbon monoxide and particles from ETS report that ETS rarely has a significant impact on carbon monoxide levels and it reportedly constitutes about 30% of the particulate matter in areas where smoking is permitted. Nicotine, on the other hand, is characteristic of ETS, but even according to Siegel's own estimates of average exposures to nicotine, a food-service worker would require constant exposure for over 150 consecutive hours in order to be exposed to the nicotine equivalent of a single cigarette. • In the second part of his review, Siegel examines six studies that assess lung cancer risks in various occupational groups, including food-service workers. According to Siegel, the six studies report roughly a 50-75% increase in lung cancer risk among 7

food-service workers. The relevance of these studies to the question of ETS exposure in restaurants is not clear. In fact, not one of the studies measured exposure to ETS or even attempted to determine ETS exposure by other means. So while the studies selected by Siegel suggest that food-service workers are at increased risk for lung cancer compared to the general population, none of the studies assessed whether this reported increase is associated with ETS exposure or whether it is associated with a multitude of other environmental, occupational and lifestyle factors that affect such workers. Even the author appears to recognize the weakness of the data when he writes that "the. . . evidence suggested that there may be a 50% increase in lung cancer risk among food-service workers that is in part attributable to tobacco smoke exposure in the workplace." Elsewhere, Siegel suggests that "this excess risk could well be due to the increased ETS exposure of food-service workers." These statements are simply conjectures on the author's part. The data he cites do not contain any reference to ETS. • The Siegel article received much attention in the media throughout the world. It is important to remember that the article is nothing more than a very limited, highly selective review of the literature on ETS exposures. The author did not review any ~ medical records, nor did he observe or examine a single food-service © ~ worker. When faced with the apparent lack of data on ETS and lung CT~ C C'a ~ W - 8 - ~ CP

cancer in food-service workers, the author resorted to conjecture, supposition and inference. 10777996 - 9 -