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REC'D JUL 8 128S = American Health Foundation ~ Preventive Medicine An Intermational Journal Devoted to Practice and Theory ACADEMIC PRESS, INC. San Diego Orlando New York London Tc*onto Montreal Sydney Tokyo TI BU 31549

REC'D JUL 8 128S = American Health Foundation ~ Preventive Medicine An Intermational Journal Devoted to Practice and Theory ACADEMIC PRESS, INC. San Diego Orlando New York London Tc*onto Montreal Sydney Tokyo TI BU 31549

Preventive Medicine EDITOR-IN-CHIEF SENIOR ASSOCIATE EDITOR CONSULTING EDITOR MANAGING EDITOR ASSISTANT EDITOR Ernst L. Wynder Charles B. Arnold Lesley A. Schurmann Candyce Kornblum Jeannette M. Sims American Health Foundation. 320 East 43rd Street. New York. New York 10017 U.S.A. ASSOCIATE EDITORS Jerome D. Cohen Steven Jonas Ovide F. Pomerleau Walter J. Rogan David Schottenfeld Moyses Szklo St. Louis Universi7y School of Medicine State University of New York at Stony Brook School of Medicine University of Connecticut School of Medicine National Institute of Environmental Health Sciences Memorial Sloan-Kettering Cancer Center The Johns Hopkins University School of Hygiene and Public Health CONSULTANTS Kunio Aoki Nagoya. Japan Keith Ball London, England E. E. Baulieu Bicetre. France Erik Bjelke Norway Gerald S. Berenson New Orleans, LA Lester Breslow Los Angeles. CA Jacob A. Brody Joseph Fraumeni, Jr. Bethesda, MD Silvio Garattini Milan, Italy Leon Gordis Baltimore, MD Merwyn R. Greenlick Portland, OR Peter Greenwald Bethesdd, MD John H-C. Ho Kowloon, Hong Kong Stephen B. Hulley San Francisco, CA Anthony B. Miller Toronto, Ontario. Canada Baruch Modan Tel Aviv. Israel Pekka Puska Helsinki. Finland Abraham Rivenson New York, NY Claude Robyn Brussels, Belgium Itving J. Selikoff New York, NY K. Shanmugaratnam 0 Bethesda, MD Donald B. Louria Newark, NJ Singapore ... Joseph W. Cullen Bethesda, MD Frits de Waard Bilthoven, The Netherlands Russell V. Luepker Minneapolis, MN Joseph L. Lyon Salt Lake City, UT Robert D. Sparks Battle Creek, MI Jerzy Staszewski Gliwice, Poland M ~ ~ Lennart Domellof Umed, Sweden Joseph D. Matarazzo Portland, OR Karl Uberla Berlin, West Germany Preventive Medicine is the offscial journal of the American Socie+of Preventive Oncology. I

Volume 13, Number 6, November 1984 Copyright ® 1984 by Academic Press, Inc. All'rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the copyright owner. The appearance of the code at the bottom of the first page of an article in this journal in- dicates the copyright owner's consent that copies of the article may be made for personal or internal use, or for the personal or internal use of specific clients. This consent is given on the condition, however, that the copier pay the stated per copy fee through the Copy- right Clearance Center. Inc. 127 Congress Street. Salem. Massachusetts 019701. for copying beyond that permitted by Sections 107 or 108 of the U.S. Copyright Law. This consent does not extend to other kinds of copying, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works, or for resale. Copy fees for pre-19it4 articles are as shown on the article title pages; if no fee code appears on the title page, the copy fee is the same as for current articles. 0091-7435/84 33.00 MADE IN THE UNITED STATES OF AMERICA PREVENTIVB MEDICINE Published bimonthly by Academic Press. lnc.. I11 Fifth Avenue. New York. New York 10003 1984: Volume 13. Price: S120.00 U.S.A. and Canada; i138.011 all other cuuntries 1985: Volume 14. Price: i129.50 U.S.A. and C:mada: 5148.SU all uther cuuntnes All prices include postage and handling. Information concerning personal subscription rates may be obtained by writing to the Publisher..For the special student rate, please see the [nformation for Authors. All correspondence and subscription orders should be addressed to Ihe Office of the Publishers at t I I Fitth Avenue, New York. N.Y. 10003. Send notices of change of address to the Office of the Publishers at least 6 to 8 weeks in advance. Please include both old and new addresses. POSTMASTER: Send changes of address to Preventive Medicine. I l l Fifth Avenue. New York. New York 10003. Second class postage paid at New Yortt. N.Y., and additional mailing offices. Copyright 0 1984 by Academic Press. Inc. TI BU 31551 T scic: o rcll mFlr tiun sive eng. the spe: iln y It YCle invi. thei H mur emc tant t:h4 Zac. etfu tlist cert usir Sllrt turG CUo n T tssu imp con T brinm iiasu e:1JC CnLc

Preventive Medicine EDITOR-IN-CHIEF SENIOR ASSOCIATE EDITOR CONSULTING EDITOR MANAGING EDITOR ASSISTANT EDITOR Ernst L. Wynder Charles B. Arnold Lesley A. Schurmann Candyce Kornblum Jeannette M. Sims American Health Foundation. 320 East 43rd Street. New York. New York 10017 U.S.A. ASSOCIATE EDITORS Jerome D. Cohen Steven Jonas Ovide F. Pomerleau Walter J. Rogan David Schottenfeld Moyses Szklo St. Louis Universi7y School of Medicine State University of New York at Stony Brook School of Medicine University of Connecticut School of Medicine National Institute of Environmental Health Sciences Memorial Sloan-Kettering Cancer Center The Johns Hopkins University School of Hygiene and Public Health CONSULTANTS Kunio Aoki Nagoya. Japan Keith Ball London, England E. E. Baulieu Bicetre. France Erik Bjelke Norway Gerald S. Berenson New Orleans, LA Lester Breslow Los Angeles. CA Jacob A. Brody Joseph Fraumeni, Jr. Bethesda, MD Silvio Garattini Milan, Italy Leon Gordis Baltimore, MD Merwyn R. Greenlick Portland, OR Peter Greenwald Bethesdd, MD John H-C. Ho Kowloon, Hong Kong Stephen B. Hulley San Francisco, CA Anthony B. Miller Toronto, Ontario. Canada Baruch Modan Tel Aviv. Israel Pekka Puska Helsinki. Finland Abraham Rivenson New York, NY Claude Robyn Brussels, Belgium Itving J. Selikoff New York, NY K. Shanmugaratnam 0 Bethesda, MD Donald B. Louria Newark, NJ Singapore ... Joseph W. Cullen Bethesda, MD Frits de Waard Bilthoven, The Netherlands Russell V. Luepker Minneapolis, MN Joseph L. Lyon Salt Lake City, UT Robert D. Sparks Battle Creek, MI Jerzy Staszewski Gliwice, Poland M ~ ~ Lennart Domellof Umed, Sweden Joseph D. Matarazzo Portland, OR Karl Uberla Berlin, West Germany Preventive Medicine is the offscial journal of the American Socie+of Preventive Oncology. I

PUtVENTIVE NEllIC1NE 13, 557 (1984) Medical Perspectives on Passive Smoking: Foreword to Passive Inhalation . The well-being of the public is the foremost responsibility of the physician and scientist alike. Considerations of cost, convenience, and custom must all be sub- urdinated to safeguarding health. ln an increasingly complex society, however, many public health issues involve low-order associations and, as such, are emo- tionalljr charged and prone to elude definitive scientitic/medical resolution. Pas- sive inhalation of tobacco smoke presents a case in point. The lay community is engaged in intense debate over laws regarding smoking in public places and in the workplace. At the same time, the scientific community is engaged in a broad spectrum of research to clarify the issue as to the breadth, or even existence, of any possible public health hazard. . it is precisely because this question is so intensely debated by the public and scientists alike that it is appropriate to convene meetings of those most intimately involved with the problem in order to review the state of the art of research from their respective points of view. History has, time and again, shown that where an association is not a de- monstrably strong one, different investigators employing different techniques will emerge with differing conclusions. As a consequence, it is fundamentally impor- tant in such cases to marshal investigators with distinct areas of expertise- chemistry, biology, physiology, epidemiology, and public health. Recognizing that each of these disciplines has limitations; their totality is such that the resultiilg effort brings to a scientific issue the maximum feasible clarity with the minimum distortion. This then permits us to determine whether the data at hand have a certain consistency and to recommend appropriate courses df action accordingly, using the process clearly described in the tirst Surgeon General's Report on Smoking and Health in a chapter entitled "Criteria of Judgment." It is the uni- formity and degree of various associations that makes the case for an associa- tion-or fails to do so. The papers presented here represent the state of the art for data regarding the issue of passive inhalation as it exists today. Undoubtedly, it will be refined and improved upon in the future. 'Thus, the materials contained herein should be considered a catalyst for further inquiry into this important public health issue. These papers provide a valuable addition to the body of scientific literature and bring us closer to achieving a consensus of opinion as to the existence of an association between passive inhalation and lung cancer and other chronic dis- eases. The public deserves a definitive answer. We trust that the Vienna confer- ence will hasten the day when that answer is at hand. GERHARD LEHNERT Direktur, Zetrtrulinstitut Jitr Arbeiesnredizin .adupk-Schunf'rlder-Sn•usse J D-?OU Huutburg 76, Fetlerul Republic ul'Gerutuiry ERNST L. WYNDER Presidertt. Autrrirun Hculth Furcndutiua 320 East 43rd Strert, Nrw York, 1Yrw Yurk 1(1017 557 0091-7435184 53.00 l'upynghl G tYWt by .icaJemic Pre». lnc. All nt{hla ui repruducuue in rey turm reaerved. TI BU 31552

Volume 13, Number 6, November 1984 Copyright ® 1984 by Academic Press, Inc. All'rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without permission in writing from the copyright owner. The appearance of the code at the bottom of the first page of an article in this journal in- dicates the copyright owner's consent that copies of the article may be made for personal or internal use, or for the personal or internal use of specific clients. This consent is given on the condition, however, that the copier pay the stated per copy fee through the Copy- right Clearance Center. Inc. 127 Congress Street. Salem. Massachusetts 019701. for copying beyond that permitted by Sections 107 or 108 of the U.S. Copyright Law. This consent does not extend to other kinds of copying, such as copying for general distribution, for advertising or promotional purposes, for creating new collective works, or for resale. Copy fees for pre-19it4 articles are as shown on the article title pages; if no fee code appears on the title page, the copy fee is the same as for current articles. 0091-7435/84 33.00 MADE IN THE UNITED STATES OF AMERICA PREVENTIVB MEDICINE Published bimonthly by Academic Press. lnc.. I11 Fifth Avenue. New York. New York 10003 1984: Volume 13. Price: S120.00 U.S.A. and Canada; i138.011 all other cuuntries 1985: Volume 14. Price: i129.50 U.S.A. and C:mada: 5148.SU all uther cuuntnes All prices include postage and handling. Information concerning personal subscription rates may be obtained by writing to the Publisher..For the special student rate, please see the [nformation for Authors. All correspondence and subscription orders should be addressed to Ihe Office of the Publishers at t I I Fitth Avenue, New York. N.Y. 10003. Send notices of change of address to the Office of the Publishers at least 6 to 8 weeks in advance. Please include both old and new addresses. POSTMASTER: Send changes of address to Preventive Medicine. I l l Fifth Avenue. New York. New York 10003. Second class postage paid at New Yortt. N.Y., and additional mailing offices. Copyright 0 1984 by Academic Press. Inc. TI BU 31551 T scic: o rcll mFlr tiun sive eng. the spe: iln y It YCle invi. thei H mur emc tant t:h4 Zac. etfu tlist cert usir Sllrt turG CUo n T tssu imp con T brinm iiasu e:1JC CnLc

PREVENTIVE MEDICINE 13, 558 (1984) Proceedings of the International Symposium on Medical Perspectives on Passive Smoking' Opening Address As president of the Austrian Society for Occupational Medicine, I welcome you all most cordially to the symposium "Medical Perspectives on Passive Smoking." I would like to extend a special welcome to our guest from Bavaria, Landesminister of Labour and Social Affairs, Dr. Pirkl. I would also like 'to welcome our own Federal Minister of Health and the Environment, Dr. Kurt Steyrer, and the initiator-or at least one of the initiators-of this event, the president of the German Society for Occupational Medicine, Professor Valentin. Finally, as a representative of our guests from abroad, I welcome the president of the American Health Foundation, Dr. Ernst Wynder. Ladies and gentlemen, we are very proud that you have assembled here in Austria for this symposium on passive smoking, not only because the state has had a monopoly on tobacco for the past 200 years, but also because we are probably one of the first countries, within the framework of legislation aimed at providing protection for employees, to give consideration to the problem of pas- sive smoking. The situation with respect to the implementation of the relevant law is, perhaps, another matter, but at least we have created a possibility aimed at ensuring the,"rights" of the nonsmoker vis-a-vis the smoker. For your infor- mation, 30% of the overall Austrian population are smokers. Broken down into men and women, the most recent available statistics show that from the age of 16, 42% of Austrian men and 28% of the women smoke. The remaining percentage of the population are, therefore, passive smokers. I believe we have a heavy program before us: I now officially declare this meeting open, and call upon the next speaker, Professor Valentin, to address a few words totyou. . t April 9-12. 1984. Vienna. Auatria. fx)91-7435184 33.00 CupynyUl s: IYtl4 by Ac;Wemrc Preaa. lne. All nl{hta u/ «pruJualua in any furm rexcvtyl. E. BAUMGARTNER Austrian Society for Occupational Medicine Leiter des Arbeitsmedizinschen Zentrums A-6060 Hall Tirol Tirol, Austria 558 TI BU 31553 vW, reF

PREVENTIVE MEDICINE 13, 558 (1984) Proceedings of the International Symposium on Medical Perspectives on Passive Smoking' Opening Address As president of the Austrian Society for Occupational Medicine, I welcome you all most cordially to the symposium "Medical Perspectives on Passive Smoking." I would like to extend a special welcome to our guest from Bavaria, Landesminister of Labour and Social Affairs, Dr. Pirkl. I would also like 'to welcome our own Federal Minister of Health and the Environment, Dr. Kurt Steyrer, and the initiator-or at least one of the initiators-of this event, the president of the German Society for Occupational Medicine, Professor Valentin. Finally, as a representative of our guests from abroad, I welcome the president of the American Health Foundation, Dr. Ernst Wynder. Ladies and gentlemen, we are very proud that you have assembled here in Austria for this symposium on passive smoking, not only because the state has had a monopoly on tobacco for the past 200 years, but also because we are probably one of the first countries, within the framework of legislation aimed at providing protection for employees, to give consideration to the problem of pas- sive smoking. The situation with respect to the implementation of the relevant law is, perhaps, another matter, but at least we have created a possibility aimed at ensuring the,"rights" of the nonsmoker vis-a-vis the smoker. For your infor- mation, 30% of the overall Austrian population are smokers. Broken down into men and women, the most recent available statistics show that from the age of 16, 42% of Austrian men and 28% of the women smoke. The remaining percentage of the population are, therefore, passive smokers. I believe we have a heavy program before us: I now officially declare this meeting open, and call upon the next speaker, Professor Valentin, to address a few words totyou. . t April 9-12. 1984. Vienna. Auatria. fx)91-7435184 33.00 CupynyUl s: IYtl4 by Ac;Wemrc Preaa. lne. All nl{hta u/ «pruJualua in any furm rexcvtyl. E. BAUMGARTNER Austrian Society for Occupational Medicine Leiter des Arbeitsmedizinschen Zentrums A-6060 Hall Tirol Tirol, Austria 558 TI BU 31553 vW, reF

something of the spirit of this city, which has something warm and unifying about it. Austria has traditionally exercised a sort of bridging function; we see ourselves as mediators between ideological principles and scientific evidence. I am there- fore very happy that you have selected Vienna as your venue, and wish you a pleasant stay here. DR. KURT STEYRER Ministry of Health and Environmental Protection Stubenring 1 A-1010 Vienna, Austria ,