1. 1 Mansel Nelson, ITEP Environmental Tobacco Smoke

2. 2 First Leading Cause of Lung Cancer Smoking is leading cause of lung cancer Causes an estimated 160,000 deaths in the U.S. every year (American Cancer Society, 2004) Rate among women is rising Now exceeds breast cancer www.nau.edu/eeop

3. 3 Third Leading Cause of Lung Cancer Secondhand smoke is third leading cause of lung cancer Estimated 3,000 lung cancer deaths every year About 1,000 never smoked; about 2,000 former smokers www.nau.edu/eeop

4. 4

5. 5 A Personal Choice

6. 6 Smoking Harms nearly every bodily organ Causing many diseases, degrades health Estimated 438,000 deaths (nearly 1 of 5 deaths) each year in U.S. More than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined www.nau.edu/eeop

7. 7 Smoking (cont.) Cancer is second leading overall cause of death Lung cancer is the first disease directly linked to smoking Risk of dying from lung cancer 23x higher among men 13x higher among women Smoking also causes cancers of bladder, oral cavity, pharynx, larynx (voice box), esophagus, cervix, kidney, lung, pancreas, and stomach, and acute myeloid leukemia www.nau.edu/eeop

8. 8 Smoking (cont.) Smokers 2–4 times more likely to develop coronary heart disease Smoking doubles a person’s risk for stroke Smokers more than 10x as likely than nonsmokers to develop peripheral vascular disease www.nau.edu/eeop

9. 9 Smoking (cont.) Causes tenfold increase in risk of dying from chronic obstructive lung disease Many adverse reproductive and early childhood effects, including increased risk for infertility, preterm delivery, stillbirth, low birth weight, and sudden infant death syndrome (SIDS) Postmenopausal women smokers have lower bone density www.nau.edu/eeop

10. 10 Often not a choice for many, including children and employees in smoking facilities

11. 11 Surgeon General’s Report Second-Hand Smoke Single greatest avoidable cause of disease and death www.who.int/nmh/publications/fact_sheet_tobacco_en.pdf

12. 12 Surgeon General’s Report (cont.) Millions of Americans, children and adults, still exposed to second-hand smoke Second-hand smoke exposure causes disease and premature death in children and adults who do not smoke www.nau.edu/eeop

13. 13 Surgeon General’s Report (cont.) Children exposed to secondhand smoke at increased risk for Sudden infant death syndrome (SIDS) Acute respiratory infections Ear problems More severe asthma www.nau.edu/eeop

14. 14 Surgeon General’s Report (cont.) Exposure of adults to secondhand smoke has immediate adverse effects Cardiovascular system and causes Coronary heart disease Lung cancer www.nau.edu/eeop

15. 15 Surgeon General’s Report (cont.) The scientific evidence indicates there is no risk-free level of exposure to secondhand smoke www.nau.edu/eeop

16. 16 Surgeon General’s Report (cont.) Eliminating smoking in indoor spaces fully protects nonsmokers Following actions DO NOT protect nonsmokers Separating smokers from nonsmokers Cleaning the air Ventilating buildings www.nau.edu/eeop

17. 17 Basic Principles of Indoor Air Quality Apply Basic Principles to ETS Source Control Ventilation Air Cleaning www.nau.edu/iaqtc

18. 18 Source Control ASHRAE Standard 62.1-2007 For air pollution sources other than people, source control is recommended. ASHRAE uses 15 micrograms/m3 for PM2.5, if there are NO carcinogens ASHRAE’s position is that the only way to effectively eliminate health risk associated with indoor exposure is to ban smoking activity www.nau.edu/iaqtc

19. 19 Ventilation for Buildings with Smoking ASHRAE Standard 62.1-2007 Smoking areas shall have more ventilation than comparable no-smoking areas. Specific ventilation rate requirements cannot be determined, because “acceptable risk” has not been determined Air from smoking areas shall not be re-circulated or transferred to no-smoking areas. 100% outside air should be used for ventilation. www.nau.edu/iaqtc

20. 20 Air Cleaning The use of air cleaners alone cannot ensure adequate air quality, particularly where significant sources are present and ventilation is inadequate. www.epa.gov/iaq/pubs/residair.html

21. 21 Air Cleaning – Don’ts These methods may make air quality WORSE DO NOT USE Ozone (sold under many different guises) Ozone is an air pollutant Chemical reactions may lead to even more dangerous air pollutants Air Fresheners typically attempt to cover up smoke smell and add more air pollutants DO NOT use electronic or electrostatic cleaners that may add ozone www.epa.gov/iaq/pubs/residair.html

22. 22 Air Cleaning A report from the U.S. Surgeon General echoes ASHRAE’s position that adverse health effects related to tobacco smoke cannot be eliminated through filtration or ventilation. True HEPA filter can eliminate some particles from cigarette smoke, but the most hazardous particles are the most likely to get through a HEPA filter. https://www.ashrae.org/about-ashrae/position-documents

23. 23 Summary The only way to fully protect non- smokers is to make the building 100% non-smoking. If smoking is allowed, aggressive ventilation will reduce the discomfort and health risks for the employees. Children should never be exposed to cigarette smoke.

24. 24 Monitoring Air Quality in Smoking Buildings ASHRAE uses 15 micrograms/m3 for PM2.5 standard, if there are NO carcinogens PM2.5 measurements can be taken to identify areas of greatest contamination Real-time particle counters Mini-vol (filter based) Other filter based methods https://www.ashrae.org/about-ashrae/position-documents

25. 25 Instruments $2K to $10+K

26. 26 More Instruments Recommend that CO2 measurements inside be about the same as outside. $450

27. 27 Tobacco Resources www.cdc.gov/tobacco/ www.surgeongeneral.gov/library/secondhandsmoke/ www.cancer.org www.lungusa.org www.nci.nih.gov/ www.ashrae.org/about-ashrae/position-documents www.nau.edu/eeop

28. 28 Institute for Tribal Environmental Professionals (ITEP) Mansel A. Nelson, Senior Program Coordinator Indoor Air Quality in Tribal Communities (IAQTC) Northern Arizona University (NAU) http://www.nau.edu/iaqtc/ mansel.nelson@nau.edu Voice 928 523 1275 FAX 928 523 1280 PO Box 5768, Flagstaff, AZ 86011 www.nau.edu/iaqtc