An Enforceable Indoor Air Quality Standard for Environmental Tobacco Smoke in the Workplace¹

Abstract

Environmental tobacco smoke (ETS) has recently been determined by U.S. environmental and occupational health authorities to be a human carcinogen. We develop a model which permits using atmospheric nicotine measurements to estimate nonsmokers' ETS lung cancer risks in individual workplaces for the first time. We estimate that during the 1980s, the U.S. nonsmoking adult population's median nicotine lung exposure (homes and workplaces combined) was 143 micrograms (micrograms) of nicotine daily, and that most-exposed adult nonsmokers inhaled 1430 micrograms/day. These exposure estimates are validated by pharmacokinetic modeling which yields the corresponding steady-state dose of the nicotine metabolite, cotinine. For U.S. adult nonsmokers of working age, we estimate median cotinine values of about 1.0 nanogram per milliliter (ng/ml) in plasma, and 6.2 ng/ml in urine; for most-exposed nonsmokers, we estimate cotinine concentrations of about 10 ng/ml in plasma and 62 ng/ml in urine. These values are consistent to within 15% of the cotinine values observed in contemporaneous clinical epidemiological studies. Corresponding median risk from ETS exposure in U.S. nonsmokers during the 1980s is estimated at about two lung cancer deaths (LCDs) per 1000 at risk, and for most-exposed nonsmokers, about two LCDs per 100. Risks abroad appear similar. Modeling of the lung cancer mortality risk from passive smoking suggests that de minimis [i.e., "acceptable" (10(-6))], risk occurs at an 8-hr time-weighted-average exposure concentration of 7.5 nanograms of ETS nicotine per cubic meter of workplace air for a working lifetime of 40 years. This model is based upon a linear exposure-response relationship validated by physical, clinical, and epidemiological data. From available data, it appears that workplaces without effective smoking policies considerably exceed this de minimis risk standard. For a substantial fraction of the 59 million nonsmoking workers in the U.S., current workplace exposure to ETS also appears to pose risks exceeding the de manifestis risk level above which carcinogens are strictly regulated by the federal government.

Urinary cotinine as a tobacco-smoke exposure index: a minireview

“…Though less frequent, similar studies have considered the eects of passive smoking on healthy adults [42]. Moreover, the carcinogenesis risk has been tested [22,74]. However, diculties in obtaining statistically signi®cant associations on the small scale sometimes require the realization of meta-analyses [93].…”

Simple, rapid and sensitive assay method for simultaneous quantification of urinary nicotine and cotinine using gas chromatography–mass spectrometry

“…Cotinine has relatively longer half-life than nicotine and it can be easily detected in urine, plasma and saliva. Urinary cotinine is a widely used biomarker due to higher concentration in urine matrix compared to other matrixes, thus could be detected accurately in urine [11,12].…”

Predictors of Success for Smoking Cessation at the Workplace: A Longitudinal Study

“…[3] Smoking at the place of work also results in a loss of productivity caused by repeated ‘small cigarette breaks' during working hours [5]. Recently, awareness of the dangers of passive smoking has raised concerns about the health of non-smoking employees and the need to protect them against ambient smoke [6]. …”