Flying the smoky skies: secondhand smoke exposure of flight attendants

Abstract

Objective: To assess the contribution of secondhand smoke (SHS) to aircraft cabin air pollution and flight attendants' SHS exposure relative to the general population. Methods: Published air quality measurements, modelling studies, and dosimetry studies were reviewed, analysed, and generalised. Results: Flight attendants reported suffering greatly from SHS pollution on aircraft. Both government and airline sponsored studies concluded that SHS created an air pollution problem in aircraft cabins, while tobacco industry sponsored studies yielding similar data concluded that ventilation controlled SHS, and that SHS pollution levels were low. Between the time that non-smoking sections were established on US carriers in 1973, and the two hour US smoking ban in 1988, commercial aircraft ventilation rates had declined three times as fast as smoking prevalence. The aircraft cabin provided the least volume and lowest ventilation rate per smoker of any social venue, including stand up bars and smoking lounges, and afforded an abnormal respiratory environment. Personal monitors showed little difference in SHS exposures between flight attendants assigned to smoking sections and those assigned to non-smoking sections of aircraft cabins. Conclusions: In-flight air quality measurements in ,250 aircraft, generalised by models, indicate that when smoking was permitted aloft, 95% of the harmful respirable suspended particle (RSP) air pollution in the smoking sections and 85% of that in the non-smoking sections of aircraft cabins was caused by SHS. Typical levels of SHS-RSP on aircraft violated current (PM 2.5 ) federal air quality standards ,threefold for flight attendants, and exceeded SHS irritation thresholds by 10 to 100 times. From cotinine dosimetry, SHS exposure of typical flight attendants in aircraft cabins is estimated to have been .6-fold that of the average US worker and ,14-fold that of the average person. Thus, ventilation systems massively failed to control SHS air pollution in aircraft cabins. These results have implications for studies of the past and future health of flight attendants.

Insufficient Smoking Restrictions in Restaurants Around Junior High Schools in Japan

“…An arrangement on the owners' conception is an issue. Also, smoking restriction methods such as provision of separate seats for children and pregnant women, observed in our study, is considered ineffective (Lambert et al 1993;Repace 2004). To regulate SHS, to reach the knowledge and methods of proper smoking restrictions to every restaurant is necessary, if it did not reach.…”

“…We defined "100% non-smoking" as totally forbidding smoking, and defined "completely non-smoking" as setting aside a separate space using a partition in a restaurant. We judged restaurants that were "100%" and "completely" non-smoking as sufficient to control SHS effectively (Lambert et al 1993;Repace 2004). Other restrictions were defined as insufficient.…”

A tobacco industry study of airline cabin air quality: dropping inconvenient findings

“…This presentation is particularly important, since it is the maximum, not the mean, levels that are generally important for regulatory purposes. 85 Another important difference in presentation existed between TNO's report and the published paper. The industry group that met at Covington & Burling in January 1989 had suggested that Malmfors compare measured levels of secondhand smoke components with existing standards.…”

Protecting the World From Secondhand Tobacco Smoke Exposure: Where Do We Stand and Where Do We Go From Here?

“…These expose the industry's strategies to prevent and obstruct the spread of smoke-free laws, investing in multimillion-dollar campaigns to confuse the public and slow down the rate of decline in cigarette consumption and social acceptability of smoking (Glantz, Barnes, Bero, Hanauer, & Slade, 1995;Muggli, Hurt, & Blanke, 2003). Worldwide, the industry has secretly hired consultants, sponsored symposia, financed research, and engaged in lobbying in order to fuel the controversy on the relationship between SHS and disease (Barnoya & Glantz, 2002;Hammond & Assunta, 2003;Muggli et al, 2003;Repace, 2004a). In recent years, especially in the United States, the industry has shifted the focus to economic claims that smoke-free environments are disastrous for the hospitality industry, investing millions of dollars in restaurant associations (Dearlove et al, 2002) and in the gaming industry (Mandel & Glantz, 2004).…”

“…' Rights Foundation, 2012). Flight attendants, exposed to extraordinarily high SHS levels in airplanes (Neilsen & Glantz, 2004;Repace, 2004aRepace, , 2004b, were instrumental in spearheading the push for legislation. Their efforts led to the elimination of smoking on U.S. flights.…”