Estimation of personal exposure to ambient nicotine in daily environment

Exposure to secondhand smoke and excess lung cancer mortality risk among workers in the "5 B's": bars, bowling alleys, billiard halls, betting establishments, and bingo parlours

OBJECTIVE

To review existing data on exposure to secondhand smoke in bars, bowling alleys, billiard halls, betting establishments, and bingo parlours (the "5 B's") as assessed by ambient nicotine air concentration measurements and to estimate the excess lung cancer mortality risk associated with this exposure.

DATA SOURCES

Using the Medline, Toxline, and Toxnet databases, the internet, and bibliographies of relevant articles, we identified studies that reported measurements of ambient nicotine concentrations in the 5 B's.

STUDY SELECTION

Studies were included if they reported a mean concentration of ambient nicotine measured in at least one of the 5 B's.

DATA EXTRACTION

We calculated a weighted average of nicotine concentrations in each of the 5 B's. We then estimated the working lifetime excess lung cancer mortality risk associated with this exposure, as well as with exposure at the upper and lower limits of the range of mean exposures reported in all of the studies in each establishment category.

DATA SYNTHESIS

Nicotine concentrations in the 5 B's were 2.4 to 18.5 times higher than in offices or residences, and 1.5 to 11.7 times higher than in restaurants. At these exposure levels, estimated working lifetime excess lung cancer mortality risk from secondhand smoke exposure for workers in the 5 B's is between 1.0-4.1/1000, which greatly exceeds the typical de manifestis risk level of 0.3/1000.

CONCLUSIONS

Workers in the 5 B's have high levels of occupational exposure to secondhand smoke and must be included in workplace smoking regulations.

An international survey of indoor air quality, ventilation, and smoking activity in restaurants: a pilot study

During a pilot study of indoor air quality in restaurants, a survey was performed in 34 medium-priced restaurants in six countries in Asia, Europe, and North America using a uniform protocol. The concentration of selected constituents of environmental tobacco smoke (ETS) present in occupied areas was determined during lunch and dinner periods by measuring the levels of four particulate-phase markers and two gas-phase markers. The particulate-phase markers determined were respirable suspended particles, ultraviolet particulate matter, fluorescing particulate matter, and solanesol particulate matter. The gas-phase markers were nicotine and 3-ethenylpyridine (3-EP). Correlation between the markers was investigated to explore an improved monitoring approach. It was concluded that at least one marker in each phase was necessary to describe adequately the ETS load. An assessment was made of the ventilation system in each restaurant, and effective ventilation rates were determined based on CO(2) measurements. Smoking activity was also monitored. These data were used to model nicotine and 3-EP concentrations that resulted in a satisfactory prediction of their levels, especially at the higher concentrations. A total number of 1370 questionnaires were returned by the restaurant patrons in five countries. In some countries, dissatisfaction rates above 20% were observed for draft, freshness of air, and noise. The dissatisfaction rates related to tobacco smoke were less than 20%, which is lower than would be predicted based on measured ETS levels. Based on the results of this international pilot study, recommendations are given for future studies of this type.

Distribution analysis of airborne nicotine concentrations in hospitality facilities

A number of publications report statistical summaries for environmental tobacco smoke (ETS) concentrations. Despite compelling evidence for the data not being normally distributed, these publications typically report the arithmetic mean and standard deviation of the data, thereby losing important information related to the distribution of values contained in the original data. We were interested in the frequency distributions of reported nicotine concentrations in hospitality environments and subjected available data to distribution analyses. The distribution of experimental indoor airborne nicotine concentration data taken from hospitality facilities worldwide was fit to lognormal, Weibull, exponential, Pearson (Type V), logistic, and loglogistic distribution models. Comparison of goodness of fit (GOF) parameters and indications from the literature verified the selection of a lognormal distribution as the overall best model. When individual data were not reported in the literature, statistical summaries of results were used to model sets of lognormally distributed data that are intended to mimic the original data distribution. Grouping the data into various categories led to 31 frequency distributions that were further interpreted. The median values in nonsmoking environments are about half of the median values in smoking sections. When different continents are compared, Asian, European, and North American median values in restaurants are about a factor of three below levels encountered in other hospitality facilities. On a comparison of nicotine concentrations in North American smoking sections and nonsmoking sections, median values are about one-third of the European levels. The results obtained may be used to address issues related to exposure to ETS in the hospitality sector.

Linear extrapolation models of lung cancer risk associated with exposure to environmental tobacco smoke

This paper presents a model to estimate the number of lung cancer deaths due to ETS exposure among the 1992 U.S. never-smoking population, based on downward linear extrapolation from the estimated risks of active smokers. The model uses several recently available data sources including an extensive review of the published literature on indoor concentration of ETS constituents measured under real-world conditions and data from the National Mortality Followback Survey and the National Health Interview Survey which furnish nationally representative estimates of the distribution of the U.S. population and the persons who died from lung cancer by sex, age, and smoking status. The linear extrapolation model estimates that five male and six female excess lung cancer deaths due to ETS exposure would be expected in the 1992 U.S. population of over 52 million never smokers age 35 and over. Explanations for differences between the results of our downward extrapolation model and those of others are presented.

Urinary cotinine in children and adults during and after semiexperimental exposure to environmental tobacco smoke

Urinary cotinine (U-cotinine) as a biomarker of environmental tobacco smoke exposure was evaluated in 14 children (age 4-11 y) and in 7 adults who were exposed to environmental tobacco smoke at an air nicotine level of 110 mg/m3 for 2 h in a bus. Nicotine in air and U-cotinine were measured by gas chromatography/mass spectrometry before, during, and after the experiment. U-cotinine rose rapidly to a maximum after a median of 6 h following the end of exposure; remained at an apparent plateau for half a day; and then decreased exponentially, with a mean half-time of 19 h (95% confidence interval 18-20 h; no significant difference between children and adults). The maximum U-cotinine was higher in the children (mean = 22 mg/l) than in the adults (13 mg/l; p = .005); decreased with age among the children (r = -.74; p = .002); and increased as the estimated inhaled nicotine dose increased. Therefore, the findings of the present study showed that young children had higher U-cotinine than adults at the same experimental environmental tobacco smoke exposure, probably because they had a higher relative nicotine dose because of a higher relative ventilation rate, and possibly also because of metabolic differences; the elimination rate did not differ. The long half-time makes U-cotinine a good biomarker of environmental tobacco smoke exposure; the time of sampling is not very critical. Dilution-adjusted concentrations should be employed, and in children, preferably by density correction. A certain urinary cotinine level indicates a lower environmental tobacco smoke exposure in a small child than in an adult.

Respiratory nicotine absorption in non-smoking females during passive smoking

The aim of this study was to measure nicotine concentrations in inspired and expired air so as to learn more about respiratory (nasopharyngeal cavity and lung) nicotine absorption from inspired air and to estimate the nicotine intake during passive smoking. A total of 17 young non-smoking women were exposed to experimental passive smoking. Inspired and expired air was sucked at a constant rate into samplers filled with acid-treated diatomite (Uniport-S) to absorb nicotine in the air. Absorbed nicotine was assayed by gas chromatography. The range of nicotine concentration in the inspired air was 40-200 micrograms/m3. In this setting, 47 samples obtained from the 17 subjects were assayed. Nicotine absorption, which was calculated as [(nicotine concentration in inspired air-nicotine concentration in expired air)/nicotine concentration in inspired air] x 100, remained at 60%-80% (mean +/- SD, 71.3% +/- 10.2%) without being affected by the nicotine concentration in the inspired air. From this result, it was estimated that the average intake of nicotine was 0.026 mg/h in a group of non-smokers exposed in a room containing a nicotine concentration of 100 micrograms/m3, which is equivalent to fairly severe involuntary tobacco smoking. This is the first report on the estimation of respiratory nicotine absorption and nicotine intake during passive smoking based on the direct measurement of nicotine concentrations in both inspired and expired air.