Effects of tobacco smoke on air quality in pubs and bars Ivan Gee, Centre for Public Health Liverpool John Moores University Investigation of Air Pollution Standing Conference, 5th June 2007
Structure of Talk Some key studies on indoor air quality in bars Our Research in Bars Segregation Ventilation Before smokefree 2007 Current research before and after July 1 st
Measuring tobacco smoke Tobacco smoke composed of many 100s of compounds so marker pollutants are used: Carbon monoxide Nicotine Fine particles (PM 10, PM 2.5, RSP) Tobacco specific particles (UVPM, FPM, Solanesol) 3-ethenylpyrridine Salivary cotinine (biomarker)
Typical ETS Levels in Workplaces AREA Nightclubs Services Industrial workplaces Offices Workplaces with: Ban on smoking Restrictions on smoking Smoking allowed Nicotine (µg/m3) 37 3.0 2.7 0.6 0 0.4 1.3 5.9 8.6 10 From: Irish Health and Safety Agency (2002)
Nicotine in US workplaces Type of workplace N o of studies N o of establishments sampled Weighted mean Range Offices 22 940 4.1 0.8 22.1 Residences 7 91 4.3 1.6 21.0 Restaurants 17 402 6.5 3.4 34.0 Betting establishments 3 4 9.8 8.0 10.7 Bowling alleys 2 6 10.5 10.1 10.7 Billiard halls 2 3 13.0 9.8 19.4 Bars 10 27 31.1 7.4 105.4 Bingo parlours 2 3 76.0 65.5 81.2 From: Siegel and Skeer (2003)
Exposure of Bar Staff in London Pubs compared to non-smoking residents Cotinine (ng/ml) 4.5 4 3.5 3 2.5 2 1.5 1 0.5 0 Non-smoking London Bar staff (n=39) Non-smokers married to smokers (n=653) Non-smokers nonsmoking homes (n=3558) [Jarvis, M et al. Brit J Add 1992; 87: 11-113]
Hospitality industry exposure About 3 million workers in the UK are exposed to ETS. 400,000 exposed hospitality workers in the UK. Their exposure to ETS is high and problematical to control. Professor Jamrozik (Imperial College, London) estimated that exposure to secondhand smoke in the workplace causes around 600 premature deaths in the UK each year 1. Equates to one premature death a week among workers in the hospitality industries. 1. Professor Konrad Jamrozik BMJ 2005;330:812
What are the control options for ETS in pubs and bars? Voluntary codes e.g. PPC Legislation Exposure Limits (EH40) Smokefree Segregation Ventilation
Public Places Charter Non-smoker Protection? White Paper Smoking Kills, 1998 Public Places Charter Customers Non Smoking Areas Ventilation Signs AoP, 1999 Staff Ventilation Training Promoting NS at work No existing legislation on passive smoking 2 Control options: Non-smoking areas & Ventilation. But little research on their effectiveness.
The impact of non-smoking areas on ETS levels in UK pubs and bars Ivan Gee, Adrian Watson & Joanna Carrington Manchester Metropolitan University
Sampling Methodology 60 pubs and bars studied in and around Manchester Oct 2000 July 2001 4 hr sampling period: 6:30 10:30 (pm) 2 3 4 5 Several locations sampled: 1) behind bar, 2) smoking areas 3) non-smoking areas, 1 7 6 Markers Used: RSP as PM2.5 ETS Specific Particles: UVPM, FPM, SolPM Nicotine 1: Timer system 2: Pump 3,7: Battery Packs 4: Manifold flow splitter 5: PM2.5 sample head (2 l/min) 6: Nicotine, XAD-4 tube (1 l/min)
Summary of Nicotine levels in various environments No of Studies No of Venues Nicotine Mean Nicotine Range (µg/m 3 ) (µg/m 3 ) Manchester Bars 1 60 55 0.5-517 Offices 22 940 4.1 0.8-22 Homes 7 91 4.3 1.6-21 Restaurants 17 402 6.5 3.4-34 Bars 10 27 31 7.4-105
Effect of no-smoking areas concentration (ug/m3) 125 100 75 50 25 RSP SolPM Nicotine The smoking areas have higher levels of ETS than nonsmoking areas. Bar areas are intermediate Some reduction in exposure for bar staff 0 Smoking Non-smoking Bar
Area differences (ug/m 3 ) ETS Marker Median Smoking Median Non Smoking NS % reduction Median Bar Bar % reduction (n=40) (n=23) (n=26) RSP 80 69 13 69 14 SolPM 43 30 30 32 26 Nicotine 55 21 62 32 42 Larger reductions of 30% for ETS specific particles in non-smoking areas Reductions at bars are <26% for ETS particles Considerable reductions in nicotine misleading due to its limited mobility not a good comparative marker for ETS
Non-smoking areas reduce levels in all areas of a pub: bar, smoking and and non-smoking areas. Probably by dilution fewer smokers per unit area Non-smoking areas have been demonstrated to reduce levels compared to smoking sections Reductions in nicotine much greater than particles But, considerable public exposure will still occur in these areas & we have no accepted ETS standards to judge air quality.
Effect of Ventilation 500 400 300 200 RSP UVPM Indication that mechanically ventilated pubs have lower levels, 100 0 N = 23 23 23 23 23 86 86 86 86 86 24 24 24 24 24 Mechanical Extrator Fans On Extractor Fans Off FPM SolPM Nicotine but this is not statistically significant. Not clear what level of ETS is appropriate
Impact of ventilation at the bar Mean difference smoking area - bar concentration (ug/m3) 50 25 0-25 -50-75 Mechanical Extractor Fans Natural RSP SolPM Nicotine At the bar mechanical ventilation systems tend to elevate levels in comparison to adjoining smoking areas. Extractor fans and natural ventilation lead to reductions of 5-20ug/m 3 at the bar
Conclusions - Ventilation The Manchester study suggests that current ventilation systems do not appear to be reducing ETS levels sufficiently Some indications that mechanical systems may be increasing levels at the bars in comparison to adjoining smoking areas. Repace has calculated that to achieve a safe working environment excessive air exchange rates will be required.
Liverpool bar survey, 2005 55 hospitality venues sampled Nicotine 3EP PM2.5 Solanesol Black, Gee, Casstles (2007) J Env. Health Res 6(1) 3-12.
Similar results for all markers Much higher levels in bars and social clubs compared to restaurants and the non-smoking venue Black, Gee, Casstles (2007) J Env. Health Res 6(1) 3-12.
Smokefree Bars 07: Researching current policy DoH funded a collaborative study by Aberdeen University, Institute of Occupational and Environmental Medicine (IOM) and Liverpool John Moores University Examining exposure, health and attitudes of staff and customers Pre and post 1 July legislation
Saliva cotinine survey Lung function testing PM2.5 continuous monitoring Personal monitoring Attitude questionnaire Aim is to evaluate the impact of the smokefree legislation
See you in the pub on July 1st x
REFERENCES Siegel and M Skeer. 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. M Tobacco Control 2003;12:333-338 T Kauppinen et al. Occupational exposure to carcinogens in the European Union. Occup. Environ Med 2000;57:10-18 ANSI/ASHRAE Standard 62-2001, Ventilation for Acceptable Indoor Air Quality, Free at: http://xp20.ashrae.org/standards/62-2001_add_menu.htm. Irish Health and Safety Agency, 2002. Report on the health effects of environmental tobacco smoke (ETS) in the workplace. Borland et al, 1992. Protection from environmental tobacco smoke in California: the case for a smoke free workplace. IJ. Am. Med Assoc., 268, 749-752. K. Jamrozik Presentation at the Royal College of Physicians conference, London, 2004 Jarvis, M et al., Repeat study of cotinine levels in 44 non smoking bar staff from pubs in London, 200, 1 Brit J Add 2002; 87: 11-113 Carrington J., Gee I.L., Watson A.F.R. The effects of smoking status and ventilation on environmental tobacco smoke concentrations in public areas of UK pubs and bars. Atmos. Environ. 20031352-2310, Black D, Gee IL, Casstles H. Monitoring the exposure of hospitality workers to second hand smoke: establishing a base-line in advance of the smoke free legislation. J Env. Health Res 2007; 6: 3-12.