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AJPH First Look, published online ahead of print Jun 18, 2009
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AJPH.2008.146241v1
99/8/1478    most recent
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August 2009, Vol 99, No. 8 | American Journal of Public Health 1478-1485
© 2009 American Public Health Association
DOI: 10.2105/AJPH.2008.146241

RESEARCH AND PRACTICE

Secondhand Smoke in Pennsylvania Casinos: A Study of Nonsmokers' Exposure, Dose, and Risk

James L. Repace, MSc

James L. Repace is with Repace Associates Inc, Bowie, MD, and the Department of Public Health and Family Medicine, Tufts University School of Medicine, Boston, MA.

Correspondence: Correspondence should be sent to James L. Repace, MSc, Repace Associates Inc, 101 Felicia Ln, Bowie, MD, 20720 (e-mail: repace{at}comcast.net). Reprints can be ordered from http://www.ajph.org by clicking on the "Reprints/Eprints" link.

Objectives. I assessed air pollution, ventilation, and nonsmokers' risk from secondhand smoke (SHS) in Pennsylvania casinos exempted from a statewide smoke-free workplace law.

Methods. I measured respirable suspended particles (RSPs), particulate polycyclic aromatic hydrocarbons (PPAHs), and carbon dioxide inside and outside casinos; measured changes in patrons' urine cotinine after casino visits; and assessed SHS impact on workers and patrons, using exposure–response models, air quality standards, and odor and irritation thresholds.

Results. PPAH and RSP concentrations in casinos were, on average, 4 and 6 times, respectively, that of outdoor levels despite generous ventilation and low smoking prevalence. SHS infiltrated into nonsmoking gaming areas. Patrons' urine cotinine increased 1.9 ng/mL on average after about 4-hour visits.

Conclusions. SHS-induced heart disease and lung cancer will cause an estimated 6 Pennsylvania casino workers' deaths annually per 10 000 at risk, 5-fold the death rate from Pennsylvania mining disasters. Casinos should not be exempt from smoke-free workplace laws.






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