James L. Repace ^1*

¹ Repace Associates, Inc.; Visiting Asst. Clinical Prof. Tufts Univ. School of Medicine

^* To whom correspondence should be addressed. E-mail: repace{at}comcast.net.

	Abstract

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 and 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 10000 at risk, 5-fold the death rate from Pennsylvania mining disasters. Casinos should not be exempt from smoke-free workplace laws.

Key Words: Cancer, Cardiovascular Disease, Community Health, Secondhand Smoke, Tobacco Control, Tobacco