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ITC protocol for measuring exposure to secondhand tobacco smoke

ITC protocol for measuring exposure to secondhand tobacco smoke. Mark Travers, MS Andrew Hyland, PhD Roswell Park Cancer Institute. Outline of Presentation. FCTC, Health effects of SHS exposure Effects of smoke-free air policies Results of air quality studies Why measure air quality?

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ITC protocol for measuring exposure to secondhand tobacco smoke

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  1. ITC protocol for measuring exposure to secondhand tobacco smoke Mark Travers, MS Andrew Hyland, PhD Roswell Park Cancer Institute

  2. Outline of Presentation • FCTC, Health effects of SHS exposure • Effects of smoke-free air policies • Results of air quality studies • Why measure air quality? • How to measure air quality using the TSI Sidepak – ITC protocol • What you can do and how we can help

  3. Why go smokefree? • SHS harmful • Lung cancer, heart disease, adverse respiratory effects in kids, and now breast cancer in younger women • FCTC, Article 8 - Protection from exposure to tobacco smoke • “Each Party shall adopt and implement in areas of existing national jurisdiction as determined by national law and actively promote at other jurisdictional levels the adoption and implementation of effective legislative, executive, administrative and/or other measures, providing for protection from exposure to tobacco smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places.”

  4. Effects Causally Associated with ETS Exposure Developmental Effects Fetal Growth: Low birthweight and decrease in birthweight Sudden Infant Death Syndrome (SIDS) Pre-term delivery Respiratory Effects Acute lower respiratory tract infections in children (e.g. bronchitis and pneumonia) Asthma induction and exacerbation in children and adults Chronic respiratory symptoms in children Eye and nasal irritation in adults Middle ear infections in children Carcinogenic Effects Lung cancer Nasal sinus cancer Breast cancer in younger, primarily premenopausal women Cardiovascular and Hematological Effects Heart disease mortality Acute and chronic coronary heart disease morbidity Altered vascular properties Source: Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. California Environmental Protection Agency, Air Resources Board, Office of Environmental Health Hazard Assessment. June 2005.

  5. Effects with Suggestive Evidence of a Causal Association with ETS Exposure Reproductive and Developmental Effects Spontaneous Abortion, Intrauterine Growth Retardation Adverse Impact on Cognition and Behavior Allergic Sensitization Decrease pulmonary function growth Adverse effects on fertility or fecundability Cardiovascular and Hematological Effects Elevated risk of stroke in adults Respiratory Effects Exacerbation of Cystic Fibrosis Chronic respiratory symptoms in adults Carcinogenic Effects Cervical Cancer Brain Cancer and lymphomas in children Nasopharyngeal cancer All cancers – adult and child Source: Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant. California Environmental Protection Agency, Air Resources Board, Office of Environmental Health Hazard Assessment. June 2005.

  6. Components of Smoking Vaccine Smoke-free Air Counter Marketing Price Treatment

  7. Evaluation of Smoke-free Air Law Implementation Public Health Impact Adverse Side Effects Support or Opposition Direct Effects Economic Impact Indirect Effects Compliance Exceptions to Law (Waivers)

  8. Evaluation of Smoke-free Air Law Public Health Impact • Decrease indoor air pollution Direct Effects • Improve health and reduce incidence of tobacco smoke related diseases • Reduce exposure to carcinogens and toxins

  9. Evaluation of Smoke-free Air Law Public Health Impact Direct Effects Indirect Effects • Decrease consumption • Promote cessation

  10. Measuring Air Quality • Cigarettes, cigars and pipes are major emitters of respirable suspended particles less than 2.5 microns (PM2.5) in diameter that are easily inhaled deep into the lungs • TSI SidePak AM510 Personal Aerosol Monitor (weight: 1 lb)

  11. Why PM2.5? • Very sensitive marker of ETS • Can monitor and record data in real time • Relatively inexpensive equipment • Marker of the more than 4,000 chemical in ETS • E.g. 2,000:1, PM2.5:PAH • Meaningful measure: there are PM2.5 standards in place to protect public health • The EPA has set standards of 15 μg/m3 as the average annual level of PM2.5 exposure and 65 μg/m3 24-hour exposure in order to protect the public health

  12. US EPA Air Quality Index

  13. Hayman Fire – Worst in Colorado History, June 8 2002

  14. Denver June 9, 2002

  15. Denver’s visibility – before Hayman fire

  16. Denver’s visibility – 1 day after Hayman fire Worst PM 2.5 - 43 µg/m3 (24-hr max) or 200 µg/m3 (hourly max)

  17. Results • Pre-post study design • Indiana Air Monitoring Study • Western New York Air Monitoring Study Travers, M.J., et al., Indoor Air Quality in Hospitality Venues Before and After the Implementation of a Clean Indoor Air Law-Western New York, 2003. Morbidity and Mortality Weekly Report (MMWR), 2004.

  18. Indiana Air Monitoring StudyDecember 2004 to January 2005 Indiana Tobacco Prevention and Cessation Roswell Park Cancer Institute

  19. Indiana Air Monitoring Study: Bloomington, IN, December 10th, 2004 VENUE 4a VENUE 7a VENUE 2a VENUE 8a VENUE 6a VENUE 5a VENUE 3a VENUE 1a 12/11/04 1:20am 12/10/04 6:00pm

  20. Indiana Air Monitoring Study: Bloomington, IN, January 21st, 2005 VENUE 2b VENUE 5b VENUE 6b VENUE 4b VENUE 7b VENUE 1b VENUE 8b VENUE 3b 1/22/05 1:34am 1/21/05 6:14pm

  21. Bloomington, IN Before and After Clean Indoor Air Law

  22. 89% 95% 24-hour PM2.5 standard (65μg/m3) annual PM2.5 standard (15μg/m3)

  23. Indoor Air Quality Before and After the New York State Clean Indoor Air Law in Western New York Hospitality Venues, July to September 2003 Mark Travers,1 Michael Cummings,1 James Repace,2 Andrew Hyland1 1Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute; Buffalo, New York 2Repace Associates, Inc.; Bowie, Maryland

  24. Change in Air Quality in Western New York Bars and Restaurants After Implementation of the New York State Clean Indoor Air Law Before Law: Average = 412 μg/m3 After Law: Average = 27 μg/m3 Only venue with active smoking during post-law sampling Mean size of venue = 365m3 Mean pre-law active smoker density = 1.38 cigs/100m3

  25. Results • Cross sectional study design • Multi-City Air Monitoring Study • Global Irish Pub Study • Global Air Monitoring Study

  26. Multi-City Air Monitoring Study: Philadelphia, PA April 10th, 2004 All venues are smoking venues with observed smoking in all venues VENUE 48 VENUE 47 VENUE 45 VENUE 44 VENUE 43 VENUE 46 VENUE 42 4/11 1:41am 4/10 7:01pm

  27. Multi-City Air Monitoring Study: New York City, NY April 17th, 2004 All venues are smoke-free by law and no smoking was observed in an venue VENUE 58 VENUE 59 VENUE 60 VENUE 57 VENUE 61 VENUE 62 VENUE 56 4/18 2:38am 4/17 6:43pm

  28. Multi-City Air Monitoring Study: New York City, NY April 17th, 2004 and Philadelphia, PA April 10th, 2004

  29. Average Level of PM2.5 by City

  30. Global Irish Pub Study • Indoor air quality was assessed in 128 Irish pubs in 15 countries, between January 21, 2004 and March 10, 2006 • The level of air pollution inside Irish pubs located in smoke-free cities was 93% lower than the level found in pubs in cities allowing indoor smoking

  31. Global Air Monitoring Study Current participating countries (n=38)

  32. Results • Case studies • One bar with a designated smoking room

  33. Why measure air quality? • Quantify exposure, determine risk • Educate the public and policy makers • Evaluate smoke-free air policies • Generate media attention

  34. Data from air monitoring studies is used to educate the public about the dangers of secondhand smoke. • News articles • Editorial support

  35. How to measure air quality using the TSI Sidepak • How does it work? • Important issues to be aware of • Calibration Factor • Flow rate • How to prepare and operate the Sidepak • Measurements and observations • Advantages • Limitations

  36. The training course at www.tobaccofreeair.org

  37. Schematic of a Laser Photometer

  38. Calibration • The TSI SidePak Personal Aerosol Monitor uses a built-in pump to bring air past a laser. • The particles in the air scatter the light from the laser and the device determines the mass concentration of particles based on the amount of scattering. • These types of devices must be calibrated with the specific type of aerosol (tobacco smoke) that you are measuring.

  39. SidePak Factory Calibration Certificate

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