Introduction: Secondhand smoke (SHS) is the third leading cause of preventable death in the United States. It is responsible for an estimated 3,000 lung cancer deaths annually in never-smokers in the US. It also accounts for over 35,000 deaths annually from coronary heart disease in never-smokers. It increases the number and severity of asthmatic attacks in over 300,000 asthmatic children each year, and is associated with Sudden Infant Death Syndrome and middle ear infections, in addition to other illnesses in children. The purpose of this study was to examine indoor air quality in a sample of hospitality venues in Paducah, Kentucky. The relation between indoor air pollution and the presence of on premises smoking was assessed.
Methods: A Personal Aerosol Monitor was used to sample and record the levels of respirable suspended particles in the air. The SidePak uses a built-in sampling pump that draws air through the device and the particulate matter in the air scatters the light from a laser. Based on this light scattering, the device determines to assess the real-time concentration of particles smaller than 2.5 microm in micrograms per cubic meter, or PM2.5.
Results: The average PM2.5 concentration in the eleven locations sampled in Paducah, Kentucky, was 177 microg/m3. The average fine particle pollution level in the non-smoking sections tested was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. The average PM2.5 level across all nine smoking-permitted hospitality locations sampled in Paducah was 200 microg/m3. For a full-time employee in the venues sampled in this study, the average annual PM2.5 exposure would be 46 microg/m3 (assuming exposure to 200 microg/m3 on the job, exposure to zero particles off the job, and a 40-hour work week). The EPA average annual PM2.5 limit is exceeded by 3.1 times due solely to occupational exposure. Of the ten locations visited that permit indoor smoking, the air monitoring was done in the non-smoking section of six of them. These locations included five restaurants and one public government office. The average fine particle pollution level in these non-smoking sections was 87 microg/m3, which is 29 times higher than the average fine particle pollution level in smoke-free air or 6 times higher than outdoor air in Paducah. It is also interesting to note that the average fine particle pollution level in the smoking section of one restaurant was actually less than the average fine particle pollution level in the "no smoking" section of two other restaurants.
Conclusions: The effects of secondhand smoke are substantial and rapid, explaining the relatively large health risks associated with secondhand smoke exposure that have been reported in epidemiological studies. This study shows that physically separating smokers and non-smokers is not an effective way to protect non-smoking patrons from tobacco smoke pollution. "No smoking" sections provided protection to nonsmokers that can be characterized as trivial at best. In fact, patrons in Paducah cannot be certain that their exposure will not be higher in the "no smoking" sections of certain venues when compared to the smoking sections of other venues. It is imperative that physicians and other healthcare providers actively and aggressively lobby local policymakers to pass regulatory and/or public health ordinances, which have been demonstrated to be effective in controlling exposure to secondhand smoke.