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This page updated November 5, 2007.
| New York Times Article on ETS in Multifamily Buildings |
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Environmental Tobacco Smoke Exposure
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Environmental Tobacco Smoke (ETS) exposure in many indoor public places
has been on the decline over the past few decades. This decrease has been documented by surveys done by the California
Department of Health Services (CDHS), and by biological monitoring
conducted by the U.S. Centers for Disease Control
(CDC). However, there are still ETS exposures that cause concern,
especially for vulnerable populations such as children and the elderly.
The home environment, where young children spend most of their time, is
the location where they are more likely to experience high exposure.
Children may also be exposed to very high concentrations of ETS in
vehicles with adult smokers. Similarly, the elderly population whom
often suffer from declining health may be exposed by their spouses or
younger caregivers. The elderly also face potentially unhealthy
exposures to ETS in multi-unit housing complexes. The elderly and
others with limited incomes may be the least able to change their
living conditions to avoid exposure. A new website managed by
research scientists who study exposure to pollutants provides the
latest information on ETS exposure studies.
There are many ways to assess exposure to ETS. In long-term health studies exposure is usually determined with
questions about spousal smoking, exposure in the workplace, number of cigarettes smoked, etc. These questionnaires
provide only a rough estimate of the length and intensity of exposure. Monitoring for ETS in the ambient environment
is usually done with a tracer compound such as nicotine or Respirable Suspended Particles (RSP). RSP measurements
estimate the mass of particles less than 10 micrometers in aerodynamic diameter (PM10). These smaller particles
are more likely to enter the lung. Most ETS particles are in the "fine" size range of less than 2.5 micrometers
(PM2.5). Nicotine is considered the best marker for ETS, given its specificity and well-established methods of
monitoring. ARB summarized the scientific literature on indoor ETS monitoring and conducted its own outdoor monitoring
study for ETS using nicotine as a marker compound. The results of the literature review and the ARB outdoor study
are described in detail in Part A of the 2005 TAC identification
report. Key findings from the report can be found in the Report's Executive Summary.
Another method of directly determining exposure to ETS is through biomonitoring. The body metabolizes toxins from
the environment and the metabolic products can often be identified by analyzing urine, blood, sputum, etc. The
CDC tracks exposure to ETS by measuring cotinine, a metabolite of nicotine, in the blood of nonsmokers. Cotinine
measurements are a good indicator of exposure to ETS over the past two to three days, and are sensitive enough
to distinguish between an exposed nonsmoker and a smoker. Cotinine analysis has been conducted for nearly two decades
on a large sample of the American public. For most of the population, levels of cotinine measured by the CDC have
declined by 70 percent since it was first measured. However, the same is not true for children. These measurements
show that more than 50 percent of U.S. children are still exposed to ETS, and cotinine levels in children are nearly
twice as high as adults. Among the most exposed adult non-smokers, concentrations of cotinine in the blood decreased
nearly 40 percent between 1988 and 2002, while the most exposed children showed no significant declines in cotinine
concentration.
According to CDHS, smoking prevalence in California
has dropped to 14 percent, the second lowest rate in the nation. However, there are still four million smokers
in California, and potentially millions of California children and older Californians exposed to ETS in their own
homes. This exposure can lead to serious adverse health outcomes. New cases of asthma and exacerbations of pre-existing
asthma can result from ETS exposure. Children's exposure may also cause an increase in the number of medical visits
for ear infections, or may result in more respiratory illnesses in general. Elderly adults may be especially susceptible
to the cardiovascular effects of ETS, which include heart attacks and chronic heart disease. The Office of Environmental
Health Hazard Assessment (OEHHA) estimated the number of deaths and illnesses in California that may be caused
by exposure to ETS. These estimates can be found in the Executive Summary
of the ARB ETS TAC report.
Links to more information on ETS exposure and health effects are provided below. |
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Exposure:
Health Effects:
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Contact us if you have any questions regarding ARB's ETS program, or
have suggestions or comments on this page.
Kate MacGregor, MPH: (916) 327-5974 or email kmacgregor@arb.ca.gov.
ETS
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