Effects of tobacco smoke on air

quality in pubs and bars

Ivan Gee, Centre for Public Health

Liverpool John Moores University

Investigation of Air Pollution Standing Conference,

5th June 2007

Structure of Talk

� Some key studies on indoor air quality in bars

� Our Research in Bars

• Segregation

• Ventilation

• Before smokefree 2007

� Current research before and after July 1st

Measuring tobacco smoke

�Tobacco smoke composed of many 100s of compounds so marker pollutants are used:

• Carbon monoxide

• Nicotine

• Fine particles (PM10, PM2.5, RSP)

• Tobacco specific particles (UVPM, FPM, Solanesol)

• 3-ethenylpyrridine

• Salivary cotinine (biomarker)

Typical ETS Levels in Workplaces

8.6 – 10 Smoking allowed

1.3 – 5.9Restrictions on smoking

0 – 0.4Ban on smoking

Workplaces with:

0.6Offices

2.7Industrial workplaces

3.0Services

37Nightclubs

Nicotine (µg/m3) AREA

From: Irish Health and Safety Agency (2002)

Nicotine in US workplaces

From: Siegel and Skeer (2003)

Type of workplaceN

oof

studies

No

of establishments

sampledWeighted

mean Range

Offices 22 940 4.1 0.8–22.1

Residences 7 91 4.3 1.6–21.0

Restaurants 17 402 6.5 3.4–34.0

Betting establishments 3 4 9.8 8.0–10.7

Bowling alleys 2 6 10.5 10.1–10.7

Billiard halls 2 3 13.0 9.8–19.4

Bars 10 27 31.1 7.4–105.4

Bingo parlours 2 3 76.0 65.5–81.2

Exposure of Bar Staff in London Pubs compared to non-smoking residents

[Jarvis, M et al. Brit J Add 1992; 87: 11-113]

0

0.5

1

1.5

2

2.5

3

3.5

4

4.5

Non-smoking

London Bar staff

(n=39)

Non-smokers

married to smokers

(n=653)

Non-smokers non-

smoking homes

(n=3558)

Co

tin

ine (

ng

/ml)

Hospitality industry exposure

� About 3 million workers in the UK are exposed to ETS.

� 400,000 exposed hospitality workers in the UK.

� Their exposure to ETS is high and problematical to control.

� Professor Jamrozik (Imperial College, London) estimated that exposure to secondhand smoke in the workplace causes around 600 premature deaths in the UK each year 1.

� Equates to one premature death a week among workers in the hospitality industries.

1. Professor Konrad Jamrozik BMJ 2005;330:812

What are the control options for ETS in pubs and bars?

�Voluntary codes e.g. PPC

�Legislation

• Exposure Limits (EH40)

• Smokefree

�Segregation

�Ventilation

White Paper

Smoking Kills, 1998

Public Places CharterCustomers

Non SmokingAreas

Ventilation SignsAoP, 1999

Staff

Ventilation TrainingPromoting NS

at work

Public Places Charter Non-smoker Protection?

�No existing legislation on passive smoking

� 2 Control options: Non-smoking areas & Ventilation.

But little research on their effectiveness.

The impact of non-smoking areas on ETS levels in UK pubs and bars

Ivan Gee, Adrian Watson & Joanna Carrington

Manchester Metropolitan University

Sampling Methodology� 60 pubs and bars studied in and around Manchester

• Oct 2000 – July 2001

� 4 hr sampling period:

• 6:30 – 10:30 (pm)

� Several locations sampled: 1) behind bar, 2) smoking areas 3) non-smoking areas,

� Markers Used:

• RSP as PM2.5

• ETS Specific Particles: UVPM, FPM, SolPM

• Nicotine

1

2 3

4

5

6

7

1: Timer system2: Pump3,7: Battery Packs4: Manifold – flow splitter5: PM2.5 sample head (2 l/min)6: Nicotine, XAD-4 tube (1 l/min)

Summary of Nicotine levels in various environments

0.5-51755601Manchester Bars

7.4-105312710Bars

3.4-346.540217Restaurants

1.6-214.3917Homes

0.8-224.194022Offices

Nicotine Range

(µg/m3)

Nicotine Mean

(µg/m3)

No of Venues

No of Studies

Effect of no-smoking areas� The smoking areas have higher levels of ETS than non-smoking areas.

� Bar areas are intermediate

� Some reduction in exposure for bar staff

0

25

50

75

100

125

co

nce

ntr

atio

n (

ug

/m3)

Smoking Non-smoking Bar

� RSP

� SolPM� Nicotine

Area differences (ug/m3)

� Larger reductions of 30% for ETS specific particles in non-smoking areas

� Reductions at bars are <26% for ETS particles� Considerable reductions in nicotine

• misleading due to its limited mobility – not a good comparative marker for ETS

32

32

69

Median Bar

(n=26)

21

30

69

Median Non Smoking

(n=23)

426255Nicotine

263043SolPM

141380RSP

Bar % reduction

NS % reduction

Median Smoking

(n=40)

ETS Marker

�Non-smoking areas reduce levels in allareas of a pub: bar, smoking and and non-smoking areas. • Probably by dilution – fewer smokers per unit area

�Non-smoking areas have been demonstrated to reduce levels compared to smoking sections

�Reductions in nicotine much greater than particles

�But, considerable public exposure will still occur in these areas & we have no accepted ETS standards to judge air quality.

Effect of Ventilation

� Indication that mechanically ventilated pubs have lower levels,

� but this is notstatistically significant.

� Not clear what level of ETS is appropriate

248623 248623 248623 248623 248623N =

Extractor Fans OffExtrator Fans OnMechanical

500

400

300

200

100

0

RSP

UVPM

FPM

SolPM

Nicotine

Impact of ventilation at the bar

-75

-50

-25

0

25

50

Me

an

diffe

ren

ce

sm

okin

g a

rea

- b

ar

co

nce

ntr

atio

n

(ug

/m3

)

Mechanical Extractor Fans Natural

� At the bar mechanical ventilation systems tend to elevate levels in comparison to adjoining smoking areas.

� Extractor fans and natural ventilation lead to reductions of 5-20ug/m3 at the bar

� RSP

� SolPM� Nicotine

Conclusions - Ventilation

�The Manchester study suggests that current ventilation systems do not appear to be reducing ETS levels sufficiently

� Some indications that mechanical systems may be increasing levels at the bars in comparison to adjoining smoking areas.

�Repace has calculated that to achieve a “safe”working environment excessive air exchange rates will be required.

Liverpool bar survey, 2005

�55 hospitality venues sampled

• Nicotine

• 3EP

• PM2.5

• Solanesol

Black, Gee, Casstles (2007) J Env. Health Res 6(1) 3-12.

�Similar results for all markers

�Much higher levels in bars and social clubs compared to restaurants and the non-smoking venue

Black, Gee, Casstles (2007) J Env. Health Res 6(1) 3-12.

Smokefree Bars 07: Researching current policy

�DoH funded a collaborative study by• Aberdeen University,

• Institute of Occupational and Environmental Medicine (IOM) and

• Liverpool John Moores University

� Examining exposure, health and attitudes of staff and customers

� Pre and post 1 July legislation

�Saliva cotinine survey

�Lung function testing

�PM2.5 continuous monitoring

�Personal monitoring

�Attitude questionnaire

Aim is to evaluate the impact of the smokefree legislation

See you in the pub on July 1st

x

REFERENCESSiegel and M Skeer. Exposure to secondhand smoke and excess lung cancer mortality risk among workers in the "5 B’s": bars, bowling alleys, billiard halls, betting establishments, and bingo parlours. M Tobacco Control 2003;12:333-338

T Kauppinen et al . Occupational exposure to carcinogens in the European Union. Occup. Environ Med 2000;57:10-18

ANSI/ASHRAE Standard 62-2001, Ventilation for Acceptable Indoor Air Quality, Free at: http://xp20.ashrae.org/STANDARDS/62-2001_add_menu.htm.

Irish Health and Safety Agency, 2002. Report on the health effects of environmental tobacco smoke (ETS) in the workplace.

Borland et al, 1992. Protection from environmental tobacco smoke in California: the case for a smoke free workplace. IJ. Am. Med Assoc., 268, 749-752.

K. Jamrozik Presentation at the Royal College of Physicians conference, London, 2004

Jarvis, M et al., Repeat study of cotinine levels in 44 non smoking bar staff from pubs in London, 200, 1 Brit J Add 2002; 87: 11-113

Carrington J., Gee I.L., Watson A.F.R. The effects of smoking status and ventilation on environmental tobacco smoke concentrations in public areas of UK pubs and bars. Atmos. Environ. 20031352-2310,

Black D, Gee IL, Casstles H. Monitoring the exposure of hospitality workers to second–hand smoke: establishing a base-line in advance of the smoke–free legislation. J Env. Health Res 2007; 6: 3-12.