Study says air worse in smoky bars than on truck-choked roads
TRENTON, N.J. -- If youâ€™re wondering whether a smoky bar or a city street filled with diesel truck fumes is more harmful to your health, you might want to skip your next happy hour.
Smoky bars and casinos have up to 50 times more cancer-causing particles in the air than highways and city streets clogged with diesel trucks at rush hour, according to a study that also shows indoor air pollution virtually disappears once smoking is banned.
Conducted by the researcher who first showed secondhand smoke causes thousands of U.S. lung cancer deaths each year, the study found casino and bar workers are exposed to particulate pollution at far greater levels than the government allows outdoors.
"This paper will help localities pass smoking bans," predicted the author, James Repace, a biophysicist who works as a secondhand smoke consultant after spending 30 years as a federal researcher. "It shows how beneficial smoking bans are for hospitality workers and patrons."
Repace tested air in a casino, a pool hall and six taverns in Delaware in November 2002 and January 2003, two months after the state imposed a strict indoor smoking ban.
His detectors measured two substances blamed for tobacco-related cancers: particulate polycyclic aromatic hydrocarbons, a group of chemicals called PPAHs for short, and respirable particles -- airborne soot small enough to penetrate the lungs.
"They are the most dangerous" substances in secondhand smoke, said Repace, a visiting assistant clinical professor at Tufts University School of Medicine in Boston.
Repace said his research also showed ventilation systems -- sometimes touted by tavern, restaurant and casino groups as an alternative to smoking bans -- canâ€™t exchange air fast enough to keep up with fumes from smokers.
The study, published in the September issue of the Journal of Occupational and Environmental Medicine, was partly funded by the nationâ€™s largest health care philanthropy, the Robert Wood Johnson Foundation of Plainsboro, N.J.
Repace found an average level of respirable particles of 231 micrograms, or millionths of a gram, per cubic meter of air in the eight Delaware venues. Thatâ€™s 15 times the 15-microgram U.S. Environmental Protection Agency limit for outdoor air, 49 times the rush-hour average on Interstate 95 in Wilmington and even tops the 199-microgram rush-hour level at Baltimore Harbor Tunnel tollbooths.
The eight venuesâ€™ average PPAH level was 134 nanograms, or billionths of a gram, per cubic meter -- five times the level in the air outside, which Repace also tested. By
comparison, the average rush hour levels of PPAHs on Interstate 95 in Wilmington and in Bostonâ€™s Roxbury neighborhood, heavily polluted by diesel and truck emissions, were 7 and 18 nanograms, respectively.
Levels of both cancer-causing substances dropped 90 percent or more after the smoking ban in all locations tested, with the air quality in the venues nearly indistinguishable from outside air.
"It demonstrates really clearly that a smoking ban results in a massive improvement in air quality," said Dr. Jonathan Foulds, director of the tobacco dependence program at University of Medicine and Dentistry of New Jerseyâ€™s School of Public Health. "Here in New Jersey, and in many other states that donâ€™t have an indoor smoking ban, this should be used to put pressure on the legislators."
Timothy Buckley, associate professor of environmental health science at Johns Hopkins Bloomberg School of Public Health in Baltimore, said other research has shown dramatic air quality improvement after smoking was banned in workplaces, but this appears to be the first study in bars or casinos.
"The magnitude of that effect is striking," Buckley said.
Foulds and Buckley both noted there is mounting evidence of the health hazards of the substances Repace tested.
"Heâ€™s identified a place where we can have a big impact of public health in this country," Buckley said.
EPA has been studying indoor air quality for nearly two decades and proved in 1992 that secondhand smoke causes lung cancer, said Bob Axelrad, senior adviser in the agencyâ€™s indoor environments division. Its focus is producing evidence to aid in decisions on smoking bans and working with pediatricians and other groups to discourage smoking in homes with children.
Meanwhile, consumer and health groups have been pushing local and state governments for workplace smoking bans -- usually with strong, well-organized opposition from the tobacco, casino and hospitality industries, said Bronson Frick, associate director of the nonprofit American Nonsmokersâ€™ Rights Foundation.
He said more than 100 studies of sales tax revenue show the bans donâ€™t reduce income for bars or restaurants, as their industries often argue, yet many ballots for the fall election include measures to repeal existing bans.
"A third of the country already is covered" by workplace, bar or restaurant bans, Frick said.
As of July, 1, 727 U.S. municipalities had some smoking restrictions, with 312 banning smoking even in bars and restaurants, according to the foundation.
Delaware, New York and Massachusetts prohibit smoking in all workplaces, restaurants and bars. California and Connecticut have similar bans, but with exemptions for workplaces with five or fewer employees. Starting in March, Rhode Island imposes a ban in most workplaces and bars. Five other states have some restrictions on smoking in public places.
A proposed ban in New Jersey was shelved in June 2003 after amendments were added that would allow smoking in casinos, bars and restaurants.
But in smoker-friendly Europe, restrictions are coming into vogue in airports, train stations and some restaurants. In March, Ireland became the first nation to ban smoking in workplaces, including pubs and restaurants, and Norway followed in June. Frick said bans begin soon in Sweden and New Zealand, and the United Kingdom is considering one.
Even office-only bans have a big impact. Axelrad noted testing showed that as smoking in offices was increasingly restricted, the level of a nicotine byproduct called cotinine in the blood of nonsmokers plunged 70 percent from 1990 to 2001.