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Fine particle air pollution and secondhand smoke exposures and risks inside 66 US casinos
Authors:Repace James L  Jiang Ruo-Ting  Acevedo-Bolton Viviana  Cheng Kai-Chung  Klepeis Neil E  Ott Wayne R  Hildemann Lynn M
Affiliation:aDepartment of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA;bRepace Associates, 101 Felicia Lane, Bowie, MD 20720, USA;cDepartment of Civil and Environmental Engineering, Stanford University, Stanford, CA, USA
Abstract:Smoking bans often exempt casinos, exposing occupants to fine particles (PM2.5) from secondhand smoke. We quantified the relative contributions to PM2.5 from both secondhand smoke and infiltrating outdoor sources in US casinos. We measured real-time PM2.5, particulate polycyclic aromatic hydrocarbons (PPAH), and carbon dioxide (CO2) (as an index of ventilation rate) inside and outside 8 casinos in Reno, Nevada. We combined these data with data from previous studies, yielding a total of 66 US casinos with smoking in California, Delaware, Nevada, New Jersey, and Pennsylvania, developing PM2.5 frequency distributions, with 3 nonsmoking casinos for comparison. Geometric means for PM2.5 were 53.8 μg/m3 (range 18.5–205 μg/m3) inside smoking casinos, 4.3 μg/m3 (range 0.26–29.7 μg/m3) outside those casinos, and 3.1 μg/m3 (range 0.6–9 μg/m3) inside 3 nonsmoking casinos. In a subset of 21 Reno and Las Vegas smoking casinos, PM2.5 in gaming areas averaged 45.2 μg/m3 (95% CI, 37.7–52.7 μg/m3); adjacent nonsmoking casino restaurants averaged 27.2 μg/m3 (95% CI, 17.5–36.9 μg/m3), while PM2.5 outside the casinos averaged 3.9 μg/m3 (95% CI, 2.5–5.3 μg/m3). For a subset of 10 Nevada and Pennsylvania smoking casinos, incremental (indoor–outdoor) PM2.5 was correlated with incremental PPAH (R2=0.79), with ventilation rate-adjusted smoker density (R2=0.73), and with smoker density (R2=0.60), but not with ventilation rates (R2=0.15). PPAH levels in 8 smoking casinos in 3 states averaged 4 times outdoors. The nonsmoking casinos' PM2.5 (n=3) did not differ from outdoor levels, nor did their PPAH (n=2). Incremental PM2.5 from secondhand smoke in approximately half the smoking casinos exceeded a level known to produce cardiovascular morbidity in nonsmokers after less than 2 h of exposure, posing acute health risks to patrons and workers. Casino ventilation and air cleaning practices failed to control secondhand smoke PM2.5. Drifting PM2.5 from secondhand smoke contaminated unseparated nonsmoking areas. Smoke-free casinos reduced PM2.5 to the same low levels found outdoors.
Keywords:Secondhand smoke   Environmental tobacco smoke   Indoor air pollution   Particulate matter   PM2.5   PAH   Real-time monitoring   Casino   Smoking activity
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