Environmental tobacco smoke in designated smoking areas in the hospitality industry: Exposure measurements, exposure modelling and policy assessment
Highlights
► Exposure to ETS was measured and modelled in Smoking Areas in pubs in Ireland. ► Concentrations were found to vary considerably according to smoking area geometry. ► Tobacco Control Legislation requires improvements to reduce ETS in smoking areas. ► Policy requires a scientific basis for their definitions of designated smoking areas.
Introduction
Environmental Tobacco Smoke (ETS) has been defined as the smoke which non-smokers are exposed to while in an indoor environment with smokers (McNabola et al., 2006). ETS has been declared by the world health organisation and many other independent research studies as carcinogenic (The Office of Tobacco Control (OTC), 2002, WHO, 2003). This environmental pollutant has been shown to be responsible for premature death and disease in children and adults who do not smoke but are passively exposed to ETS (Repace and Lowery, 1985). ETS exposure has been shown to increase population respiratory symptoms by 30–60% and it is well established that ETS is associated with cardiovascular disease (Meyers and Neuberger, 2009). ETS exposure has been associated with a 31% increase in the risk of AMIs compared with a doubling of the risk associated with direct smoking (Barnoya, 2005). ETS has also been shown to have adverse effects on reproduction and cot death in children (OTC, 2002).
ETS has been shown to comprise a mixture of over 4000 chemical including toxic substances such as acetone, hydrogen cyanide, ammonia, formaldehyde, benzene, 1,3 butadiene and many more (Baker and Proctor, 1990, Nelson et al., 1998). Epidemiological evidence has shown that ETS exposure causes an increased risk of cancer of 20–30%, an increased risk of heart disease of 25–30%, an increased risk of strokes of up to 82% and an increased risk of other non-fatal respiratory illnesses (Bates and Fawcett, 2002). In addition, the risk of the above ailments have been shown to be even higher for staff and patrons of bars, restaurants, nightclubs and other hospitality outlets, as these can be a unique group exposed to extreme levels of ETS (McNabola et al., 2006, Mulcahy et al., 2005, Repace, 2004).
The evidence of such high levels of ETS in hospitality venues and ETS exposure in the workplace have prompted governments around the world to introduce smoking bans and other tobacco control policies in order to reduce its environmental health impact (Clancy, 2009). Tobacco control policy has been an evolving area of public health protection from as early as the 1930 and 1940s (Clancy, 2009, McNabola and Gill, 2009) and modern tobacco control policy has been introduced in many jurisdictions banning smoking in the workplace including hospitality venues. These policy measures have been shown to have positive impacts on the levels of ETS exposure, smoking prevalence, reduction in cigarette sales volumes and reductions in tobacco related deaths and illness (McNabola and Gill, 2009).
Exposure to markers of ETS in numerous bars in the UK and Ireland have shown falls of over 90% of pre-ban levels following the introduction of smoking bans (Donnelly and Whittle, 2008, McNabola et al., 2006, Mulcahy et al., 2005). Smoking prevalence has been shown to fall by 9–12% across various jurisdictions while cigarette sales volumes were also shown to decrease by 7–11% following the introduction of a smoking ban (McNabola and Gill, 2009). Hospital admissions for acute myocardial infarctions (AMI) have shown reductions of 27–40% in the United States and of 17% in Europe (McNabola and Gill, 2009).
In general terms, over the past 60 years, a significant body of evidence on the dangers of tobacco use and ETS has been established and progress has been made in the control of tobacco. The first global health treaty, the WHO Framework Convention on Tobacco Control (FCFC), was established recognising the global tobacco epidemic and setting standards for participating countries to effect its control (WHO, 2003).
Article 8 of the FCFC relating to protection from exposure to tobacco smoke arises from the recent success of workplace bans on smoking across various jurisdictions (Clancy, 2009). Built into many such tobacco control policies has been an allowance for the provision of a designated smoking area on work premises. These designated smoking areas have been included to provide smokers with a controlled area within which smoking is permitted, providing protection against ETS exposure amongst non-smokers while being respectful of an individual's right to smoke should they wish to do so. As such, legislation has set out varying definitions of designated smoking areas (DSA) to which employers must adhere.
This paper presents an investigation of DSA policy in tobacco control legislation. DSAs tobacco control policy in various jurisdictions was reviewed in terms of its potential impacts on ETS exposure. Concentrations of ETS exposure in differing legislative definitions of DSAs in Irish pubs were measured and compared with levels of ETS exposure in the ‘smoke free’ areas of these pubs. Computational fluid dynamics (CFD) modelling was also carried out to examine the dispersion of ETS in different hypothetical DSAs. The results of this investigation demonstrate the impact of DSAs with differing geometries on ETS exposure among non-smokers and produces recommendations for improvements in global DSA tobacco control policy.
Section snippets
Legislative background and review
DSAs, once they adhere to definitions set out in legislation, are zones within the workplace that are exempt from a ban on smoking because they are deemed to be open to natural ventilation to such an extent that they are considered to be effectively outdoors. Therefore the hypothesis behind a legal DSA is that the natural dispersion which occurs in outdoor environments is replicated in a DSA and hence levels of ETS exposure cannot reach the dangerously high values of an enclosed indoor
Methodology
This study comprised investigations in a number of key areas relating to DSAs: a review of DSAs in Irish tobacco control legislation as outlined above; followed by an experimental field measurement campaign of ETS exposure in the DSA and ‘smoke free’ areas of a number of pubs in Dublin, Ireland. Finally a numerical modelling investigation of the dispersion of ETS in differing hypothetical DSAs was also completed.
Field measurements
The results of the field measurement campaign are summarised in Table 2. The mean concentrations of benzene in Type I and Type II DSAs were 5.11 μg/m3 and 5.42 μg/m3 respectively, while the mean concentrations of 1, 3 butadiene in Type I and Type II DSAs were 3.56 μg/m3 and 4.46 μg/m3 respectively. Comparing these figures it can be seen that the mean concentrations of both benzene and 1,3 butadiene in both DSA types were similar. The results of a paired t-test between the two sets of data confirms
Exposure measurements
The field measurements campaign demonstrated that similar levels of ETS were present in the two DSA types tested. However varying levels of ETS exposure were found in the intended ‘smoke-free’ areas of the pubs. This was likely to be due to the fact the Type I DSAs are most commonly located in internal courtyards or some other internal component of the building in question. Type II DSAs with their partial perimeter and enclosed roof tend to be constructed on the outside of a building. This
Conclusions
The results of this investigation highlight the weakness of the current legal definitions of DSAs in the legislation of many countries and demonstrate through numerical modelling the large degree of variation in ETS exposure concentrations possible in similar DSAs of differing dimensions. The absence of control on the dimensions of DSA in legislation is outlined as an area of tobacco control policy warranting further research and refinement.
The existing levels of ETS exposure recorded in pubs
Notation
- k
turbulent kinetic energy (m2/s2)
- ε
turbulent kinetic energy dissipation rate (m2/s3)
- ρ
density (kg/m3)
- ui
velocity in the ith direction (m/s)
- uj
velocity in the jth direction (m/s)
- xi
distance in the ith direction (m)
- xj
distance in the jth direction (m)
- αk
inverse effective Prandtl number for k
- αε
inverse effective Prandtl number for ε
- μeff
effective viscosity (Pa.s)
- β
coefficient of thermal expansion
- c
speed of sound (m/s)
- gi
acceleration due to gravity in the ith direction (m/s2)
- T
Temperature (K)
- Prt
turbulent
Acknowledgements
The authors would like to thank the Centre for Transport Research (PRTLI programme) and the ETI project (ERTDI programme), Trinity College Dublin for funding this investigation.
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