Hahn, Ellen J.

Lee, Kiyoung

Okoli, Chizimuzo T.C.

Powell, Robert W.

Troutman, Adewale

English

University of Kentucky

University of KentuckyUKnowledgeNursing Faculty Publications College of Nursing3-2005Smoke-free Laws and Indoor Air Pollution inLexington and LouisvilleEllen J. HahnUniversity of Kentucky, ejhahn00@email.uky.eduKiyoung LeeChizimuzo T.C. OkoliUniversity of Kentucky, ctokol1@uky.eduAdewale TroutmanRobert W. PowellRight click to open a feedback form in a new tab to let us know how this document benefits you.Follow this and additional works at: https://uknowledge.uky.edu/nursing_facpubPart of the Health Policy Commons, Nursing Commons, and the Public Health CommonsThis Article is brought to you for free and open access by the College of Nursing at UKnowledge. It has been accepted for inclusion in Nursing FacultyPublications by an authorized administrator of UKnowledge. For more information, please contact UKnowledge@lsv.uky.edu.Repository CitationHahn, Ellen J.; Lee, Kiyoung; Okoli, Chizimuzo T.C.; Troutman, Adewale; and Powell, Robert W., "Smoke-free Laws and Indoor AirPollution in Lexington and Louisville" (2005). Nursing Faculty Publications. 11.https://uknowledge.uky.edu/nursing_facpub/11Smoke-free Laws and Indoor Air Pollution in Lexington and LouisvilleNotes/Citation InformationPublished in Louisville Medicine, v. 52, no. 10, p. 391-392, 394, 409, 415.The copyright holder has granted the permission for posting the article here.This article is available at UKnowledge: https://uknowledge.uky.edu/nursing_facpub/11Smoke-free Laws and Indoor Air Pollution in Lexington and Louisville Secondhand smoke (SHSJ exposure is the third leading cause of preventable death in the United States. 1 SHS is a mix-ture of the smoke from the burning end of tobacco products (sidestream smoke) and the smoke exhaled by smokers (mainstream smoke). 1,2 Secondhand smoke is a major source of indoor air pollution containing a complex mixture of more than 4,000 chemicals, more than 50 of which are can-cer-causing agents.1,2 Secondhand smoke is known to cause cancer2,3 and is associ-ated with an increased risk for lung cancer and coronary heart disease in nonsmoking adults.1 ,2,3 Approximately 60 percent of people in the United States have biological evidence of secondh,md smoke exposure.4 Among children aged less than 18 years, an esti-mated 2 2 pern:-nt are exposed to second-hand smoke in their homes, with estimates ranging from 11 .7 percent in Utah to 34.2 percent in Kentucky. 5 The purpose of this study was to (a) assess the impact of Lexington-Fayette County's smoke-free law on indoor air quality; and (b) compare air qual ity in Lexington, Ky. after the ordinance was enacted with air quality in Louisville, Ky. without a smoke-free law. Indoor fine parti-cle concentrations were measured before and after the smoke-free law went into effect in Lexington and during the second time period in Louisville. Although many states and local commu-niti e~ have adopted strong workplace smoking rest rictions, the tobacco-growing Mates lag behind in protecting workers from the dangers of secondhand smoke. 2 In July 2003, the Lexington-Fayette Urban County Council passed Kentucky's first smoke-free law by an 11-3 vote. After ,1 seven month legal delay, the smoke-free law was implemented on April 27, 2004. The law prohibits smoking in most public places includ ing, but not limited to, restau-rants, bars, bowl ing alleys, bingo halls, convenience stores, laundromats, and other businesses open to the public. There Me 1,903 U.S. municipalities with local clean indoor air laws, 358 of which pro· vide 100 percent smoke-free protection, as of Jan. 4, 2005 (http/Avww.no-smoke .orglpdf/med iaordl ist.pclt). About one-third of the U .S. population is protect-ed by a local or state smoke-free indoor air law.6 Indoor fine particle concentrations were measured using the Aerocet 531 photome-ter before and after the smoke-free law went into effect in Lexington and during the second time period in Louisville. The monitor was calibrated against a gravimet-ric measurement of particulate maller with Some countries that have enacted forms of smoke-free policies Armenia New Zealand Australia Norway Bhutan Pakistan Bulgaria Romania Canada, Ottawa Russia China, Hong Kong Scotland England South Korea Germany Spain Greece Sweden India Thailand Ireland Tanzania Italy Uganda Iran Vietnam Japan, Tokyo Wales Newfoundland Z1mbabwe Netherlands Some states that have enacted forms of smoke-free policies California Connecticut Delaware Florida Idaho Massachusetts Maine New York South Dakola Utah Ellen J. Hahn, DNS, RN Kiyoung Lee, SeD, CIH Chizimuzo T.C. Okoli, MSN, RN Adcwalc Troutman, MD, MA, MPH Robert W. Powell, MD MAHCII 2005 391 2.5 minometer in diameter ,llld smaller (2.5PM) in a series of laboriltOry experiments to en~ure accuracy. The first phase (before the smoke-free law was schcduk'<l to go into effect in Lexington) was conducted Friday and Saturday from 7:30p.m. to 12:30 a.m. in S<>ptrmber 2003. The second phase (after the law was in effect in Lexington and in Louisville w ithout a smoke-free law) was con-duc.tcd during the same time periods in September 2004. The aver-ilge time spent in each venue was 43 minutes. The number of peo-ple inside, the number of bummg cigarettes, and building charac-teristics were recorded. Of the I 0 establishments in each city, th ree were restaurants, three were bars, and four were other ven-ues includ ing two music clubs. a bowling alley, and a coffee house. Measurement in one lexington location was exdudccl because of apparent smoking after the smoke-free law. Indoor Air Pollution in Lexington Dropped 91 percent after the Smoke-free Law Among the nine Lexington locations before the smoke·frce law went in to effect, indoor 2.5PM concentrations ranged from 21 to 422 pg/m3, with an average of 199 pg/m3 (see Figure I on page 394). After the smoke-free law was implemented, average indoor 2.5PM c.oncentrations in the same locations was 18 pg/m 3, which was 11 times lower than before the smoke-free law. While there is no federal or state standard for indoor air quality, the National Ambient Air Quality StandJrd for 2.5PM is 65 pg!m3 for 24 hours? Smoke-free Laws Significantly Improve I ndoor Air Quality When air quality in 10 Louisville locations was mc.1surcd in September 2004, indoor 2.5PM <cOncentrations ranged from 29 to 1,110 pg/m3, with an average of 304 pg/m3 (see Figure 2 on page 394). When comparing average indoor particulate levels in Lexington pre-ordinance and l ou isville, air pollution WdS sl ightly higher in the Louisville venues ('>t'e Figure 3 on page 41 5). However, when comparing .werage indoor air pol lution in Lexington post-ordinance to Louisville during the same time peri-od, particulate levels were 1 7 times higher in Louisville without a smoke-free law. It is hypothe~i/<'d that if Louisville enacted and enforced a comprehensive smoke-free ordinance, there would be a dramatic drop in indoor air pollution similar to the Lexington experience. Indoor Air Pollution Increased As More Cigarettes Were Smoked The data also were analyn•d to identify factors such as building chara<:tcristics as well as smoking density that might explain the differences in indoor fine particle levels. Building characteristics included room size, number of pNsons present, description of the 392 LOUISVILLE 'IEOICINE venue, temperature, relative humidity, air pressure at cntryways and maximum occupancy. Smoking dmsity was calculated by the number of burning cigarettes per 100 m.l Building characteristin and smoking density did not show,, significant association with indoor fine particles. When smoking density was classified into three groups, there was a c lear association between smoking den-sity and indoor fine particles (sec Figure 4 on page 415). When no cigarettes were burned, indoor particulate levels were 19.3 :t 18.6 pg!m3. When less than one cigarette was burned in 100m3, indoor levels were 194.3 ± 312.4 JJg/m3. When more than one cigarette was burned, indoor levels were 300.0 ± 212.2 pg/m3. Conclusions Similar to other studies, we found a signi ficant improvement in air quality as a result of implementing a smoke-free law. One California study showed an 82 per< ent average decline in air pol-lution after smoking was prohibited. 8 In Delaware, 90 percent of the respirJble suspended particle (RSP) level in hospitality venues was attributed to tobacco smoke in a study conducted before and after implementation of their statewide smoke-free law.9 When indoor air quality was measured in 20 hospitality venues in west-ern New York, average levels of RSP decreased 84 percent in these venues after the smoke-free law took effcct.10 While the measurement of actual improvement in respiratory and/or cardiac health was beyond the scope of this study, there is empirica l evidence that smoke-free laws not only improve air quality but they also lead to better health outcomes. When a smoke-free l3w was implemented in Helena, Montana, the number of admissions for acute myocardial infarction fell significantly in just six months after implementation of the law. 11 As a result, the Centers for Disease Control and Prevention issued a warning to all patients with heart disease to avoid secondhand smoke exposure. In another study of bartenders in San Francisco after a smoke-free law went into effect, mean FEY 1 v,1lues improved significantly after controlling for personal smoking and recent upper respiratory tract in fcc tions.12 As Louisville continues to debate the proposal to prohibit smoking in public plates and workplaces, these data provide empirical evidence that workers and patrons would indeed breathe easier as a result of a <:omprehensive smoke-free ordinance. l,i\1 References 1. NatiOnal C3nc:et' Institute. Health Effects of Exposure to Envrooment Tobacco Smol<e. Smoklng and Tobacco Control Monograph No. 10 ( PDF- 71k). Bethesda, MO: U.S. Department of Health and Human SeN1ces, Nationallnst~utes of Health, National Cancer Institute; 1999. NIH Pub. No. 99-4645. 2. National Toxicology Program. 10th Repor1 on Carcinogens. Research Triangle Park, NC: U.S. Depsrlment of Health and Human Services, Public Health Service, NatiOnal Toxicology Program, December 2002 references coobnued 011 page 409 ~ ~ ., E u :c :::0 u ~ ., Q. E ~ "' ~ u ·e "' ..,; ::E "--$ ., E " :0 :::> " -"' a. E ~ co e " .E "' "' ::;: a. 500 450 400 350 300 250 200 150 100 50 0 Restaurant A 422 Restaurant Restaurant Bar A B C BarB Bare Music Venue • Before the Law • After the Law Coffee House 0 Bowling Alley Figure 1. Indoor air quality in nine Lexington venues before and after implementation of the smoke-free Jaw 1200 ----~11"10.-----------------------------1000 800 600 400 347 200 29 0 ~'?- ~<() ~0 '1><:' '1><:' '1><:' ,.§ ,.§ ,.§ F}'lj F}'lj F}'lj «-IQ «-IQ «-IQ Figure 2. Indoor patiiculate levels in 10 Louisville venues, September 2004 394 LOUISVILLE MEDICINE ALLIANCE ACTIVITIES Susan Yar·<>d, J CMS Alliance Pt·esid(•nt Feeling lucky? There is still time to make plans to come to the JCMSA's Monte Carlo i'ight on '>larch 19 at Audubon Country Club. There will be plenl) of iood ,lnd fun, plus ;m opportunlt\ to bid on great silent auction items Come try your luck on our Blackjack tables, or maybe Te'a~ Hold- em is }our game. \Ve'\e got Craps and Roulette also. \Ve will ha\e a great piece of je,,elry, don.lted by Moore Jewelry, which will be raffled off at the end of the evening. All proceeds from the Monte Carlo Night will go toward Alliance charities, including The Healing Place, Supplies Over Seas. McDowell House, Brennan House, l lospital Hospitality House and International Book Project. Please help us make this evening a success. I would li~e to thank all of the members ''ho have worked so hard to make this fund-raiser a success, especially Shirley Jennings Wheeler, Betty Allen, Marie Schwab and Anita Garrison. Their help has been 1n,aluable. Also, thanks to all of our members who Smoke-free References ... continued trom page 392 3. U.S. EnVIronmental Protection Agency. Respiratory Health Effects of Passive Smolong Lung Cancer and Other Oisofders. Washington. DC U S Enwonmentat Protecbon Agency; 1992 Pub. No. EPMi00'6-901006F 4 CDC Seccnd NatJonal Repott on Human Exposure to EnVIIOM'entlll ChemcaJs: Tobacco SmoOt Atlanta GA. U.S. Department of Heal:h and Human Ser..ces. CDC. NatJonal Cente< lot Enwonmental Health; 2003:80 NCEH Pub No 03-0022 5 CDC Stat•specfc prevalence of cigarette smolung among adUltS. and choldren's and adolescents' exposure to environmental tobacco smoke-UMed States, 1996. Molbod ty and Mortaldy Weekly Report 1997;46(44): 1038-1 ()43 6. Shopi<lnd OR. Ge~ach KK. Burns OM. Hartman AM. G1bson JT. State-specific trends 1n smoke-free workplace polocy coverage: 11\e current populabon survey tobacco use supplement. 1993 to 1999. J Occup Environ Med. 2001;43(8):680-686. 7. US EPA 1997 NatJonal ambient air quality standards for partiCulate matter: f.nal rule. fed Regrst 62. 38652 and 38656 8. Ott. W Sw•tzer. P Rob•nson. J. Particle concentrabons 11Slde a tavern before and after prolllb bon of smok•ng Evaluabng 11\e pe<fonnance of an Indoor at qua ty model. J Air Wast ManegAssoc 1996 46:1120-1134. 9 Repac:e. J Resp<r.~ble parlldes and carooogens., 11\e a• of Oelo~are ~ta ty ven-ues before and alter a srnc>loog ban. J Occup Envron Med 2004 46 887 ·905 10 Mortlld•ty and Morta ty Wee~ Report, Indoor All Qua ty 111 Hosprla ty Venoes Before and Afte< Imp ementabon of a Clean Indoor AJr Law- Weste<n New Yotlt. 2003. November 12. 2004, 53(44);1038-1()41 have donated items to the silent auction. We could not succeed without your help. For ticket iniorm,ltion about the Monte Carlo 'ight, please con-tact Shirlev Jenn1ngs \\'heeler at 45 l-5068, or Su<.an Yared at 426-7761. We "ill be happy to help you. We are in the process of taking applications for our Allied Health Scholarships. Applicat ion information is posted at most of the Jefferson County colleges. If you need information about these scholarships, ple,lse <an tact Jennifer Bratton at 24 3·8888. Invitations to our "Day at the Track" wi ll be out shortly. This event will be April 30 at Churchi ll Downs, and will provide the funds for these scholarships. Plan to come see the newly-renovated Churchill Do"ns this year. It should be a great day. Once again, than~ you to all who help make the Alliance a success. L\1 http'}fwww,ct:Jc gov/mrnwrJJXe¥iew/mmw!htmVmm5344a3.htm 11. Sargent RP. Shepard RM. Glantz SA. Reduced incidence ol adllliSSIOil$ lor myocar. d•almfarctJOn assooated With pubic smoking ban: before and after SWdy BI.IJ 2004:328(7446) 977·980 12. Elsner MO. Sm!h AK. Boanc PO. Bartenders' Resporntory Hea !h After Estabhshmel\t o( Smolr.e-Free Bats and Taverns. JAMA 1998;280:1909-1914 ~ REALTOR S 642 1 Bardstown Road l OUISVIlle. KY 40291 502-523·1956 Cell 877-385-4663 Toll Free 502-454·7000 Fax dd1son@semon•n.com Debbie Dison REAlTOR GRI DebbleDison.semonln.com A$$1$lant VICe-Pres~ MARCH 2005 409 .... 350 ~ Q) -Q) E 300 (J .c ::I 250 (J .... Q) c. 200 E nl 150 .... 0) 0 .... (J 100 E ? • &I') 50 N :!!!: ll. 0 1 Pre-ban Post-ban Pre-ban Post-ban Lexington --Louisville __j Figure 3. Average indoor particulate levels in Lexington pre- and post-ordinance and Louisville pre-ordinance .... Q) 350 j -Q) E (J 300 .c ::I 250 (J 300.0 .... Q) 194.3 c. 200 E nl 150 .... Ol 0 .... 100 (J E &I') 50 N :!!!: 0 ll. 0 0-1 >1 j Smoking density (# cig/1 00 rf,) _j f igure 4. Air particle levels and the average number of burning cigarettes adjusted for room size MARCH 2005 415 

Smoke-Free Laws and Indoor Air Pollution in Lexington and Louisville

Smoke-free Laws and Indoor Air Pollution in Lexington and Louisville

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Smoke-free Laws and Indoor Air Pollution in Lexington and Louisville

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