Concerns Raised about Outdoor Secondhand Smoke

Indoor smoking bans have forced smokers at bars and restaurants onto outdoor patios, but a new University of Georgia study in collaboration with the Centers for Disease Control and Prevention suggests that these outdoor smoking areas might be creating a new health hazard.

The study, thought to be the first to assess levels of a nicotine byproduct known as cotinine in nonsmokers exposed to secondhand smoke outdoors, found levels up to 162 percent greater than in the control group. The results appear in the November issue of the Journal of Occupational and Environmental Hygiene.

"Indoor smoking bans have helped to create more of these outdoor environments where people are exposed to secondhand smoke," said study co-author Luke Naeher, associate professor in the UGA College of Public Health. "We know from our previous study that there are measurable airborne levels of secondhand smoke in these environments, and we know from this study that we can measure internal exposure.

"Secondhand smoke contains several known carcinogens and the current thinking is that there is no safe level of exposure," he added. "So the levels that we are seeing are a potential public health issue."

Athens-Clarke County, Ga., enacted an indoor smoking ban in 2005, providing Naeher and his colleagues and ideal environment for their study. The team recruited 20 non-smoking adults and placed them in one of three environments: outside bars, outside restaurants, and, for the control group, outside the UGA main library. Immediately before and after the six-hour study period, the volunteers gave a saliva sample that was tested for levels of cotinine, a byproduct of nicotine and a commonly used marker of tobacco exposure.

The team found an average increase in cotinine of 162 percent for the volunteers stationed at outdoor seating and standing areas at bars, a 102 percent increase for those outside of restaurants and a 16 percent increase for the control group near the library.

Naeher acknowledges that an exposure of six-hours is greater than what an average patron would experience but said that employees can be exposed for even longer periods.

"Anyone who works in that environment -- waitresses, waiters, or bouncers -- may be there for up to six hours or longer," Naeher said. "Across the country, a large number of people are occupationally exposed to secondhand smoke in this way."

Studies that measured health outcomes following indoor smoking bans have credited the bans with lowering rates of heart attacks and respiratory illness, but Naeher said that the health impacts of outdoor secondhand smoke are still unknown.

In Naeher's study, cotinine levels in the volunteers at the bar setting saw their levels increase from an average pre-exposure level of 0.069 ng/ml (nanograms per milliliter) to an average post-exposure level of 0.182 ng/ml. The maximum value observed, however, was 0.959 ng/ml. To put that number into context, a widely cited study has determined that an average cotinine level of 0.4 ng/ml increases lung cancer deaths by one for every 1,000 people and increases heart disease deaths by one for every 100 people.

Still, the researchers caution that it's too early to draw policy conclusions from their findings. Cotinine is a marker of exposure to tobacco, Naeher said, but is not a carcinogen. The team is currently planning a study that would measure levels of a molecule known as NNAL, which is a marker of tobacco exposure and a known carcinogen, in people exposed to second-hand smoke outdoors.

"Our study suggests that there is reason to be concerned about second-hand smoke levels outdoors and our findings are an incentive for us to do further studies to see what the effects of those levels are," said Gideon St. Helen, study co-author.

Product Showcase

  • Full Line of Defense Against Combustible Dust Nilfisk

    Nilfisk provides a comprehensive range of industrial vacuums meticulously crafted to adhere to NFPA 652 housekeeping standards, essential for gathering combustible dust in Class I, Group D, and Class II, Groups E, F & G environments or non-classified settings. Our pneumatic vacuums are meticulously engineered to fulfill safety criteria for deployment in hazardous surroundings. Leveraging advanced filtration technology, Nilfisk ensures the secure capture of combustible materials scattered throughout your facility, ranging from fuels, solvents, and metal dust to flour, sugar, and pharmaceutical powders. Read More

  • Safety Knives

    The Safety Knife Company has developed a quality range of safety knives for all industries. Designed so that fingers cannot get to the blades, these knives will safely cut through cardboard, tape, strapping, shrink or plastic wrap or a variety of other packing materials. Because these knives have no exposed blades and only cut cardboard deep, they will not only protect employees against lacerations but they will also save product. The Metal Detectable versions have revolutionary metal detectable polypropylene knife bodies specifically for the food and pharmaceutical industries. This material can be detected and rejected by typical detection machines and is X-ray visible. Read More

  • Preventative Heat Safety

    Dehydration and heat exposure impair physical and cognitive performance. Proper hydration boosts heat stress resilience, but hydration needs are highly individualized and hard to predict across a workforce. Connected Hydration® empowers industrial athletes to stay safe through behavioral interventions, informed by sports science, and equips safety teams with critical insights to anticipate high-risk situations and adapt to evolving environmental factors. Curious about applying the latest in sports science based hydration strategies for industrial athletes? Stop by booth #1112 at AIHA or schedule a free demo today at https://epcr.cc/demo. Read More

Featured

Webinars