Secondhand Smoke in Pennsylvania Casinos: A Study of Nonsmokers' Exposure, Dose, and Risk

Objectives. I assessed air pollution, ventilation, and nonsmokers' risk from secondhand smoke (SHS) in Pennsylvania casinos exempted from a statewide smoke-free workplace law. Methods. I measured respirable suspended particles (RSPs), particulate polycyclic aromatic hydrocarbons (PPAHs), and carbon dioxide inside and outs de casinos; measured changes in patrons' urine cotinine after casino visits; and assessed SHS impact on workers and patrons, using exposure-response models, air quality standards, and odor and irritation thresholds. Results. PPAH and RSP concentrations in casinos were, on average, 4 an 1 6 times, respectively, that of outdoor levels despite generous ventilation and low smoking prevalence. SHS infiltrated into nonsmoking gaming areas. Patrons' urine cotinine increased 1.9 ng/mL on average after about 4-hour visits. Conclusions. SHS-induced heart disease and lung cancer will cause an estimated 6 Pennsylvania casino workers' deaths annually per 10000 at risk the death rate from Pennsylvania mining disasters. Casinos shown not be exempt from smoke-free workplace laws. (Am J Public Health. 2009 99. 1478-1485. doi:10.2105/AJPH.2008.146241)