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Prepared August 29, 2008
The author, subject and related questions for each of the eight letters sent to the Iowa Department of Public Health by directors of Iowans for Equal Rights are presented below. Full text of the letters, including background information, can be accessed by clicking on the inquiry link for each letter.
Inquiry No. 1, Mr. Coates: Effects of emergency declaration; how comments that are part of the formal rulemaking record can be made.
Questions: Based on the foregoing background and my layperson’s understanding I have three questions:
1. What was the “emergency” that caused the department’s Smokefree Air Act’s enforcement rules to adopted through an emergency declaration?
2. Does the health department consider comments submitted through the Web form as provided at www.iowasmokefreeair.gov, or public comments made at forthcoming public meetings presently scheduled for August 20, 2008, to be formal or informal?
3. Does the health department consider itself to have a formal, statutory duty to “consider fully” all comments, data or other submissions presented through the Web form? . . .
2. Why do the health department’s rules not require that identity of persons who file complaints with it concerning the Smokefree Air Act be credibly confirmed or provide for required information to do so? . . .
Questions: Based on the forgoing and my layperson’s understanding I ask the following questions:
1. What regulatory analysis, including consideration of different material risks arising from exposure to ETS in indoor and outdoor areas, has the Iowa Department of Public Health conducted in drafting its enforcement rules for the Smoke Free Air Act? . . .
Inquiry No. 8, Mr. Shanno: Separate designated smoking rooms according to ASHREA 62.1 Standard 2007.
Questions: Based on the preceding information and my layperson’s understanding I ask the following:
1. Were methods other than a prohibition of smoking in public places seriously considered by the Iowa Department of Public Health in promulgating its enforcement rules for HF 2212, the Smokefree Air Act?
2. Why were separately ventilated smoking rooms rejected by the Iowa Department of Public Health as means for compliance with HF 2212, the Smokefree Air Act?
3. The reduced ventilation rates under ASHRAE Standard 62.1 are contingent on “Smoke Free” environments, such as those created for public places under the health department’s current enforcement rules. How does the Iowa Department of Public Health reconcile increased health risks to employees and patrons caused by reduced ventilation and consequently higher concentrations of airborne toxins and carcinogens not related to tobacco smoke with the legislative purpose “. . . in order to protect the public health and the health of employees”?
ASHRAE has published the latest version of ANSI/ASHRAE Standard 62.1-2007, Ventilation for Acceptable Indoor Air Quality, which sets minimum ventilation rates and other requirements for commercial and institutional buildings. The new 2007 ventilation standard contains key changes impacting ventilation system designers and their designs.
"Standard 62.1 has served the building industry and the public as the most prominent standard on ventilation for indoor air quality," Dennis Stanke, committee chair, said. "Changes in the 2007 standard build on the improvements published in the 2004 version, providing additional guidance for designers of building ventilation systems."
The new standard includes requirements for the separation of areas with environmental tobacco smoke (ETS) from areas without ETS in the same building. Although some local building and health codes prohibit smoking indoors in many buildings and locations, other codes allow smoking in designated areas. In buildings that allow smoking in designated areas, effective separation of ETS areas ensures "ETS-free" areas contain little or no ETS-related contaminants. The new separation requirements help designers ensure effective separation, according to Stanke.
The new 2007 ventilation standard published by the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) contains key changes impacting ventilation system designers and their designs. ANSI/ASHRAE Standard 62.1-2007, Ventilation for Acceptable Indoor Air Quality, sets minimum ventilation rates and other requirements for commercial and institutional buildings.
The new standard includes requirements for the separation of areas with environmental tobacco smoke (ETS) from areas without ETS in the same building. Although some local building and health codes prohibit smoking indoors in many buildings and locations, other codes allow smoking in designated areas. In buildings that allow smoking in designated areas, effective separation of ETS areas ensures ETS-free areas contain little or no ETS-related contaminants. The new separation requirements help designers ensure effective separation, Stanke says.
5.0 CONCLUSIONS
• There is a consensus among cognizant medical authorities that ETS is a health risk, causing lung cancer and heart disease in adults, and causing adverse effects on the respiratory health of children, including exacerbating asthma and increasing risk for lower respiratory tract infection.
• At present, the only means of eliminating health risks associated with indoor exposure is to ban all smoking activity.
• Although complete separation and isolation of smoking rooms can control ETS exposure in non-smoking spaces in the same building, adverse health effects for the occupants of the smoking room cannot be controlled by ventilation.
• No other engineering approaches, including current and advanced dilution ventilation, “air curtains” or air cleaning technologies, have been demonstrated or should be relied upon to control health risks from ETS exposure in spaces where smoking occurs, though some approaches may reduce that exposure and address odor and some forms of irritation.
• An increasing number of local and national governments, as well as many private building owners, are implementing/adopting bans on indoor smoking.
• At a minimum, ASHRAE members must abide by local regulations and building codes and stay aware of changes where they practice; they should also educate/inform their clients of the limits of engineering controls in regard to ETS.
• Because of ASHRAE’s mission to act for the benefit of the public, it encourages elimination of smoking in the indoor environment as the optimal way to control ETS exposure.
Are ventilation systems effective in removing harmful substances from environmental tobacco smoke?
That's a question likely to be asked by business owners and others as they look for ways to deal with the new indoor smoking ban in Quebec and Ontario.
The answer is no, according to the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE). ASHRAE has determined that although complete separation and isolation of smoking rooms can control environmental tobacco smoke exposure in non-smoking spaces in the same building, adverse health effects for the occupants of smoking areas cannot be controlled by ventilation.
"No matter how good the system, unless you strap a filter on your nose, you still breathe the mixture in the room that contains secondhand smoke," said Larry Schoen, P.E., who helped write ASHRAE's Environmental Tobacco Smoke Position Document.
The document provides information on the health consequences of exposure of nonsmokers to tobacco smoke in indoor environments, and on the implications of this knowledge for the design, installation and operation of heating, ventilation and air-conditioning systems.
To obtain a free copy of the position document, visit http://www.ashrae.org/positiondocuments.
Smoking restrictions are nothing new, but anti-tobacco activists are increasingly asking governments to go much further, even calling for total bans on lighting up in public places such as bars and restaurants. But there are good and workable ways to banish smoke but not smokers, so that people who smoke don’t have to suffer social exclusion.
We don’t think people should be free to smoke wherever they like and we know many people dislike the smell of tobacco smoke and find it annoying.
But we believe that total smoking bans are unnecessary and unfair, and many public opinion polls have shown them to be unpopular. It is perfectly possible to continue to strike a balance by accommodating non-smokers and smokers separately and providing proper ventilation to reduce involuntary exposure to environmental tobacco smoke (ETS).
Very few countries have adopted the total public place smoking bans that have been introduced in Ireland, Norway and New Zealand and a complete ban in 1999 in British Columbia in Canada, for example, was overturned by the courts in March 2000 on the basis that it was excessive. . . .
This is about indoor air quality – and good ventilation is already recognised as a sound way to address it. There is debate about ventilation. For example, the American Society of Heating, Refrigerating and Air-conditioning Engineers (ASHRAE) accepts that ventilation can reduce ETS, but takes the view that because it can’t totally eliminate every trace, it can’t totally eliminate health risks. However, it’s clear that the full potential of ventilation in reducing ETS to acceptably low levels has not yet been fully illustrated.
We are working with independent bodies to show how ventilation can greatly reduce ETS and improve indoor air quality. For example, we are working with the Building Services Research and Information Association (BSRIA) to test the effectiveness of air change rates on gases and particulate matter in indoor air.
Ventilation requirements for high-rise residential buildings are among changes being proposed for ASHRAE's indoor air quality standard.
Three proposed addenda to ANSI/ASHRAE Standard 62.1-2004, Ventilation for Acceptable Indoor Air Quality, are available for comment until May 1. To obtain drafts of or comment on proposed addenda e, f and h, go to www.ashrae.org/standards. . . .
The scope also states that the standard includes no specific prescribed ventilation rates for smoking-permitted spaces or for improperly separated non-smoking spaces (since these spaces might also contain environmental tobacco smoke).
"Although they contain no specific compliance requirements, statements of scope and purpose must be clear and accurate to help users of the standard apply it properly," he said.
In other news about Standard 62.1, the impact of ventilation rates on occupant health is being studied through ASHRAE research.
One of the key issues the American Gaming Association will tackle next year will be fighting initiatives across the country that would ban smoking in casinos.
The association's chief executive, Frank Fahrenkopf, said the industry is "tremendously concerned" about the proliferation of anti-smoking petitions and other measures.
Smoking bans hurt business for casinos because some gamblers prefer to smoke, Fahrenkopf said.
As an alternative, the American Gaming Association is pushing casino members to adopt improved air filtration systems that can suck up smoke and blow in fresh air.
The association is working with the American Society of Heating, Refrigerating and Air Conditioning Engineers to create a "best practices" air filtration standard that casinos can follow, Fahrenkopf said.
After the first of the year, the trade group expects to meet with the heads of several state gaming associations to discuss a standard that can be shown to state legislators and residents, he said.
"The real battle is not the federal level," Fahrenkopf said. "It's going to be at the state level."
ASHRAE concludes that:
• It is the consensus of the medical community and its cognizant authorities that ETS is a health risk, causing lung cancer and heart disease in adults, and exacerbation of asthma, lower respiratory illnesses and other adverse effects on the respiratory health of children.
• At present, the only means of effectively eliminating health risk associated with indoor exposure is to ban smoking activity.
• No other engineering approaches, including current and advanced dilution ventilation or air cleaning technologies, have been demonstrated or should be relied upon to control health risks from ETS exposure in spaces where smoking occurs. Some engineering measures may reduce that exposure and the corresponding risk to some degree while also addressing to some extent the comfort issues of odor and some forms of irritation.
• An increasing number of local and national governments, as well as many private building owners, are adopting and implementing bans on indoor smoking.
• At a minimum, ASHRAE members must abide by local regulations and building codes and stay aware of changes in areas where they practice, and should educate and inform their clients of the substantial limitations and the available benefits of engineering controls.
• Because of ASHRAE’s mission to act for the benefit of the public, it encourages elimination of smoking in the indoor environment as the optimal way to minimize ETS exposure.
a new Environmental Tobacco Smoke Position Document from the American Society of Heating, Refrigerating and Air-Conditioning Engineers tells design engineers how to work with local regulations and codes on secondhand smoke. ASHRAE said it believes designers "should educate their clients of the substantial limitations and available benefits of engineering controls."
The document contains information on the health consequences of non-smokers' exposure to tobacco smoke indoors and how this affects the design, installation, and operation of HVAC systems. The 55,000-member organization said it realizes indoor smoking bans are the best way to minimize exposure but also recognizes "much of the population" is exposed to secondhand smoke in workplaces, homes, and public places.
The document outlines four design and operation approaches: banning smoking indoors, smoking allowed only in isolated rooms, smoking allowed in separate but not isolated spaces, and mixed occupancy of smokers and non-smokers. To obtain a free copy, visit "position documents" at www.ashrae.org.
[FROM JIM REPACE:
Despite the fact that secondhand smoke (SHS) is a dangerous air pollutant, it often goes unregulated, and this permits various groups associated with the tobacco, casino, and hospitality industries to falsely claim or imply that ventilation can control it. This paper clearly shows that SHS particulate matter, if treated simply as respirable dust, cannot be controlled to the level of the U.S. National Ambient Air Quality Standard (NAAQS) for fine particles without cleaning the outdoor supply air AND hugely excessive and impractical rates of ventilation in excess of 80 air changes per hour. Secondly, it shows that if SHS is treated as the toxin and carcinogen it actually is, using combined lung cancer and heart disease dose-response relationships developed as guidance by Australian ventilation and medical authorities (and identical to those developed by Repace et al.(1998), it cannot be controlled to acceptable levels of risk used by U.S. federal regulatory agencies without tornado-like rates of ventilation of more than 120,000 air changes per hour. This is true regardless of whether ventilation is used alone or in conjunction with air cleaning. However, as my JOEM (2004) paper showed, after a smoking ban, hospitality industry air pollution levels are essentially no different from outdoor levels. ]
How does ventilation compare to smoking bans in controlling SHS in hospitality venues? On Nov. 27, 2002, Delaware banned smoking in all restaurants, bars and casinos, with the intent of giving hospitality workers the same occupational health protection that other workers had enjoyed since 1994.
This afforded an opportunity to investigate contemporary levels of SHS in the hospitality industry. I conducted an indoor/ outdoor air quality study in the Wilmington, Del., metropolitan area before and after the enactment of Delaware’s clean indoor air law.1 Table 1 describes the venues investigated, including a casino, six bars, and a pool hall.
The pollutants measured were respirable particulate matter (RSP) and particulate polycyclic aromatic hydrocarbons (PPAH), which are emitted by cigarettes, pipes, and cigars. . . .
I deployed concealed continuous real-time monitors for RSP, i.e., airborne particulate matter in the combustion range below 3.5 microns in diameter (PM3.5), and PPAH, as well as carbon dioxide, carbon monoxide, temperature, and relative humidity. All indoor venues visited were selected by personnel of the American Lung Association of Delaware to represent a cross-section of the spectrum of area hospitality venues. . . .
After 30 years of recommending ventilation rates for the control of tobacco smoke odor, Standard 62.1-2004 revised the Minimum Ventilation Rate Table to apply only to no-smoking spaces, recognizing the mortal hazard of SHS as defined by cognizant authorities.16 However, Standard 62.1-2004 requires additional (but unspecified) ventilation in excess of the table rates for engineers designing for smoking venues. . . .
Although no cognizant authority has set an acceptable level for SHS per se, we can ask if there is some level of mortality risk that federal regulatory agencies have viewed as acceptable? . . . .
LAWRENCEVILLE — Ventilation systems do little to clear the air of second-hand cigarette smoke, a health physicist told members of a committee studying Gwinnett’s smoking ban Wednesday.
J. L. Repace explained that those most at risk from smoking in restaurants are bartenders and waitresses at smoke-filled bars, who can have up to a seven times higher risk of heart problems and cancer. . . .
While two experts testified that ventilation is ineffective in protecting people from second-hand smoke, a consultant who tested the system at Wild Bill’s nightclub in Duluth said that system does the trick.
Less than a year before the county voted to ban smoking in public places, the indoor entertainment hall added a $1 million HVAC system to allow smoking in a portion of the facility.
When owner Bill Gentry applied for an exemption to the ban because of the expensive system, the commission denied his claim but set up a committee to study the ban.
“This facility is probably the best I’ve been in. I stood 2 feet from a table full of smokers, and I didn’t smell a thing,” said Tim Gilbert of HESM and Associates who tested the facility. “There’s always going to be some health risk involved, but some engineering practices can make them reasonably safe.”
Repace called any statistics that support ventilation “propaganda.” . . .
“The best we can do for health outcomes in ventilation is separation,” said Schoen, an active member of the American Society of Heating, Refrigerating and Air-Conditioning Engineers. . . .
“There is a certain inevitability to smoking bans being passed,” Lord said. “By allowing exemptions for ventilation, this committee may be opening the door for many of these restaurants, who falsely believe the ban is hurting their business, to install a ventilation system that may be obsolete in six months,” he said. “What I’m trying to prevent is more Wild Bill’s scenarios.”
The engineering society standards recommend walls and sliding doors between smoking and nonsmoking sections, separate ventilation systems and pressurization. Those standards have been adopted by governments nationwide.
The issue of how to deal with secondhand smoke has been a subject of debate within ASHRAE for many years.1 This debate has centered around ANSI ASHRAE Standard 62, Ventilation for Acceptable Indoor Air Quality, whose stated purpose is to “specify minimum ventilation rates and indoor air quality that will be acceptable to human occupants and are intended to minimize the potential for adverse health effects.” Acceptable indoor air quality is defined as “air in which there are no known contaminants at harmful concentrations as determined by cognizant authorities and with which a substantial majority (80% or more) of the people exposed do not express dissatisfaction." . . .
This approach alarmed the tobacco industry because, as Philip Morris noted, it “would effectively double the costs for heating and cooling in areas which allow smoking.”1 This increased ventilation cost became a reason for building owners to make buildings smoke-free, and these smoke-free policies reduce cigarette consumption by 29% by making it easier for people to cut down or stop smoking.2 As a result, the tobacco industry, working both directly and through the hospitality and gaming industries,1,3 has mounted a continuous campaign to have ASHRAE Standard 62 provide for smoking in buildings. . . .
Given the high levels of ventilation required to meet even a “comfort” design goal based on modern evidence, combined with the demand for “guidance” encouraged by the tobacco industry and its allies, 1 what is ASHRAE to do?
There are two broad ASHRAE policies that are relevant: On June 9, 2002, “The Board of Directors affirm[ed] the implied policy that ASHRAE standards shall consider health impacts where appropriate” (100-117-006 & 520-166-013) and the ASHRAE Code of Ethics states in part: “Our efforts shall be directed at all times to the enhancement of the public health, safety and welfare.”22 As noted, spaces designed in accordance with the guidelines in Standard 62-2001 Appendix I can lead to levels of RSP that are not consistent with “public health, safety, and welfare."
These policies would seem at odds with recommendations in Standard 62-2001 Appendix I, which are based on unrealistic assumptions, which bias recommendations to lower ventilation rates. In many ways, Appendix I was similar to a civil engineering society developing recommendations for bridge construction based on liberal assumptions about strength of building materials, while assuming that the number of vehicles on the bridge was low. While such guidance might serve economic needs of contractors who wish to cut corners, it could be viewed as violating basic engineering principles and ethics.
Since ASHRAE seems unwilling to develop a standard based on de minimus risk,1,13 perhaps it would be best to simply include a statement in Standard 62, as the Board Policy Committee did in its report to the ASHRAE Board of Directors on June 25, 2002, that “There is evidence that acceptable air quality cannot be achieved where smoking is permitted,”5 delete Section 6.1.3.5, the statement in the standard about the need for additional ventilation or air cleaning when smoking is permitted, drop the forthcoming ETS design guide, and leave it at that.