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Secondhand Smoke in Pennsylvania Casinos: A Study of Nonsmokers’ Exposure, Dose, and Risk (PDF) 

Mining is described as the most dangerous industry.34 Sixteen Pennsylvania miners died in 15 disasters from 1995 to 2002, a rate of 1.2 deaths per10000 mine workers per year.34 The estimated rate of worker deaths per year from SHS is about 5 times the average annual death rate for Pennsylvania miners in coal mine disasters.

By the workplace standards of the US ½Q22 Occupational Safety and Health Administration ½Q20 (OSHA), which employs a 45-year average time period, casino workers’ risk from SHS-induced lung cancer and heart disease combined is 26 times the level indicating significant risk of material impairment.30

Pennsylvania’s new clean indoor air law permits smoking in 25% to 50% of casino floors. Confining smokers to a smaller area will increase the local smoker density in the smoking area and not protect nonsmoking areas from drifting or recirculated tobacco smoke. . . .

Conclusions

Despite ventilation rates per occupant 50% higher on average than those formerly recommended by ventilation engineers for smoking-permissible casinos, the average RSP concentration measured inside 3 Pennsylvania casinos in which smoking was permitted averaged 6 times that of outdoor levels; PPAH concentrations averaged 4 times outdoor levels, exposing both workers and patrons to harmful levels of air pollution. In the only casino with a separate nonsmoking floor, considerable amounts of RSPs and PPAHs infiltrated the nonsmoking salon. Based on measured RSP levels, SHS odor and irritation thresholds were massively exceeded in smoking areas and considerably exceeded in 1 nonsmoking salon. Using default values, the Active Smoker Model predicted combined RSP observations to within 14%.

Based on cotinine-derived RSP levels, SHS in Pennsylvania casinos produces an estimated excess mortality of approximately 6 deaths per year per 10000 workers at risk, 5 times the rate at which Pennsylvania coal miners have died in mining disasters and 26 times OSHA’s significant risk level. Nonsmoking workers or patrons exposed to casino SHS at the observed level of occupancy for 8 hours would experience ‘‘unhealthy air’’ according to the US Air Quality Index and, at maximum occupancy or exposure duration, ‘‘very unhealthy’’ air. Cotinine- derived PPAHs from SHS increases workers’ 24-hour exposure to PPAHs by an estimated 6-fold over measured outdoor background levels.

Further research is needed to generalize exposures observed in this study to the casino industry as a whole. It is clear, however, that Pennsylvania casino workers and patrons are put at significant excess risk of heart disease and lung cancer from SHS through a failure to include casinos in the state’s smoke-free-workplace law.

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