Tobacco researchers urge ASHRAE to drop plans for guide on dealing with secondhand smoke in HVAC systems



ANAHEIM, Calif. - ASHRAE's plan to include design information for smoker-friendly restaurants, bars and casinos in its indoor air quality standard endangers the health of patrons and employees, and is counter to the group's code of ethics.

That's according to two anti-smoking activists who appeared at the American Society of Heating, Refrigerating and Air-Conditioning Engineers' January winter meeting to pressure it to drop plans for a forthcoming HVAC system design guide on dealing with secondhand smoke.

Stanton Glantz, Ph.D., a University of California-San Francisco professor of medicine, and James Repace, a health physicist and former Environmental Protection Agency scientist, say the society's current approach to smoking, which focuses on "comfort" by removing visible pollutants and odors, ignores the considerable health risks in buildings where smoking is permitted. And many nonsmokers can never be comfortable in an area where there's smoking, they add.

Former Environmental Protection Agency scientist James Repace says up to 60,000 people in the United States die each year from secondhand smoke. The only way to prevent this are comprehensive indoor smoking bans, he says.

Health risks

Numerous studies in the past 15 years have linked secondhand smoke - often called "environmental tobacco smoke" or "ETS" in scientific papers - to heart disease and lung cancer, in addition to respiratory problems. The U.S. Surgeon General first issued a report on the dangers of smoking to bystanders in 1986, saying that separate smoking and nonsmoking sections reduce, but do not eliminate, the risks of secondhand smoke. The federal EPA named secondhand smoke a cancer-causing substance for humans in 1992.

Since then, hundreds of communities have strengthened their indoor anti-smoking ordinances, with some outlawing tobacco use even in such longtime smokers' hangouts as bars and diners. Currently, five states - Maine, California, Delaware, Connecticut and New York - ban smoking inside almost all public places. Similar bills have been introduced in several other states.

But many tavern, casino and restaurant owners oppose such blanket prohibitions, saying they have a right to allow patrons to use a legal substance. Many also fear smokers will stay home if bans are enacted.

ASHRAE officials have been grappling with tobacco's place in its Standard 62, "Ventilation for Acceptable Indoor Air Quality," for more than 20 years. Although little known outside the HVAC engineering community, the society's voluntary standards often impact building codes in the United States and around the world.

Stanton Glantz, a University of California-San Francisco professor of medicine, told ASHRAE members that focusing on “comfort” in regards to secondhand smoke is a dangerous precedent.

Seeking smoke-free standards

That's the reason anti-smoking activists have been pressuring ASHRAE to adopt a zero-tolerance policy toward smoking in its standards, saying ventilation can't remove all of the toxins or carcinogens in secondhand smoke. The hospitality industry, however, which caters to smokers in bars and casinos, says it needs guidance on how to provide the best environment for its customers.

James Repace says the best environment is a smoke-free one. The former EPA scientist now runs Repace Associates Inc., a Bowie, Md.-based company that consults on secondhand smoke issues. He has published dozens of studies on the effects of tobacco on nonsmokers. He also frequently testifies on behalf of groups seeking to enact smoking bans.

"There isn't any doubt that we're dealing with a substance that will kill people," Repace told ASHRAE members during his presentation.

Up to 60,000 people in the United States die annually because of secondhand smoke, he said. And adding ventilation won't solve the problem. He cited research he had conducted on the air quality inside Boston, Toronto and Wilmington, Del., bars. In the case of the Boston and Wilmington taverns, he measured the air quality before and after smoking bans were imposed. After smoking was snuffed out, carcinogen levels dropped by more than 90 percent, he said.

"You can't do that with ventilation," he added.

Repace's study of the Black Dog Pub in Scarborough, Ontario, refuted the findings of earlier tests that showed the pub's expensive ventilation system - compliant with ASHRAE's Standard 62 - virtually eliminated secondhand smoke exposure.

Former ASHRAE President William Coad says the group must provide guidance to the engineering community, and that includes dealing with secondhand smoke.

Ventilation solutions questioned

While Repace's study did show that there were fewer pollutants in the pub's nonsmoking section, it was still more than 10 times the EPA's recommended levels, he said.

It would take "tornado-level" ventilation - more than 100,000 cubic feet per minute, per occupant - to make the air safe for nonsmokers, Repace estimated.

That's why smoking bans are the only logical choice, he said.

"The rational approach for ASHRAE is to say that secondhand smoke kills and I think there are cognizant authorities who say that," Repace said, adding that focusing on just removing odor can lull patrons or workers into a false sense of security.

University of California-San Francisco Professor Stanton Glantz questions the ability of an HVAC system to effectively remove tobacco odors, let alone the harmful ingredients in secondhand smoke. He co-authored an article on the problems with the society's approach to smoking in the March 2004 issue of ASHRAE Journal. Glantz says offering a comfort-oriented design guide for secondhand smoke ignores scientific facts about the risks tobacco smoke poses to nonsmokers. It also disregards the society's own public health goals.

"Secondhand smoke exposure is almost as bad as being a pack-a-day smoker," he said. "The cardiovascular system is exquisitely sensitive to secondhand smoke."

Glantz has been a high-profile critic of ASHRAE in recent years. He operates a Web site, www.tobaccoscam.ucsf.edu, which is often critical of the group's rule-making process and says the society has allowed itself to be influenced by tobacco interests during the last 20 years.

"The tobacco industry has spent a lot of time and money trying to confuse ASHRAE," he said.

Some say society must guide

William Coad, a licensed professional engineer and former ASHRAE president, disagreed with Glantz's assessment.

"In case anyone gets the impression that ASHRAE is pro-smoking, ASHRAE went nonsmoking about 20 years ago, before it was popular," Coad said.

However, that doesn't mean that the society shouldn't include directions on designing HVAC systems for smoking areas, he added.

"I feel very strongly that ASHRAE must provide guidance," he said, adding that it is not the society's place to tell building owners that they cannot permit smoking. "We can't tell people that they cannot cross the bridge.

"The easiest thing in the world on this dilemma is if everybody quit smoking," Coad said. "But this is the real world, and it isn't going to happen."

Even within the health community, there is some disagreement on just how great a danger secondhand smoke poses to the public. In May 2003, a 39-year study of 35,561 nonsmoking spouses was published in the British Medical Journal. It found that living with a smoker (and presumably being exposed to considerable amounts of secondhand smoke) does not significantly increase the risk of lung cancer or heart disease. The report, whose authors received some funding from the tobacco industry, was criticized by many medical organizations as flawed and biased.

The American Council on Science and Health also says that the case against secondhand smoke is overstated. No friend of the tobacco industry, it has published several booklets on the dangers of smoking.

The New York-based nonprofit group says it aims to separate real health risks from trivial scares.

While it agrees with the EPA's assessment that secondhand smoke is a major respiratory irritant and supports actions to limit or eliminate public exposure, "the link between secondhand smoke and premature death ... is a real stretch," according to an online editorial by council President Elizabeth Whelan, who holds a master's and doctorate in public health. The group calls secondhand smoke a "weak" risk factor in the development of lung cancer and heart disease.

(For reprints of this article, contact Jill DeVries at (248) 244-1726 or e-mail devriesj@bnpmedia.com.)