Conducting Indoor Air Quality Studies

Mark Travers, M.S.

Roswell Park Cancer Institute

Evaluation of Clean Indoor Air Law

Implementation Public Health Impact

Adverse Side Effects

Support or Opposition

Compliance

Exceptions to Law (Waivers)

Direct Effects

Indirect Effects

Economic Impact

Evaluation of Clean Indoor Air Law

Public Health Impact

Direct Effects

• Decrease indoor air pollution

• Reduce exposure to carcinogens and toxins

• Improve health and reduce incidence of tobacco smoke related diseases

Tobacco Control Model of Nicotine Addiction

Agent

Vector Host

Tobacco Products

Tobacco Product Manufacturers;

Other Users

Smoker/ChewerIncidental Host

EnvironmentFamilial, Social,

Cultural, Political, Economic, Historical,

Media

Involuntary Smoker

Source: Orleans & Slade, 1993

Paradigm for Tobacco Control

Price/economic Smoke-free air Media Cessation activities Prevention activities Regulation/Liability

Access Marketing

Society

TobaccoAddiction

Individual

Adult Per Capita Cigarette Consumption and Major Smoking and Health Events – United States, 1900-2003

0

1000

2000

3000

4000

5000

1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2000

YEAR

Num

ber

of C

igar

ette

s

Source: United States Department of Agriculture; 2002 and 2003 estimates are preliminary

End of WW II

1st Smoking-Cancer Concern

Fairness Doctrine Messages on TV

and Radio

Non-Smokers Rights Movement

Begins

Federal Cigarette Tax Doubles

Surgeon General’s Report on ETS

1st Surgeon General’s

Report

1st World Conference on Smoking and Health

Broadcast Ad Ban

1st Great American Smoke-out

OTC Nicotine Medications

Master Settlement Agreement

Great Depression

Price

Smoke-free Air

Treatment

CounterMarketing

Components of Smoking Vaccine

Measuring Air Quality

• Cigarettes, cigars and pipes are major emitters of respirable suspended particles less than 2.5 microns (PM2.5) in diameter that are easily inhaled deep into the lungs

• TSI SidePak AM510 Personal Aerosol Monitor (weight: 1 lb)

• This device is a real-time laser photometer with a built-in sampling pump that measures airborne particle mass-concentration

Why PM2.5?

• Very sensitive marker of ETS• Can monitor and record data in real time• Relatively inexpensive equipment• Marker of the more than 4,000 chemical in ETS

– E.g. 2,000:1, PM2.5:PAH

• Meaningful measure: there are PM2.5 standards in place to protect public health– The EPA has set standards of 15 μg/m3 as the average

annual level of PM2.5 exposure and 65 μg/m3 24-hour exposure in order to protect the public health

US EPA Air Quality Index

Air QualityAir Quality

Index PM2.5 (g/m3) Health Advisory

Good 0-50 ≤15 None.

Moderate 51-100 16-40 Unusually sensitive people should consider reducing prolonged or heavy exertion.

Unhealthy forSensitive Groups

101-150 41-65 People with heart or lung disease, older adults, and children should reduce prolonged or heavy exertion.

Unhealthy 151-200 66-150 People with heart or lung disease, older adults, and children should avoid prolonged or heavy exertion. Everyone else should reduce prolonged or heavy exertion.

VeryUnhealthy

201-300 151-250 People with heart or lung disease, older adults, and children should avoid all physical activity outdoors. Everyone else should avoid prolonged or heavy exertion.

Hazardous ≥301 ≥251 People with heart or lung disease, older adults, and children should remain indoors and keep activity levels low. Everyone else should avoid all physical activity outdoors.

Why use the TSI SidePak Personal Aerosol Monitor?

• All the reason on the previous slide and,

• Convenient small size– Can easily be placed discretely in a small bag

This picture shows an example of the bag used to carry the SidePak and QTrak instruments during air monitoring

Limitation of PM2.5 as a Marker of ETS

• Not specific to tobacco smoke; other sources include cooking, vehicles, ambient/background levels

• Can minimize this weakness with a pre-post study design

Calibration

• The TSI SidePak Personal Aerosol Monitor uses a built-in pump to bring air past a laser.

• The particles in the air scatter the light from the laser and the device determines the mass concentration of particles based on the amount of scattering.

• These types of devices must be calibrated with the specific type of aerosol (tobacco smoke) that you are measuring.

SidePak Factory Calibration Certificate

Calibration: Unadjusted Data

0

1000

2000

3000

4000

5000

0 50 100 150 200

Elapsed time in minutes

PM

2.5

in m

icro

gram

s pe

r cu

bic

met

er

MIE dataRAM

SidePak

Repace, J., Respirable particles and carcinogens in the air of Delaware hospitality venues before and after a smoking ban. Journal of Occupational and Environmental Medicine, 46:9, 887-905.

Oct. 10th 2003 Bowie, MD

Calibration: Adjusted Data

0

500

1000

1500

2000

0 50 100 150 200

Elapsed time in minutes

PM

2.5

in m

icro

gram

s pe

r cu

bic

met

er

MIE dataRAM

0.32*SidePak

Oct. 10th 2003 Bowie, MD

Piezobalances and SidePak (Factory-Calibrated)

Elapsed Minutes

Piezobalance and SidePak (Custom-Calibrated)

Measuring Air Quality• TSI Q-Trak Plus Indoor

Air Quality Monitor

• Measures 4 indoor air quality parameters– Temperature– Humidity– Carbon Monoxide– Carbon Dioxide

• Not essential to do these studies but does provide many advantages

Study Design

• Longitudinal or Pre-Post– Compare the same venues before and after they

go smoke-free

• Cross-sectional– Compare smoke-free cities with cities that

allow smoking– Compare smoke-free venues to smoking venues

in the same city

Venue Selection

• Depends on your study goals• Random Sample

– Difficult logistically

– With small sample size results might not be generalizable

• Convenience Sample– More feasible

– Can target types of venues that would be affected by a new policy

Measurements and Observations

• PM2.5 from SidePak

• Average number of people

• Average number of burning cigarettes

• Volume of room using sonic measure

• Temp, humidity, CO, CO2 from Q-Trak

Da y of w e e k:

Da te :

Na m e s of obse rve rs:

Tim e S ta rt Logging:

Tim e S top Logging:

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Location Nam e:

Entry Tim e:Ex it Tim e:

Length:W idth:Height:

Tim e # People # Cigs

Time Activity Pattern

Can calculate…

Average smoker density– Average number of burning cigarettes per

100m3

With a QTrak You Can Calculate…

• Ventilation estimate– From CO2, average number of people, room

volume

Results

• Cross sectional study design– Multi-City Air Monitoring Study

Multi-City Air Monitoring Study: Philadelphia, PA April 10th, 2004

0

200

400

600

800

1000

1200

0 50 100 150 200 250 300 350 400

Elapsed time in minutes

Fin

e p

art

icle

air

po

lluti

on

(P

M2.

5 in

μg

/m3 )

All venues are smoking venues with observed smoking in all venues

4/107:01pm

4/111:41am

VENUE42

VENUE43

VENUE44

VENUE45

VENUE46

VENUE47

VENUE48

Multi-City Air Monitoring Study: New York City, NY April 17 th, 2004

0

100

200

300

400

500

600

0 50 100 150 200 250 300 350 400 450 500

Elapsed time in minutes

Fin

e p

art

icle

air

po

lluti

on

(P

M2.

5 in

μg

/m3 )

All venues are smoke-free by law and no smoking was observed in an venue

4/176:43pm

4/182:38am

VENUE56

VENUE57

VENUE58

VENUE59

VENUE60

VENUE61

VENUE62

0

200

400

600

800

1000

1200

0 50 100 150 200 250 300 350 400

Elapsed time in minutes

Fine

par

ticle

air

pol

lutio

n (P

M2.

5 in

μg/

m3)

New York City

Philadelphia

Multi-City Air Monitoring Study: New York City, NY April 17 th, 2004 and Philadelphia, PA April 10th, 2004

Average Level of PM2.5 by City

104 94

26 27

293

392

254 231

25

343

0

100

200

300

400

500

Hartfo

rd

L.A.(a

ll ve

nues)

L.A.(c

omplia

nt ven

ues)

Buffalo

Baltim

ore

Was

hingt

on, D

C

Philadelp

hia

Hobok

en

New Y

ork C

ity

Galve

ston

PM

2.5

in m

icro

gram

s p

er c

ub

ic m

eter

Results

• Pre-post study design– Indiana Air Monitoring Study– Western New York Air Monitoring Study

Travers, M.J., et al., Indoor Air Quality in Hospitality Venues Before and After the Implementation of a Clean Indoor Air Law-Western New York, 2003. Morbidity and Mortality Weekly Report (MMWR), 2004.

Indiana Air Monitoring StudyDecember 2004 to January 2005

Indiana Tobacco Prevention and Cessation

Roswell Park Cancer Institute

0

200

400

600

800

1000

1200

1400

0 100 200 300 400

Elapsed Time in Minutes

Fin

e p

art

icle

air

po

llu

tio

n (

PM

2.5 i

n μ

g/m

3)

VENUE1a

VENUE2a

VENUE3a

VENUE4a

VENUE5a

VENUE6a

VENUE7a

VENUE8a

Indiana Air Monitoring Study: Bloomington, IN, December 10th, 2004

12/10/046:00pm

12/11/041:20am

0

200

400

600

800

1000

1200

1400

0 100 200 300 400

Elapsed Time in Minutes

Fin

e p

art

icle

air

po

llu

tio

n (

PM

2.5

in μ

g/m

3 )

VENUE1b

VENUE2b

VENUE3b

VENUE4b

VENUE5b

VENUE6b

VENUE7b

VENUE8b

1/21/056:14pm

1/22/051:34am

Indiana Air Monitoring Study: Bloomington, IN, January 21st, 2005

0

200

400

600

800

1000

1200

1400

0 100 200 300 400

Elapsed Time in Minutes

Fin

e p

arti

cle

air

po

lluti

on

(P

M2

.5 in

μg

/m3) Pre-Law 12/10/04

Post-Law 1/21/05

Bloomington, IN Before and After Clean Indoor Air Law

Average Level of Indoor Air Pollution Before and After Implementation of Clean Indoor Air Legislation,

Bloomington, IN

347

371814 14

0

100

200

300

400

500

Pre-Law Post-Law Post-Law Compliant(n=6)

Avera

ge P

M2

.5 level (μ

g/m

3)

Smoking allowed pre-law (n=7)

Non-smoking (n=2)

annual PM2.5 standard(15μg/m3)

24-hour PM2.5 standard (65μg/m3)

89% 95%

Indoor Air Quality Before and After Indoor Air Quality Before and After the New York State Clean Indoor Air the New York State Clean Indoor Air Law in Western New York Hospitality Law in Western New York Hospitality

Venues, July to September 2003Venues, July to September 2003

Mark Travers,1 Michael Cummings,1 James Repace,2 Andrew Hyland1

1Division of Cancer Prevention and Population Sciences, Roswell Park Cancer Institute; Buffalo, New York

2Repace Associates, Inc.; Bowie, Maryland

-98%

-80%

-98%

-84%

-86%

-89%

-98%

-98%-95%

-73%

-91%

-96%

-95%-84%

0

200

400

600

800

1000

1200

1400

Res

pir

ab

le S

usp

end

ed P

art

icle

s (μ

g/m3 o

f P

M2

.5)

Change in Air Quality in Western New York Bars Change in Air Quality in Western New York Bars and Restaurants After Implementation of the and Restaurants After Implementation of the

New York State Clean Indoor Air LawNew York State Clean Indoor Air Law

Before Law: Average = 412 μg/m3

After Law: Average = 27 μg/m3

Only venue with active smoking during post-law sampling

Mean size of venue = 365m3

Mean pre-law active smoker density = 1.38 cigs/100m3

Change in Air Quality in Western New York Change in Air Quality in Western New York Large Recreation Venues After Implementation Large Recreation Venues After Implementation

of the New York State Clean Indoor Air Lawof the New York State Clean Indoor Air Law

-96%

-76%-64%

-70%

0

50

100

150

200

Pool Hall Bingo Hall Bowling Bowling

Res

pir

ab

le S

usp

end

ed P

art

icle

s (μ

g/m3 o

f P

M2

.5)

Before Law: Average = 101 μg/m3

After Law: Average = 18 μg/m3

Mean size of venue = 3,530m3

Mean pre-law active smoker density = 0.22 cigs/100m3

Average Particle Concentration versus Average Smoking Density

0

200

400

600

800

1000

1200

1400

1600

0.00 1.00 2.00 3.00 4.00

Average Smoking Density (burning cigs per 100m3)

Ave

rage

PM

2.5

(mic

rogr

ams

per

cu

bic

met

er)

r=0.421

Average Particle Concentration versus Average Smoking Density by Ventilation

0

200

400

600

800

1000

1200

1400

1600

0.00 1.00 2.00 3.00 4.00

Average Smoking Density (burning cigs per 100m3)

Ave

rage

PM

2.5

(mic

rogr

ams

per

cu

bic

met

er)

1.0<ACH<2.1

ACH 1.0

ACH 2.1

r=0.908

r=0.834

r=0.832

Results

• Case studies– One bar/restaurant after smoking ban goes into

effect– One bar with a designated smoking room

Air Quality Over Time in a Air Quality Over Time in a Western New York BarWestern New York Bar

0

50

100

150

200

250

300

350

400

450

11

:41

PM

11

:46

PM

11

:51

PM

11

:56

PM

12

:01

AM

12

:06

AM

12

:11

AM

12

:16

AM

12

:21

AM

12

:26

AM

12

:31

AM

12

:36

AM

12

:41

AM

12

:46

AM

12

:51

AM

12

:56

AM

1:0

1 A

M

1:0

6 A

M

1:1

1 A

M

Re

sp

ira

ble

Su

sp

en

de

d P

art

icle

s (

μg

/m3 o

f P

M2.

5)

Normal smoking night of July 18th

Limited smoking night of July 23rd

Midnight July 24th, smoking stops, new law in effect

0

100

200

300

400

500

600

ug

/m3

PM

2.5

Enter barExit bar

Average in 20 smoke-free venues = 27 g/m3

Average in non-smoking part of bar = 192 g/m3

Air Monitoring in a Bar Receiving a Smoking WaiverAir Monitoring in a Bar Receiving a Smoking WaiverAir monitor was placed in the middle of the bar (non-smoking area), 15 feet from the door to the smoking room

Door to smoking room opened and left open for 4 minutes Door to smoking room opened

Saturday, February 28th, 2004

0

100

200

300

400

500

600

ug

/m3

PM

2.5

Enter barExit bar

Average in 20 smoke-free venues = 27 g/m3

Average in non-smoking part of bar = 192 g/m3

Air Monitoring in a Bar Receiving a Smoking WaiverAir Monitoring in a Bar Receiving a Smoking WaiverAir monitor was placed in the middle of the bar (non-smoking area), 15 feet from the door to the smoking room

Door to smoking room opened and left open for 4 minutes Door to smoking room opened

Saturday, February 28th, 2004

Influencing Policy Decisions

• Media

• Politicians

• The Public

Summary

• The TSI SidePak is a is scientifically valid and effective tool for real-time PM2.5 monitoring in SHS studies

• Can show immediate, direct causal link between smoking and fine particle air pollution

• With some expert training and guidance lay persons can collect data in their own communities

• Simple environmental monitoring studies can be powerful in policy debates

Equipment Availability

• Rent– Ashtead Technologies– http://www.ashtead-technology.com/

• Buy– TSI Inc.– http://www.tsi.com

• Borrow– Roswell Park Cancer Institute

Contact

• Mark Travers– Roswell Park Cancer Institute– Mark.travers@roswellpark.org– (716) 845-5881 work– (716) 868-4784 cel– (716) 845-8487 fax

Summary- What you have to do• Prepare SidePak (3 steps)

– Charge battery– Clean and grease the impactor– Zero calibrate

• Start logging data (record the time!)• Lock the SidePak keypad• Visit venues and record observations

– Times of entry, counts and exit– Count # people every 15 minutes– Count # burning cigarettes every 15 minutes– Take notes on who, what, where, and when– Measure room volumes (use sonic measure)– A few descriptive sentences on each place

• Buy something in each place you visit (be a patron)• Try and spend at least 5 minutes outside between venues

Summary- What you have to do• When you’re done monitoring, unlock the

SidePak keypad

• Stop logging (record the time!)

• Turn off the device, don’t forget to recharge it for next time

• Connect SidePak to PC and download the data from the device

• Enter your notes/observations into an Excel spreadsheet

Chicago Air Monitoring Study

2005 National Conference on Tobacco of Health

METHODS• Conducting Indoor Air Quality Studies -

Training– Over 50 registrants

– 30 Volunteer researchers

– Groups of 2-5 volunteers

• What did we ask of participants? – Visit Chicago bars and restaurants for at least 30 minutes

– Place a TSI SidePak AM510 Personal Aerosol Monitor to measure air quality in a bag with a small tube protruding to sample the air

– Record additional observations

METHODS• Outcome Measures

– Respirable Suspended Particles (RSPs) less than 2.5 microns in diameter (PM2.5)

– Observations every 15 minutes in each establishment• Number of people present• Number of burning cigarettes • Volume (Zircon DM S50 Sonic Measure)

• Data Collection– Convenience sample of 37 bars and restaurants– Wednesday and Thursday night (6pm to 12 midnight)– Average duration of 44 minutes

Average Levels of Indoor Air Pollution

719 25 21

128

0

50

100

150

200

SheratonLobby

ChicagoOutside

New YorkCity (Smoke-

free)

ChicagoSmokefree

ChicagoSmoking

Res

pir

able

Su

spen

ded

Par

ticl

es (

μg/

m3 of

PM

2.5)

NCTH Air Monitoring Investigators

Global Assessment of Secondhand Smoke Air Pollution

• Provide collaborators in 20 countries with equipment, training and expert support

• Develop global scorecard

• Present results at 2006 WCTH in Washington, DC

Prospective Countries• United States• Canada• Venezuela• Brazil• Uruguay• United Kingdom• Ireland• Scotland• France• Spain• Germany• Switzerland• Italy

• India

• Malaysia

• Thailand

• China

• Hong Kong

• South Korea

• Australia

• New Zealand

• Japan

• Austria• Belgium• Poland• Hungary• Russia• Greece• Turkey• Syria• Saudia Arabia• Egypt• Tunisia• Côte d’Ivoire• Nigeria