LYMErix Preventive Lyme vaccine or blundering mistake

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Measuring Tobacco Smoke Pollution in Multi-Unit
Housing
NCTOH Ancillary Meeting on Smoke-free Multi-Unit
Housing June 9th 2009
Mark Travers, PhD and Brian King, MPH Roswell
Park Cancer Institute Dave Bohac. P.E. Center
for Energy and Environment Neil Klepeis, PhD
Stanford University
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Conceptual Model Examining Air Pollution and
Public Health
Source From Ott, W., Total human exposure.
Environ Sci Technol, 1985. 19(10) p. 880-886 AND
Ott W. Exposure Analysis A Receptor-Oriented
Science. In Ott WR, Steinemann AC, Wallace LA,
editors. Exposure Analysis. Boca Raton Taylor
Francis 2007. p. 3-32.
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Measuring Exposure to Tobacco Smoke Pollution
(TSP)

• Two most common techniques
• Nicotine Monitoring
• Particle Monitoring

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Comparison of 2 SHS Monitoring Methods
Ref Apelberg B, Travers MJ
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www.tobaccofreeair.org
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Measuring Exposure to Tobacco Smoke Pollution

• 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

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Particle Size
Human Hair
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Bloomington, IN Before and After Smoke-free Air
Law
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Change in Indoor Fine Particle Air Pollution
after Smoke-free Air Law Implementation by Venue
Type
Significant change from pre- to post-law using
paired-samples t test on log-transformed PM2.5
values, 90.1 reduction (95 C.I. 87.9 to
91.9).
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US EPA Air Quality Index
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Press Release following the Oregon Air Monitoring
Project in 2006
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Generated Media on Air Monitoring Studies
U.S.A.
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U.S.A.
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U.S.A.
See next slide
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U.S.A.
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Rationale

• children have little or no control over their
  exposure
• limited attention, and research documenting the
  level of TSP in cars -gt no in vivo studies
• few successful laws

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• Method continued
• PM2.5 was measured using a TSI Dustrak and TSI
  Sidepak Personal Aerosol Monitor (TSI, Inc., St.
  Paul, MN) positioned in the middle of the back
  seat, at the level of a childs head in a car
  seat.

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• Method
• levels of PM2.5 were measured in 4 different
  cars
• each participant completed five 4.5 hour
  sessions
• car owners smoked one cigarette under 5
  controlled in vivo air-sampling conditions
• Summary of Conditions

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RSP Levels in a Car When Smoking 1 Cigarette
Windows up, engine off, no ventilation
Condition 1
Cigarette start, t22
Cigarette finish, t33
PM2.5 measured with TSI Dustrak, calibration
factor 0.32, participant 2, session 1.
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Wildland Firefighter Exposures

• About 600 µg/m3 at base camp.
• About 1,100 µg/m3 to 2,100 µg/m3 or more during
  active, front-line, firefighting

Sources Materna 1992, Reinhardt 2004.
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Average PM2.5 Levels - Conditions 2-5
Average for conditions 2, 4, and 5 excluded
data collected in car 4 due to sequential
lighting.
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How Dangerous is Smoking in Cars?

• http//www.vimeo.com/1513382
• Media demonstration by Neil Klepeis, Ph.D. and
  the California Department of Health

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What is an outdoor area?

• Outdoor patio areas of restaurants and bars are
  often enclosed to varying degrees by walls,
  awnings, umbrellas etc
• A park on the other hand may be a truly open
  outdoor area

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Conclusions for Outdoor Locations

• The degree of enclosure has a major impact on
  exposures
• Highly enclosed places behave just like indoor
  locations
• Smoking in more open spaces still leads to
  significant TSP exposure, however,
• Exposures are more variable and dependent on wind
  direction and proximity effect
• Exposures tend to be transient

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SHS Transfer Within Homes
Van Deusen et al (2006)

• TSI SidePak used to assess particulate matter
  levels (PM2.5) as surrogate for SHS
• Single and multi-unit homes in Erie and Niagara
  Counties (n12)
• February - August 2006

p lt0.01 compared with smoke-free homes
(Mann-Whitney U test)
Source Van Deusen A, Hyland AJ, Travers MJ, Wang
C, Higbee C, King B, Alford A, and Cummings KM.
Secondhand smoke and particulate matter exposure
in the home. Nicotine and Tobacco Research. In
Press.
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Who Lives in Multi-Unit Housing?
80 Million (26)
11 Million (55)
570,000 (38)
383,000 (33)
Source Adapted from the U.S. Census Bureau,
American Housing Survey, 2007.
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• Duplex

1930s
8-Plex
1970
1964
12-Plex
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2001
New 4 story
1982
138 unit
1999
11 story
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Factors Affecting Transport of SHS in Multi-Unit
Dwellings

• Driving Force, Stack Effect Hot Air Rises
• Driving Force, Wind Effect Air Currents Across
  Building
• Many Cracks and Crevices in MUDs Fixtures,
  Outlets, Baseboards, Sprinklers, Plumbing
• Significant Air Flow Between Units As much as
  30 to 50 of air comes from other apartments
• Tiny SHS Particles Travel in Cracks

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WinterStack Effect
In at the bottom and out the top
Taller Building gt Bigger Effect
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Wind Effect
In on windward side and out on leeward side
Taller Building gt Bigger Effect
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Mechanical Effect

• Mechanical ventilation is required by code
  bathrooms some kitchens
• Exhaust ventilation gt draws air into an
  apartment
• Flow imbalances can also cause air to move from
  one apartment to another

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What if you open a window?

• Smoker on a lower floor in winter will
  probably increase SHS transfer problem to
  upstairs neighbor

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How Does The Air Get In and Through and Out?

• Anyway it can!
• Gaps in walls, floors, mechanical chases
• Some are accessible and others too diffuse or
  inaccessible for sealing

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Most openings are small and diffuse
Gaps around sink plumbing
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Baseboards and sprinkler heads
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Gaps along baseboard under carpet
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Gaps behind baseboard heaters
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Light fixtures Leaky (2.5 si) Tight (0.1 si)
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Some openings are BIG!
Why do our clothes smell like smoke?
Plumbing access panel removed
Open between tubs
Neighbors bathtub
Pegboard is not a good air barrier!
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Hidden high rise chases large uncontrolled flows
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Hidden chase openings difficult to access
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Add mineral wool fire-safing to high rise shaft
openings
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Seal with listed fire barrier
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Major components of TSP classified by their
physicochemical properties
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Multi-Unit Dwellings

• Convenience sample of multi-unit residential
  buildings
• West Seneca, New York (July 15th - August 21st,
  2008)
• 6 buildings (66 units) invited to participate
• 5 multi-unit buildings (18 units) consented
• n8 smoke-free and n10 smoking

• TSI SidePak AM510 air monitors
• Primary living area of each unit and hallway of
  each building
• Mean Monitoring Time Non-Smoking - 64 hrs
  Smoking - 65 hrs Hallways 67 hrs
• Daily logs of smoking and other activities
• Real-time outdoor levels ? Outside Patio
  (non-smoker) DEC Monitoring Station

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Multi-Unit Dwellings
Basement
First Floor
Second Floor
3
6
7
10
11
2
1
5
4
8
9
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Multi-Unit Dwellings
Average PM2.5 Levels According to Apartment
Smoking Policy and Monitor Location
Unhealthy for Sensitive Groups
p lt0.01 compared with Patios (Mann-Whitney U
test)
Source King BA, Travers MJ, Cummings KM,
Mahoney MC, and Hyland AJ. Quantitative
Assessment of Secondhand Smoke Transfer in
Multi-Unit Dwellings. 2009 Joint Conference of
SRNT and SRNT-Europe. Dublin, Ireland.
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Multi-Unit Dwellings
Apartment Building 1
Peak 120 (µg/m3)
Peak 39 (µg/m3)
First Floor
Lag Time 10 Minutes r0.821,
plt0.01
Source King BA, Travers MJ, Cummings KM,
Mahoney MC, and Hyland AJ. Quantitative
Assessment of Secondhand Smoke Transfer in
Multi-Unit Dwellings. 2009 Joint Conference of
SRNT and SRNT-Europe. Dublin, Ireland.
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Multi-Unit Dwellings
Apartment Building 5
Peak 200 (µg/m3)
Peak 61 (µg/m3)
Second Floor
Lag Time 3 Minutes r0.745,
plt0.01
Lag Time 2 Minutes r0.777,
p0.011
Source King BA, Travers MJ, Cummings KM,
Mahoney MC, and Hyland AJ. Quantitative
Assessment of Secondhand Smoke Transfer in
Multi-Unit Dwellings. 2009 Joint Conference of
SRNT and SRNT-Europe. Dublin, Ireland.
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Apartment1Seepage through heating and cracks
Roof
Unit 405
Monitor
4th Floor
Hall
Outside
Unit 305
Smoker 1
3rd Floor
Hall
Unit 205
2nd Floor
Smoker 2
Hall
1st Floor
Hall
Lobby
Parking Garage
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Sniffing for Tobacco Smoke in an Apt. Bldg.
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Multi-Day Measurements in a Single Room
Observe the Daily Cycle
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Apartments 2Smoke Rise from PatioLeakage
through heatingWind driven movement
Monitor
Patio
Living Room
Smoker
Wind
Patio
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Very Long-Term Monitoring in an Apartment
Observed Intermittent Peak Levels
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Smoke Travels to Upstairs Unit Apartment 2 in
Evening Hours
Particle Concentrations Exceed 250 Micrograms
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Apartments 3Smoke Rise from PatioWind
driven movement
Patio
Living Room
Smoker
Wind
Patio
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Habitual Smoker on Patio Over 6 Days of
Monitoring in Apartment 3
Dramatic Increase in Particle Levels on
Upstairs Patio When Smoker Arrives and Smokes
Daily on Downstairs Patio
Smoker Present 6 Days
Smoker Not Present 6 Days
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Preliminary Findings for MUD Monitoring

• Tobacco Particles are Detected in Apartments
  Above Smokers
• Can Reach Significant Levels
• Long term monitoring can show patterns of
  exposure
• Real-Time Sniffing Can be Useful to Demonstrate
  Elevated Levels Relative to Clean Outdoor Levels
• Nicotine is not useful as an indicator
• Filter and Pump Method May Bear Fruit

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Central exhaust turned off at midnight
SHS odor threshold is 0.6 1.4 ug/m3
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What about other particle sources?
Total PM2.5
UVPM
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What about nicotine transfer?
Nonsmokers Units
30 gt LOD of 0.07 ug/m3
Nicotine penetration is 50 to 10 compared to
tracer gases (median 17)
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Conclusions for MUD

• Air is shared throughout a MUD, it transfers
  between apartments and common areas
• TSP transfer does occur and has been documented
• However, exposure assessment is much more
  complicated than one-room indoor settings
• There are a much larger number of variables that
  effect exposures
• The dynamic and complex physical characteristics
  of TSP have a large impact on exposure
  measurements

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Conclusions for MUD

• Nicotine monitoring has the advantage of being
  specific to TSP but will likely underestimate
  exposure and lead to false negatives.
• Particle monitoring has the advantage of
  real-time continuous monitoring but cannot
  distinguish TSP particles from background and
  other sources.
• There is currently no gold standard measurement
  method for MUH and there is no method suitable
  for general advocacy efforts

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Next Steps More Sidepak Monitoring

• Document Elevated Particle Levels from Known
  Smokers' Units
• But we need an Effective Measurement that
  Uniquely Identifies Tobacco Smoke Particle Seepage

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Next Steps Inexpensive and Silent UCB Particle
Monitor

• Place in homes for
• long time periods
• Continuous logging of air pollution levels
• May be able to different tobacco from other
  particles

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Next Steps Particle Filter Absorbance
Characterization

• Uses pumps and filters, for long-term sampling
• Can differentiate particles from tobacco versus
  other sources
• Inexpensive but time consuming

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Questions?
Mark Travers, PhD Department of Health
Behavior Roswell Park Cancer Institute (716)
845-5881 mark.travers_at_roswellpark.org