Testimony of James Repace, MSc.

Summary:

1. Measurements of respirable particulate air pollution in the Foxwoods and Mohegan Sun Casinos last Saturday night showed levels 7 times outdoors in smoking areas and 5 times outdoors in nonsmoking areas, threatening the health of both workers and patrons.

2. Fine particle and carcinogen air pollution declined by 90% to 95% to outdoor levels in Delaware casinos, bars, and restaurants following a smoke-free workplace law.

3. Secondhand smoke is an occupational risk to workers for chronic heart disease, lung, breast, and nasal cancer, and respiratory disease.

4. Secondhand smoke presents an acute risk of heart attack to persons with cardiovascular disease.

Senator Handley, Representative Sayers, and Members of the Public Health Committee:

1. My name is James Repace. I am an international secondhand smoke consultant, and have been invited to testify as an expert witness in this hearing by the United Auto Workers, Region 9A.

5. The 2006 California EPA Report on Environmental Tobacco Smoke as a Toxic Air Contaminant (CalEPA, 2006) concludes that SHS causes lung, breast, and nasal sinus cancer, as well as heart disease mortality, and can induce adult onset asthma, and The 2006 Surgeon General’s Report states unequivocally: “There is no safe level of SHS” (SG, 2006). A number of studies have reported decreases in acute myocardial infarction (heart attack) following smoking bans (Juster et al. 2007), and the Centers for Disease Control and Prevention has warned nonsmokers with cardiovascular conditions “to avoid exposure to SHS” (Pechacek and Babb, 2004). Because some persons frequenting casinos will have undiagnosed heart or arterial conditions, they are placed at risk unknowingly. The effects of even brief (minutes to hours) passive smoking are often nearly as large (averaging 80% to 90%) as chronic active smoking (Barnoya and Glantz, 2005). Although ventilation can affect levels of SHS, ASHRAE (2005), the international society of ventilation engineers, stated flatly: “no engineering approaches, including current and advanced dilution ventilation and air cleaning technologies have been demonstrated or should be relied upon to control [SHS] in spaces where smoking occurs.”

6. The Bill before you, "An Act Prohibiting Smoking in Regulated Areas of Casinos,” is important because Secondhand Smoke (SHS) is a significant threat to the health of casino workers and casino patrons. Although modern casinos may have large space volumes and state-of-the-art ventilation systems, these cannot eliminate SHS. Similarly although some casinos maintain nonsmoking areas, these areas are not smoke free. This has been demonstrated in Connecticut Casinos. On February 23, 2008, (last Saturday night), scientists from the Roswell Park Cancer Institute in Buffalo, NY measured respirable particles (RSP), a federally regulated outdoor air pollutant, using a real-time portable air pollution monitor in both the Foxwoods and Mohegan Sun Casinos here in Connecticut (Skeps et al., 2008). They have shared their data with me for this hearing. Figures 1 and 2 below show area-monitored air pollution levels which reflect the average SHS concentrations in smoking and nonsmoking areas.

7. Figure 1 shows RSP pollution in the smoking areas of both Foxwoods and Mohegan Sun are similar and about 7 times outdoors. Fig. 1 also shows that while the nonsmoking areas in both casinos are lower than in the smoking areas, they remain heavily polluted with RSP at levels 4 to 5 times outdoors. Figure 2 shows that whether it’s nonsmoking Bingo, Poker, or Slots, RSP remains 3 to 5 times outdoors, and in all cases 2 to 4 times the level of the Federal Clean Air Standard. This is not surprising and agrees well with measurements I have made in the Delaware Park Casino in Wilmington, DE in 2004 (Repace, 2004), and Harrahs, Philadelphia Park, and the Mohegan Sun Casinos in Pennsylvania (Repace, unpublished). In the Delaware Park Casino, air quality measurements I made demonstrated a 90 to 95% drop in fine particle and carcinogen air pollution in this casino after a state-wide workplace smoking ban.

8. Studies I have conducted of the SHS biomarker, cotinine, in the urine of casino workers in Indiana in the Horseshoe Casino in Hammond Indiana, indicate that casino workers exposed in close proximity to smokers have SHS doses many times higher than the average U.S. nonsmoker for much longer periods of time, and thus are at considerably greater risk of the diseases of SHS than the average person (Repace, 2007). These results show that SHS in casinos creates a serious threat to worker & patron health which neither ventilation nor nonsmoking sections can control to de minimis levels (Repace, 2005).

Figure 1.

Data measured by Roswell Park Cancer Institute (2008).

References

ASHRAE Position Document on Environmental Tobacco Smoke, Approved by ASHRAE Board of Directors, June 30, 2005. American Society of Heating, Refrigerating, and Air Conditioning Engineers) Atlanta, GA, 2005.

Barnoya J, Glantz SA. Cardiovascular Effects of Secondhand Smoke Nearly as Large as Smoking. Circulation, 111:2684-2698 (2005).

CalEPA, 2006. California Environmental Protection Agency, Air Resources Board Office of Environmental Health Hazard Assessment, State of California. Proposed Identification of Environmental Tobacco Smoke as a Toxic Air Contaminant As Approved by the Scientific Review Panel, June 24, 2005.

Juster HR, Loomis BR, Hinman TM, Farrelly MC, Hyland A, Bauer UE, Birkhead GS. Declines in Hospital Admissions for Acute Myocardial Infarction in New York State After Implementation of a Comprehensive Smoking Ban. American Journal of Public Health, 97: 2035-2039 (2007).

Pechacek TF, Babb S. Commentary: How acute and reversible are the cardiovascular risks of secondhand smoke? BMJ VOLUME 328: 980-983 (2004).

Repace JL. Respirable Particles and Carcinogens in the Air of Delaware Hospitality Venues Before and After a Smoking Ban. Journal of Occupational and Environmental Medicine, 46:887-905 (2004).

Repace JL. SECONDHAND SMOKE IN PENNSYLVANIA CASINOS: A STUDY OF NONSMOKERS’ EXPOSURE AND DOSE (in preparation).

REPACE, JL. EXPERT REPORT ON THE EMPRESS HORSESHOE CASINO. In The Matter of Januszewski et al., v. Horseshoe Hammond, USDC, NDIN, Hammond Div., 2:00CV352JM. March 14, 2006.

Repace JL. Controlling Tobacco Smoke Pollution. Technical Feature, ASHRAE IAQ Applications: 6, #3, 11-15 (2005).

Skeps R, Higbee C, Travers M, Hyland A. Air Monitoring: Foxwoods and Mohegan Sun Casinos. Roswell Park Cancer Institute, Department of Health Behaviors, February 26, 2008.