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unit down the hall. No instances of appliance use or pyrolosis
<br />were reported in either of the units immediately before or dur-
<br />ing this time period. The lag time resulting in the highest cor-
<br />relation between peak levels was 10 min. The elevated PMI S
<br />levels observed in the smoke -permitted unit following the re-
<br />ported instances of smoking, coupled with the elevated levels
<br />observed in the hallway following the period during which the
<br />front door of the smoke -permitted unit was opened, implicate
<br />the open door of the smoke -permitted unit as the primary
<br />mechanism of transfer.
<br />This study documents SHS incursions from smoke -permitted
<br />units to smoke-free units and shared hallways within the same
<br />MUH building. Therefore, the estimated 62.2 million individu-
<br />als who reside in smoke-free units within smoke -permitted
<br />buildings across the United States (Giovino et al., 2009; U.S.
<br />Census Bureau, 2009) may be susceptible to involuntary SHS
<br />incursions and the health risks associated with such exposures.
<br />The PM,., levels observed in this study were comparable in
<br />magnitude to those observed by Van Deusen et al. (2009) in
<br />their assessment of SHS transfer within homes, which included
<br />seven MUH units. These levels suggest that individuals who re-
<br />side in close proximity to one another in MUH are especially
<br />vulnerable to compromised air quality from SHS incursions
<br />originating in units where smoking is permitted. The quantity
<br />of cigarettes smoked and median PMZ S levels in the present
<br />study were greatest between 4:00 PM and 11:59 PM, which cor-
<br />responds to the time period when persons are typically present
<br />in their home (Klepeis et al., 2001).
<br />While our data provide evidence of SHS transfer from
<br />smoke -permitted units into smoke-free units and shared hall-
<br />ways, a thorough analysis of real-time data plots and participant
<br />activity logs indicates that the extent of transfer is dependent
<br />upon many determinants, including ventilation and distance
<br />between smoke -permitted and smoke-free units. Since ventila-
<br />tion systems and the physical separation of nonsmokers from
<br />smokers do not fully eliminate SHS (Cains, Sannata, Poulos,
<br />Ferson, and Stewart, 2005; Repace, 2004; Repace, Hyde, and
<br />Brugge, 2006; Repace and Lowrey, 1980, 1985), prohibiting
<br />smoking in MUH is the only effective means of completely pro-
<br />tecting nonsmokers from exposure (USDHHS, 2006). There are
<br />currently no federal or state laws that prohibit MUH operators
<br />from prohibiting smoking on their properties (Schoenmarklin,
<br />2005). Moreover, the legal permissibility of these policies ex-
<br />tends to MUH subsidized through the U.S. Department of
<br />Housing and Urban Development (USDHUD), which strongly
<br />encourages Public Housing Authorities to restrict smoking in
<br />their buildings (USDHUD, 2009).
<br />To our knowledge, this study is the first to assess real-time
<br />SHS transfer between smoke -permitted and smoke-free living
<br />units within the same MUH structure. Strengths of this study in-
<br />clude the use of a scientifically validated monitoring instrument
<br />capable of real-time data acquisition, the inclusion of MUH
<br />structures with varying quantities of living units, and the utiliza-
<br />tion of daily activity logs to account for factors that can confound
<br />air quality levels. However, there are also some limitations that
<br />should be acknowledged. First, the study assessed particles less
<br />Nicotine & Tobacco Research
<br />8.A. - Page 25
<br />than 2.5 µm in diameter (PMIS), which are emitted from many
<br />combustible materials and thus not specific to tobacco smoke;
<br />however, cigarette smoke has previously been shown to serve as a
<br />major source of PMIS, especially when background levels are low
<br />(Travers et al., 2004). Moreover, vapor phase nicotine levels col-
<br />lected in one of the assessed buildings were comparable to ex-
<br />pected concentrations derived from PMIS levels observed during
<br />the same time period. A second limitation is the inability to con-
<br />trol for extraneous sources of PMIS from nonparticipating units.
<br />However, in order to reduce the potential for confounding from
<br />unmeasured units, a rigorous definition was used to establish
<br />SHS transfer from a participating smoke -permitted unit to a
<br />nearby participating smoke-free unit and/or hallway within the
<br />same building. This definition required that an instance of SHS
<br />transfer included a documented smoking event, followed by tem-
<br />porally elevated PMIS levels in both the smoke -permitted unit
<br />and the smoke-free unit, which could not be attributed to any
<br />other documented source. Finally, outdoor air quality was as-
<br />sessed for only 3 of the 11 buildings as a result of safety and logis-
<br />tical constraints. Nonetheless, outdoor PMIS levels measured by a
<br />nearby Department of Environmental Conservation monitoring
<br />station were comparable to those observed on the assessed patios
<br />during the same time period.
<br />In conclusion, the results of this study indicate that SHS can
<br />transfer between living units within the same MUH building.
<br />However, further research is needed to substantiate causality.
<br />More specifically, there is a need for the development of tech-
<br />nology that is capable of tracking transfer between units in real
<br />time using a marker specific to SHS. In the present absence of
<br />such technology, evaluations of airborne particulate should be
<br />conducted under controlled conditions in which the presence of
<br />active smoking and potential confounders is documented for
<br />every unit in the building. Nonetheless, the present findings
<br />suggest that the implementation of a 100% smoke-free building
<br />policy remains the most effective way to ensure that residents of
<br />MUH units are not exposed to SHS.
<br />None declared.
<br />Flight Attendant Medical Research Institute; Cooperative Agree-
<br />ment Number 1R36 DP001848 from the U.S. Centers for Disease
<br />Control and Prevention (CDC).
<br />Acknowledgments
<br />Its contents are solely the responsibility of the authors and
<br />do not necessarily represent the official views of the funding
<br />agencies.
<br />Alpert, H., Carpenter, C., Travers, M. J., & Connolly, G. (2007).
<br />Environmental and economic evaluation of the Massachusetts
<br />smoke-free workplace law. Journal of Community Health, 32,
<br />269-281. doi:10.1007/s10900-007-9048-6
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