Environmental tobacco smoke (ETS) is the mixture of smoke that comes from the burning end of a cigarette, pipe, or cigar, and smoke exhaled by the smoker. It is a complex mixture of over 4,000 compounds, more than 40 of which are known to cause cancer in humans or animals and many of which are strong irritants. ETS is often referred to as “second-hand smoke” and exposure to ETS is often called “passive smoking.”

Health Effects of Environmental Tobacco Smoke

In 1992, EPA completed a major assessment of the respiratory health risks of ETS (Respiratory Health Effects of Passive Smoking: Lung Cancer and Other Disorders EPA/600/6-90/006F). The report concludes that exposure to ETS is responsible for approximately 3,000 lung cancer deaths each year in non-smoking adults and impairs the respiratory health of hundreds of thousands of children.

Infants and young children whose parents smoke in their presence are at increased risk of lower respiratory tract infections (pneumonia and bronchitis) and are more likely to have symptoms of respiratory irritation like cough, excess phlegm, and wheeze. EPA estimates that passive smoking annually causes between 150,000 and 300,000 lower respiratory tract infections in infants and children under 18 months of age, resulting in between 7,500 and 15,000 hospitalizations each year. These children may also have a build-up of fluid in the middle ear, which can lead to ear infections. Older children who have been exposed to second-hand smoke may have slightly reduced lung function.

Asthmatic children are especially at risk. EPA estimates that exposure to second-hand smoke increases the number of episodes and severity of symptoms in hundreds of thousands of asthmatic children, and may cause thousands of non-asthmatic children to develop the disease each year. It was estimated between 200,000 and 1,000,000 asthmatic children have their condition made worse by exposure to second-hand smoke each year. Exposure to second-hand smoke causes eye, nose, and throat irritation. It may affect the cardiovascular system and some studies have linked exposure to second-hand smoke with the onset of chest pain.

 

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Reducing Exposure to Environmental Tobacco Smoke

Don’t smoke at home or permit others to do so. Ask smokers to smoke outdoors.

The 1986 Surgeon General’s report concluded that physical separation of smokers and non-smokers in a common air space, such as different rooms within the same house, may reduce – but will not eliminate – non-smokers’ exposure to environmental tobacco smoke.

If smoking indoors cannot be avoided, increase ventilation in the area where smoking takes place.

Open windows or use exhaust fans. Ventilation, a common method of reducing exposure to indoor air pollutants, also will reduce but not eliminate exposure to environmental tobacco smoke. Because smoking produces such large amounts of pollutants, natural or mechanical ventilation techniques do not remove them from the air in your home as quickly as they build up. In addition, the large increases in ventilation it takes to significantly reduce exposure to environmental tobacco smoke can also increase energy costs substantially. Consequently, the most effective way to reduce exposure to environmental tobacco smoke in the home is to eliminate smoking there.

Do not smoke if children are present, particularly infants and toddlers.

 Children are particularly susceptible to the effects of passive smoking. Do not allow baby-sitters or others who work in your home to smoke indoors. Discourage others from smoking around children. Find out about the smoking policies of the day care centre providers, schools, and other caregivers for your children. The policy should protect children from exposure to ETS.

 

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How Does Climate Change Affect the Indoor Environment?

Indoor Air Quality Assessment

Importance of Indoor Air Quality in Classrooms

Climate change can affect conditions indoors by worsening existing indoor air quality issues and introducing new ones. Most people in the United States spend about 90% of their time indoors. The air we breathe indoors, and ultimately our health, can be impacted by many factors, including the air quality outdoors, people’s activities indoors, and the design, construction, operation and maintenance of a building.

Changes in the climate can affect the air we breathe indoors in many ways. For example, changes in the climate can worsen the quality of the air outdoors which infiltrates into indoor environments. Rising carbon dioxide (CO2) levels and warmer temperatures can increase outdoor airborne allergens which can infiltrate indoor spaces. Warmer temperatures and shifting weather patterns can lead to more frequent and severe wildfires. Smoke and other particle pollution generated outdoors, including from wildfire events and dust storms, can infiltrate indoor environments and contribute to levels of indoor particulate matter.

Additionally, more frequent and longer outdoor heat waves can result in higher indoor temperatures. Climate change is also increasing the frequency and severity of some extreme weather events, such as extreme precipitation, flooding, and storms, which can result in damage to buildings and allow water or moisture to enter indoors. Increased indoor dampness and humidity can lead to increases in mold, dust mites, bacteria, and other biological contaminants indoors. Extreme weather events can also create conditions that support increases in and the spread of pests and infectious agents that can make their way indoors.

Lastly, power outages may occur with more frequent extreme weather, making it more difficult to maintain comfortable indoor temperatures and healthy indoor air quality, and leading to more frequent use of portable generators. Carbon monoxide poisoning from improper use of portable generators results in hundreds of deaths and thousands of illnesses each year.

Tips to Help You and Your Home Withstand Extreme Weather and Maintain Indoor Air Quality

Electric Power Outage

• Plan for an alternate power source: Consider how to provide electric power safely if floods, high winds, ice storms or other weather events result in power outages. See: Safely Provide Power for Lighting, Cooking and Heating.
• Plan for an alternate shelter: Include a backup location where you know there will be power and you will be welcome as part of your emergency plan for power loss.

Heavy Rains

Direct water away from your home:

• Add gutters and/or maintain gutters: Keep gutters and downspouts free of debris and leaks. Direct downspouts away from the house.
• Slope ground away from building: If rain puddles against the foundation after a storm, correct the problem by re-grading the area or installing underground drainage. 

Heat Wave

• Keep air-conditioned air out of the attic*: Air seal ductwork and air handlers in the attic. Reduce unwanted solar heating of your home, in other words, reduce solar gains.
• Add reflective coating on the roof.
• Add reflective film on windows.
• When you reroof choose a light colour.
• When you get new windows, select windows with low solar heat gain

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Indoors and Outdoors Particulate Matter

As many of us return to the office, and congregate indoors over dinner and drinks during the summer holidays, we need to think about ventilation to minimise the indoor spread of COVID-19. SARS-CoV-2, the virus that causes COVID, is spread mostly by larger particles called droplets, but also by smaller particles called aerosols, and by touch from contaminated surfaces.

Aerosol particles are lighter than droplet-sized particles, and can be suspended in the air for longer. The suspension and therefore transmission of aerosols is facilitated by poor ventilation. Increasing ventilation indoors, with fresh outdoor air, is a key method of dispersing viral particles. Ventilation can reduce the risk that just one COVID-positive person (who might not yet know they’re infectious) will infect others.

There are some simple measures you can take, both at home and at work, to improve ventilation over the holiday period and beyond.

1. Open windows and doors

The best strategy at home and at work is simply to open windows and doors.

If you’re having friends and family over for a meal, or your office Christmas party, consider moving tables and chairs closer to open windows and opening up a door to create a thorough breeze. Or, if weather permits, eat outside.

2. Set your air conditioner to pull fresh air from outside

Air conditioners can help, but they must be on the right setting.

At work or home, you don’t want to recirculate indoor air, as this just fans the same air around the room (but now colder or warmer).

Instead, always make sure your air conditioner is set to bring in 100% fresh air from outside. There are settings in offices that allow the system to increase air change per hour, meaning it can reduce the time it takes for all the air inside the room to be completely replaced with outside fresh air.

But the direction of the airflow is also important. For example, airflow from an air conditioner (that was recirculating air rather than pulling it from outside) was implicated in spreading the virus to a number of diners at tables downstream in a restaurant in China.

Offices welcoming back staff should prepare their air conditioners by having their engineers service the system to pull in fresh air faster than the pre-COVID setting (which may have been around 40 litres per second per person) at no less than 60 litres per second, per person.

In hospitals, aged-care facilities and hotel quarantine, qualified engineers should be brought in to assess the adequacy of the air conditioner’s airflow. This is particularly crucial for any “hot zones” accommodating people who are COVID-positive.

The World Health Organisation recommends hot zones have 12 airflow changes per hour (that’s 80 litres per second per person), meaning the air is totally replaced 12 times every 60 minutes. This is the gold standard for ventilation, and can be very hard to achieve in many buildings.

3. Use fans

Guidelines released by CDC recommend placing fans near open windows to enhance airflow. The recommendation is to keep fans on at all times when a room is occupied, for example at restaurants.

As with aircons, fans can be dangerous if they push the air directly from one person to another, and one is infectious. You should place the fan so it increases the flow of fresh air into the room, and shouldn’t be placed so the air moves from the room towards the open window or open door.

4. Don’t bother with HEPA filters at home

High-efficiency particulate air (HEPA) filters have been marketed as a way to reduce the concentration of SARS-CoV-2 particles in the air.

Their effectiveness is dependent on the airflow capacity of the unit, the configuration of the room, the number of people in the room, and the position of the filter in the room.

But there’s no evidence to suggest a portable HEPA filter unit will help in your home. So, don’t rush out and buy one.

They may be effective in some areas of health care, such as a COVID ward in a hospital or in aged care homes, particularly when used in negative-pressure rooms. The combination of the HEPA filter and negative air pressure reduces the risk of aerosol particles escaping into the corridor.

5. In public transport

COVID outbreaks have been traced back to exposure on public transport. For example, a young man in Hunan Province, China, travelled on two buses and infected multiple people who were sitting in different areas of the buses. A study of this cluster was carried out by Chinese researchers, who put forward one theory regarding air flow:

The study’s authors recommend all windows be open on public transport to help disperse viral particles. If you’re on a tram or a bus, you should open them if you can. However, on some forms of public transport it might be impossible, like trains. In these instances, you should wear a mask.

Likewise, it’s ideal to have the windows down in Ubers and taxis. But if you can’t or don’t want to, turn on the air conditioner and have it pull fresh air from outside. And still wear a mask!

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