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Clean Air Standards for Workplaces and Public Places Ordinance <br /> Page 2-Substitute Bill No.24-12 <br /> cause of disease in healthy nonsmokers, including heart disease, stroke, respiratory disease, and lung <br /> cancer. The National Cancer Institute determined in 1999 that secondhand smoke is responsible for the <br /> early deaths of approximately 53,000 Americans annually. (National Cancer Institute (NCI), "Health <br /> effects of exposure to environmental tobacco smoke: the report of the California Environmental Protection <br /> Agency. Smoking and Tobacco Control Monograph 10,"Bethesda, MD: National Institutes of Health, National <br /> Cancer Institute (NCI), August 1999) <br /> The Public Health Service's National Toxicology Program (NTP) has listed secondhand smoke <br /> as a known carcinogen. (Environmental Health Information Service (EHIS), "Environmental tobacco smoke: <br /> first listed in the Ninth Report on Carcinogens," U.S. Department of Health and Human Services (DHHS), <br /> Public Health Service, NTT, 2000; reaffirmed by the NTP in subsequent reports on carcinogens,2003,2005) <br /> There is indisputable evidence that implementing 100% smoke-frec environments is the only <br /> effective way to protect the population from the harmful effects of exposure to secondhand smoke. <br /> (World Health Organization (WHO), "Protection from exposure to secondhand smoke: policy <br /> recommendations," World Health Organization (WHO), 2007) <br /> In reviewing 11 studies concluding that communities see an immediate reduction in heart attack <br /> admissions after the implementation of comprehensive smoke free laws, the Institute of Medicine of <br /> the National Academies concluded that data consistently demonstrate that secondhand smoke exposure <br /> increases the risk of coronary heart disease and heart attacks and that smoke free laws reduce heart <br /> attacks. (Institute of Medicine (IOM) of the National Academies, Board on Population Health and Public <br /> Health Practice, Committee on Secondhand Smoke Exposure and Acute Coronary Events, "Secondhand smoke <br /> exposure and cardiovascular effects: making sense of the evidence," Washington, DC: National 4cademies <br /> Press, October 2009) <br /> A significant amount of secondhand smoke exposure occurs in the workplace. Employees who <br /> work in smoke-filled businesses suffer a 25-50% higher risk of heart attack and higher rates of death <br /> from cardiovascular disease and cancer, as well as increased acute respiratory disease and measurable <br /> decrease in lung function. (Pitsavos, C.; Panagiotakos, D.B.; Chrysohoou, C.; Skoumas, J.; Tzioumis, K.; <br /> Stefanadis, C.; Toutouzas, P., "Association between exposure to environmental tobacco smoke and the <br /> development of acute coronary syndromes: the CARDI02000 case-control study," Tobacco Control 11(3); 220- <br /> 225, September 2002) <br /> Studies measuring cotinine (metabolized nicotine) and NNAL (metabolized nitrosamine NNK, <br /> a tobacco-specific carcinogen linked to lung cancer) in hospitality workers find dramatic reductions in <br /> the levels of these biomarkers after a smoke free law takes effect. Average cotinine levels of New York <br /> City restaurant and bar workers decreased by 85% after the city's smoke free law went into effect. <br /> &.a j, "The State of Smoke-Free New York City: A One Year Review,"New York City Department of Finance, <br /> New York City Department of Health &Mental Hygiene, New York City Department of Small Business Services, <br /> New York City Economic Development Corporation, March 2004). <br /> After the implementation of Ontario, Canada's Smoke free Indoor Air Law, levels of NNAL <br /> were reduced by 52% in nonsmoking casino employees and cotinine levels fell by 98%. (Geoffrey T. <br /> Fong, et. al., "The Impact of the Smoke-Free Ontario Act on Air Quality and Biomarkers of Exposure in <br /> Casinos: A Quasi-Experimental Study," Ontario Tobacco Control Conference, Niagara Falls, Ontario, <br /> December 2,200 6) <br />