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Clean Air Standards for Workplaces and Public Places Ordinance <br /> Page 3-Substitute Bill No, 24-12 <br /> Following a Health Hazard Evaluation of Las Vegas casino employees' secondhand smoke <br /> exposure in the workplace, which included indoor air quality tests and biomarker assessments, the <br /> National Institute of Occupational Safety & Health (NIOSH) concluded that the casino employees are <br /> exposed to dangerous levels of secondhand smoke at work and that their bodies absorb high levels of <br /> tobacco-specific chemicals NNK and cotinine during work shifts. NIOSH also concluded that the "best <br /> means of eliminating workplace exposure to (secondhand smoke] is to ban all smoking in the casinos." <br /> (Health hazard evaluation report: environmental and biological assessment of environmental tobacco smoke <br /> exposure among casino dealers, Las Vegas, NV. By Achutan C, West C, Mueller C, Boudreau Y, Mead K. <br /> Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, <br /> National Institute for Occupational Safety and Health,NIOSH HETA No. 2005-0076 and 2005-0201-3080, May <br /> 2009) <br /> Secondhand smoke is particularly hazardous to elderly people, individuals with cardiovascular <br /> disease, and individuals with impaired respiratory function, including asthmatics and those with <br /> obstructive airway disease. (California Environmental Protection Agency (Cal EPA), "Health effects of <br /> exposure to environmental tobacco smoke", Tobacco Conh•ol 6(4): 346-353, Winter, 1997.) The Americans <br /> With Disabilities Act, which requires that disabled persons have access to public places and workplaces, deems <br /> impaired respiratory function to be a disability. (Daynard, R.A., "Environmental tobacco smoke and the <br /> Americans with Disabilities Act,"Nonsmokers' Voice 15(1): 8-9) <br /> The U.S. Centers for Disease Control and Prevention has determined that the risk of acute <br /> myocardial infarction and coronary heart disease associated with exposure to tobacco smoke is non- <br /> linear at low doses, increasing rapidly with relatively small doses such as those received from <br /> secondhand smoke or actively smoking one or two cigarettes a day, and has warned that all patients at <br /> increased risk of coronary heart disease or with known coronary artery disease should avoid all indoor <br /> environments that permit smoking. (Pechacek, Terry F.; Babb, Stephen, "Commentary: How acute and <br /> reversible are the cardiovascular risks of secondhand smoke?"British Medical Journal 328: 980-983, April 24, <br /> 2004) <br /> Given the fact that there is no safe level of exposure to secondhand smoke, the American <br /> Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) bases its ventilation <br /> standards on totally smoke free environments. ASHRAE has determined that there is currently no air <br /> filtration or other ventilation technology that can completely eliminate all the carcinogenic components <br /> in secondhand smoke and the health risks caused by secondhand smoke exposure, and recommends <br /> that indoor environments be smoke free in their entirety. (Samet, J.; Bohanon, Jr.,H.R.; Coultas, D.B.; <br /> Houston, T.P.; Persily, A.K.; Schoen, L.J.; Spengler, J.; Callaway, C.A., "ASHRAE position document on <br /> environmental tobacco smoke," American Society of Heating, Refrigerating and Air-Conditioning Engineers <br /> (ASHRAE), 2005) <br /> During periods of active smoking, peak and average outdoor tobacco smoke (OTS) levels <br /> measured in outdoor cafes and restaurant and bar patios near smokers rival indoor tobacco smoke <br /> concentrations. (Klepeis, N.; Ott, W.R.; Switzer, P., "Real-time measurement of outdoor tobacco smoke <br /> particles,"Journal of the Air& Waste Management Association 57: 522-534, 2007) <br /> Nonsmokers who spend six-hour periods in outdoor smoking sections of bars and restaurants <br /> experience a significant increase in levels of cotinine when compared to the cotinine levels in a smoke <br /> free outdoor area. (Hall, J.C.; Bernert, J.T.; Hall, D.B.; St Helen, G.; Kudon, L.H.;Naeher, L.P., "Assessment <br />