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<br /> concluded that the "best means of eliminating workplace exposure to
<br /> [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
<br /> Prevention,National Institute for Occupational Safety and Health, NIOSH HETA No. 2005-0076 and 2005-
<br /> 0201-3080, May 2009.)
<br /> Secondhand smoke is particularly hazardous to elderly people, individuals
<br /> with cardiovascular disease, and individuals with impaired respiratory function,
<br /> including asthmatics and those with obstructive airway disease.
<br /> (California Environmental Protection Agency(Cal EPA), "Health effects of exposure to environmental
<br /> tobacco smoke", Tobacco Control 6(4):346-353, Winter, 1997.) The Americans With Disabilities Act, which
<br /> requires that disabled persons have access to public places and workplaces, deems impaired respiratory
<br /> function to be a disability. (Daynard, R.A,,"Environmental tobacco smoke and the Americans with
<br /> Disabilities Act," Nonsmokers'Voice 15(1):8-9.)
<br /> The U.S. Centers for Disease Control and Prevention has determined that the
<br /> risk of acute myocardial infarction and coronary heart disease associated with
<br /> exposure to tobacco smoke is non-linear at low doses, increasing rapidly with
<br /> relatively small doses such as those received from secondhand smoke or
<br /> 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
<br /> should avoid all indoor environments that permit smoking.
<br /> (Pechacek, Terry P.;Babb, Stephen, "Commentary. How acute and reversible are the cardiovascular risks of
<br /> secondhand smoke?"British Medical Journal 328:960-983,April 24, 2004.)
<br /> Given the fact that there is no safe level of exposure to secondhand smoke,
<br /> the American Society of Heating, Refrigerating and Air Conditioning Engineers
<br /> (ASHRAE) bases its ventilation standards on totally smoke free environments.
<br /> ASHRAE has determined that there is currently no air filtration or other ventilation
<br /> technology that can completely eliminate all the carcinogenic components in
<br /> secondhand smoke and the health risks caused by secondhand smoke
<br /> exposure, and recommends that indoor environments be smoke free in their
<br /> entirety.
<br /> (Samey,J.; Bohanon,Jr.,H,R.;Coultas, D.B.; Houston, T.P.; Persily, AX; Schoen, L.J.;Spengler,J.;
<br /> Callaway, C.A., "ASHRAE position document on environmental tobacco smoke,"American Society of
<br /> Heating, Refrigerating and Air-Conditioning Engineers(ASHRAE), 2005.)
<br /> During periods of active smoking, peak and average outdoor tobacco smoke
<br /> (OTS) levels measured in outdoor cafes and restaurant and bar patios near
<br /> smokers rival indoor tobacco smoke concentrations.
<br /> (Klepeis, N.;Ott, W.R.;Switzer, P,, "Real-time measurement of outdoor tobacco smoke particles,"Journal of
<br /> the Air& Waste Management Association 57:522-534,2007.)
<br /> Nonsmokers who spend six-hour periods in outdoor smoking sections of bars
<br /> and restaurants experience a significant increase in levels of cotinine when
<br /> compared to the cotinine levels in a smoke free outdoor area.
<br /> (Hall,J.C.;Bernert,J.T.; Hall, D.B.;St Helen, G.; Kudon, L.H.; Naeher, L.P., "Assessment of exposure to
<br /> secondhand smoke at outdoor bars and family restaurants in Athens, Georgia, using salivary cotinine,"
<br /> Journal of Occupational and Environmental Hygiene 6(11):698-704, November 2009.)
<br /> Residual tobacco contamination, or "thirdhand smoke," from cigarettes,
<br /> cigars, and other tobacco products is left behind after smoking occurs and builds
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