Original article

Scand J Work Environ Health 1996;22 suppl 1:1-24    pdf

Assessment of air quality in Stockholm by personal monitoring of nonsmokers for respirable suspended particles and environmental tobacco smoke

by Phillips K, Bentley MC, Howard DA, Alván G

Exposure to respirable suspended particles (RSP) from all sources and environmental tobacco smoke (ETS) was assessed for 190 nonsmokers in Stockholm during 1994. Each subject wore a personal monitor for 24-h, provided saliva samples for cotinine analysis, and completed a detailed questionnaire about air quality and life-style.

The subjects consisted of housewives and househusbands in one main group and working men and women in the second. The housewives and househusbands wore a single monitor throughout the 24-h period and the working subjects wore one monitor at work and a separate monitor while not at work. The geodemographic distribution of the recruited subjects accurately reflected the population of Stockholm.

For most of the subjects, exposure to ETS and nicotine was at or below the limits of quantification (LOQ). This finding was supported by the fact that about 80% of the recruited subjects claimed that their exposure to ETS was "none" or "low."

The concentration of RSP was found to be highest (median 39 µg·m-3) in homes where smoking occurred and below the LOQ in the workplace irrespective of its smoking status. These levels are at the lowest end of typical indoor air levels for RSP.

For the housewives and househusbands living in smoking homes (nonsmoking homes in parentheses), the median exposure levels were 39 µg·m-3 (18 µg·m-3) for RSP, 17 µg·m-3 (0.12 µg·m-3) for ETS particles, and 1.1 µg·m-3 (0.05 µg·m-3) for nicotine. Both the prep and postmonitoring cotinine saliva levels measured for these housewives and househusbands were 2.9 ng·ml-1 (pre- 0.56 ng·ml-1, post- 0.41 ng·ml-1). The highest exposure levels were recorded for the housewives and househusbands in the age range of 35--49 years.

For the working subjects, the exposure measured in smoking workplaces (nonsmoking workplaces in parentheses) gave median levels of 16 µg·m-3 (16 µg·m-3) for RSP, 1.1 µg·m-3 (0.42 µg·m-3) for ETS particles and 0.2 µg·m-3 (0.15 µg·m-3) for nicotine. Similarly measured exposures at home (nonsmoking homes in parentheses), including all other locations outside the workplace, gave median levels of 24 µg·m-3 (19 µg·m-3) for RSP, 1.4 µg·m-3 (0.2 µg·m-3) for ETS particles, and 0.15 µg·m-3 (0.07 µg·m-3) for nicotine.

Overall, the exposure levels of ETS due to living with smokers in Stockholm was found to be much lower than similar exposures measured previously in the United Kingdom and the United States. Over 70% of all the nicotine measurements and 60% of all the ETS measurements were below the LOQ. When the median values for nicotine and ETS particles are converted to cigarette equivalents, Stockholm housewives and househusbands living with smokers would receive 6--9 cigarette equivalents per year, working nonsmokers living with smokers would receive 0.6--0.7 cigarette equivalents at home, and nonsmokers working with smokers would be exposed to 0.1--0.2 cigarette equivalents at work. The exposures were therefore up to six times greater at home than in workplaces where smoking was occurring.

Although all the subjects were recruited as nonsmokers on the basis of their self-reported nonsmoking status, saliva cotinine measurements were used for confirmation. Subjects with cotinine levels below 25 ng·m-1 were considered to be nonsmokers although the selection of a threshold level within the range of 10--50 ng·m-1 was not considered to be critical. With a threshold of 25 ng·m-1, between 2.7% and 5.3% were later shown to be misclassified as nonsmokers, depending on the definition of misclassification used.

During the study period the air quality in Stockholm could be described according to British nomenclature as "very good" for the majority of the time. The daily average at no time fell below "good," and the maximum hourly nitrogen dioxide level was 111 µg·m-3 (inner city at street level) on the coldest day (average -0.2 C).