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Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects (1986)
Commission on Life Sciences (CLS)

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. "Appendix C: Adjusments to Epidemiologic Estimates of Excess Lung Cancer in Persons Exposed to Environmental Tobacco Smoke." Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects. Washington, DC: The National Academies Press, 1986.

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Environmental Tobacco Smoke: Measuring Exposures and Assessing Health Effects

per unit dose.* Further, the risk for a truly unexposed nonsmoker, i.e., γ0(t,s), is assumed to be the same for men and women. This assumption is supported, in part, by the results given in Chapter 12 and, in part, by earlier studies of Garfinkel (1981) and Friedman et al. (1984). Doll (1984), however, gives different risks for men and women of lung cancer mortality in nonsmokers.

If dE is actual dose in the “exposed” persons and dN is the actual dose in persons who believe themselves to be “unexposed,” then we have, from Equation 1:

(2A)

and

(2B)

The relative risk for a person identified as “exposed” compared to a person identified as “unexposed” [RR(dE)] is given by Equation 2A divided by 2B:

(3)

which, from Chapter 12, is 1.34, the relative risk estimated from the epidemiologic studies.

From the studies that measured cotinine in “exposed” and “unexposed” persons, we assume that the operative dose level, dE, among “exposed” individuals is 3 times as high as the dose level in the self-reported “unexposed” persons, dN, and that the ratio of 3:1 is proportional to a lifetime dose difference. Therefore, Equation 3 may be rewritten as:

(4)

Equation 4 can be solved for βdN, which is the increase in risk for persons called “unexposed,” but who, in fact, have been exposed

*  

Work by Doll and Peto (1978) shows that the relative risk for direct smokers increases as a linear-quadratic function of dose, rather than the simple linear form shown here. A more sophisticated model would take into account the several stages at which cigarette smoke operates in the multistage development of cancer. At low doses the linear-quadratic is well approximated by the linear, i.e., 1+β1d+β2d2 is close to 1+βd because the d2 term approaches zero.

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291
Front Matter (R1-R8)
Contents (R9-R14)
Executive Summary (1-12)
1 Introduction (13-22)
Part I: Physicochemical and Toxicological Studies of Environmental Tobacco Smoke (23-24)
2 The Physicochemical Nature of Sidestream Smoke and Environmental Tobacco Smoke (25-53)
3 In Vivo and In Vitro Assays to Assess the Health Effects of Environmental Tobacco Smoke (54-62)
Part II: Assessing Exosures to Environmental Tobacco Smoke (63-64)
4 Introduction (65-68)
5 Assessubg /Exposures to Environmental Tobacco Smoke in the External Environment (69-100)
6 Assessing Exposures to Enviromental Tobacco Smoke Using Questionnaires (101-119)
7 Exposure-Dose Relationship for Environmental Tobacco Smoke (120-132)
8 Assessing Exposures to Environmental Tobacco Smoke Using Biological Markers (133-160)
Part III: Health Effects Possibly Associated with Exposure to Environmental Tobacco Smoke by Nonsmokers (161-162)
9 Introduction (163-165)
10 Sensory Reactions To and Irritation Effects of Environmental Tobacco Smoke (166-181)
11 Effects of Exposure to Environmental Tobacco Smoke on Lung Function and Respiratory Symptoms (182-222)
12 Exposure to Environmental Tobacco Smoke and Lung Cancer (223-249)
13 Cancers Other than Lung Cancer (250-256)
14 Cardiovascular System (257-268)
15 Other Health Considerations in Children (269-276)
Appendixes (277-278)
Appendix A: Guidelines for Public and Occupational Chemical Exposures to Materials that are Also Found in Environmental Tobacco Smoke (279-283)
Appendix B: Method of Combining Data From Studies of Environmental Tobacco Smoke Exposure and Lung Cancer (284-288)
Appendix C: Adjusments to Epidemiologic Estimates of Excess Lung Cancer in Persons Exposed to Environmental Tobacco Smoke (289-293)
Appendix D: Risk Assessment- Exposure to Environmental Tobacco Smoke and Lung Cancer (294-338)