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

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. "Appendix D: Risk Assessment- Exposure to Environmental Tobacco Smoke and Lung Cancer." 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

of the true relative risk based on Method 2 depends only on β4/β1 (and not on β1), the estimate of AN(EP) also depends only on β4/β1.) Estimates of the attributable number of lung cancer deaths based on Method 2 lie between 1,768 and 3,220. (These estimates are approximately halved when the summary rate ratio of 1.14, from the U.S. studies is used in place of the overall summary rate ratio of 1.3.) If the true value of d0 were 0.01 cigarettes per day, then 259 lung cancer deaths in nonsmoking women would be attributable to ETS. On the other hand, the maximum estimate of the attributable number based on Method 3 with d0=0.2 (3,170 deaths) is in agreement with that based on Method 2 (3,220 deaths). The minimum estimates, however, differ by approximately threefold.

The calculation of the number of lung cancers attributable to ETS in 1985 in nonsmoking males is similar. Garfinkel (1981) and Wilson (personal communication), respectively, give data on I0(t) and N(t) for nonsmoking males. Since estimates of I0(t) in males and females are nearly equal and the estimates for females are more stable (Garfinkel, 1981), we use the same estimates of I0(t) for males as for females. Using these data, the estimated number of lung cancers which occurred in lifelong nonsmoking males in 1985 is 5200. For males, the fraction “exposed” is taken to be 14% (based on the control series from the Correa et al. (1983) study of males). Using relative risk estimates based on Method 1, it is estimated that 820 of the 5,200 lung cancer deaths are attributable to ETS. Estimates of the attributable number in males based on Methods 2 and 3 are given in Table D-5. Overall, the results for men are similar to those for women.

D-4 LIFETIME RISK OF DEATH FROM LUNG CANCER ATTRIBUTABLE TO ETS

Among Lifelong Nonsmokers

Permissible exposure limits to environmental agents are often set at levels low enough to reduce the lifetime risk of death attributable to the agent to 1 in 105 or 106. For purposes of comparison with other environmental and occupational standards, we have attempted to estimate the fractions of all deaths among nonsmoking men and women who survive past age 45 that are

Page
306
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)