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Protection from exposure to second-hand tobacco smoke. Policy recommendations. control odour,63which per se is not an indicator The International Standards Organization (ISO) of the level of toxins in the air because these is drafting a recommended standard ISO 16814 w levels may be high even without a strong odour on ventilation and tobacco smoke prepared by of tobacco smoke. Even higher ventilation rates Technical Committee ISOM 205 on building would be required to eliminate toxins, which is environment design. However, policy-makers the only safe option for health. These ventila- need to be aware that the ISO standards have r tion levels are neither physically practical nor been heavily influenced bytobacco industry lob- economically feasible. In order to eliminate the bying in the past.6 In addition, the present draft toxins in SHS from the air, so many air exchanges of ISO 16814, while recognizing that "no realistic would be required that it would be impractical, combination of ventilation and filtration will uncomfortable and unaffordable. 65 provide a reasonably safe environment where w smoking is permitted ,,70 creates the illusion Similarly, neither central nor local aircleaning that ventilation may prevent recirculation or devices can reduce the levels of toxins from SHS movement of air from designated smoking areas w in indoor air to safe levels. The performance of into non-smoking areas. The 2005ASHRAE posi- _ these devices also usually declines over time tion statement, not the present draft of the ISO because they require high and expensive levels 16814 standard, reflects the best available cur- of maintenance, and they may even become rent scientific evidence on ventilation and SHS. ¦ sources of indoor air pollution. The "one pass" systems advocated by the tobacco industry and One particular ventilation-based approach pro- its allies do not re-circulate air and therefore moted by tobacco companies, and which some are much more expensive to operate because jurisdictions have accepted in specific settings, outdoor air has to be continuously heated or particularly bars and restaurants, is the impte- cooled. In any case, these systems do not reduce mentation of smoking areas separated from tobacco smoke to safe levels.66,67 non-smoking areas by physical barriers and with separate ventilation systems. These so- Despite decades of pressure from the tobacco called "designated smoking rooms," (DSRs), industry, 68 the American Society of Heating, with exhaust of air to the outside, isolated return Refrigerating, and Air Conditioning Engineers air, and negative pressurization in relation to (ASHRAE), the leading professional standards- adjoining spaces, have been designed and test- setting organization in the United States on ed for the degree of protection provided. Based ventilation, no longer provides recommended on existing literature, such rooms may reduce standards forventilation when tobacco smoking but not eliminate the exposure to SHS inside is present. In its 2005 environmental tobacco the DSR. In addition, DSRs do not eliminate smoke' (ETSI position document, ASHRAE con- non-smokers' exposure to second-hand smoke cludes, "At present, the only means of effective- in adjacent spaces, 71, 72 offer no protection to ly eliminating [the] health risk associated with workers required to work in them, and may also indoor exposure is to ban smoking activity."59 Intensify exposure of smokers to SHS, thus The position document also states, "Because of increasing risks to their health.73 For example, ASHRAE's mission to act for the benefit of the the door to the designated smoking room can public, it encourages elimination of smoking act as a pump moving smoke out of the room in the indoor environment as the optimal way when people enter and leave the room. to minimize ETS exposure." f The Cat/EPA used the term 'environmental tobacco smoke IETSI in its report. WHO prefers the terms second-hand tobacco smoke" or "involuntary smoking." ALL three terms are synonymous. r e