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A comprehensive search of the scientific literature for this report is complete through September 1991. In addition, pertinent studies published through July 1992 have been included in the analysis in response to recommendations made by reviewers. Due to both resource and time constraints, the scope of this report has been limited to an analysis of respiratory effects, primarily lung cancer in nonsmoking adults and noncancer respiratory illnesses in children, with emphasis on the epidemiologic data. Further, because two thorough reviews on passive smoking were completed in 1986 (by the U.S. Surgeon General and the National Research Council), this document provides a summary of those reports. | EPA 600 6-90 006F December 1992 RESPIRATORY HEALTH EFFECTS OF PASSIVE SMOKING LUNG CANCER AND OTHER DISORDERS Major funding for this report has been provided by the Indoor Air Division Office of Atmospheric and Indoor Air Programs Office of Health and Environmental Assessment Office of Research and Development U.S. Environmental Protection Agency Washington D.C. DISCLAIMER This document has been reviewed in accordance with U.S. Environmental Protection Agency policy and approved for publication. Mention of trade names or commercial products does not constitute endorsement or recommendation for use. ii CONTENTS Tables. viii Figures. xiii Foreword . xv Preface. xvi Authors Contributors and Reviewers . xvii 1. SUMMARY AND CONCLUSIONS . 1-1 1.1. MAJOR CONCLUSIONS. 1-1 1.2. BACKGROUND .1-2 1.3. PRIMARY FINDINGS . 1-4 1.3.1. ETS and Lung Cancer. 1-6 1.3.1.1. Hazard Identification. 1-6 1.3.1.2. Estimation of Population Risk. 1-11 1.3.2. ETS and Noncancer Respiratory Disorders . 1-12 2. INTRODUCTION. 2-1 2.1. FINDINGS OF PREVIOUS REVIEWS. 2-2 2.2. DEVELOPMENT OF EPA REPORT. 2-5 2.2.1. Scope. 2-5 2.2.2. Use of EPA s Guidelines. 2-6 2.2.3. Contents of This Report. 2-8 3. ESTIMATION OF ENVIRONMENTAL TOBACCO SMOKE EXPOSURE. 3-1 3.1. INTRODUCTION. 3-1 3.2. PHYSICAL AND CHEMICAL PROPERTIES . 3-2 3.3. ASSESSING ETS EXPOSURE . 3-10 3.3.1. Environmental Concentrations of ETS. 3-12 3.3.1.1. Markers for Environmental Tobacco Smoke. 3-18 3.3.1.2. Measured Exposures to ETS-Associated Nicotine and RSP . 3-22 3.3.2. Biomarkers of ETS Exposure. 3-40 3.3.3. Questionnaires for Assessing ETS Exposures. 3-48 3.4. SUMMARY. 3-51 4. HAZARD IDENTIFICATION I LUNG CANCER IN ACTIVE SMOKERS LONG-TERM ANIMAL BIOASSAYS AND GENOTOXICITY STUDIES. 4-1 .
