Secondhand Smoke Threatens Casino Workers' Health

Newswise — New research suggests that casino workers face a higher risk of heart disease and lung cancer because they work in buildings filled with tobacco smoke.

By one scientist's calculation, six of every 10,000 nonsmoking casino employees in Pennsylvania will die each year because of exposure to secondhand smoke.

The estimate does not rely on the tracking of individual casino workers over time, nor does it compare them to workers who have not had smoke exposure. Still, the findings suggest a significant risk to the health of the workers, said study author James Repace, a Washington D.C.-area consultant who studies the effects of secondhand smoke.

Casino workers "are really the most exposed group in society now," Repace said. "The only other group that's exposed so much is bartenders," but many states have banned smoking in bars and restaurants.

The Flight Attendant Medical Research Institute — which has studied the risk of secondhand smoke to flight attendants when airlines allowed smoking — funded the study. The casino findings appear online and in the August issue of the American Journal of Public Health.

Nonsmoking mandates at casinos remain rare in the United States. As a result, gambling and smoking still have a strong connection.

In the new study, Repace recruited volunteers to visit three Pennsylvania casinos for four hours. After the visits, he measured the levels of a byproduct of tobacco smoke in the urine of eight subjects.

The levels were approximately 10 times higher than average.

Repace also tested the air quality inside three casinos. He found that the levels of two indicators of tobacco smoke — cancer-causing chemicals and particles small enough to inhale — were an average of four to six times higher inside than outside.

Both measurements led to the estimate of the number of deaths attributable to tobacco exposure in non-smoking casino workers in Pennsylvania; Repace said the total number of casino workers in the state is expected to soon reach 12,000.

Scientists expect that more than 90 percent of the deaths will be from heart disease, with the rest from lung cancer, which is uncommon in nonsmokers. Repace said that an annual death rate of six per 10,000 is roughly five times the extra risk of death for mineworkers from Pennsylvania mine disasters.

Holly Thomsen, a spokesperson for the American Gaming Association, a trade group for the casino industry, said its members are committed to "the highest level of safety and comfort" inside casinos.

Casinos serve both smoking and nonsmoking customers, she said, and "we realize that balancing the needs of these two distinct sets of patrons, as well as those of our employees who don't smoke, is of paramount importance."

The American Journal of Public Health is the monthly journal of the American Public Health Association. Visit www.apha.org for more information. Complimentary online access to the journal is available to credentialed members of the media. Contact Patricia Warin at APHA, (202) 777-2511 [email protected].

Repace, J. Secondhand smoke in Pennsylvania casinos: A study of nonsmokers' exposure, dose, and risk. Am J Public Health 99(8), 2009.