Exposure to environmental tobacco smoke in German restaurants, pubs and discotheques GABRIELE BOLTE a , DIETER HEITMANN b , MANDY KIRANOGLU a , RUDOLF SCHIERL c , JUERGEN DIEMER b , WOLFGANG KOERNER b AND HERMANN FROMME a a Department of Environmental Health, Bavarian Health and Food Safety Authority, Oberschleissheim, Germany b Department Analytical Laboratories and Evaluation of Chemicals, Bavarian Environment Agency, Augsburg, Germany c Institute and Outpatient Clinic for Occupational and Environmental Medicine, Ludwig-Maximilians-University, Munich, Germany In contrast to other countries, there is an on-going debate but still no smoke-free legislation in Germany. Exposure to environmental tobacco smoke (ETS) in hospitality venues is assumed to be high, but air quality data are lacking. Therefore, the aim of our study was to perform a comprehensive exposure assessment by analysing the indoor air concentration of toxic or carcinogenic ETS compounds in restaurants, pubs, and discotheques. Active sampling of indoor air was conducted for 4 h during the main visiting hours in 28 hospitality venues. Polycyclic aromatic hydrocarbons (PAH), volatile organic compounds (VOC), aldehydes/ketones, and cadmium were analysed. In addition, particle mass concentration was assessed with two different methods and particle number concentration (PNC) was determined. Median nicotine levels were 15 mg/m 3 in restaurants, 31 mg/m 3 in pubs, and 193 mg/m 3 in discotheques. Across these three sampling site categories median levels of 3-ethenylpyridine ranged from 3 to 24 mg/m 3 , median levels of benzene from 8 to 20 mg/m 3 , median levels of cadmium from 3 to 10 ng/m 3 , and median levels of the sum of 16 PAH according to US-EPA from 215 to 375 ng/m 3 , respectively. Median PM 2.5 mass concentration assessed gravimetrically varied between 178 and 808 mg/m 3 and PNC between 120,000 and 210,000 particles per cm 3 in restaurants, pubs, and discotheques. The majority of the particles had a size of 0.01–0.5 mm. Concentrations of ETS compounds were always highest in discotheques. The strong correlation between ETS-specific markers (nicotine, 3-ethenylpyridine) and PM 2.5 , PAH, VOC, aldehydes/ ketones, and cadmium indicated ETS as main source of these toxic or carcinogenic substances. In conclusion, indoor air concentrations of ETS constituents were high in German hospitality venues and represented a substantial health threat. Effective measures to protect patrons and staff from ETS exposure are necessary from a public health point of view. Journal of Exposure Science and Environmental Epidemiology (2008) 18, 262–271; doi:10.1038/sj.jes.7500590; published online 13 June 2007 Keywords: second-hand smoke, PM 2.5 , polycyclic aromatic hydrocarbons, volatile organic compounds, nicotine, indoor air quality. Introduction Environmental tobacco smoke (ETS) is by far the most significant indoor air quality issue in health terms. ETS is a well-known health threat and has been classified as carcinogenic to humans (WHO IARC, 2004, U.S. Depart- ment of Health and Human Services, 2006). In contrast to other countries, a considerable proportion of the population in Germany is exposed to ETS because tobacco consumption is still high in the German population. A recent national telephone health survey among adults revealed smoking prevalences of 37% for men and 28% for women (Lampert and Burger, 2005). In case of adolescents, 32% of 15-year- old boys and 34% of 15-year-old girls reported regular smoking (Langness et al., 2005). Among young adults, smoking prevalence may be even higher with 54% for men aged 18–19 years and 48% for women aged 18–19 years (Schulze and Lampert, 2006). In addition, there is currently no comprehensive smoking ban in public places, particularly hospitality premises. As a result, exposure to ETS is one of the most important public health issues in Germany. Data of the German Environmental Survey 1998 indicated that approximately 20% of all adult non-smokers were exposed to ETS at home, in the work place or in other places, when ETS exposure was defined as cotinine excretion in urine (Heinrich et al., 2005). On the basis of the questionnaire data obtained within the German Health Survey 1998, 55% of all adult non-smokers were frequently exposed to ETS. The proportion of ETS-exposed non-smokers may rise up to 90% in case of 18 to 19-year-old men. For all age groups, ETS exposure at other places including restaurants or bars is predominant compared to ETS exposure at home or in the work place (Schulze and Lampert, 2006). An exposure study in seven European cities demonstrated the highest nicotine concentrations in bars and discotheques compared to other public places such as train stations or Received 21 February 2007; accepted 13 April 2007; published online 13 June 2007 1. Address all correspondence to: Dr. Gabriele Bolte, Department of Environmental Health, Bavarian Health and Food Safety Authority, Veterinaerstr. 2, 85764 Oberschleissheim, Germany. Tel.: þ 49 89 31560 159. Fax: þ 49 89 31560 835. E-mail: gabriele.bolte@lgl.bayern.de Journal of Exposure Science and Environmental Epidemiology (2008) 18, 262–271 r 2008 Nature Publishing Group All rights reserved 1559-0631/08/$30.00 www.nature.com/jes