NIOSH Bulletin 54, "Environmental Tobacco Smoke in the Workplace" (DHHS (NIOSH) Pub. No. 91-108), shows no workplace data at all in its Table 2. Several early studies are ignored; another's workplace result is only mentioned in the text, and Janerich's is omitted entirely, with childhood exposures of both shown instead. Half of the studies (71% of cases) are Asian; and there are barely half as many cases as the 1432 in the US studies below.

These are the US studies of workplace ETS, as the EPA used only US studies in its Report. Notice the missing results in two very large studies that were otherwise analyzed in detail, and that both found no risk.

Wu AH, Henderson BE, Pike MC, Yu MC. Smoking and other risk factors for lung cancer in women. JNCI 1985;74(4):747-751. Nonsmoker data given for adeno-carcinoma only. "For nonsmoking ADC cases, we did not observe any elevated risk associated with passive smoke exposure ... at work (RR=1.3; 95% CI=0.5, 3.3)." 29 ADC cases.

Kabat GC, Wynder EL. Lung cancer in nonsmokers. Cancer 1984;53:1214-1221. (Men) "Eighteen of 25 cases reported having been exposed to cigarette smoke at work compared to 11 of 25 controls. The difference is just statistically significant (p=0.05)." (Women) "No differences on exposure to passive smoking at home or at work were found in women,...26 of 53 cases were exposed at work compared to 31 of 53 controls." [Calculated RRs=1.6 & 0.6; 1.1 all. Male controls may have underreported exposure, since it is supposedly less than females despite more male smoking.]

Garfinkel L, Auerbach O, Joubert L. Involuntary smoking and lung cancer: A case-control study. JNCI 1985;75(3):463-469. "OR for exposure at work during the last 5 years was 0.88; for the last 25 years, it was 0.93." CIs 0.66-1.18 and 0.73-1.18. 134 cases.

Janerich DT, Thompson WD, Varela LR, Greenwald P, Chorost S, Tucci C, Zaman MB, Melamed MR, Kiely M, McKneally MF. Lung cancer and exposure to tobacco smoke in the household. NEJM 1990;323:632-636. "Estimating the odds ratio as a continuous variable for an equivalent differential of 150 person-years of exposure gave an odds ratio of 0.91 (95 percent confidence interval, 0.80 to 1.04), indicating no evidence of an adverse effect of environmental tobacco smoke in the workplace...." 191 cases.

Stockwell HG, Goldman AL, Lyman GH, Noss CI, Armstrong AW, Pinkham PA, Candelora EC, Brusa MR. Environmental tobacco smoke and lung cancer risk in nonsmoking women. JNCI 1992;84(18):1417-1422. "We found no statistically significant increase in risk associated with environmental tobacco smoke at work or during social activities (data not shown)." 210 cases.

Fontham ETH, Correa P, Wu-Williams A, Reynolds P, Greenberg RS, Buffler PA, Chen VW, Boyd P, Alterman T, Austin DF, Liff J, Greenberg SD. Lung cancer in nonsmoking women: A multicenter case-control study. Cancer Epidemiol Bio-markers Prev 1991;1:35-43. "Exposures to cigarette smoking from spouse(s), other household members, on the job and in other activities of adult life ("social") are each associated with an overall 40-60% significant elevation in the risk of adenocarcinoma of the lung. As noted previously for spouse-related exposures, the risk estimates for all lung cancers without regard to cell type tend to be slightly lower than the comparable estimates for adeno-carcinoma of the lung." All types, 1-15 yrs 1.23 (0.86-1.77); 16-30 yrs 1.45 (1.05-2.00); >30 yrs 1.30 (0.93-1.80); ever 1.34 (1.03-1.73). No evidence of dose-response. 359 cases.

Brownson RC, Alavanja MCR, Hock ET, Loy TS. Passive smoking and lung cancer in nonsmoking women. AJPH 1992;82(11):1525-1530. "In general, there was no elevated lung cancer risk associated with passive smoke exposure in the workplace (not shown in table). Only lifetime nonsmokers showed a slight increase in risk in the highest quartile of workplace exposure (OR=1.2; 95% CI=0.9, 1.7)," which was nonsignificant. 431 cases.

Courtesy of Carol Thompson 08/23/93
Smokers' Rights Action Group
P.O. Box 259575
Madison, WI 53725-9575
Phone: 608-249-4568