Exposure to second-hand smoke air pollution assessed from bar patrons' urinary cotinine

We used physical and pharmacokinetic modeling to estimate personal exposures to respirable particle (RSP) and carcinogenic particulate polycyclic aromatic hydrocarbon (PPAH) air pollution from second-hand smoke (SHS) from the increase in urinary cotinine of eight patrons of three bars in Bismarck, North Dakota. We compared SHS-RSP levels to the U.S. Air Quality Index (AQI), used to forecast outdoor air pollution conditions. We measured smoker density and air exchange rates to generalize our results. Urinary cotinine increased by an average of 4.28 ng/ml to 6.88 ng/ml to 9.55 ng/ml above preexposure background from 6-hr exposures in the three bars. Corresponding estimated SHS-RSP levels were, respectively, 246 microg/m3, 396 microg/m3, and 549 microg/m3, comparable to those measured in 6 Wilmington, Delaware, bars and in 14 western New York bars. Estimated personal SHS-RSP air pollution exposures for the eight subjects, when converted to the 24-hr averaging time of the AQI, were "code red" (unhealthy). Measured outdoor air quality RSP levels for the same period were 1%-3% of the indoor RSP levels in the three bars, and were AQI "code green" (healthy). Estimated SHS-PPAH levels were comparable to peak 3-hr PPAH levels reported at a highway tollbooth. Bismarck cotinine-estimated SHS-RSP varied with smoker density, as did measured SHS-RSP levels in smoking bars in Delaware and New York. Our results show that smoking in bars produces levels of personal air pollution for bar patrons that merit air pollution alerts when sustained in the outdoor air.