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Indoor Air Quality

Environmental and Occupational Health
Annemarie Delle Donne, RN, BSN
Indoor air pollution is a serious health threat.  The levels of many air pollutants can be two to five times higher in indoor air than outdoor air, and in some cases can be 100 times higher.  Indoor air pollution is a real concern because people spend so much time indoors (American Cancer Society, 2013).

Cigarette smoke is a combination of approximately 7,000 chemicals, and over 60 of these are known carcinogens, making it the most toxic indoor air pollutant (American Cancer Society, 2013).  Some chemicals in tobacco smoke include nicotine, cyanide, benzene, formaldehyde, ammonia, acetylene, and methanol, as well as carbon monoxide and nitrogen oxide gases. Nationally, over 70% of people who smoke say they would like to quit, but only 34% try and only 10% succeed and remain tobacco-free for one year (Institute of Medicine, 2001). 

Second-hand smoke (SHS) is a mixture of the smoke given off by a burning cigarette, pipe, or cigar (side stream smoke) and the smoke exhaled by smokers (mainstream smoke) (American Cancer Society, 2013).  SHS can cause a wide range of adverse health effects such as heart disease (resulting in approximately 46,000 deaths per year), lung cancer (resulting in 3,400 deaths per year), and 7,500-15,000 hospitalizations per year.  The link between SHS and breast cancer is still being investigated.  Children who are exposed to SHS and have the flu are more likely to need hospitalization in intensive care units.  The costs of extra medical care, illness, and death caused by SHS are over $10 billion (American Cancer Society, 2013).  Second-hand smoke (SHS) is a major trigger of childhood asthma (Mannino, Homa, & Redd, 2002).  According to the 2006 Surgeon General’s report, there is no risk-free level of exposure to second-hand smoke.  Many parents of children with asthma underestimate the smoke exposure and subsequent harm to their child ((United States Department of Health and Human Services [USDHHS], 2006).  Children’s bodies are still developing and are significantly affected by SHS.  The poisons in SHS put them at greater risk for upper respiratory diseases, low birth-weight, sudden infant death syndrome (SIDS),  asthma, bronchitis, pneumonia, middle ear infections, and cognitive and behavioral problems (USDHHS, 2006). SHS exposure is also associated with increased respiratory illness resulting in more missed days of school in children, especially in children with asthma (Gilliland, et. al., 2003).


American Cancer Society (2013).  Questions about smoking, tobacco, and health.  Retrieved from:

Institute of Medicine (2001).  Clearing the smoke:  Assessing the science base for tobacco harm reduction.  National Academy of Sciences; Washington, DC.

Gilliland, F. D., Berhane, K., Islam, T., Wenten, M., Rappaport, E., Avol, E., Gauderman, W. J., McConnell, R., & Peters, J. M. (2003).  Environmental tobacco smoke and absenteeism related to respiratory illness in schoolchildren.  American Journal of Epidemiology, 157(1), 861-869.

Mannino, D. M., Homa, D. M., & Redd, S. C. (2002).  Involuntary smoking and asthma severity in children:  Data from the third National Health and Nutrition Examination Survey.  Chest, 122(2), 409-415.

United States Department of Health and Human Services (2006).  The health consequences of involuntary exposure to tobacco smoke:  A report of the Surgeon General. Centers for Disease Control and Prevention, Office of Smoking and Health; Atlanta, Georgia.