Monitoring smoke-drift in a mental health setting Reply

Our REFRESH project used air quality monitors to detect levels of pollution from second-hand tobacco smoke in the home.

Recently we employed one of the monitors for a different purpose – to analyse smoke drifting from an area where smoking is permitted to another where it is not.

The setting was in an organisation that cares for people with mental health issues. It’s important that the issue of smoking within mental health settings is addressed, because there are disproportionately more people smoking/using tobacco who also have a poor mental health diagnosis when compared to the population as a whole.

This, in turn, reinforces health inequalities and adds to the burden of ill-health which people with a poor mental health diagnosis already experience.

RESIDENTIAL
The organisation we visited has a residential area, where service users can smoke. But lighting up is banned in the adjoining communal areas where residents and staff gather. These areas are workplaces for the employees and they shouldn’t have to be exposed to second-hand smoke.

But there were reports that people sometimes smelled tobacco smoke in these spots. Could the smoke from residents’ homes be drifting, invisible and undetected, into areas where it shouldn’t be?

The organisation was interested to find out so we set up our monitor in the communal activities room of their centre and let it run for five days, measuring tiny particles in the air.

EXPOSURE
For indoor exposure, the World Health Organisation air quality guidance level (for 24-hour average exposure) is 25 micrograms per cubic metre (µg/m3) of particle size PM2.5.

Our results showed:
• that throughout this period, air quality was consistently – and almost continuously – above the WHO guidance value of exposure;

• that the highest reading was 245.2µg/m3 (on a Saturday afternoon);

• that even overnight (10pm-6am), when most residents would be in their own flats, particulate matter in the activities room remained above WHO guidance levels on all occasions;

• that there appeared to be a distinct patterning to the presence of particulate matter – the Friday and the Sunday saw mid-morning to mid-afternoon and late evening peaks of activity (when levels were roughly three times higher than the WHO guidance level);

• that the results displayed an unusually slow build-up of particulate matter (especially on the Saturday reading – if smoking were taking place in the same room, we would expect to see sudden ‘spikes’ in the data instead of a long, steady build-up), so this may indicate significant smoke-drift from adjoining private living spaces and/or other communal areas where smoking is taking place;

• that other sources of potential particulate matter – large candles, an open fire, frying/burning food in the vicinity – need to be ruled out, although due to the measured particulate size they are unlikely to be providing readings of this scale.

PROBLEM
The results of our short study indicate that there may be a significant problem with second-hand smoke in communal areas of the organisation’s premises.

If the readings are indeed tobacco smoke drift, then it is hazardous to the health of all those who live or work in the centre (smokers and non-smokers alike) and should be addressed as a matter of urgency, in consultation with residents and centre users.

We suggested a number of ways the issue could be addressed.

1. that the timeframe during which air quality was monitored is re-examined to identify (and rule in or out) potential other sources of particulate matter, such as large candles, frying/burning food etc.;

2. that if second-hand tobacco smoke is indeed the cause of such high readings, then the organisation updates/applies its existing tobacco policy or develops a new one (either of which ASH Scotland would be happy to review), in an attempt to remove second-hand smoke from communal and working areas, starting from a given date – ensuring good discussion and communication beforehand with residents and centre users about what changes are being made and why;

3. that once the new/updated policy is in place, ASH Scotland returns with an air quality monitor and leaves it running for another five days;

4. that we analyse the readings and report back on the results, hopefully indicating a positive change.

We have already provided suggestions as to how their in-house tobacco policy might be strengthened, to improve compliance with no-smoking areas and to ensure that all staff are aware of what their rights and responsibilities are.

The organisation is now studying our recommendations and we hope to work further with them to help them counteract the potential problem of smoke-drift into staffed areas on their premises.

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