Secondhand Smoke and Casino Dealers

Posted on by Christine West, RN, MSH, MPH

dealer behind a roulette table with fumes of smokeSimply working in a casino does not mean dealers must gamble with their health. There is nothing lucky about developing a respiratory illness, lung cancer, or heart disease—especially if you are a healthy nonsmoker. Results of new research conducted by the National Institute for Occupational Safety and Health (NIOSH) on secondhand smoke—the exposure of non-smokers to tobacco smoke—confirm that dealers at the casinos investigated were exposed to secondhand smoke. Secondhand smoke, also called environmental tobacco smoke, is a combination of smoke given off by the burning end of a tobacco product and the smoke exhaled by the smoker. Secondhand smoke is made up of approximately 4,000 chemicals, of which about 40 are known to cause cancers.

Longstanding NIOSH policy, consistent with and based on the U.S. Surgeon General’s position on secondhand smoke, recommends that workers should not be involuntarily exposed to tobacco smoke. Any exposure to secondhand smoke increases the risk of lung cancer, other respiratory diseases, and heart disease. Studies have shown that even low levels of secondhand smoke exposure can be harmful. The only way to fully protect nonsmokers from secondhand smoke exposure is to completely eliminate smoking in indoor spaces.

The NIOSH investigation was conducted in response to requests for an evaluation of secondhand smoke from dealers at Bally’s, Paris, and Caesars Palace casinos in Las Vegas, Nevada. NIOSH investigators conducted onsite health hazard evaluations to measure casino dealers’ exposure to secondhand smoke and to determine whether they reported related health symptoms. Employees were selected to participate in the study if they reported that they did not use any tobacco products, did not live with someone who smokes inside their home, or were not exposed to secondhand smoke in any setting other than their job at the casino. For comparison, a group of administrative and engineering staff who were not exposed to secondhand smoke at their casino job were included in the study.

NIOSH collected urine samples before and after the workers’ shifts to determine the levels of two secondhand smoke components, cotinine and NNAL (a cigarette carcinogen) in their urine. Casino dealers were found to have increasing levels of NNAL in their urine over an 8-hour work shift showing that the cigarette smoke and a carcinogen are being taken up into their bodies. NIOSH also conducted air sampling which found that components of secondhand smoke were present in the air of the three casinos. Casino dealers had more respiratory symptoms than the administrative and engineering employees, but differences were not statistically significant.

NIOSH recommended that:

  • The casinos should institute casino-wide no smoking policies to eliminate exposure to secondhand smoke and develop smoking cessation programs for casino employees who smoke.
  • A physician should evaluate employees with respiratory symptoms related to workplace exposures.
  • The casinos should form a health and safety committee that includes employee and management representatives to address workplace health and safety concerns.
  • The casinos should also eliminate smoking near building entrances and air intakes to prevent tobacco smoke from entering the work environment. Any modifications of the ventilation systems should be done in adherence with current guidelines.

In addition to scientifically confirming secondhand smoke exposure among the casino dealers, the results of this research also provide additional support for the use of NNAL as a marker of secondhand smoke exposure and will aid other researchers in future studies.

NIOSH would like to hear from you. If your workplace has gone smoke-free, please tell us about the transition. Were there specific steps taken that seemed to make the transition to a smoke-free environment easier?

The complete reports of the casino health hazard evaluations can be found at this Document in PDF. More information on the Health Hazard Evaluation (HHE) Program is available on the HHE topic page. Information on the health effects of second hand smoke can be obtained from the CDC Office on Smoking and Health and the U.S. Surgeon General’s Report on the Health Consequences of Involuntary Exposure to Tobacco Smoke.

Lieutenant Commander West of the United States Public Health Service is an epidemiologist assigned to NIOSH in the Division of Surveillance Hazard Evaluations and Field Studies.

Posted on by Christine West, RN, MSH, MPHTags

54 comments on “Secondhand Smoke and Casino Dealers”

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    We at [company name removed] were contacted by a casino group asking whether we could alleviate the second hand smoke in their gambling areas and other adjacent indoor facilities some time ago. We do have fan driven ceiling registers that easily replace existing registers and ties into the facility’s HVAC system and utilize high efficiency HEPA filters accessible within the room for filter replacement. We never heard back from them but this very inexpensive device could be employed to significantly reduce the secondhand smoke by pressurizing the space and creating more ultra-clean air changes per hour. Obviously, the best solution is non-smoking. We have this being used to provide a focused ultraclean air zone over surgical procedures to dramatically reduce infections.

    We would like to emphasize that the only way to eliminate the health hazards associated with secondhand smoke exposures from indoor environments is to ban smoking.

    Note: References to a product or service does not constitute an endorsement of any commercial product by NIOSH or the U.S. government.

    Do you have any results for formaldehyde concentrations in the smoking area? If so, can you provide them, or a range?

    Full-shift Personal Breathing Zone (PBZ) and area air sampling for formaldehyde was conducted at Paris, Bally’s, and Caesars Palace casinos in the gaming areas where smoking was permitted during swing shift for 4 days. The geometric means were 8.96 ug/m3 and 8.91 ug/m3 formaldehyde from the PBZ and area samples, respectively, for all three casinos combined. PBZ concentrations for formaldehyde ranged from 2.3 to 29 ug/m3 and area concentrations ranged from 2.3 to 36 ug/m3 for all three casinos combined. The OSHA PEL is about 920 ug/m3 and the NIOSH REL is about 20 ug/m3. For more information, please review the full report at

    “Longstanding NIOSH policy, consistent with and based on the U.S. Surgeon General’s position on secondhand smoke, recommends that workers should not be involuntarily exposed to tobacco smoke.”

    No worker should be exposed to secondhand smoke, voluntarily or involuntarily.

    I was in Vegas recently and talked to a head bartender who had to have two of her waitresses quit recently. One actually had three people come and pat her belly, then all three lit up right in her face.

    Folks must think cocktail waitresses and their unborn are of a different class……..disposable.

    I have made a preliminary analyis of your data and arrived at the following conclusions:

    1.The average of the workers’ median pre-shift/post-shift Urine Cotinine: U = ~26 ng/ml, using a “Rosetta Stone” conversion equation*, corresponds to an estimated secondhand smoke PM2.5 level of: SHS-RSP = 364 U(ng/ml)/24 (hours) = (364)(26)/24 = 390 ug/m3, which in turn corresponds to a U.S. EPA Air Quality Standard descriptor for PM2.5 equivalent to Very Hazardous Air Pollution.
    2.Using a second Rosetta Stone equation the Serum Cotinine equivalent of the workers’ median cotinine level is P = U/6.5 = 26/6.4 = 4 ng/ml, which is greater than the 95th percentile for U.S. population based on CDC’s National Environmental Chemical data base for serum cotinine for 1999-2002 (Table 32). This strongly reinforces NIOSH’s conclusion that casinos should institute casino-wide no smoking policies.
    * Repace JL, Al-Delaimy WK, Bernert JT. Correlating Atmospheric and Biological Markers in Studies of Secondhand Tobacco Smoke Exposure and Dose in Children and Adults. JOEM 48: 181-194 (2006).

    Est. 40-Yr Working Lifetime risk (11 deaths/1000-0.4 ng/ml Pers-40 Yr)(4 ng/ml): R = 110 deaths per 1000

    This is 124 times OSHA’s Significant Risk Level.

    I have been a casino dealer for over 20 years now and have watched as many of my non-smoking friends have died from cancer. There are even more who have not died, but have been treated for various cancers. All the while the casinos turn a blind eye and continue to pass out free tobacco products to the customers who are smoking less than 3 feet from my breathing space and blowing their smoke in my face.

    I admit, I am a smoker. But when I smoke, I do so when I choose to do so. I do not smoke with every breath I take, nor through my nose and eyes.

    I would like to quit smoking, but every day when I go into work my employer forces me to smoke throughout my shift. This is like an alcoholic who wants to stop drinking, but their employer forces them to consume alcohol all day at work. How do they quit? I face the same dilemna.

    “The consequences are too real to ignore. After working for more than two decades in a well known casino, [name removed] found that he had become stricken with lung cancer despite never having smoked tobacco products.

    [Name removed] was fired from his job after becoming a vocal advocate for the health of other casino workers.” – this just unacceptable.

    Electronic Cigarettes could be an answer.

    I have only worked in the casino for 2 years, and as a non-smoker have started experiences symptoms of a smoker. I am appalled at the smoking situation, and can only compare it to asbestos. Asbestos is PROVEN to cause asbestosis, lung cancer, mesothelioma, and digestive system cancers.

    The Environmental Protection Agency (EPA) was required by the Clear Air Act to produce regulations to regulate air pollutants hazardous to health.

    These are called the National Emission Standards for Hazardous Air Pollutants. Asbestos is one of these and regulating it was delegated to the Department. Well, CIGERATTE SMOKE AND SECOND HAND SMOKE ARE PROVEN TO CAUSE LUNG CANCER AND OTHER ILLNESSES. Why is it taken so long for the EPA to do something about it??? We know the Casinos aren’t going to stand up and do anything about it, those who are high enough on the corporate ladder are simply not exposed to the cigarette smoke and see banning smoking as loosing money. It’s obvious that loosing money is more important to the corporate world than the heath of their employees, so instead of fighting a losing battle, it’s time to start fighting this with the EPA and Clear Air Act. If Casinos won’t take the first steps, then we must push them by bringing the issues up and beyond their controls.

    The smoke is one of the worst parts of the job to endure. I constantly have teary eyes, headaches, and even get a cough from the smoke I am forced to deal with at work. It should be illegal to smoke inside any building and the casinos should be held liable for any and all possible future ailments relating to the environment we are forced to work in.

    I applaud your efforts to inform the public of these hazards we endure. I hope it will bring about changes in the future. We all deserve the right to breath clean air.

    I have worked as a dealer in one of the casinos tested for almost 30 years. When I started, I ran min-marathons and was an active athlete.

    Today, I have serious bronchial asthma which I take 3 different medications for and miss work due to the smoke irritating my throat and lungs. I have a chronic cough. I have had to get an FMLA just to save my job due to my illness which I acquired from my job but the management does not look favorably at employees with FMLA’s. We have been told we cannot fan the smoke away from us even though there are players that blatantly blow it in our face and violations can result in written documentation or termination. There are chip racks with fans available but management has not seen fit to even get those for us, much less the fans mentioned in the first post on this blog. There is “no smoking” everywhere else in the hotel and casino except on the gaming floor and bars for the dealers, bartenders and cocktail waitress’ to breathe. There certainly isn’t any smoking in the Executive Offices . Why is my health less important than everyone else in this country? The almighty dollar! I know of over 50 people that have worked with me that have contracted cancer—most died! The respiratory problems are off the chart! If all smoking was banned in public then every business would have an equal playing field so why won’t our legislators pass the laws we need to stop poisoning us?????? Can you imagine the savings in health care? With this report and the employees getting fed up – I can see many lawsuits coming!

    I have been a casino dealer for over 30 years. I have a spot on my lung which I get checked every year to determine whether there is any growth. So far, so good. I also smoked for a lengthy period of time, quit in 1979 when I became a dealer at [name removed].

    I have approached the head of human resources, several times to have him install table fans (he bragged that he put them in at [another] Casino) Last time I talked to him he said that there was no interest in the fans. Interest, from who? It is the only horrible part of the job breathing in second hand smoke which is usually blown directly into the dealers face by disgruntled players. Fans, can change the atmosphere of the whole casino. Mgt. says that the dealers would be abusive, How?

    Casinos seem to be special parties and receive mindless exemptions from the smoking bans. As far as a smoke filled work environment is concerned, minimum requirements should stipulate that respirators be worn by all employees subject to the “hazardous environment”. A properly trained and conscientious firefighter would never think of entering into a similar smoke-filled environment without airway protection. I don’t get the free passes that are handed to the casinos.

    In the introductory post for this blog topic, Lt. Commander West asserted that: “Longstanding NIOSH policy, consistent with and based on the U.S. Surgeon General’s position on secondhand smoke, recommends that workers should not be involuntarily exposed to tobacco smoke.”

    I read the HHE report on casinos, but didn’t see a mention of any such policy, at least not as worded above.

    Please provide citations to permit interested readers of this blog to learn when (and in what context) this NIOSH policy was initially established in a formal manner by NIOSH and when (and in what context) it was most recently reaffirmed in a formal manner by NIOSH. Thanks.

    Current Intelligence Bulletins (CIBs) are issued by the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention to disseminate new scientific information about occupational hazards, draw attention to a formerly unrecognized hazard, report new data on a known hazard, or disseminate information on hazard control. In June 1991, CIB 54 entitled Environmental Tobacco Smoke (ETS) in the Workplace, Lung Cancer and Other Health Effects was issued to disseminate information about the potential risk of cancer and heart disease in workers exposed to ETS which was based on the 1964 Surgeon General’s report on smoking and health and a review of epidemiologic studies on the health effects from ETS exposure. The CIB states that “the best method for controlling worker exposure to ETS is to eliminate tobacco use from the workplace and to implement a smoking cessation program.” CIB 54 has not been rescinded, and continues to be referenced when recommending eliminating exposure to secondhand smoke in workplaces.

    Now that the NIOSH report is out, Smoke-Free Gaming is working aggressively to get more casino employees and casino patrons (gamblers) on board to get casinos smoke free.

    We have learned that the health of the employees, whose health is gravely compromised from breathing secondhand smoke (air pollution) is of little or no concern to their employer. Why? Because casino management is known to fire them at will!

    BUT, casinos listen to their customers so that is why we are doing all we can to get the gamblers who hate the smoke to join in our efforts. Guess what? It’s working! Professional gamblers are mostly non smokers. They are the ones who complained about the smoke and that is why the World Series of Poker, the World Poker Tour, etc. and poker rooms across the country are non smoking.

    We even have an online petition for employees, gamblers and everyone else to sign.

    We hope the NIOSH report will be a tool for legal pursuits, more no-smoking policies and more clean indoor air laws.

    This is a health issue! Breathing is not a choice!

    My wife and I went to the (name removed) casino in Conn 6 weeks ago. I am an asthmatic, have been all my life. We enjoy gambling there. We usually go twice a year. We stay in the so called no smoking room to gamble. This last time we went,in order to pick up your car when you leave there, you have to go through a large smoking room. I nearly died walking through this room, must have taken me 3 or 4 minutes. By the time I got to the end, exit where the cars are, I was breathless, couldnt breath. From that experience, I developed Chronic Bronchitis, and saw my doctor three times for medication, nebulizer and other lung help. I was disabled with this Chronic Bronchitis for 6 weeks and am just starting to feel normal. As much as I love the casinos, I am deathly afraid of returning to one. I refuse to go through that nightmare again. In my opinion, they should not allow smoking in any of those casinos. Its like a slow death in there.

    Casino workers face a higher risk of heart disease and lung cancer because they work in buildings filled with tobacco smoke. Casinos serve both smoking and nonsmoking customers, balancing the needs of these two distinct sets of patrons, as well as those of our employees who don’t smoke, is of paramount importance.

    You had to do a study with tax dollars to determine that casino dealers were exposed to second hand smoke? PULEEZE!

    “Employees were selected to participate in the study if they reported that they did not use any tobacco products, did not live with someone who smokes inside their home, or were not exposed to secondhand smoke in any setting other than their job at the casino.”

    Excuse me, I find it hard to believe that they were not exposed to secondhand smoke in any setting other than their job at the casino. Give us a break. If you don’t like it, go where it isn’t. What happened to the land of the free? If they want to be stupid, let ’em!

    Unions have been the traditional vehicle in satisfying both employees and companies in health related workplace issues for decades and pro or anti Union supporters can’t argue against that fact. Why don’t the companies turn to the U.A.W and the T.W.U to work out a solution. There must be a way to protect both health and revenue. Large smoke free areas, better ventilation (with Union inspection), all bronchial illnesses 100% covered with paid sick leave would be a good start.

    There is no denying that both smoking and secondhand smoke are unhealthy. However, having said that what about choice?

    Casino employees choose of their own free will whether or not to work a casino. Perhaps that is the highest paying job in the area which does not require a college education or skilled trade however that is still their choice; accept a lower paying job, move to another area or get an education. Last time I check this was still a free country where we choose our own destiny. Nobody is forced to work or gamble in a smoky casino environment. Casinos are a choice not a necessity! It should be up to the owner of the establishment to decide whether or not to become smoke free.

    There are MANY behaviors which can be classified as high risk such as sun bathing, eating McDonalds everyday or motocross but that doesn’t mean we need legislation to protect us. We all have the freedom to choose and must live the repercussions of our decisions.

    I have worked in a casino in Nevada for just over 2 years now. Since I have started we have had approx. 8-10 people contract cancer and many have since died in a short time from being diagnosed. This seems to be a very high number. Also, we have had many illnesses as well. This needs to be checked out.

    Although we have not been able to speak with you to obtain more information about the employees with cancer and their exposures, the following information about occupational cancer clusters may be helpful to you. A cancer cluster is an unusual concentration of cancer cases in a defined area or time.

    ◦Cancer is a common disease, cancer can be found among people at any workplace. In the United States, one in two men and one in three women will develop cancer over the course of their lifetime.
    ◦Cancer clusters thought to be related to a workplace exposure usually consist of the same types of cancer rather than several different types of diagnoses.
    ◦When a known or suspected cancer-causing agent is present and the types of cancer occurring have been linked with these exposures in other settings, we are more likely to make the connection between cancer and a workplace exposure. We also look to see whether cancer is occurring among employees in particular jobs or areas of the workplace. Persons occupationally exposed to secondhand smoke are at risk of developing lung cancer, cardiovascular illness, and respiratory health effects. As a result, NIOSH recommends eliminating tobacco use in the workplace.
    ◦The time between first exposure to a cancer causing agent and clinical recognition of the disease is called the latency period. Latency periods vary by cancer type, but usually are 15 to 20 years, or longer. Because of this, past exposures are more relevant than current exposures as potential causes of cancers occurring in workers today.
    If you or your coworkers have been diagnosed with an illness potentially associated with exposure to secondhand smoke, you may wish to share our report with a health care provider and discuss the section of the report that documents the presence of a lung carcinogen over a work shift and reported respiratory health effects in the casino dealers. Only a health care provider familiar with your or your coworkers specific medical and work history can make a determination as to whether an illness you are affected with is work-related. Inform your supervisor and/or the individual(s) responsible for workplace safety and health in your facility and then seek care from a health care provider who can evaluate your health symptoms. For more information about occupational cancer and cancer cluster evaluations on the NIOSH website at You can also find information published by the National Cancer Institute about health effects related to exposure to secondhand smoke, at and in the U.S. Surgeon General’s Report at

    I hear the only cause for cancer (according to fellow posters) is cigarettes. These casinos are on a very congested street, where it took 12 an hour to pass 1 casino. Of course all this vehicle traffic isn’t the problem, has to be the hated smokers; according to Anti smoker advocates theres toxicology or other causes that is plausible for cancer.

    Couldn’t get a total ban; so to forward your agenda, create a study that will only support your preconceived need. Scary what smokers taxes are paying for, no wonder contraband is not being seen as a crime; if this is science that the taxes are paying for.

    PS: No mention that NNAL comes from potatoes, tomatoes, grain, eggplant; how do they account for that confounder? “urinary COT levels adjusted for creatinine for all three casinos combined decreased over an 8-hour shift.” How do you account for the dealers telling what they feel in a written survey; then that statement used as a medical opinion, thats scientific & exact.

    Cool Blog, oddly enough I had read a article from september fourth two thousand and four that was remarkably similar to your post.

    Uggh! John and Sharon must be smokers. It is not that eassy for someone to just up and quite there job and take a harder and/or lesser paying job. I work in a casino and hate being expost to nasty stinky smoke. So put that in your ciggeret and smoke it but just don’t make me have to breath your “stinkbomb”!

    I have been a casino dealer for a few years now in Detroit and I am hearing about this new cigarette that is going to be mandatory called the FSC Cigarette. According to the website, these new cigarettes have more harmful chemical byproducts in them that make the cigarettes go out by themselves and also create more toxins in the smoke. Does the government not realize that implementing these procedures not only affect smokers, but people exposed to second hand smoke as well! Smoking is NOT outlawed indoors everywhere YET, and they shouldn’t be making cigarette smoke more harmful until that is accomplished.

    I may be young, but being a casino dealer has always fasinated me. However, losing a lung as not. I fail to understand why a non-smoking environment is an issure. Sure, you may lose your business with the smoking population, but may also gain a new population, of those who were hoping for a place to enjoy without worrying about having to involuntarily smoke. Workers do have the free choice to work in a smoke filled environment, but it may be their best option available. Make it easier on everyone and ban smoking. Those who must, cant live without and will just absolutely die at the fact that they can not smoke for a few hours, can simply step outside, and come back in when they feel they can handle such pressure!

    I work in a casino & the smoke is horrible. And when I was pregnant twice I was shocked how many people still blew the smoke straight in my face, regardless of being pregnant. No remorse of these people! You would think these casinos would put up a non-smoking sign at least for the pregnant people (nope). I pray everyday that someday (in my lifetime) the casinos will all go smoke free!!! Please lets all work together to go smoke free, so we can all be healthy!!

    Thank goodness Ohio is a smoke-free state. We are soon adding a few casinos. Pros and cons of casino impact on communities aside, at least those who work in the casinos will not be exposed to the numerous toxic chemicals and carcinogens in second-hand and side-stream smoke. When our state went smoke-free there was the usual gnashing of teeth and dire predictions of hundreds of bars and restaurants going under and the state losing hundreds of thousands in tax revenue; none of which came to pass.

    I do not smoke it is unhealthy and whenever I go to a casino there are always people standing next to me smoking when I want to place a bet on the roulette table, I wish there were 2 seperate rooms for which one is smokefree to play.

    As a casino worker, I was wondering what rights do we have against second-hand smoke in an environment. I have mixed feelings on this matter. I can see the rights of the smoker/customer but what about the rights of workers. I can speak for most my my co-workers who rely on allergy medicines and have beeb prescribed inhalers. (Note-all workers are in good shape, as is a qualification to work in this field) Quite frankly, this is very disappointing. Personally, the field of expetise is food-serving. It is very dificult to let go to a job you enjoy and has given me such sinority. (granted in this particular restuarant it is non-smoking but still open to casino smoke from openness of the casino.

    Looking at the posts on site-Rose working 22 years at Station casinos died of lung cancer . I really do not want to be on of the statistics and would like to retire at the age of 65!

    Just wanted to express my concern. ANy suggestion is greatly appreciated.

    Longstanding NIOSH policy, consistent with and based on the U.S. Surgeon General’s findings and recommendations on Environmental Tobacco Smoke, recommends that workers should not be involuntarily exposed to tobacco smoke. The most current U.S. Surgeon General’s report is available at Decisions on where/when smoking is allowed or banned is based on state and/or local ordinances. I would suggest contacting your local health department as a potential resource for information about smoking provisions in your area. If you are experiencing health symptoms that you feel are related to your workplace, I recommend that you seek care from a health care provider who is trained in occupational medicine.

    I was employed as a dealer at a casino called the Grand Bay Casino in Antigua for the last two years and I constantly begged management to ban smoking because I just couldn’t handle the second-hand smoke but they always refused. The owner even went as far to say to me that I was a young guy and I can handle it. There were many situations were I had to cover my float and stop dealer during a game because I felt like passing out from all the smoke, and I was given warning letters for this. That place was like hell for me to work. We weren’t allowed to keep our tips as dealers and the pay was crap. And the thing that I hate the most was that the players and the management also were mostly from countries where smoking in casinos even isn’t allowed but they come to my little caribbean country and feel they can get away with anything.

    Dear fellow libertarians,
    If there is one thing that we all ought to realize when talking about rights, it is this


    For example, what would you say to smokers, who have children, smoking in their own private homes? Now that isn’t forbidden by law. And yet, one cannot help wonder how to balance the parent’s right to smoke with the child’s right to avoid second-hand smoke? Of-course, the child may not always complain and may even take to early smoking. Now, if nobody is complaining, there is no argument from rights, no question of conflict of rights. But then, the child’s health could surely have been far better in a healthier environment – you see the point, don’t you?

    We have to choose the right balance between opposing rights of different people keeping the larger picture in perspective – by trying to identify which things are gratuitous and which absolutely important (good health, for example).

    I’m sitting in a casino hotel right now. I’d love to be gambling, but there was too much smoke in the casino. I couldn’t breathe. I don’t think I’ll be back until smoking is illegal.

    My husband is a dealer at one of the top casinos in Vegas. He has worked there just over two years, and is now so sick from having smoke blown in his face that he hasn’t even been able to work for the past week. There are those who say he should just find another job, but have they looked at the Las Vegas economy lately? He’s lucky to have a job at all.

    Meanwhile, I’m stuck with a husband who is so sick he can barely breathe.

    I have long thought that all indoor areas should ban smoking. I even did a report on it in high school. They could make up the revenue lost from smokers with the non-smokers who won’t come anywhere near the casinos because of the smoke.

    I’m glad smoking has been banned in all spanish casinos, as Elaine said in the previous post this was a huge issue for non smoking dealers. Not sure what the situation is in Vegas as I haven’t been there for quite a while, but I thought it was banned.

    I don’t even understand why we are even debating about this right now, it should of been illegal from the get go plain and simple. Why did our government let the casinos be exempt from the law that states smoking is illegal in enclosed public places?

    I had perfect health up until the time I decided to take a job working in a casino. I’ve been a bodybuilder for most of my life, never took any drugs or supplements. I worked at [name removed] for one year, that’s all it took for me to come down with a serious case of chronic sinusitis.

    And now that I don’t work there and can’t afford healthcare, a lot of the bills that they should be paying for has come out of my pocket. I’m still trying to remove the sinusitis from my body, I’ve been dealing with it for a year now.

    The filtration in that casino is horrible, I don’t even understand how OCEA even allowed them to get away with it.

    your post about Secondhand Smoke and Casino Dealers is really interesting, thanks for stuff like this.

    In response to the first comment on this blog, NIOSH wrote that, “We would like to emphasize that the only way to eliminate the health hazards associated with secondhand smoke exposures from indoor environments is to ban smoking.”

    Using exactly the same reasoning, NIOSH should be forced as well to emphasize that the only way to eliminate the health hazards associated with cooking fumes from indoor environments is to ban cooking. Following such a dictum would indicate that restaurants and fast food outlets that cook food with methods other than microwaves or boiling over electric ranges should be required to do so in a separate building as ventilation can never provide complete protection. This would be particularly true for Bar-B-Que restaurants and fast food outlets that advertise such things as “flame-broiled” beef items while running promotions and advertising aimed at children.

    In terms of workers actually engaged in cooking, special respirators should be required of course, even if management initially objects. Moving beyond mere cooking concerns, workers should also clearly be protected from involuntary exposure to carcinogenic UV radiation while on the job. Sunscreen and awnings can provide partial protection from the sun’s rays (in much the same way that ventilation can provide such protection from tobacco smoke) but the only way to eliminate the health hazards associated with such exposures is to ban daytime patio dining. Sun exposure is neither an inherent nor a necessary part of the dining experience, particularly not for the workers who might serve in waiting or cleaning operations in such areas.

    I should hope that NIOSH applies their concerns fairly in these regards.

    Michael J. McFadden
    Author of “Dissecting Antismokers’ Brains”

    Smokers none of which really want to continue to smoke, dont believe them when they say they dont want to quit, they all do.

    2 weeks of hell, and your problem your trying to inflict others with is gone, get a grip, quit and dont try quitting aids, they’ll just make it easier to quit and you’ll go back sooner.

    Indians Casinos are different (soveriegn lands) but Casinos in the US somehow one day will be subject to a major class action law suit with the knowledge of what we currently know of smoking and cigs. Get a life smokers your lossers.

    Those of you who dislike being in a casino with smoking in Las Vegas, or Atlantic City need to WRITE to the casino hotels! The only way we will get rid of smoking in casinos is when the patrons request it. If they can stop smoking in the pubs in Ireland, and elsewhere in Europe, we in the U.S. can stop this deadly practice.

    Actually workers in casinos are prone to diseases because it has plenty of smokers smoking while gambling. It’s about the customers is always right policy that’s why workers suffered from this kind of activity.

    I have been working at a casino for the past 3 yrs and am concern about developing some form of cancer. I’m sure I’m not alone. I make decent money and it would be almost impossible to find another job that pays this well. What to do?

    We cannot tell you what your individual risk is for developing cancer as this is affected by many factors such as dose, intensity, duration of exposure and other non-tobacco related risk factors such as diet, physical activity, and genetics. We encourage you to discuss your individual exposure risk profile with your health care provider and share concerns with your employer. There is sufficient scientific evidence to conclude that populations involuntary exposed to tobacco smoke have an elevated risk of developing lung cancer, according to the 2006 U.S. Surgeon General’s report on the Health Consequences of Involuntary Smoking. In addition, second hand smoke has immediate adverse effects on the cardiovascular system and respiratory tract. Engineering approaches, including current and advanced dilution ventilation or air cleaning technologies should not be relied upon to control health risks from indoor tobacco smoke exposure. The only means of effectively eliminating health risks associated with indoor tobacco smoke exposure is to ban smoking activity.

    Every worker has a right to a safe and healthy workplace free of known health risks; progress has been made to eliminate smoking in many workplaces but invol¬untary exposure to tobacco smoke remains a serious public health hazard for millions of American workers where smoking is allowed, especially in the hospitality/recreational industry.

    Is it legal for casino’s to asked job applicant to sign a waiver release of casino liability for smoke related illnesses. I have two sister-in-laws here in california that always have flu like illnesses.

    Your inquiry involves a legal question concerning workers’ compensation laws which vary by state. We are not able to provide you with legal advice; however you may want to contact California’s Division of Worker’s Compensation at (800) 736-7401 or visit for more information about California’s workers’ compensation laws.

    jok you wrote “I have been working at a casino for the past 3 yrs and am concern about developing some form of cancer. … What to do?”

    Basically, stop worrying. Or at least look at your concern from a realistic perspective. As a nonsmoker you have about 4 chances in a thousand of getting lung cancer. According to the EPA Report, even in the poorly ventilated and smokey work conditions of the 1950s and 60s, your chances of eventually getting lung cancer after 40 straight years of work would only go up by about 19%: i.e. about one extra chance in a thousand. I’m pretty sure the casino you’re working at has ventilation/filtration systems that are probably about ten times as powerful as the ones used fifty years ago, so your odds would probably be more like one extra chance in ten thousand… and that’s only if you work there, AND work in the smoking sections every night, for the next 37 years.

    My guess is that you’ll have a lot of far more serious things to worry about during those years. And remember: even those chances as computed by the EPA have been thought to be exaggerated by many people who’ve examined their work.

    – MJM

    Christine, thank you for your response. I am wondering though if you have any specific comment on the measurements gathered in the NIOSH report that this blog entry concentrates on. Several years ago I carefully researched and wrote a book in this area (“Dissecting Antismokers’ Brains”) and three of the elements I examined there were measured in this current NIOSH report: Toluene, Acetaldehyde, and Formaldehyde. I will note below what the levels were measured at and then compare them to the OSHA type PELs (Permissible Exposure Limits) and TLVs (Threshold Limit Values) that are designed to ensure worker safety.

    CHEMICAL MEASUREMENT TLVorPEL Fraction of Concern Level Limit

    Formaldehyde 9mcg/m^3 940mcg/m^3 approx 1/100th

    Acetaldehyde 10mcg/m^3 45,000mcg/m^3 approx 1/4500th

    Toluene 14mcg/m^3 188,000mcg/m^3 approx 1/13,430th

    It is possible that some of the other readings were more significant, but from the above it would seem unlikely. While it is certainly true that to totally “eliminate risk” from any exposure to any exposure that is harmful in concentration the only complete answer is elimination of the exposure, such a remedy is not generally thought to be a rational recommendation for policy. For example, sunshine and ethyl alcohol are both carcinogenic. Yet I doubt I would see a recommendation here stating that sunscreen and awnings do not provide full protection and that the only “safe” work experience would be indoors — thus necessitating a ban on daytime patio dining facilities. Similarly, although ethyl alcohol is highly volatile (roughly 100,000,000 mcg evaporate from a single martini into the air workers breathe in a single hour) the remedy does not seem to be eliminating alcoholic beverages from restaurants where families gather to eat healthy foods.

    So I am puzzled by the concentration on tobacco smoke. Can you clarify it for me, or point out any errors in my numbers above or my reasoning?

    Thank you.

    Michael J. McFadden


    Chemical Concentrations: Table at the end of []
    Alcohol Carcinogen Exposure: []

    Thank you for your question. The blog summarized findings and recommendations from a health hazard evaluation conducted at the request of workers at three casinos. The findings and recommendations for minimizing occupational exposures to tobacco smoke are consistent with the findings of the Surgeon General on the adverse health effects of tobacco smoke, and with NIOSH’s longstanding policy on minimizing exposures to tobacco smoke in the workplace. More information is available through NIOSH’s topic page at

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