Second-hand smoke is a major cause of preventable disease and death in the Eastern Mediterranean Region. To assess how second-hand smoke impacts air quality, respirable suspended particles (PM2.5), which are emitted during cigarette and waterpipe smoking, were measured inside and outside of 18 smoking and 5 nonsmoking public venues in Gaza city. Median PM2.5 level inside the smoking venues was 117 μg/m3, which exceeds the WHO guidelines for daily PM2.5 exposure (25 μg/m3) by more than 4-fold. The median level inside the smoking venues (117 μg/m3) was significantly higher than outside the venues (43 μg/m3), and significantly higher than the median level inside non-smoking venues (40 μg/m3). By contrast, particulate levels outside non-smoking venues (35 μg/m3) did not differ from the corresponding levels inside (40 μg/m3). To protect employees and the public from second-hand smoke exposure, policies prohibiting smoking in public places are needed in Gaza city.
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