—I appreciate Mr Robertson's comments and agree that findings from my review support his 1988 survey finding that ETS levels in restaurants are about 1.5 times higher than in offices. Since Healthy Buildings International contributed much of the important data I reviewed, these comments add valuable support to the finding of increased ETS exposure for restaurant workers.However, Robertson inaccurately interprets how I concluded that the 50% excess lung cancer risk among food service workers is most likely attributable to this increased ETS exposure. This conclusion was not based on the coincidental finding that the ratio of ETS levels in restaurants compared with offices and the ratio of lung cancer risk among food service workers compared with other workers were both about 1.5. Rather, it was based on my review of the possible explanations for the consistent finding of an elevated lung cancer risk among food service workers.
Siegel M. The Hazards of Involuntary Smoking in the Restaurant Workplace-Reply. JAMA. 1994;271(8):584-585. doi:10.1001/jama.1994.03510320024014