TABLE III. (Cont'd.) Cases of specified notifiable diseases, United States, weeks ending April 16, 1988 and April 18, 1987 (15th Week)

*For measles only, imported cases includes both out-of-state and international importations. N: Not notifiable U: Unavailable *International Out-of-state

Syphilis (Civilian)

TABLE III. (Cont'd.) Cases of specified notifiable diseases, United States, weeks ending April 16, 1988 and April 18, 1987 (15th Week)

remia

Fever

Syndrome

(RMSF)

Mortality data in this table are voluntarily reported from 121 cities in the United states, most of which have populations of 100,000 or more. A death is reported by the place of its occurrence and by the week that the death certificate was filed. Fetal deaths are not included.

**Pneumonia and influenza.

†Because of changes in reporting methods in these 3 Pennsylvania cities, these numbers are partial counts for the current week. Complete counts will be available in 4 to 6 weeks.

††Total includes unknown ages.

§ Data not available. Figures are estimates based on average of past available 4 weeks.

10. McEvoy M, Porter K, Mortimer P, Simmons N, Shanson D. Prospective study of clinical, laboratory, and ancillary staff with accidental exposures to blood or body fluids from patients infected with HIV. Br Med J 1987;294:1595-7.

11. Health and Welfare Canada. National surveillance program on occupational exposure to HIV among health-care workers in Canada. Canada Dis Weekly Rep 1987;13-37:163-6.

12. Anonymous. Needlestick transmission of HTLV-III from a patient infected in Africa. Lancet 1984;2:1376-7.

13. Oksenhendler E, Harzic M, Le Roux JM, Rabian C, Clauvel JP. HIV infection with seroconversion after a superficial needlestick injury to the finger [Letter]. N Engl J Med 1986; 315:582.

14. Neisson-Vernant C, Arfi S, Mathez D, Leibowitch J, Monplaisir N. Needlestick HIV seroconversion in a nurse [Letter]. Lancet 1986;2:814.

15. Weiss SH, Goedert JJ, Gartner S, et al. Risk of human immunodeficiency virus (HIV-1) infection among laboratory workers. Science 1988;239:68-71.

16. Centers for Disease Control. 1988 agent summary statement for human immunodeficiency virus and report on laboratory-acquired infection with human immunodeficiency virus. MMWR 1988;37(suppl S-4).

17. Centers for Disease Control. Apparent transmission of human T-lymphotrophic virus type III/lymphadenopathy-associated virus from a child to a mother providing health care. MMWR 1986;35:76-9.

18. Centers for Disease Control. Update: human immunodeficiency virus infections in healthcare workers exposed to blood of infected patients. MMWR 1987;36:285-9.

19. Ramsey KM, Smith EN, Reinarz JA. Prospective evaluation of 44 health care workers exposed to human immunodeficiency virus-1, with one seroconversion [Abstract]. Clin Res 1988;36:1A.

20. Gioannini P, Sinicco A, Cariti G, Lucchini A, Paggi G, Giachino O. HIV infection acquired by a nurse. Eur J Epidemiol 1988;4:119-20.

21. Grint P, McEvoy M. Two associated cases of the acquired immune deficiency syndrome (AIDS). PHLS Commun Dis Rep 1985;42:4.

22. Klein RS, Phelan JA, Freeman K, et al. Low occupational risk of human immunodeficiency virus infection among dental professionals. N Engl J Med 1988;318:86-90.

23. Ponce de León RS, Sánchez-Mejorada G, Zaidi-Jacobson M. AIDS in a blood bank technician in Mexico City [Letter]. Infect Control Hosp Epidemiol 1988;9:101-2.

24. US Department of Labor, US Department of Health and Human Services. Joint Advisory Notice: protection against occupational exposure to hepatitis B virus (HBV) and human immunodeficiency virus (HIV). Federal Register 1987;52:41818-24.

In December 1986, the 18th Surgeon General's report on smoking and health was released (1). This report, "The Health Consequences of Involuntary Smoking," described the health effects of exposure to environmental tobacco smoke (ETS). Its major conclusions were 1) that involuntary (or passive) smoking is a cause of disease, including lung cancer, in healthy nonsmokers, and 2) that children of parents who smoke have a higher frequency of respiratory infections, such as pneumonia and bronchitis, than do children of nonsmoking parents.

To evaluate beliefs, attitudes, and exposure related to involuntary smoking among U.S. residents, questions about ETS were included in the 1986 Adult Use of Tobacco Survey, which was conducted by the Office on Smoking and Health, Center for Health Promotion and Education, CDC. Data for this telephone survey were collected from a national probability sample of 13,031 adults (17 years of age) representing the noninstitutionalized, civilian U.S. population (2). Respondents were asked if they thought ETS was harmful to health in general and to their own health specifically and

if they were annoyed by exposure to ETS. In addition, working respondents (n = 8,600) were asked about the extent of their exposure to ETS at work and about policies that restrict smoking at their worksites. Finally, respondents were asked whether they would choose smoking or nonsmoking sections in planes, restaurants, and other public places when a choice was available.

Eighty-eight percent of all respondents (93% of never smokers, 89% of former smokers) considered ETS to be generally harmful to health. In addition, 79% of current smokers felt that ETS was generally harmful; of these, 75% reported that ETS was "very harmful" or "somewhat harmful," as opposed to "slightly harmful" or "not harmful." Sixty-nine percent of all respondents (62% of former smokers, 74% of never smokers) considered ETS to be harmful to their own health.* Seventy-one percent of all respondents (43% of current smokers, 74% of former smokers, and 85% of never smokers) were annoyed by the cigarette smoke of others.

Among working respondents, 42% reported restrictions on smoking in their workplaces; 3% reported a total ban on smoking; and 55% reported no restrictions. Sixty-five percent of respondents who reported no restrictions against smoking in their worksites are at least somewhat exposed to ETS. Of these, 14% reported a "very smoky" worksite. Fifty-three percent of respondents who worked in environments with restrictive smoking policies reported exposure to ETS. Of these, 11% reported that their worksite is "very smoky." Even among the 2.5% of respondents reporting a total ban on smoking in the workplace, 21% still reported being at least somewhat exposed to ETS at work.

If given a choice, 61% of all respondents choose nonsmoking seating in airplanes, restaurants, and other public places. Most former smokers (69%) and never smokers (82%) choose nonsmoking sections, as do 14% of current smokers.

Reported by: Office on Smoking and Health, Center for Health Promotion and Education, CDC. Editorial Note: These data indicate that a large percentage of smokers and nonsmokers regard ETS as a health hazard. In addition, a majority of nonsmokers and almost half of current smokers are annoyed by ETS. These results represent substantial changes in beliefs and attitudes since the 1970s. For example, a national opinion

conducted by the Roper Organization in 1978 1978 for the Tobacco Institute (3) showed that 58% of respondents (40% of smokers, 69% of nonsmokers) considered passive smoking hazardous. The Roper survey also found that 60% of nonsmokers and 5% of smokers were annoyed by being near a person who was smoking.

In 1986, 36% of a random sample of the members of the American Society for Personnel Administration (ASPA)* reported that their worksites had restrictive smoking policies (4). A similar percentage of respondents to the Adult Use of Tobacco Survey reported such policies. In a second survey of ASPA members in 1987, the percentage of members reporting a restrictive smoking policy had increased to 54% (4). Data from the Adult Use of Tobacco Survey suggest that these policies reduce, but do not eliminate, ETS exposure in the workplace. In fact, the 1986 Surgeon General's report concluded that simply separating smokers and nonsmokers within the same airspace is not sufficient to prevent exposure of nonsmokers to ETS (1).

*Current smokers were not asked this question.

*ASPA is a society of personnel executives representing manufacturing and nonmanufacturing firms and nonbusiness organizations such as hospitals, educational institutions, and government agencies.