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V. Control of Indoor Air Pollutants 389
Environmental tobacco smoke (ETS) represents the exposure to tobacco
smoke by individuals other than the smoker. For decades, the U.S. Surgeon
General has indicated that smoking is a cause of lung cancer and cardiovas-
cular disease for individuals who smoke. The U.S. Environmental Protec-
tion Agency has also concluded that ETS is a lung carcinogen for others
breathing it.
The presence of biological contaminants gained widespread recognition
with the outbreak of Legionnaires' disease in Philadelphia, Pennsylvania
in 1976. In that year 221 persons attending a convention of Legionnaires
developed pneumonia symptoms and 34 subsequently died. The agent, a
bacterium later named Legionella pneumophila, was found in the cooling
tower of the hotel's air-conditioning system. This bacterium has subse-
quently been responsible for other outbreaks of Legionnaires' disease. The
bacteria in water supplies may be eliminated by suitable treatment proce-
dures. Legionnella represents one of many types of biological agents which
can cause allergic reactions and illness in the indoor environment.
One of the more difficult challenges remaining is the characterization of
"sick building" syndrome. On numerous occasions, some employees in
certain office buildings or other workplaces have developed a combination
of symptoms including respiratory problems, dryness of the eyes, nose,
and throat, headaches, and other nonspecific complaints. In such situations
a substantial portion of the workers may exhibit these symptoms, which
decrease in severity or stop when the worker is away from the building
over the weekend or for longer periods. Investigations into the cause of
these symptoms sometimes provide explanations, uncover ventilation
problems, or identify an irritant gas. But many of these problem buildings
are very difficult to understand and additional research is necessary to
understand the cause-and-effect relationships.
V. CONTROL OF INDOOR AIR POLLUTANTS
The control and regulation of indoor air quality are influenced by individ-
ual property rights and a complicated mosaic of federal, state, and local
government jurisdiction with conflicts, overlaps, and gaps in addressing
these issues. Table 23-3 shows a large number of agencies and departments
involved in indoor air quality control efforts at the federal level.
Government can institute certain laws and regulations for the citizens'
well-being. Environmental and occupational examples abound, such as
clean water and air legislation and workplace safety and health regulations.
As the extension of this role into the home occurs, implementation and
enforcement become more problematic. Examples of proactive regulatory
approaches are building codes, zoning, consumer product standards, and
safety requirements. Table 23-4 shows what various parties, from the indi-

