The CDC, in its first study comparing air quality at airports with and without smoke-fee policies, finds that pollution levels adjacent (within a meter or 39 inches) to smoking areas are five times higher than levels at airports that entirely ban smoking. Levels inside smoking areas, including bars and restaurants, were 23 times higher than at smoke-free airports.

“Significant secondhand smoke exposure is going on. …These are unnecessary dangers for airport employees and passengers,” says Tim McAfee, director of CDC’s Office on Smoking and Health. He says the report shows smoking areas are not ventilated enough, adding that a ban on all indoor smoking is the “only effective protection” against secondhand smoke.

McAfee says there’s “no safe level” of secondhand smoke exposure. The CDC says it causes heart disease and lung cancer in non-smoking adults and is a known cause of sudden infant death syndrome or SIDS, respiratory problems, ear infections and asthma attacks in infants and children. It says even brief exposure can trigger acute cardiac events such as heart attack.

Although federal laws ban smoking on all U.S. domestic and international commercial airline flights, they do not require airports to be smoke-free. Most airports with designated smoking areas are located in states without smoke-free laws or are exempted from such laws.

Five of the 29 largest U.S. airports, accounting for about 15% of U.S. air travel last year, allow smoking in designated public areas: Hartsfield-Jackson Atlanta International Airport, Washington Dulles International Airport, McCarran International Airport in Las Vegas, Denver International Airport and Salt Lake City International Airport.

Many passengers surveyed say they want smoking areas, says Kimberly Gibbs, spokeswoman for Dulles International Airport. Because the airport has many international flights, she says passengers switching gates cannot simply step outside for a smoke without having to go through security again. She says police patrol the airport to ensure smoking occurs only in designated lounges, situated in three of the six concourses.

Last month, the CDC measured the levels of particulate matter — an indicator of secondhand smoke — in the smoking and non-smoking areas of the five airports and compared them to the overall levels at four smoke-free hub counterparts: Chicago O’Hare International, Fort Lauderdale-Hollywood International, Orlando International and Phoenix Sky Harbor International.

Co-author Brian King, a CDC epidemiologist, says the findings are consistent with those from other studies the agency has done on secondhand smoke exposure in indoor smoking areas. Yet with the airports, he says he was surprised by the amount of air leaking from smoking rooms into adjacent areas.

The report found that the passenger boarding areas in the five airports that allow smoking have a slightly higher, but statistically insignificant, level of pollution than that found overall at smoke-free airports.

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The findings, released by the World Health Organisation on Tuesday, are from a tobacco survey conducted in China in 2010 by the centers for disease control and prevention in China, the United States and the WHO.

Around 100,000 people die from exposure to second-hand smoke in China each year, in addition to an estimated 1 million people who die from direct tobacco consumption.

Women in rural areas of China were more affected, with almost 3 in every 4 exposed to second-hand smoke at home, compared to just over half in urban areas.

“There is no safe level of exposure to tobacco smoke. Creating 100 percent smoke-free environments is the only way to protect people from the harmful effects of second-hand tobacco smoke,” said Michael O’Leary, WHO representative in China.

“Tobacco use and second-hand smoke exposure in reproductive-aged women can cause adverse reproductive health outcomes, such as pregnancy complications, fetal growth restriction, preterm delivery, stillbirths, and infant death.”

About a quarter of China’s 1.3 billion people are smokers, or about as many people as there are in the United States. But the country is gradually becoming more aware of this public health problem.

The Ministry of Health warned in May that more than 3 million Chinese would die of smoking-related illnesses annually by 2050 if nothing is done to curb this habit.

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Researchers from the University of Athens, the Hellenic Cancer Society and the Harvard School of Public Health had 15 healthy study participants go inside a chamber meant to simulate a bar or car filled with secondhand smoke particulates for 20 minutes to see how their breathing was impaired.

In just that short amount of time, air flow through the participants’ airways was impeded.

“The observed short-term effects of secondhand smoke tell us that even a short exposure is indeed harmful for normal airways,” study researcher Dr. Panagiotis Behrakis, M.D., FCCP, of the University of Athens, said in a statement.

The new findings were presented at the annual meeting of the American College of Chest Physicians; because the study has yet to be published in a peer-reviewed journal, findings should be regarded as preliminary.

Similarly, a study published in 2007 in the American Journal of Public Healthshowed that cancer-causing NNK — a compound that comes from the smoke of cigarettes — builds up by 6 percent every hour in bar- and restaurant-workers who are exposed to secondhand smoke during their night shifts, TIME reported.

“We were somewhat surprised by the immediacy of the effect and the fact that we could measure the average hourly increase,” study researcher Michael Stark, principal investigator at the Mulmomah County Health Department in Oregon, told TIME.

Earlier this year, a study in theAmerican Journal of Public Healthshowed just how many lives secondhand smoke claims in the U.S. each year: 42,000, Livescience reported.

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