Passive Smoking Exposure and Risk for Irish Bar Staff

Ventilation failed to protect the health of bar staff. Carbon monoxide from environmental tobacco smoke (ETS-CO) measured in 14 bars in Galway, Ireland showed mean ETS-CO levels of 6.36 ppm (St. Dev. 4.36 ppm), with median levels at 6.00 ppm. Peak CO exceeded 63 p.p.m. in two premises. Passive smoking at the level of 6 ppm of ETS-CO for 30 minutes is known to induce as much dysfunction of the coronary circulation as that in smokers. Exposure to ETS-CO levels equivalent to 6 ppm for 40 years carries an estimated combined excess mortality risk from heart disease and lung cancer sufficient to cause the premature death of 1 out of 5 bar staff. Of the 78,000 workers in alcohol-licensed premises throughout Ireland in 1999, about 56,000 were employed in pubs. Assuming only half are employed fulltime, this translates into an estimated 150 deaths per year in the full-time pubworkers alone. INDEX TERMS Passive smoking, Environmental Tobacco smoke, Carbon monoxide, Risk, Health effects INTRODUCTION Passive smoking has been identified as a cause of cancer, cardiovascular disease and stroke in non-smokers with the risk of illness increasing with length of exposure (NCI, 1999; Bonita, et al., 1999 ). For catering workers, the increased risk of developing cancer has been estimated to be on average more than 50% that of the general public, with air measurements suggesting such workplaces to be as much as 6 times more polluted with environmental tobacco smoke (ETS) than offices (Siegel 1993). Bergman et al (1996), suggests waitresses to have the highest mortality rate for any occupational group in California, including four times the lung cancer rate. Eisner et al.(1998) studied the association between ETS exposure and respiratory symptoms in bartenders before and after California’s prohibition on smoking in all bars and taverns in 1998. After ETS exposure completely ceased, objective measures of pulmonary function in both smokers and nonsmokers showed a marked 5% to 7% improvement after only one month of smoke-free air. Eisner et al. (1998) conclude that establishment of smokefree bars and taverns was associated with improvement of respiratory health. In the only published European study of bar workers, Jarvis et al (1992) studied salivary cotinine in 42 non-smoking bar staff in 27 pubs in London and Birmingham. Jarvis et al (1992) reported a median salivary cotinine level of 7.4 ng/ml, similar to that found by Jarvis (1992) in English pubworkers. Repace (2002) estimated that, for an 8-hr ETS exposure 7.4 ng/ml equated to 6 ppm of ETS-CO. Otsuka et al. (2002) in a study of 28 healthy young nonsmoking women, found that inhaling 6 ppm of ETS-CO for 30 minutes induces dysfunction of the coronary circulation as much as that in smokers. In an earlier study of pubs, Jarvis et al (1983) measured ETS-CO levels of 13 ppm which they concluded were ‘towards the extreme end of acute natural exposure. * Contact author email: [email protected] Proceedings: Indoor Air 2002