Occupational exposure to second hand smoke and respiratory and sensory symptoms: A cross-sectional survey of hospital workers in Egypt

Objective

Exposure to Second Hand Smoke (SHS) has been associated with an increased risk of respiratory symptoms, upper and lower respiratory tract diseases and an increased risk of asthma and chronic obstructive pulmonary disease. The majority of cases of mortality and morbidity is attributable to exposure of adults to SHS and is related to cardiovascular diseases and lung cancer. In Egypt, comprehensive smoke-free laws exist, however, in many workplaces they are poorly enforced consequently exposing workers to the detrimental health hazards of SHS. We aimed at determination of workplace exposure to Second Hand Smoke (SHS) and its association with respiratory and sensory irritation symptoms in hospital workers in Port-said governorate in Egypt.

Material and Methods

A cross-sectional face to face survey was conducted by the use of a standardised questionnaire among 415 adult hospital workers; representing 50% of all employees (81% response rate); recruited from 4 randomly selected general hospitals in Port-said governorate in Egypt.

Results

All hospitals employees reported exposure to SHS — on average 1.5 (SD = 2.5) hours of exposure per day. After controlling for potential confounders, exposure to SHS at work was significantly associated with an increased risk of wheezes (OR = 1.14, p < 0.01), shortness of breath (OR = 1.17, p < 0.01), phlegm (OR = 1.23, p < 0.01), running and irritated nose (OR = 1.14, p < 0.01) as well as a sore, scratchy throat (OR = 1.23).

Conclusions

These findings point out that workplace exposure to SHS is evident in hospitals in Port-said governorate and that workers are adversely affected by exposure to it at work. This underlines the importance of rigorous enforcement of smoke-free policies to protect the workers’ health in Egypt.     

Bar workers' exposure to second-hand smoke: the effect of Scottish smoke-free legislation on occupational exposure

OBJECTIVES: To examine changes in bar workers' exposure to second-hand smoke (SHS) over a 12-month period before and after the introduction of Scottish smoke-free legislation on the 26 March 2006. METHODS: A total of 371 bar workers were recruited from 72 bars in three cities: Aberdeen, Glasgow, Edinburgh and small towns in two rural regions (Borders and Aberdeenshire). Prior to the introduction of the smoke-free legislation, we visited all participants in their place of work and collected saliva samples, for the measurement of cotinine, together with details on work patterns, self-reported exposure to SHS at work and non-work settings and smoking history. This was repeated 2 months post-legislation and again in the spring of 2007. In addition, we gathered full-shift personal exposure data from a small number of Aberdeen bar workers using a personal aerosol monitor for fine particulate matter (PM(2.5)) at the baseline and 2 months post-legislation visits. RESULTS: Data were available for 371 participants at baseline, 266 (72%) at 2 months post-legislation and 191 (51%) at the 1-year follow-up. The salivary cotinine level recorded in non-smokers fell from a geometric mean of 2.94 ng ml(-1) prior to introduction of the legislation to 0.41 ng ml(-1) at 1-year follow-up. Paired data showed a reduction in non-smokers' cotinine levels of 89% [95% confidence interval (CI) 85-92%]. For the whole cohort, the duration of workplace exposure to SHS within the last 7 days fell from 28.5 to 0.83 h, though some bar workers continued to report substantial SHS exposures at work despite the legislation. Smokers also demonstrated reductions in their salivary cotinine levels of 12% (95% CI 3-20%). This may reflect both the reduction in SHS exposure at work and falls in active cigarette smoking in this group. In a small sub-sample of bar workers, full-shift personal exposure to PM(2.5), a marker of SHS concentrations, showed average reductions of 86% between baseline and 2 months after implementation of the legislation. CONCLUSIONS: Most bar workers have experienced very large reductions in their workplace exposure to SHS as a result of smoke-free legislation in Scotland. These reductions have been sustained over a period of 1 year.     

Workplace Secondhand Smoke Exposure in the U.S. Trucking Industry

Background

Although the smoking rate in the United States is declining because of an increase of smoke-free laws, among blue-collar workers it remains higher than that among many other occupational groups.

Objectives

We evaluated the factors influencing workplace secondhand smoke (SHS) exposures in the U.S. unionized trucking industry.

Methods

From 2003 through 2005, we measured workplace SHS exposure among 203 nonsmoking and 61 smoking workers in 25 trucking terminals. Workers in several job groups wore personal vapor-phase nicotine samplers on their lapels for two consecutive work shifts and completed a workplace SHS exposure questionnaire at the end of the personal sampling.

Results

Median nicotine level was 0.87 μg/m³ for nonsmokers and 5.96 μg/m³ for smokers. As expected, smokers experienced higher SHS exposure duration and intensity than did nonsmokers. For nonsmokers, multiple regression analyses indicated that self-reported exposure duration combined with intensity, lack of a smoking policy as reported by workers, having a nondriver job, and lower educational level were independently associated with elevated personal nicotine levels (model R² = 0.52). Nondriver job and amount of active smoking were associated with elevated personal nicotine level in smokers, but self-reported exposure, lack of a smoking policy, and lower educational level were not.

Conclusions

Despite movements toward smoke-free laws, this population of blue-collar workers was still exposed to workplace SHS as recently as 2005. The perceived (reported by the workers), rather than the official (reported by the terminal managers), smoking policy was associated with measured SHS exposure levels among the nonsmokers. Job duties and educational level might also be important predictors of workplace SHS exposure.     

Effects of a smoke-free law on hair nicotine and respiratory symptoms of restaurant and bar workers

OBJECTIVE: Bar and restaurant workers' exposure to secondhand smoke (SHS) was compared before and 3 and 6 months after implementation of a smoke-free ordinance. METHODS: Hair nicotine, self-reported exposure to SHS, and respiratory symptoms were assessed on 105 smoking and nonsmoking workers from randomly selected establishments in Lexington, Kentucky. Thirty-eight percent were current smokers with more than half smoking 10 or fewer cigarettes per day. Workers provided a hair sample at baseline and at the 3-month interview. RESULTS: There was a significant decline in hair nicotine 3 months postlaw when controlling for cigarettes smoked per day. Bar workers showed a significantly larger decline in hair nicotine compared with restaurant workers. The only significant decline in SHS exposure was in the workplace and other public places. Regardless of smoking status, respiratory symptoms declined significantly postlaw. CONCLUSIONS: Hospitality workers demonstrated significant declines in hair nicotine and respiratory symptoms after the law. Comprehensive smoke-free laws can provide the greatest protection to bar workers who are the most vulnerable to SHS exposure at work.     

Exposure to secondhand smoke at work: a survey of members of the Australian Liquor, Hospitality and Miscellaneous Workers Union

OBJECTIVE: To measure workers' attitudes towards and experiences of exposure to secondhand smoke (SHS) in the workplace. METHOD: A stratified random sample of members from the Victorian Branch of the Australian Liquor, Hospitality and Miscellaneous Workers Union (LHMU) was interviewed by telephone in September 2001. Of the 1,078 respondents surveyed (77% response rate), hospitality workers comprised 49% of the sample, while the remainder comprised community services, property services and manufacturing workers. RESULTS: Overall, 54% of union members were employed in workplaces that did not completely ban smoking and 34% reported being exposed to SHS during their typical working day. Workplaces with total smoking bans had a high level of compliance with these restrictions, with no workers in these settings indicating exposure to SHS at work. Compared with other workers, hospitality workers reported working in environments that had more permissive smoking policies. Consistent with this, 56% of hospitality workers said they were exposed to SHS during a typical day at work compared with 11% of other workers. Overall, 79% of workers expressed concern about exposure to SHS, including 66% of smokers. Compared with other workers, hospitality workers reported a higher level of concern about exposure to SHS at work. CONCLUSION: These findings provide evidence that many workers, and especially those employed in the hospitality sector, are exposed to SHS during their working day and are concerned about the effects of such exposure on their health. IMPLICATIONS: These findings indicate that workplace smoke-free policies are effective in reducing worker exposure to SHS and demonstrate support for the extension of smoke-free policies to hospitality workplaces.     

Smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness for smoke-free air in the workplace: a study from the Balkans

Objective

Identify the psychosocial variables that predict smokers’ compliance with smoke-free policies at work, and non-smokers’ assertiveness for smoke-free rights in Greek and Bulgarian workplaces.

Methods

Data were collected from employees in Greece and Bulgaria. The main outcome measures were smokers’ compliance with smoke-free policies, and non-smokers’ assertiveness intentions. Demographic variables, tobacco use and dependence, as well as beliefs about second-hand smoke (SHS) exposure and smoking at work were also assessed.

Results

Regression analyses showed that smokers’ compliance with smoke-free policies was predicted by age, perceived health risks of smoking, and beliefs related to the benefits of smoking at work. Non-smokers’ assertiveness was predicted by annoyance from exposure to SHS at work, and assertiveness-related social cognitions (e.g., attitudes, social norms, and self-efficacy).

Conclusions

Interventions to promote support for tobacco control policies at work in Greece and Bulgaria may benefit from targeting smokers’ beliefs about the actual effects of tobacco use on health and job performance. Accordingly, efforts to promote non-smokers assertiveness should build stronger assertiveness-related attitudes, convey anti-smoking normative messages, and strengthen self-efficacy skills.     

Secondhand smoke exposure in young people and parental rules against smoking at home and in the car

Objectives

Secondhand smoke (SHS) exposure is an important cause of morbidity in children. We assessed the impact of family rules about smoking in the home and car on SHS exposure prevalence in students in grades six to 12.

Methods

We studied never-smoking young people (n=1,698) in the random sample cross-sectional South Carolina Youth Tobacco Survey, a 2006 survey of middle and high school students in South Carolina.

Results

Overall, 40% of the students reported SHS exposure in either the home or car in the past week; among these, 85% reported exposure in cars. Subsequent analyses focused on students who lived with a smoker (n=602). Compared with those whose families prohibited smoking in the home or car, SHS exposure prevalence was 30% (p<0.0001) higher for households with smoke-free rules for only one place (home or car) and 36% (p<0.0001) higher for households with no rules. Compared with students from households with strict rules, SHS exposure prevalence was 48% greater (p<0.0001) among those with only partial rules against smoking in the home or car, and 55% (p<0.0001) greater among those from households with no rules. Similarly, compared with students with strict family rules for home and car that were adhered to, SHS exposure prevalence was significantly higher (p<0.0001) among students when only one or no rules were followed.

Conclusions

Young people from families that made and enforced strong rules against smoking in homes and cars were much less likely to report SHS exposure. Parents would be wise to endorse and enforce strong smoke-free policies for both homes and cars.Secondhand smoke (SHS) exposure is associated with many adverse health effects on children including sudden infant death syndrome, respiratory infections, asthma, and otitis media.¹ The established negative effects of SHS on child health have led the American Academy of Pediatrics^2,3 and the American Medical Association⁴ to urge pediatricians and physicians in other medical specialties to assist parents in protecting their children from tobacco smoke.The two places where children may be at greatest risk of SHS exposure are family homes and cars. One way that parents can protect their children from SHS exposure is to make rules prohibiting smoking in these places. Thus far, studies of rulemaking have tended to focus on SHS exposure in homes,^5–14 with results suggesting that establishing strong smoke-free rules in homes is a promising strategy to reduce children''s household exposure to SHS.Given the concentrated pollution levels found within the small enclosed area of a car,¹⁵ rules to protect children against SHS exposure in cars may be important. The study of children''s exposure to SHS in cars is a timely topic given that some states, such as Arkansas, California, Louisiana, and Maine, have enacted legislation against smoking in the car when children are present. However, cars have received relatively scant attention from researchers as a source of SHS exposure. Little is known about the prevalence of SHS exposure in cars, let alone whether rules prohibiting smoking in cars are beneficial in reducing SHS exposure in young people. Previous studies to report on the relationship between rules against smoking in the car and SHS exposure generated promising findings, indicating that smoking bans in cars were associated with a sevenfold decrease in children''s SHS exposure¹³ and significant reductions in salivary cotinine levels, a biomarker of SHS exposure.¹⁶Family rules concerning smoke-free homes and cars can be effective toward establishing a smoke-free environment only to the extent that such rules are enforced. Few studies have considered the impact of both rulemaking and rule enforcement on SHS exposure. The only previous report to explore how completeness of smoke-free rules affects SHS exposure was not a study of child SHS exposure.⁵ To address these current gaps in the evidence, we assessed the influence on children''s SHS exposure of family rulemaking and rule enforcement related to smoking in the home and in the car.     

Attitudes towards second hand smoke amongst a highly exposed workforce: survey of London casino workers

STUDY OBJECTIVE: To examine knowledge, attitudes and experiences of London casino workers regarding exposure to second hand smoke (SHS) in the workplace. DESIGN: Postal survey of 1568 London casino workers in 25 casinos who were members of the TGWU or GMB Trade Unions. MAIN RESULTS: Of the workers, 559 responded to the survey (36% response), 22% of whom were current smokers. Of the respondents, 71% report being nearly always exposed to heavy levels of SHS at work, and most (65%) want all working areas in their casino to be smoke-free. The majority (78%) are bothered by SHS at work, while 91% have wanted to move away from where they are working because of it. Fifty-seven per cent believe their health has suffered as a result of SHS. Of the workers who smoke at work, 59% believe that they would try to quit smoking if no one was allowed to smoke in the casino. CONCLUSIONS: The majority of responders are bothered by SHS, and many are concerned about the health impacts. Most want all working areas in their casino to be smoke-free. Despite difficulties in generalizing from this limited sample, these findings add weight to the argument that the legislation on smoking in public places in England should encompass all workplaces, without exemption.     

Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke — United States, 1999–2012

Background

Exposure to secondhand smoke (SHS) from burning tobacco causes disease and death in nonsmoking children and adults. No risk-free level of SHS exposure exists.

Methods

National Health and Nutrition Examination Survey (NHANES) data from 1999–2012 were used to examine SHS exposure among the nonsmoking population aged ≥3 years. SHS exposure among nonsmokers was defined as a serum cotinine level (a metabolite of nicotine) of 0.05–10 ng/mL. SHS exposure was assessed overall and by age, sex, race/ethnicity, poverty level, education, and whether the respondent owned or rented their housing.

Results

Prevalence of SHS exposure in nonsmokers declined from 52.5% during 1999–2000 to 25.3% during 2011–2012. During this period, declines were observed for all population subgroups, but disparities exist. During 2011–2012, SHS was highest among: children aged 3–11 years (40.6%), non-Hispanic blacks (46.8%), persons living below the poverty level (43.2%), and persons living in rental housing (36.8%). Among children aged 3–11 years, 67.9% of non-Hispanic blacks were exposed to SHS compared with 37.2% of non-Hispanic whites and 29.9% of Mexican Americans.

Conclusion

Overall, SHS exposure in the United States has been reduced by half since 1999–2000. However, 58 million persons were still exposed to SHS during 2011–2012, and exposure remains higher among children, non-Hispanic blacks, those living in poverty, and those who rent their housing.

Implications for Public Health Practice

Eliminating smoking in indoor spaces fully protects nonsmokers from SHS exposure; separating smokers from nonsmokers, cleaning the air and ventilating buildings cannot completely eliminate exposure. Continued efforts to promote implementation of comprehensive statewide laws prohibiting smoking in workplaces and public places, smoke-free policies in multiunit housing, and voluntary smoke-free home and vehicle rules are critical to protect nonsmokers from this preventable health hazard in the places they live, work, and gather.     

Comprehensive US Statewide Smoke-Free Indoor Air Legislation and Secondhand Smoke Exposure,Asthma Prevalence,and Related Doctor Visits: 2007–2011

Objectives. We evaluated the impact of comprehensive statewide smoke-free indoor air laws on secondhand smoke (SHS) exposure, asthma prevalence, and asthma-related doctor visits.Methods. We used the 2007–2011 Behavioral Risk Factor Surveillance System data sets. We employed a paired t test to determine whether comprehensive statewide smoke-free indoor air laws reduced SHS exposure. We performed weighted logistic and Poisson regressions to obtain likelihood of reporting asthma symptoms and incidence rate ratio (IRR) of doctor visits owing to severe asthma symptoms.Results. After such laws were enacted, people in states with comprehensive smoke-free indoor air laws had a lower level of SHS exposure (P < .01), decreased odds of reporting current asthma symptoms (adjusted odds ratio [AOR] = 0.57; 95% confidence interval [CI] = 0.51, 0.63), and a decreased frequency of doctor’s visits owing to severe asthma symptoms (IRR = 0.80; 95% CI = 0.69, 0.92) than did their counterparts in fully adjusted models.Conclusions. Comprehensive statewide smoke-free indoor air laws appear to be effective in reducing SHS exposure and improving asthma outcomes. Regulations requiring smoke-free indoor environments and public areas are beneficial, and smoke-free indoor air laws should be enforced in all states.There is an increasing body of literature indicating that secondhand smoke (SHS) exposure has an adverse effect on health. SHS appears to be associated with a high risk of heart disease,1 acute stroke,2 and lung cancer.3 As the harmful consequences of SHS exposure have become increasingly recognized, the US federal government is urging state governments to establish policies to eliminate exposure to SHS. Accordingly, many states have enacted comprehensive statewide smoke-free indoor air laws to improve Americans’ public health by eliminating SHS exposure in 3 indoor locations: worksites, restaurants, and bars. However, not all states have comprehensive smoke-free laws that require the 3 locations to be smoke-free. In 2014, it was reported that only 26 states and the District of Columbia had comprehensive smoke-free laws, whereas 5 states had smoking bans in 2 of the 3 locations, 5 other states had smoking bans in 1 of the locations, and 14 states had no smoking restrictions, designated areas, or separate ventilation laws (

Observations from behind the bar: changing patrons' behaviours in response to smoke-free legislation in Scotland

Background  

"Smoke-Free" legislation prohibiting smoking in all enclosed public places was introduced in March 2006. This qualitative study presents insights from bar workers about their observations of the changing social bar environment, changing patrons' behaviours and challenges bar workers have faced in managing smoke-free legislation.     

Effect of smoke-free patio policy of restaurants and bars on exposure to second-hand smoke

ObjectiveWhile there is increasing support for restricting smoking in restaurant and bar patios, there is limited evidence on the effectiveness of this policy. This study examined the effect of smoke-free patio policy of restaurants and bars on adult second-hand smoke (SHS) exposure.MethodsData were drawn from the 2005–2012 Canadian Tobacco Use Monitoring Survey (n = 89,743), a repeated cross-sectional survey of youth and adult. Regression analysis, a quasi-experimental design was used to examine the effect of provincial smoke-free patio policy on self-reported exposure to SHS.ResultsAnalyses suggest that exposure to SHS on patios of bars and restaurants declined following the adoption of provincial smoke-free patio policy. Relative to pre-policy SHS exposure, regression results showed a reduction in the probability of SHS exposure of up to 25% in Alberta. Similarly, in Nova Scotia, the probability of SHS exposure declined by up to 21%. Analyses stratified by smoking status found similar significant effect on both smokers and non-smokers.ConclusionsFindings suggest that provincial patio smoking ban on bars and restaurants had the intended effect of protecting non-smokers from SHS exposure. This study is consistent with a large body of evidence showing that a strong smoke-free legislation is an effective public health measure.     

Before and after study of bar workers' perceptions of the impact of smoke-free workplace legislation in the Republic of Ireland

Background  

Objectives : To compare support for, and perceptions of, the impacts of smoke-free workplace legislation among bar workers in the Republic of Ireland (ROI) pre- and post-implementation, and to identify predictors of support for the legislation.     

Association between exposure to workplace secondhand smoke and reported respiratory and sensory symptoms: cross-sectional study

The purpose of this work was to assess the relation between exposure to secondhand smoke (SHS) at work and reported respiratory and sensory symptoms. A cross-sectional telephone survey of 382 nonsmoking indoor workers in Victoria, Australia was used. After controlling for potential confounders, exposure to SHS at work for part of the day was significantly associated with an increased risk of wheeze (OR = 4.26), frequent cough (OR = 2.26), sore eyes (OR = 3.77), and sore throat (OR = 2.70). Among workers who had not experienced a cold in the past 4 weeks, we found strong dose-response relationships between increasing levels of exposure to SHS at work and morning cough, frequent cough, sore eyes and sore throat, and a positive relationship for wheeze. These findings provide compelling evidence that nonsmoking indoor workers are adversely affected by exposure to SHS at work and underline the importance of workplace smoke-free policies in protecting the health of workers.     

Total prohibition of smoking but not partial restriction effectively reduced exposure to tobacco smoke among restaurant workers in Finland

Objectives

To assess work-related exposure to tobacco smoke in Finnish restaurants, a series of nationwide questionnaire surveys were conducted among restaurant workers and the levels of indoor air nicotine concentrations were measured in restaurants. The survey aimed to evaluate the impact of the smoke-free legislation in general and in particular after the total smoking ban launched in 2007.

Materials and Methods

In 2003–2010, four national questionnaire surveys were conducted among restaurant workers and the concentration of nicotine in indoor air was measured in different types of restaurants, bars and nightclubs.

Results

Between 2003 and 2010, the proportion of restaurant workers reporting occupational exposure to tobacco smoke dropped from 59% to 11%. Among pub workers, the decrease was from 97% to 18% and in workers of dining restaurants from 49% to 10%, respectively. The median concentration of nicotine in indoor air of all restaurants decreased from 11.7 μg/m³ to 0.1 μg/m³. The most significant decrease was detected in pubs where the decrease was from 16.1 μg/m³ to 0.1 μg/m³. Among all restaurant workers, in 2003–2010 the prevalence of daily smokers was reduced from 39% to 31% in men and from 35% to 25% in women.

Conclusion

Total prohibition of smoking but not partial restriction in restaurants was effective in reducing work-related exposure to tobacco smoke. Strict tobacco legislation may partly be associated with the significant decrease of daily smoking prevalence among restaurant workers.     

Smoke-free policies and non-smokers’ reactions to SHS exposure in small and medium enterprises

Introduction

Non-smoker employees can significantly improve the existing smoke-free policies in the workplace by asserting their right for smoke-free air and confronting smoker colleagues. The aim of the study was to assess the psychological and social drivers of non-smokers’ readiness to assert their right for smoke-free air in the workplace.

Materials and Methods

Twenty-six small-and-medium enterprises (SME) with diverse background were randomly selected, and 284 employees agreed to participate in the study. Our study focused on the responses of 85 non-smokers (M age = 34 years, SD = 7.98, 84.2% worked in indoor offices). A cross-sectional design was used and participants completed a structured anonymous questionnaire assessing background and demographic characteristics, and psychosocial predictors of assertiveness intentions.

Results

Although more than half of non-smokers reported they were often/almost always bothered by exposure to SHS, roughly one third of them reported having asked their colleagues not to smoke at work. Regression analysis showed that the effects of distal predictors (i.e. annoyance due to SHS exposure) were mediated by past behaviour, attitudes (protection motivation beliefs), social norms, and self-efficacy.

Conclusions

Health beliefs related to SHS exposure, and concerns about workplace health and job performance, social norms and self-efficacy can increase the assertiveness of non-smokers in workplace settings. Related campaigns should focus on communicating normative messages and self-efficacy training to empower non-smoker employees to act assertively towards protecting their smoke-free rights.     

餐厅服务人员被动吸烟现状及对餐厅禁烟立法态度的调查

目的了解上海市餐厅服务人员的被动吸烟现状、对餐厅禁烟立法的态度和对餐厅实施禁烟政策后经营状况的预测,为本市餐厅禁烟立法提供参考依据。方法采用分层随机抽样方法,在上海市黄浦区抽样5类〔大型中餐厅、中小型中餐厅、休闲西餐厅、快餐厅及咖啡厅(酒吧)〕共100家餐厅的981名服务人员进行一对一问卷调查。结果67.1%的餐厅服务人员在工作场所有被动吸烟情况,平均每天被动吸烟时间为3.4±2.6小时,其中酒吧最为严重,普遍实施禁烟规定的快餐厅相对较好,31.7%的人员会在顾客吸烟时主动予以劝阻;74.1%的被调查者支持通过立法在上海所有餐厅完全禁烟;61.6%的被调查者认为餐厅实施禁烟不会对经营情况产生负面影响。结论上海市中餐厅、咖啡厅(酒吧)服务人员的被动吸烟情况比较严重,餐厅禁烟立法普遍获得员工的认同。今后需要对餐饮业员工加强吸烟危害的认知并提高法律意识。     

Secondhand smoke exposure and respiratory symptoms among casino, club, and office workers in Victoria, Australia

OBJECTIVE: To examine the association between smoke-free policies, exposure to secondhand smoke (SHS) at work, and self-reported respiratory and sensory symptoms of workers. METHOD: Ninety-one nonsmoking workers recruited from three workplaces with varying smoking policies completed a telephone-administered questionnaire and provided saliva samples (before and after usual work shift) for cotinine analysis. RESULTS: Mean before-after shift saliva cotinine per hour worked was significantly higher among club (0.42 ng/mL/hr worked) than casino workers (0.18 ng/mL/hr worked) (P < 0.001), club than office workers (0.03 ng/mL/hr worked) (P < 0.001), and casino than office workers (P < 0.001). Casino and club workers reported similar levels of respiratory morbidity and were more likely to have sore eyes (odds ratio [OR] = 5.5, P < 0.01) and a sore throat (OR = 4.3, P < 0.05) compared with office employees. CONCLUSION: Air-conditioning interventions reduce, but fail to eliminate, exposure of hospitality workers to SHS. Such exposure is associated with measurable increases in the risk of respiratory symptoms.     

The relationship between upper extremity musculoskeletal symptoms attributed to work and risk factors in office workers

Purpose  

Office workers are exposed to various individual, work-related and psychosocial factors during work that have been associated with the development of musculoskeletal symptoms. There is an increasing in evidence that suggests that musculoskeletal symptoms in the upper extremity are very common among office workers. The aim of this study was to examine the effects of individual, work-related physical and psychosocial factors on the prevalence of shoulder, elbow and wrist/hand symptoms attributed to work in office workers.