Occupational exposure of non-smoking restaurant personnel to environmental tobacco smoke in Finland

BACKGROUND: Environmental tobacco smoke (ETS) exposure levels in different restaurant types in Finland were assessed before the National Tobacco Act restricting smoking in restaurants was activated. METHODS: Exposure to ETS was determined by measuring nicotine in the breathing zone of non-smoking restaurant workers and by quantification of the nicotine metabolites cotinine and 3-hydroxycotinine in the urine of these workers during one whole work week. Altogether 23 workers from 15 restaurants were included in the study. RESULTS: The geometric mean (GM) breathing-zone nicotine level was 3.9 microg/m(3) (3.7 microg/m(3) in pubs, 1.4 microg/m(3) in dining restaurants, and 10.2 microg/m(3) in nightclubs). The GM cotinine and trans-3'-hydroxycotinine level in urine were 3.3 ng/mg((creatinine)) and 15.3 ng/mg((creatinine)), respectively. The exposure to ETS of restaurant workers in dining restaurants was clearly lower than that of workers in pubs and nightclubs as indicated by all ETS-markers used in the present study. During the work week, the cotinine and 3'-hydroxycotinine levels in urine of the study subjects increased. The correlation between breathing zone nicotine and urine cotinine and hydroxycotinine was 0.66 for both compounds. Post-shift cotinine and hydroxycotinine levels were not significantly higher than the pre-shift levels. CONCLUSIONS: If 9 ng cotinine/mg((creatinine)) is considered as the level above which heavy exposure has occurred, then this level was exceeded by 14 (approximately 60%) subjects at least once during the work week. Nicotine metabolite concentrations in the urine increased during the work week in 80% of the subjects, and the increase was especially noticeable for subjects working in both pubs and nightclubs. The study indicates that measures to restrict ETS exposure in restaurants are needed.