- Bartenders' Respiratory Health After Establishment of Smoke-Free Bars
and Taverns
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- Mark D. Eisner, MD; Alexander K. Smith, BS; Paul D. Blanc, MD, MSPH
Context: The association between environmental tobacco smoke (ETS)
exposure and respiratory symptoms has not been well established in adults.
Objective: To study the respiratory health of bartenders before
and after legislative prohibition of smoking in all bars and taverns by
the state of California.
Design: Cohort of bartenders interviewed before and after smoking
prohibition.
Setting and Participants: Bartenders at a random sample of bars
and taverns in San Francisco.
Main Outcome Measures: Interviews assessed respiratory symptoms,
sensory irritation symptoms, ETS exposure, personal smoking, and recent
upper respiratory tract infections. Spirometric assessment included forced
expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measurements.
Results: Fifty-three of 67 eligible bartenders were interviewed.
At baseline, all 53 bartenders reported workplace ETS exposure. After the
smoking ban, self-reported ETS exposure at work declined from a median of
28 to 2 hours per week (P-value less than 0.001).
Thirty-nine bartenders (74%) initially reported respiratory symptoms.
Of those symptomatic at baseline, 23 (59%) no longer had symptoms at follow-up
(P-value less than 0.001).
Forty-one bartenders (77%) initially reported sensory irritation symptoms.
At follow-up, 32 (78%) of these subjects had resolution of symptoms (P-value
less than 0.001).
After prohibition of workplace smoking, we observed improvement in mean
FVC (0.189 L; 95% confidence interval [CI], 0.082-0.296 L; 4.2% change)
and, to a lesser extent, mean FEV1 (0.039 L; 95% CI, -0.030 to 0.107 L;
1.2% change).
Complete cessation of workplace ETS exposure (compared with continued
exposure) was associated with improved mean FVC (0.287 L; 95% CI, 0.088-0.486;
6.8% change) and mean FEV1 (0.142 L; 95% CI, 0.020-0.264 L; 4.5% change),
after controlling for personal smoking and recent upper respiratory tract
infections.
Conclusion: Establishment of smoke-free bars and taverns was associated
with a rapid improvement of respiratory health.
Source: JAMA. 1998; 280:1909-1914
