Citizens for Clean Air and Clean Lungs



Bartenders who worked for as little as one month in smoke-free conditions after California law banned smoking in their workplace reported a significant drop in coughing and other respiratory problems and showed improved lung function, according to a new study by researchers at the University of California San Francisco.

The study, appearing in the December 9 issue of the Journal of the American Medical Association (JAMA), is the first to examine the short-term health effects of reducing second-hand smoke (JAMA abstract). It was designed to study the health impact of California State Assembly Bill 13, which prohibited smoking in most bars and taverns in the state as of January 1, 1998.

The rationale for the new law was to protect the health of California workers by reducing their exposure to second-hand smoke. "We saw the chance to examine how the smoking ban would affect respiratory symptoms and lung function among an occupation usually exposed to many hours of second-hand smoke every week," said Mark D. Eisner, MD, a pulmonary and critical care medicine post-doctoral fellow in UCSF's Cardiovascular Research Institute and lead author on the JAMA paper.

The issue of JAMA also includes an editorial on workplace smoking and health by Ronald M. Davis, MD, director of the Center for Health Promotion and Disease Prevention in Detroit.

About three-fourths of the 53 bartenders in the UCSF study reported respiratory symptoms such as wheezing, coughing and phlegm production during the month before the smoke-free workplace law went into effect. One to two months later, 59 percent of those who had indicated respiratory symptoms were now symptom-free. In addition, more than three-fourths of the bartenders initially reported sensory irritation such as red, teary eyes, runny nose, and sore or scratchy throats during the month before the smoking ban. During the follow-up study, more than three-fourths of this group were symptom-free.

Finally, researchers measured the lung function of the bartenders before and after implementation of the smoke-free workplace law. By two different measures used, lung function improved after the ban.

"The bartenders experienced a significant improvement in lung function simply from avoiding second-hand smoke in the workplace," Eisner said. "That's a pretty big change over a short period of time."

Surprisingly, even among bartenders who smoked cigarettes themselves, reduced exposure to second-hand smoke led to improved respiratory symptoms and function.

"The study clearly shows that reducing second-hand smoke exposure quickly leads to improved symptoms and lung function," Eisner said. "This is one of the first studies to look at such a heavily exposed occupational group," he added, noting, "It may be hard to generalize the study to people with lower exposures."

Co-authors on the JAMA report with Eisner are Alexander K. Smith, a UCSF medical student, and Paul D. Blanc, MD, associate professor of medicine and chief of the division of occupational and environmental medicine at UCSF.

The study was supported by the National Heart, Lung and Blood Institute of NIH, and an NIH National Research Service Award.

NOTE TO REPORTERS AND EDITORS: Drs. Eisner and Blanc will be available at UCSF until Tuesday, Dec. 8, when they leave for a European conference. To arrange an interview with them before Dec. 8, contact Wallace Ravven, (415) 502-1332.

California Researchers Took Advantage Of Opportunity
The NEW YORK TIMES notes that researchers at the University of California at San Francisco took advantage of an opportunity to study the respiratory health of California bartenders before and after the state's ban on smoking in bars went into effect January 1, 1998. The study, published in the most recent issue of the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, found that a large majority of the bartenders reported improved respiratory health only after a few months. Because of the difficulty of measuring exposure to secondhand smoke, there have been few studies of the short term health effects of smokefree environments. The UCSF researchers noted that their study has limitations because exposure to smoke was not assessed directly and the participating bartenders who smoke may have reduced their smoking between tests.

The article also points out that 64 percent of bartenders "strongly" or "somewhat" disagreed with the smoking ban, "making it unlikely that reports of reduced symptoms were inspired by anti-smoking fervor."

Source(s): NEW YORK TIMES, (12/15/98) "When Bars Say 'No' To Smoking", Erica Goode, p. D7


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