Smoking control in the workplace: is workplace size related to restrictions and programs?

Active cigarette smoking, secondhand smoke exposure at work and home, and self-rated health

OBJECTIVES

Although active smoking has been reported to be associated with poor self-rated health (SRH), its association with secondhand smoke (SHS) is not well understood.

STUDY DESIGN

A cross-sectional study was conducted to examine the association of active smoking and SHS exposure with SRH.

METHODS

A total of 2558 workers (1899 men and 689 women), aged 16-83 (mean 45) years, in 296 small and medium-sized enterprises were surveyed by means of a self-administered questionnaire. Smoking status and exposure levels to SHS (no, occasional or regular) among lifetime non-smokers were assessed separately at work and at home. SRH was assessed with the question: How would you describe your health during the past 1-year period (very poor, poor, good, very good)? SRH was dichotomized into suboptimal (poor, very poor) and optimal (good, very good). Odds ratios (ORs) with 95% confidence intervals (CIs) for reporting suboptimal vs optimal SRH according to smoking status and smoke exposure were calculated.

RESULTS

Current heavy smokers (20+ cigarettes/day) had a significantly increased suboptimal SRH than lifetime non-smokers after adjusting for sociodemographic, lifestyle, physical and occupational factors (OR 1.34, 95% CI 1.06-1.69). Similarly, lifetime non-smokers occasionally exposed to SHS at work alone had worse SRH than their unexposed counterparts (OR 1.50, 95% CI 1.02-2.11). In contrast, lifetime non-smokers exposed at home alone had no significant increase in suboptimal SRH.

CONCLUSIONS

The present study indicates an increase in suboptimal SRH among current heavy smokers, and suggests that SHS exposure at work is a possible risk factor for non-smokers. Whether or not the association is causal, control of smoking at work may protect workers from developing future health conditions.

Worksite tobacco prevention in the Canton of Zurich: stages of change, predictors, and outcomes

OBJECTIVES

This study provides information about the prevalence of tobacco prevention (TP) and the stages of change with respect to the introduction of TP among companies in the Canton of Zurich (n = 1,648). It explores the factors that predict restrictiveness of smoking policies, number of individual support measures, interest in services to promote TP, and the relationship between TP and health outcomes.

METHODS

Data were gathered by means of a written questionnaire and analysed using ordinal regression models.

RESULTS

Whereas many companies maintain smoke-free policies, only few provide cessation-courses. Health and welfare organisations have strictest, and building and hospitality companies have least strict policies. Company size predicts number of individual support measures but not policy restrictiveness. Both measures are predicted by personal concern of the representative. Interest in services is predicted by tobacco-related problems and medium stages of change. Finally, stricter policies are associated with lower proportion of smokers and less tobacco-related problems.

CONCLUSIONS

Health professionals should support less advanced companies in their endeavour to implement TP. The findings provide a baseline to evaluate the implementation of the forthcoming smoke-free legislation.

Evaluating the Michigan SENSOR Surveillance Program for work-related asthma

BACKGROUND

Most Occupational Safety and Health Administration (OSHA) inspections are based on employee complaints or targeting of industry groupings. Limited use has been made of illness data to target inspections and evaluation of such targeting is even more limited.

METHODS

This study compared 545 Michigan OSHA (MIOSHA) inspections performed as follow up to reports of work-related asthma (WRA) with 12,268 non-disease initiated OSHA inspections performed during the same time period (1989-2002).

RESULTS

SENSOR asthma inspections were more likely to be conducted in larger, unionized employers. Although the likelihood of citations ( approximately 50%), type of citation, and monetary penalties ( approximately 30%) were not different between disease and non-disease initiated inspections, the number of citations and amount of monetary penalties were less in disease initiated inspections. Citations and penalties were more likely for small as compared to large employers, and were less likely at unionized worksites.

CONCLUSIONS

Even without the availability of specific standards for agents that cause WRA, inspections triggered by a WRA index case are very much like other inspected worksites in terms of the prevalence of violations observed at the worksite. The advisability of making referrals to OSHA and additional ways to evaluate the effectiveness of this type of intervention model are discussed.

Epidemiologic basis for an occupational and environmental policy on environmental tobacco smoke

ETS contains numerous toxins. Robust epidemiologic evidence implicates ETS as a cause of lung cancer and as a primary cause and source of exacerbation of excess respiratory disease. There is also increasing evidence that ETS may be associated with other outcomes, including heart disease. There is currently little doubt that ETS is an important and avoidable health hazard. Unfortunately, ETS is frequently encountered in the workplace--where it is no safer than in other environments and where it presents hazards to exposed workers and to others. A unique aspect of workplace ETS is that exposure is rarely an outcome of essential manufacturing, extraction, or service delivery processes. Moreover, ETS exposure, with its growing list of known hazards, is preventable by engineering or policy means. Implementation of policies to prevent workplace ETS can be highly effective while entailing low costs and yielding primary and secondary benefits to employers and employees. ACOEM strongly supports an increase in the scope and effectiveness of policies and efforts that protect against exposure to ETS in the workplace and elsewhere. To that end, ACOEM supports voluntary, regulatory, and legislative initiatives to eliminate ETS from the workplace, including public spaces such as bars, casinos, restaurants, schools, day-care centers, and public transportation. ACOEM also encourages employers to provide employee training concerning the health hazards of ETS and voluntary personal smoking-cessation programs.