More Proof of Harm from Second-Hand Smoke in Bars

PORTLAND, Ore., June 28 -- Non-smokers who work in bars and restaurants where smoking was permitted had significantly higher levels of a tobacco-specific carcinogen than those who worked where the air wasn't tainted.

A small study, reported in the August issue of the American Journal of Public Health, found that bartenders and other restaurant workers who don't smoke but were exposed to smoke on the job were six times more likely to have three detectable metabolites of 4-(methylnitrosamino)-1-(3-pryridyl)-1-butanol (P=0.005) in their urine than people with similar jobs in smoke-free establishments. The presence of the compound, known as NNAL, is specific to tobacco use or exposure.

The study also found that the exposed workers had higher mean levels of NNAL (P

According to Smoke Free USA, an organization that tracks smoking bans, Arizona, California, Delaware, New York, Connecticut, Maine, Massachusetts, Ohio, Puerto Rico, Rhode Island, Vermont, and Washington now ban smoking in bars and restaurants. Nevada has a ban on smoking in most public places, New Jersey has a ban on smoking in restaurants and bars, but casinos are exempt, and Montana banned smoking in restaurants but bars are exempt from the ban until 2009.

The authors noted a number of limitations to their study, including the possibility that workers in communities that permitted indoor smoking might have multiple exposures during off-hour trips to stores, theaters, and other indoor venues that permit smoking.

The authors said they attempted to control this possible limitation by including only volunteers who said they had had less than two hours non-workplace exposure to environmental smoke in the previous week.

Another limitation was the finding that 45% of the staff from bars and restaurants that banned smoking also had detectable levels of NNAL. The authors said this finding was "consistent with those from a study of nonsmoking casino patrons" and was probably caused by the unusually long half life of NNAL.

Finally, the authors pointed out, their "estimate of hourly increase in NNAL, cotinine, and nicotine are valid only for four or more hours of exposure to tobacco smoke, because [they] confirmed the sample to those who worked at least four hours during the targeted shift."