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Preliminary Research Results

Introduction to projects
Measurement of Exposure to Particles in Pubs

The Ultrafine Particle Component of Environmental Tobacco Smoke (ETS) and its Measurement
James Mc Laughlin, Department of Experimental Physics,University College Dublin.

Methodologies to evaluate the exposure and health effects of the workplace smoking ban
Goodman PG1, Clancy Luke2 1Dublin Institute of Technology,2 St James's Hospital Dublin

Respiratory Health of Barworkers-Survey

Evaluating the health impact on barworkers of the Republic of Ireland smoke-free workplace law (All Ireland Bar Study)*
Presented by Shane Allwright, Department of Public Health and Primary Care, Trinity College Dublin


Preliminary Results

Exposure

Ultrafine Airborne Particle Measurements in Dublin Pubs before and after the Smoking Ban
Kevin Kelleher, James McLaughlin.
Environmental Physics Group, Physics Dept., University College Dublin.

Particulate pollution levels and smoking prevalence in Dublin Pubs pre and post the introduction of the workplace smoking ban.
McCaffrey, M1, Goodman, PG2, Clancy, Luke3
1Dublin City Council, 2Dublin Institute of Technology, 3Research Institute for a Tobacco Free Society

Health Effects

Evaluation of the lung function of Barworkers in Dublin, pre and post the introduction of a workplace ban on smoking in Ireland.
M. Agnew1,Dr. Patrick Goodman 2,Prof. Luke Clancy1, Dept. of Respiratory Medicine, St. James's Hospital, Dublin1.Department Physics, Dublin Institute of Technology.

The impact on barworkers of the Republic of Ireland smoke-free workplace law: Preliminary findings from the All Ireland Bar Study*
Presented by Gillian Paul, Department of Public Health and Primary Care, Trinity College Dublin.

The Effect of the Legislative ban on smoking rates among bar workers
B Mullally1, B Greiner1, I Perry1, S Allwright2
1Department of Epidemiology and Public Health, University College Cork, Ireland.  2Department of Public Health and Primary Care, Trinity College Centre for Health Science, Adelaide & Meath Hospital incorporating the National Children's hospital Tallaght, Dublin 24.

Attitudes of bar workers and owners in rural Galway before the smoking
Dr Lisa Pursell. Marie Galvin, Michael Keogh, Dr. Saorise Nic Gabhainn, Dr. Diarmuid O'Donovan
NUIG, Galway.

ETS from cigarette smoking has two main components: (a) mainstream smoke which is that exhaled by the smoker and (b) sidestream smoke which is emitted from the burning tip of the cigarette between puffs. The particle size range for sidestream smoke is typically 0.01- 1.0 ?m (micrometers - 10-6m). Within this size range the particles of less than about 0.2 ?m are generally referred to as the ultrafine or nucleation mode whereas the particles between 0.2 and 1.0 ?m are in what is known as the accumulation mode.   The exhaled mainstream smoke is generally in the size range 0.1 - 1.0 ?m (i.e. mainly in the accumulation mode).  When initially emitted into the air the smoke particles are in the size ranges given above but due primarily to their initial high concentrations they coagulate rapidly and produce larger particles with sizes above 2 ?m.  This is what is called a coarse mode component.  When ETS is inhaled the site of deposition of the particles in the human respiratory system is dependant upon many factors such as particle size, breathing characteristics, individual lung morphometry etc.  While previously much attention has been paid to the coarse mode component of ETS there is increasing interest in the ultrafine smoke particles. Even though they may only form a small percentage of the total mass of ETS they are present at very high particle concentrations and due to their high diffusion coefficient they deposit very efficiently in the lower respiratory tract such as in the alveolar region of the lung. In addition there is evidence that the particle clearance mechanisms of the lung are quite inefficient at removing such deposited ultrafine particles.  For these and other reasons it was decided to measure* the concentration of ultrafine particles in bars in Dublin before and after the introduction of the smoking ban. In collaboration with colleagues at DIT, who measured the coarse mode particles (see presentation abstract for this seminar by McCaffrey et al), the ultrafine particles were simultaneously measured in the selected bars by UCD (see presentation abstract for this seminar by Kelleher and Mc Laughlin). This simultaneous measurement in bars of both particle size modes appears to be a "first".    Details of the observed significant decreases of both the coarse and ultrafine mode components of the airborne particles in the bars seen in the post-ban period are presented at this seminar by Marie McCaffrey and Kevin Kelleher respectively.

* Measurement of the Ultrafine Particles:  Direct measurement of the ultrafine component of ETS requires the use of a specialised device such as a condensation nucleus counter (CNC). In the CNC (TSI P-Trak)  used in the present work (presented at this seminar  by UCD post-graduate PhD student  Kevin Kelleher) air is passed though an internal  chamber in the counter  where isopropyl alcohol vapour condenses on the  ultrafine particles . This causes them to grow to a size at which the particles can be individually counted by the scattering of light from a laser beam.  The P-Trak instrument can measure ultrafine particles down to a size of about 0.02?m or 20 nanometres (20 x 10-9m).

Introduction: On the 29th March 2004, the workplace smoking ban came into operation in the republic of Ireland.  We viewed this as an important opportunity to conduct a rigorous scientific study into the exposure of bar workers both pre and post the introduction of the smoking ban, and to see if the ban would have the predicted effect in reducing indoor pollution. We also wanted to determine if any acute health benefits could be detected among bar staff. In anticipation of a workplace ban, early in 2003 we started to develop the Dublin Bar Workers exposure and health effect methodologies as outlined here. Bar workers were chosen as they were a working group who were viewed as having high exposure to Environmental Tobacco Smoke (ETS) in the workplace.  The preliminary results of the exposure and health effects are presented elsewhere in this forum.

Methods Exposure: Smoke is made up of particles and gases. It is well know from many studies that particles in the air are harmful to health.  The EU and the USEPA set limit values for particles in the outdoor air, there are no such values for indoor air.  The parameters legislated for are particles called PM10 and PM2.5, these particular sizes are chosen as they have been shown to be able to penetrate the human respiratory system. In 2002/2003 we conducted a trial study in rural bars (ref ERS 2003) which showed that the particle measurement system was appropriate for use in bars.  We followed this up with a pilot study in 2003 looking at an intervention to stop smoking (ATS 2004).  These two studies helped us to develop the methodology used in the Dublin bar study.

We decided to measure PM2.5 and PM10 concentration in bars pre and post the workplace smoking ban.  Measurements were made in 40 bars, which represents the biggest exposure based scientific study of this nature available.

In collaboration with Prof. McLaughlin UCD, as part of the All Ireland study, we conducted joint measurements in  12 bars, where the range of exposure measurements were expanded to include ultrafine particles.

In putting together such a study it's important to consider as many confounding factors as possible, so a protocol was developed for the monitoring.
All monitoring was conducted at busy times in the bars, usually at evening times.  The monitors (optical based light scattering devices, which are portable and data log) were placed on a table in the centre of the bar.  The device recorded readings for a minimum of three hours at each bar.  The number of people present, the number smoking (inside or outside) was recorded each hour.  The existence and or use of ventilation systems and whether doors and windows were open or closed were also recorded. 

The post ban measurements were conducted on the same day of the week and in the same month of the year, one year on from the original measurements, this ensured that day of the week and seasonal variations were controlled for.  Outdoor particle measurements were also recorded at each bar.
Benzene: Benzene is a gas emitted by burning cigarettes, (petrol is another source), it is a known carcinogen, and it is legislated for by the EU.  We measured Benzene concentrations in each bar both before and after the introduction of the smoking ban.  The benzene monitors were co-located with the PM10/PM2.5 monitors.

Methods Health Effects: We approached the Mandate trade union for assistance in recruiting bar staff to participate in a confidential scientific study to evaluate any acute respiratory health benefits associated with the smoking ban. The project criteria were submitted for ethics approval, which was received.

In total 81 bar staff attended for pulmonary function testing at the laboratory in St James's hospital pre the ban, of those 75 re-attended for the post ban tests (93% return rate).
Respiratory parameters such as breath (carbon monoxide) CO, (peak expiratory flow rate) PEFR and (vital capacity) VC were all measured. In addition a detailed questionnaire on respiratory symptoms was also completed pre and post the ban by the bar workers when they attended the laboratory.

Results: Successful measurements have been made at 40 bars for both the pre and post ban periods, yielding a comprehensive database for scientific research.  In the case of benzene pre ban levels ranged from 6.75-78.7  gm-3, with a mean value of 18.4 gm-3.  The post ban levels are not yet complete, but comprehensive data from the PEOPLE project shows that mean benzene levels in Dublin are below 3 gm-3.

Conclusions: We have successfully conducted exposure assessments in 40 bars pre and post the workplace smoking ban.  Providing Dublin with the biggest database of pre and post intervention exposure data for ETS.  We have measured a range of exposure parameters, PM10, PM2.5 and Benzene.  Additional information on number of customers and percentage of people smoking has also been recorded. (Results of the PM measurements are presented elsewhere).  Comprehensive laboratory based pulmonary function data has been gathered pre and post ban.

Benzene measurements inside the bars pre the ban are significantly higher than levels experienced by the general population, and are on average greater than 3 times above the recommended EU limit values of 5 gm-3.

Background
As workers in the hospitality industry were at particular risk of high and sustained exposure to secondhand smoke (SHS), a study was set up to evaluate the impact of the law on bar workers' exposure to SHS and on their respiratory health (All Ireland Bar Study).  The study methods will be described together with an update on progress to date.

Methods
The respiratory health of barworkers was assessed, in the six months before the workplace smoking, ban, by questionnaire and lung function tests .  Exposure to secondhand smoke (SHS) over the previous few days was assessed by measuring salivary cotinine and verbal report.  Participants were also asked about their attitudes to the ban.  A follow up survey was undertaken one year later in order to assess changes in exposure to SHS, in
respiratory health and in attitudes.  Bar staff from Northern Ireland were also enrolled in order to control for secular changes unrelated to the smoking ban.

The study also includes air measurement in a sample of Dublin pubs to compare levels of exposure pre-  and post-implementation of the law (conducted at the same time of year to adjust for seasonal effects).  These measurements will be presented separately.

Results
329 bar staff from Dublin, Cork, Galway and Northern Ireland were enrolled in the baseline survey between September 2003 and March 2004. 91 bar staff from Dublin (mostly Mandate members), and 129 bar staff from Cork, 68 from Galway and 41 from Northern Ireland (Derry, Strabane and Limivady) were enrolled.  The majority of the barworkers who volunteered for the study were male, Irish residents and had an average age under 40 years. Bar owners, managers, permanent and temporary bar staff all participated in the study.  

The follow up survey has just been completed (September 2004 and March 2005).  The follow-up rate in Dublin was over 90%. The follow up rates for the other three areas will be presented.

Conclusions
A high rate of follow up was achieved enabling the study to provide important information on the impact of the smokefree workplace law on bar workers in Ireland.

Study personnel
Dublin: Shane Allwright, Michele Agnew, Luke Clancy, Pat Goodman, Kevin Kellerher, James McLaughlin, Gillian Paul, Michael Ryan, Alan Smith
Galway: Maureen D'Eath, Marie Galvin, Michael Keogh, Saorise Nic Gabhainn, Diarmuid O'Donovan, Lisa Pursell
Cork: Birgit Greiner, Sangeetha Kalimuthu, Bernie Mulally, Ivan Perry, Meenakshe Uppal
N. Ireland:  Eamon O'Kane, Brendan Bonner, Damian Gavin, Bill McConnell

Background
As workers in the hospitality industry were at particular risk of high and sustained exposure to secondhand smoke (SHS), the All Ireland Bar Study was set up to evaluate the impact of the law on bar workers' exposure to second-hand smoke and on their respiratory health .

Methods
Bar staff from Dublin, Cork, Galway and Northern Ireland were enrolled in the baseline survey between September 2003 and March 2004. Their respiratory health was assessed with a questionnaire and lung function tests.  Exposure to SHS over the days prior to interview was assessed by salivary cotinine samples.  In addition, they were asked about self reported SHS exposure and their attitudes to the ban.  A follow up survey was undertaken one year later (September 2004 and March 2005) in order to assess changes in exposure to SHS, in respiratory health and in attitudes.  The Northern Ireland bar staff were enrolled to control for secular changes unrelated to the smoking ban.

Results
329 bar staff were enrolled in the baseline survey.  High levels of respiratory and sensory irritation symptoms were reported by bar staff: 85% (105/124) of smokers and 63% (130/205) non smokers reported any respiratory symptom (wheeze or shortness of breath or cough in the morning or cough during the rest of the day or phlegm).  Sixty nine per cent (86/124) of smokers and 70% (144/205) of non smokers reported any sensory irritation (eye irritation or sore throat or nose irritation).

Salivary cotinine levels in self reported non smokers ranged from 0.5 to 175ng/ml (mean = 9.8 ng/ml, median = 5.8 ng/ml); and in smokers ranged from 2.3 to 838.2 ng/ml (mean= 281.2 ng/ml, median= 285.9 ng/ml).

Follow up survey data have been processed for 72 of the 91 Dublin barmen so far. Reported respiratory and sensory symptoms have declined in both smokers and non smokers in this subset of the Dublin sample.  Prior to the smoking ban 100% (9/9) of smokers and 86% (54/63) of non smokers reported any respiratory symptom.  These figures decreased to 78% (7/9) and 62% (39/63) respectively after the ban.  Eighty nine per cent (8/9) of smokers and 87% (55/63) of non smokers reported any sensory symptom before the smoking ban.  Following the ban these figures declined to 44% (4/9) and 46% (29/63) respectively.  Paired statistical analyses on the complete sample are ongoing.

Conclusions
Preliminary analyses on a subset of the Dublin participants are suggestive of declines in SHS exposure, in respiratory symptoms, and in sensory irritation.  However, paired statistical analyses on the full sample are required before the impact of the ban can be assessed.

Study personnel
Dublin: Shane Allwright, Michele Agnew, Luke Clancy, Pat Goodman, Kevin Kellerher, James McLaughlin, Gillian Paul, Michael Ryan, Alan Smith
Galway: Maureen D'Eath, Marie Galvin, Michael Keogh, Saorise Nic Gabhainn, Diarmuid O'Donovan, Lisa Pursell
Cork: Birgit Greiner, Sangeetha Kalimuthu, Bernie Mulally, Ivan Perry, Meenakshe Uppal
N. Ireland:  Eamon O'Kane, Brendan Bonner, Damian Gavin, Bill McConnell

In order to assess the impact the smoking ban has had on airborne particle concentrations in Dublin pubs, ultrafine particle measurements were made in twelve pubs throughout the city and county both before and after the introduction of the ban. The pre- and post- ban measurements for each pub were carried out at the same time of day and on the same day of the week using a P-TRAK condensation nucleus counter. These measurements were typically made over a four-hour period, during which a record was made of staff, customer and smoker numbers. Pre-ban ultrafine airborne particle concentrations on occasions reached as high as 250,000 per cm3 with an overall average of approximately 85,000 per cm3.  In the post-ban period the typical concentrations are now approximately 20,000 particles per cm3 with maximum values of around 80,000 per cm3, which is similar to the levels found in non-smoking homes. The findings of these measurements show substantial decreases, of between 62% and 83%, in the ultrafine airborne particle concentrations in the investigated Dublin pubs since the implementation of the ban.

Background: On the 29th March 2004 the Irish government introduced a comprehensive ban on smoking within the workplace including Pubs and Restaurants.  This offered an opportunity to assess the exposure levels of particulates in Pubs in Dublin, pre and post the introduction of the smoking ban.  Sources such as cooking, and transportation of outdoor particles as well as and other materials dispersed by activities in Pubs may also contribute to the level of indoor particles. It was therefore important to determine the effect of the smoking ban on particle levels.

Methods Particulate levels (PM10 and PM2.5) were measured in 40 pubs prior to the introduction of the smoking ban, outdoor levels were also recorded at each venue.  These measurements were conducted over at least a 3 hour period at each venue. 

Following the introduction of the ban, repeat measurements have been made.  The repeat measurements were conducted on the same day of the week, and the same month, but one year on from the original measurements, this was to control for day of week and seasonal variations.  The PM measurements were made using a light scattering optical based instrument (Aerocet 531).  The following results are based on 24 bars where exposure levels pre and post the ban have been analysed. 

Results (mgm^-3) Pre ban Post Ban %Change t value

Ave PM10 79 37.4 -53% -1.95

Ave PM2.5 40.2 4.97 -87.6% -2.48

(Ave)Max PM10 221 79.8 -63.9% -3.07

(Ave) Max PM2.5 142 10.2 -92.8% -3.69

outdoor PM10 28 27 - 3.6% NS

outdoor PM2.5 6.6 6.4 - 3.0% NS

Figure 1.   Shows results from a single pub.

Discussion I This work shows there has been a significant reduction in particulate levels in pubs following the introduction of the smoking ban.  The most striking results are for the smaller particles (PM2.5) and for the maximum exposure levels.  This indicated that the smoking ban has lead to a significant reduction in indoor particulate levels in Dublin bars.

Pub demographics and smoking prevalence
Additional measurements such as number of people present, number smoking, ventilation systems etc were also recorded
Preliminary results based on this selection of 4 pubs, with from 40 to 300 patrons, the following results were obtained;

Results No of people Number smoking

Pre ban post ban pre ban post ban

Pub 1 150 300 39 (26%) 12 (4%)

Pub 2 131 60 12 (9%) 3.5 (6%)

Pub 3 81 139 10 (12%) 4 (3%)

Pub 4 41 129 7 (17%) 3.5 (3%)

Discussion II

In three out of the four venues we see that the number of people present has risen, while it has dropped in one venue. These readings were taken on the same weekday one year apart.  Until all the 40 pubs have been completed we will not be able to determine whether there are more customers or not post the ban.  What is clear however is that there is a dramatic drop in the number of customers smoking.  The number of people smoking in the pre-ban period was on average 16% of customers at any given time.  After the ban this has dropped to 4% and these were all outside the premises, which represents a 75% decrease in smoking. The fact that people had to go outside to smoke is likely to be a major factor in this result.

Conclusion: The smoking ban has successfully reduced the particulate exposure levels in Dublin Pubs, indicating that ETS was the major contributor to particulate exposure levels.  
The ban has also had the additional benefit of giving rise to a significant drop in the number of customers smoking.

Background: It is well recognised that passive smoking causes respiratory, cardiac and vascular damage to those exposed to it.   Bar workers, both smokers and non-smokers are a group with long hours of workplace exposure to high levels of second hand smoke.  The intervention to prohibit smoking in the workplace, including bars and restaurants, provided an opportunity to study the health effects of such an intervention.  This workplace smoking ban came into effect on 29th March 2004.

Methods: Bar workers were recruited to the study through their Trade Union (Mandate). 81 volunteered.   The average age was 46.9yrs (range 22 - 68yrs).  They had long years of workplace exposure to environmental tobacco smoke with the average being 28.4 yrs      (range 6 - 52yrs ).   They attended the Respiratory Laboratory in St. James's Hospital between September 2003 and March 2004 for initial (pre ban) evaluation of breath Carbon Monoxide (CO), spirometry (FEV1, FVC), lung volumes and diffusing capacity (DLCO), and for similar tests a year later (post ban).   In addition a questionnaire covering history of asthma, working hours, hours of exposure to cigarette smoke (home/ workplace), personal smoking history, and recent respiratory symptoms was completed by each subject.    Exhaled Carbon Monoxide was measured using a MicroCo meter (Micromedical, UK) and lung function was measured using a Vmax 22 system (SensorMedics, USA).

Results: To date analysis has been carried out on 56(69%) of the volunteers. From those, we have observed that mean CO levels have decreased from 5.2ppm to 3.2ppm (-38%). While the greatest reduction in CO occurred in non-smokers, 4.4ppm to 2.43ppm (-45%), there was also a fall in current smokers, 14ppm to 9.75ppm (-30%).

Conclusions: These initial results show that the workplace smoking ban has reduced breath CO levels in non-smoking and ex-smoking bar staff. Within this group there is also a significant increase in Peak Flow Rate and FVC.  When all the measured parameters are fully analysed we will be able to give more comprehensive results

Background
As workers in the hospitality industry were at particular risk of high and sustained exposure to tobacco  smoke pollution (TSP), the All Ireland Bar Study was set up to evaluate the impact of the law on bar workers' exposure to second-hand smoke and on their respiratory health .

Methods
Bar staff from Dublin, Cork, Galway and Northern Ireland were enrolled in the baseline survey between September 2003 and March 2004. Their respiratory health was assessed with a questionnaire and lung function tests.  Exposure to TSP over the days prior to interview was assessed by salivary cotinine samples.  In addition, they were asked about self reported TSP exposure and their attitudes to the ban.  A follow up survey was undertaken one year later (September 2004 and March 2005) in order to assess changes in exposure to TSP, in respiratory health and in attitudes.  The Northern Ireland bar staff were enrolled to control for secular changes unrelated to the smoking ban.

Results
329 bar staff were enrolled in the baseline survey.  High levels of respiratory and sensory irritation symptoms were reported by bar staff: 85% (105/124) of smokers and 63% (130/205) non smokers reported any respiratory symptom (wheeze or shortness of breath or cough in the morning or cough during the rest of the day or phlegm).  Sixty nine per cent (86/124) of smokers and 70% (144/205) of non smokers reported any sensory irritation (eye irritation or sore throat or nose irritation).

Salivary cotinine levels in self reported non smokers ranged from0.5 to 175ng/ml (mean = 11.8 ng/ml, median = 5.8 ng/ml); and in smokers ranged from 2.3 to 838.2 ng/ml (mean= 281.2 ng/ml, median= 285.9 ng/ml).

Follow up survey data have been processed for 72 of the 91 Dublin barmen so far. Reported respiratory and sensory symptoms have declined in both smokers and non smokers in this subset of the Dublin sample.  Prior to the smoking ban 100% (9/9) of smokers and 86% (54/63) of non smokers reported any respiratory symptom.  These figures decreased to 78% (7/9) and 62% (39/63) respectively after the ban.  Eighty nine per cent (8/9) of smokers and 87% (55/63) of non smokers reported any sensory symptom before the smoking ban.  Following the ban these figures declined to 44% (4/9) and 46% (29/63) respectively.  Paired statistical analyses on the complete sample are ongoing.

Conclusions
Preliminary analyses on a subset of the Dublin participants are suggestive of declines in TSP exposure, in respiratory symptoms, and in sensory irritation.  However, paired statistical analyses on the full sample are required before the impact of the ban can be assessed.

Study personnel
Dublin: Shane Allwright, Michele Agnew, Luke Clancy, Pat Goodman, Kevin Kellerher, James McLaughlin, Gillian Paul, Michael Ryan
Galway: Maureen D'Eath, Marie Galvin, Michael Keogh, Saorise Nic Gabhainn, Diarmuid O'Donovan, Lisa Pursell
Cork: Birgit Greiner, Sangeetha Kalimuthu, Bernie Mulally, Ivan Perry, Meenakshe Uppal
N. Ireland:  Eamon O'Kane, Brendan Bonner, Damian Gavin, Bill McConnell

Background

Bar worker health has gained a lot of attention in Ireland due to the ban on smoking in workplaces including bars.  It is expected that the smoking ban will have a positive effective on the smoking behaviour of Irish bar workers.

There is concern about the widening gap in mortality and morbidity between the managerial and professional social classes, and those with lower levels of education.  As bar workers are a heterogeneous group comprising of owners, managers, part and full time staff (including students), social class and educational status can vary widely.

Although the overall number of smokers from 1999-2003 (SLAN,2003) has decreased, this is not occurring at the same rate for males and females across all sectors in society or for all age groups.

Objectives
To determine the prevalence of smoking and smoking amount among bar workers in Cork City.

To determine the influence of social class, gender and age on smoking behaviour in Irish bar workers. 

To determine if the legislative ban has had an effect on smoking behaviour and the role of social class, education, gender and age.

Method
A follow-up study on bar workers (random, N=129; refusal rate of bars was 8%) and catering staff(control) from Cork City was conducted before (Jan & March 2004) and one year after (Jan & March 2005) the implemtation of Europe's first legislative ban on work place smoking.  This study is part of a larger national study on bar workers' health, including participants from Cork, Dublin, Galway and N. Ireland. Data obtained a questionnaire, a salivary sample (cotinine) and respiratory health (FEV1 and PEF) measurements.

Results

Prevalence of smoking among Cork bar workers was 54.3% (baseline, 46% were regular smokers): twice that of the general population.  Social class broadly effects smoking prevalence among bar workers but age was found to be a confounder.

Gender also played a large role in smoking prevalence and consumption rates. Female bar workers had a much higher prevalence of smoking than male bar workers overall and males were more likely to be 'heavy smokers' or to have 'never smoked' than females.

Preliminary results on smoking prevalence and smoking amount post-ban will be reported.  The data collection is still ongoing.


Conclusions

Smoking prevalence is extremely high among bar workers and social class, gender and age play an essential role in their smoking behaviour.  The results of this on-going follow-up study will clarify some of the topical issues around differential effects of workplace health protection measures on health-related behaviour.

Attitudes of bar owners and workers in rural Galway before and after the smoking ban

Lisa Pursell, Marie Galvin,  Maureen, D'Eath, Michael Keogh, Saorise Nic Gabhainn, Diarmuid O'Donovan and Shane Allwright, NUIG, Galway.

The Galway element of the muticentre study of the respiratory health of bar workers (All Ireland Bar Study) recruited 68 bar owners (58%) or staff  (42%). Potential participants in all public bars in County Galway were initially contacted by letter. Arrangements were made with respondents to visit them at their place of work for completion of a questionnaire, repiratory tests and cotinine samples. Post-ban follow up visits are being arranged approximately 1 year after the initial visits. Follow up data are available to date (11 March) on 30 bar staff. In this presentation questions that addressed the attitudes of Galway bar workers and owners to the smoking ban are considered. Preliminary results of analysis of data before (n=68) and after the ban (n=30) are presented.

Participants were asked to state whether they agreed or disagreed with a series of statements positing either positive or negative aspects of the ban on smoking in public bars. They were also asked whether they agreed or disagreed with the ban in general.

Before the ban 68% agreed with the ban in general, 19% were undecided and 22% disagreed with the ban. Preliminary analysis of post-ban data revealed little difference in the distribution of these responses (67%, 10% and 23% respectively). Agreement with several of the statements, suggesting either negative or positive aspects of the ban, was associated with overall agreement / disagreement with the ban in general and with smoking status. For example, before the ban, 73% agreed with the statement that smoke free bars will make visits to them more comfortable. However, 87% of those who agreed with the ban in general, agreed with this statement compared to only 29% of those who disagreed with the ban in general. Similarly, of those who smoked, 48% agreed with this statement compared to 86% of non-smokers.

Comparison of responses to the series of statements before and after the ban, indicate some changes in the proportions agreeing or disagreeing with them. In particular, before the ban, preliminary results show 73% agreed that smoke free bars would make visits to them more comfortable; this has changed to 93% in agreement since the ban. After the ban 90% agreed that the smoking ban is needed to protect the health of workers compared to 59% before the ban. Seventy percent, however, now agree with the statement that the ban has resulted in job losses compared to 46% before the ban.

In conclusion, preliminary analyses of the attitudes of a subset of the Galway bar workers (30 out of 68) indicate overall support for the ban with some changes indicating increased support for some consequences of the ban  However, only tentative conclusions can be drawn from these small numbers.  Analyses of the changes in attitudes of bar staff from all four study areas (n=329) will be undertaken once the data collection process has been completed (end March 2005).

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