Audrey Naji

Publications of Audrey Naji

• UK smoke-free legislation: changes in PM2.5 concentrations in bars in Scotland, England, and Wales.

  Authors: Sean Semple, Martie van Tongeren, Karen S Galea, Laura MacCalman, Ivan Gee, Odette Parry, Audrey Naji, Jon G Ayres

  The Annals of occupational hygiene. 02/2010; 54(3):272-80.

  Evaluate the effect of smoke-free legislation on fine particulate [particulate matter <2.5 microm in diameter (PM(2.5))] air pollution levels in bars in Scotland, England, and Wales. Design: AirEvaluate the effect of smoke-free legislation on fine particulate [particulate matter <2.5 microm in diameter (PM(2.5))] air pollution levels in bars in Scotland, England, and Wales. Design: Air quality was measured in 106 randomly selected bars in Scotland, England, and Wales before and after the introduction of smoking restrictions. PM(2.5) concentrations were measured covertly for 30-min periods before smoke-free legislation was introduced, again at 1-2 months post-ban (except Wales) and then at 12-months post-baseline (except Scotland). In Scotland and England, overt measurements were carried out to assess bar workers' full-shift personal exposures to PM(2.5). Postcode data were used to determine socio-economic status of the bar location. PM(2.5) levels prior to smoke-free legislation were highest in Scotland (median 197 microg m(-3)), followed by Wales (median 184 microg m(-3)) and England (median 92 microg m(-3)). All three countries experienced a substantial reduction in PM(2.5) concentrations following the introduction of the legislation with the median reduction ranging from 84 to 93%. Personal exposure reductions were also within this range. There was evidence that bars located in more deprived postcodes had higher PM(2.5) levels prior to the legislation. Prior to legislation PM(2.5) concentrations within bars across the UK were much higher than the 65 microg m(-3) 'unhealthy' threshold for outdoor air quality as set by the US Environmental Protection Agency. Concentrations in Scottish and Welsh bars were, on average, two or more times greater than in English bars for which seasonal influences may be responsible. Legislation in all three countries produced improvements in indoor air quality that are consistent with other international studies.

• Bar workers' Health and Environmental Tobacco Smoke Exposure (BHETSE): Symptomatic improvement in bar staff following smoke-free legislation in Scotland.

  Authors: Jon G Ayres, Sean Semple, Laura Maccalman, Scott Dempsey, Shona Hilton, Finton J Hurley, Brian G Miller, Audrey Naji, Mark Petticrew

  Occupational and environmental medicine. 03/2009;

  OBJECTIVE: To examine changes in the health of bar workers after the introduction of smoke-free legislation. DESIGN: Longitudinal study following bar workers from before the introduction ofOBJECTIVE: To examine changes in the health of bar workers after the introduction of smoke-free legislation. DESIGN: Longitudinal study following bar workers from before the introduction of legislation (26th March 2006), at 2 months after introduction and again at 1 year post-baseline to control for seasonal differences. SETTING: Bars across a range of socio-economic settings in Scotland. PARTICIPANTS: 371 bar workers recruited from 72 bars. INTERVENTION: Introduction of smoke-free legislation prohibiting smoking in enclosed public places, including bars. Main outcomes measures: Change in prevalence of self-reported respiratory and sensory symptoms. RESULTS: 371 bar workers were recruited prior to introduction of the legislation. Of the 191 (51%) seen at 1-year follow-up the percentage of those reporting any respiratory symptom fell from 69 to 57% (p=0.02) and for sensory symptoms from 75 to 64% (p=0.02) following reductions in exposure. Reductions in the percentage of those reporting respiratory symptoms were greater at two months, probably due at least in part to the effect of season. Excluding respondents who reported having a cold, either at baseline or at one year, the reduction in respiratory symptoms was similar, although the reduction was greater for "any" reported sensory symptom (69% falling to 54%; p=0.011). For non-smokers (n=57) the reductions in reported symptoms were significant for phlegm production (32% to 14%, p=0.011) and red/irritated eyes (44% to 18%, p=0.001). There was no clear relationship between baseline salivary cotinine levels, or change in salivary cotinine levels, and change in symptoms. CONCLUSIONS: Bar workers in Scotland report significantly fewer respiratory and sensory symptoms one year after their working environment became smoke-free. These improvements, controlled for seasonal variations, were seen in both non-smokers and in smokers, and indicate that smoke-free working environments may have potentially important benefits even for smokers.

• Secondhand smoke levels in Scottish pubs: the effect of smoke-free legislation.

  Authors: Sean Semple, Karen S Creely, Audrey Naji, Brian G Miller, Jon G Ayres

  Tobacco control. 04/2007; 16(2):127-32.

  To compare levels of particulate matter, as a marker of secondhand smoke (SHS) levels, in pubs before and 2 months after the implementation of Scottish legislation to prohibit smoking inTo compare levels of particulate matter, as a marker of secondhand smoke (SHS) levels, in pubs before and 2 months after the implementation of Scottish legislation to prohibit smoking in substantially enclosed public places. Comparison of SHS levels before and after the legislation in a random selection of 41 pubs in 2 Scottish cities. Fine particulate matter <2.5 microm in diameter (PM2.5) was measured discreetly for 30 min in each bar on 1 or 2 visits in the 8 weeks preceding the starting date of the Smoking, Health and Social Care (Scotland) Act 2005 and then again 2 months after the ban. Repeat visits were undertaken on the same day of the week and at approximately the same time of the day. PM2.5 levels before the introduction of the legislation averaged 246 microg/m3 (range 8-902 microg/m3). The average level reduced to 20 microg/m3 (range 6-104 microg/m3) in the period after the ban. Levels of SHS were reduced in all 53 post-ban visits, with the average reduction being 86% (range 12-99%). PM2.5 concentrations in most pubs post-ban were comparable to the outside ambient air PM2.5 level. This study has produced the largest dataset of pre- and post-ban SHS levels in pubs of all worldwide smoke-free legislations introduced to date. Our results show that compliance with the Smoking, Health and Social Care (Scotland) Act 2005 has been high and this has led to a marked reduction in SHS concentrations in Scottish pubs, thereby reducing both the occupational exposure of workers in the hospitality sector and that of non-smoking patrons.

• Expectations and changing attitudes of bar workers before and after the implementation of smoke-free legislation in Scotland.

  Authors: Shona Hilton, Sean Semple, Brian G Miller, Laura Maccalman, Mark Petticrew, Scott Dempsey, Audrey Naji, Jon G Ayres

  BMC public health. 01/2007; 7(147):206.

  BACKGROUND: In Scotland on March 26, 2006 a comprehensive prohibition on smoking in all enclosed public places was introduced. This study examines bar workers' attitudes towards a smoke-free workingBACKGROUND: In Scotland on March 26, 2006 a comprehensive prohibition on smoking in all enclosed public places was introduced. This study examines bar workers' attitudes towards a smoke-free working environment. METHODS: An intervention study comparing bar workers' opinions before and after the implementation of the smoke-free legislation. Bars were randomly selected in three Scottish cities (Glasgow, Edinburgh & Aberdeen) and towns (Aberdeenshire & Borders). Bar workers were recruited from 72 bars that agreed to participate from 159 approached. Pre- and post-implementation attitudes towards legislation, second-hand smoke and smoke-free working environments were compared. RESULTS: Initially the majority of bar workers agreed with the proposed legislation on smoking (69%) and the need for it to protect the health of workers (80%), although almost half (49%) thought the legislation would damage business. In 266 bar workers seen at both surveys, a significant positive attitudinal change towards the legislation was seen. Post-implementation, support for the legislation rose to 79%, bar workers continued to believe it was needed to protect health (81%) and concerns about the impact on business were expressed by fewer than 20%. Only the statement that the legislation would encourage smokers to quit showed reduced support, from 70% pre-implementation to fewer than 60% post-implementation. Initial acceptance was greater among younger bar workers; older workers, initially more sceptical, became less so with experience of the legislation's effects. CONCLUSION: This study shows that bar workers had generally positive attitudes towards the legislation prior to implementation, which became stronger after implementation. The affirmative attitudes of these key stakeholders are likely to contribute towards the creation of 'smoke-free' as the new social norm.

• Expectations and changing attitudes of bar workers before and after the implementation of smoke-free legislation in Scotland

  Authors: Shona Hilton, Sean Semple, Brian Miller, Laura Maccalman, Mark Petticrew, Scott Dempsey, Audrey Naji, Jon Ayres

  BMC Public Health. 01/2007;

  Abstract Background In Scotland on March 26, 2006 a comprehensive prohibition on smoking in all enclosed public places was introduced. This study examines bar workers' attitudes towards aAbstract Background In Scotland on March 26, 2006 a comprehensive prohibition on smoking in all enclosed public places was introduced. This study examines bar workers' attitudes towards a smoke-free working environment. Methods An intervention study comparing bar workers' opinions before and after the implementation of the smoke-free legislation. Bars were randomly selected in three Scottish cities (Glasgow, Edinburgh & Aberdeen) and towns (Aberdeenshire & Borders). Bar workers were recruited from 72 bars that agreed to participate from159 approached. Pre- and post-implementation attitudes towards legislation, second-hand smoke and smoke-free working environments were compared. Results Initially the majority of bar workers agreed with the proposed legislation on smoking (69%) and the need for it to protect the health of workers (80%), although almost half (49%) thought the legislation would damage business. In 266 bar workers seen at both surveys, a significant positive attitudinal change towards the legislation was seen. Post-implementation, support for the legislation rose to 79%, bar workers continued to believe it was needed to protect health (81%) and concerns about the impact on business were expressed by fewer than 20%. Only the statement that the legislation would encourage smokers to quit showed reduced support, from 70% pre-implementation to fewer than 60% post-implementation. Initial acceptance was greater among younger bar workers; older workers, initially more sceptical, became less so with experience of the legislation's effects. Conclusion This study shows that bar workers had generally positive attitudes towards the legislation prior to implementation, which became stronger after implementation. The affirmative attitudes of these key stakeholders are likely to contribute towards the creation of 'smoke-free' as the new social norm.