Air quality, mortality, and economic benefits of a smoke – free workplace law for non-smoking Ontario bar workers

Repace Associates, Inc, 101 Felicia Lane, Bowie, MD, 20720.
Indoor Air (Impact Factor: 4.9). 04/2013; 23(2):93-104. DOI: 10.1111/ina.12004


We estimated the impact of a smoke-free workplace bylaw on non-smoking bar workers' health in Ontario, Canada. We measured bar workers' urine cotinine before (n = 99) and after (n = 91) a 2004 smoke-free workplace bylaw. Using pharmacokinetic and epidemiological models, we estimated workers' fine-particle (PM 2.5) air pollution exposure and mortality risks from workplace secondhand smoke (SHS). Workers' pre-law geometric mean cotinine was 10.3 ng/ml; post-law dose declined 70% to 3.10 ng/ml and reported work hours of exposure by 90%. Pre-law, 97% of workers' doses exceeded the 90th percentile for Canadians of working age. Pre-law-estimated 8-h average workplace PM 2.5 exposure from SHS was 419 ug/m3 or 'Very Poor' air quality, while outdoor PM 2.5 levels averaged 7 ug/m3 , 'Very Good' air quality by Canadian Air Quality Standards. We estimated that the bar workers' annual mortality rate from workplace SHS exposure was 102 deaths per 100 000 persons. This was 2.4 times the occupational disease fatality rate for all Ontario workers. We estimated that half to two-thirds of the 10 620 Ontario bar workers were non-smokers. Accordingly, Ontario's smoke-free law saved an estimated 5–7 non-smoking bar workers' lives annually, valued at CA $50 million to $68 million (US $49 million to $66 million). Practical Implications Worker's cotinine measurements can be compared with population databases to assess an occupational group's dose of secondhand smoke relative to the general population. Cotinine can be used to estimate secondhand smoke air pollution exposures and risks for workers and evaluate the efficacy of smoke-free workplace laws in terms of lives and social costs saved. Although Canadian bars are now smoke-free, substantial exposure persists on bar patios, and in many other countries, indoor air in bars remains polluted with secondhand smoke.

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