The 13th World Conference on Tobacco OR Health

Objective: At the time of the study, Washington and Oregon laws exempted bars and restaurants from clean indoor air laws, and both states' laws preempted the passage of more stringent local clean indoor air ordinances. When preemption was legislated in Oregon, however, previously enacted local ordinances prohibiting smoking in all indoor workplaces were allowed to remain in place. This difference in worker protection policies provided an opportunity to demonstrate the impact of exemption and preemption policies on the prevalence of a tobacco-specific carcinogen (NNK) among nonsmoking bar and restaurant workers.

Methods: Participants were 90 verified nonsmoking bar and restaurant workers in Oregon and Washington. Urine specimens collected before and after a workshift of at least 4 hours were analyzed for 3 NNK metabolites and reported as total NNAL. Urinary cotinine and nicotine were also measured. Urinalysis results from participants protected from workplace secondhand smoke (SHS) were compared to results from participants exposed to SHS in the workplace.

Results: In adjusted analyses, participants exposed to workplace SHS were more likely to have any detectable level of NNAL (O.R. = 6, p <0.01), and higher levels of total NNAL (0.055 vs. 0.016 pmol/ml, p < 0.001), compared to non-exposed participants. Increased levels of NNAL were also associated with hours of a single workplace exposure (beta = 0.05, p < 0.01). Prevalence of cotinine and nicotine were also significantly higher among exposed participants. These findings clearly demonstrate that bar and restaurant workers need to be protected from workplace exposure to cancer-causing secondhand smoke.