Abstract
Objectives
Secondhand smoke (SHS) is a defined occupational hazard. The association though between SHS exposure in semi-open air venues and tobacco specific carcinogen uptake is an area of debate.
Material and Methods
A cross sectional survey of 49 semi-open air cafes in Athens, Greece was performed during the summer of 2008, prior to the adoption of the national smoke free legislation. All venues had at least 1 entire wall open to allow for free air exchange. Indoor concentrations of particulate matter smaller than 2.5 microns (PM2.5) attributable to SHS were assessed during a work shift, while 1 non-smoking employee responsible for indoor and outdoor table service from each venue provided a post work shift urine sample for analysis of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL).
Results
Post work shift NNAL concentrations were correlated with work shift PM2.5 concentrations attributable to SHS (r = 0.376, p = 0.0076). Urinary NNAL concentrations among employees increased by 9.5%, per 10 μg/m3 increase in PM2.5 concentrations attributable to SHS after controlling for the time of day and day of week.
Conclusions
These results indicate that the commonly proposed practice of maintaining open sliding walls as a means of free air exchange does not lead to the elimination of employee exposure to tobacco specific carcinogens attributable to workplace SHS.
References
Hatsukami DK, Lemmonds C, Zhang Y, Murphy SE, Le C, Carmella SG, et al. Evaluation of carcinogen exposure in people who used “reduced exposure” tobacco products. J Natl Cancer Inst. 2004;96(11):844–852, http://dx.doi.org/10.1093/jnci/djh163.
Stanfill SB, Connolly GN, Zhang L, Jia LT, Henningfield JE, Richter P, et al. Global surveillance of oral tobacco products: Total nicotine, unionised nicotine and tobacco-specific N-nitrosamines. Tob Control. 2011;20(3):e2, http://dx.doi.org/10.1136/tc.2010.037465.
Upadhyaya P, Carmella SG, Guengerich FP, Hecht SS. Formation and metabolism of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol enantiomers in vitro in mouse, rat and human tissues. Carcinogenesis. 2000;21(6):1233–1238, http://dx.doi.org/10.1093/carcin/21.6.1233.
Yuan JM, Koh WP, Murphy SE, Fan Y, Wang R, Carmella SG, et al. Urinary levels of tobacco-specific nitrosamine metabolites in relation to lung cancer development in two prospective cohorts of cigarette smokers. Cancer Res. 2009;69(7): 2990–2995, http://dx.doi.org/10.1158/0008-5472.CAN-08-4330.
Derby KS, Cuthrell K, Caberto C, Carmella S, Murphy SE, Hecht SS, et al. Exposure to the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) in smokers from 3 populations with different risks of lung cancer. Int J Cancer. 2009;125(10):2418–2424, http://dx.doi.org/10.1002/ijc.24585.
Sureda X, Fernandez E, Lopez MJ, Nebot M. Secondhand tobacco smoke exposure in open and semi-open settings: A systematic review. Environ Health Perspect. 2013;121(7): 766–773, http://dx.doi.org/10.1289/ehp.1205806.
St Helen G, Bernert JT, Hall DB, Sosnoff CS, Xia Y, Balmes JR, et al. Exposure to secondhand smoke outside of a bar and a restaurant and tobacco exposure biomarkers in nonsmokers. Environ Health Perspect. 2012;120(7):1010–1016, http://dx.doi.org/10.1289/ehp.1104413.
Lopez MJ, Fernandez E, Gorini G, Moshammer H, Polanska K, Clancy L, et al. Exposure to secondhand smoke in terraces and other outdoor areas of hospitality venues in eight European countries. PLoS One. 2012;7(8):e42130, http://dx.doi.org/10.1371/journal.pone.0042130.
Vardavas CI, Kafatos A. Greece’s tobacco policy: Another myth? Lancet. 2006;367(9521):1485–1486, http://dx.doi.org/10.1016/S0140-6736(06)68646-7.
Vardavas CI, Anagnostopoulos N, Patelarou E, Minas M, Nakou C, Dramba V, et al. Five-year trends of second-hand smoke exposure in Greece: A comparison between complete, partial, and prelegislation levels. J Aerosol Med Pulm Drug Deliv. 2012 Dec;25(6):349–354, http://dx.doi.org/10.1089/jamp.2011.0949.
Vardavas CI, Fthenou E, Patelarou E, Bagkeris E, Murphy S, Hecht SS, et al. Exposure to different sources of second-hand smoke during pregnancy and its effect on urinary cotinine and tobacco-specific nitrosamine (NNAL) concentrations. Tob Control. 2013 May;22(3):194–200, http://dx.doi.org/10.1136/tobaccocontrol-2011-050144.
Karabela M, Vardavas CI, Tzatzarakis M, Tsatsakis A, Dockery D, Connolly GN, et al. The relationship between venue indoor air quality and urinary cotinine levels among semiopen-air cafe employees: What factors determine the level of exposure? J Aerosol Med Pulm Drug Deliv. 2011;24(1):35–41, http://dx.doi.org/10.1089/jamp.2010.0837.
Wilson T, Shamo F, Boynton K, Kiley J. The impact of Michigan’s Dr Ron Davis smoke-free air law on levels of cotinine, tobacco-specific lung carcinogen and severity of self-reported respiratory symptoms among non-smoking bar employees. Tob Control. 2012;21(6):593–595, http://dx.doi.org/10.1136/tobaccocontrol-2011-050328.
Stark MJ, Rohde K, Maher JE, Pizacani BA, Dent CW, Bard R, et al. The impact of clean indoor air exemptions and preemption policies on the prevalence of a tobacco-specific lung carcinogen among nonsmoking bar and restaurant workers. Am J Public Health. 2007;97(8):1457–1463, http://dx.doi.org/AJPH.2006.094086.
Jones IA, St Helen G, Meyers MJ, Dempsey DA, Havel C, Jacob P 3rd, et al. Biomarkers of secondhand smoke exposure in automobiles. Tob Control. 2013;23(1):51–57, http://dx.doi.org/10.2105/AJPH.2006.094086.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Vardavas, C.I., Karabela, M., Agaku, I.T. et al. Secondhand smoke exposure within semi-open air cafes and tobacco specific 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentrations among nonsmoking employees. IJOMEH 27, 875–881 (2014). https://doi.org/10.2478/s13382-014-0294-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.2478/s13382-014-0294-4