Journal of Gambling Studies

, Volume 29, Issue 2, pp 255–268 | Cite as

The Correlations of Work Conditions with Unhealthy Lifestyles and Occupational Health Problems of Casino Croupiers in Macau

  • Sydney X. Hu
  • Andrew Luk
  • Carmen Leong
  • Cecilia U
  • Florence Van
Original Paper


The Macau economy and employment of residents rely heavily on the gaming industry. It is important that the working conditions in casinos are not harmful to the health of the casino employees. This study examines the correlations between work conditions, unhealthy lifestyles and occupational health problems amongst casino croupiers in Macau. Its findings will provide casino managers and policy makers with evidence and awareness of the workplace health risks for the casino workers. The data were gathered by a questionnaire survey of 1,042 croupiers, which represents roughly 5 % of the croupier population in Macau. Work conditions were measured by worker satisfaction towards the biological, chemical and physical elements in their work environments. Unhealthy lifestyles were measured by practices of excessive drinking, smoking, electronic game playing and addictive substance use as well as gambling. Occupational health problems were measured by experiences of work related illnesses or symptoms. Results showed that high percentages of respondents were dissatisfied with the work conditions. On average each croupier experienced 10 work related health problems in the past 7 days. Over 5 % of the respondents drank more than three glasses of alcohol a day, 24 % smoked cigarettes, 12 % took addictive substances, 14 % gambled in the past 7 days. The analysis showed that dissatisfaction with work conditions did not correlate with unhealthy lifestyles but were strongly and significantly correlated with stress-related occupational health problems (R = 0.377–0.479, P < 0.001) and other occupational health problems (R = 0.348–0.461, P < 0.001). Casino workers in Macau experience a variety of problems associated with their work conditions that can be hazardous to their health. The working conditions in casinos need to be regularly monitored and improvements such as occupational health training and enhanced health related policies can be introduced.


Casino workers Unhealthy lifestyle Work conditions Occupation health and hazards 


Conflict of interest



  1. GMB Scotland. (2006). 3rd GMB scotland report on casino workers health and safety. GMB Scotland.Google Scholar
  2. American Medical Association. (2007). Emotional and behavioral effects of video games and internet over use. Chicago, IL: American Medical Association.Google Scholar
  3. Battaglia, E. (2009). Substance abuse—An occupational hazard? Drug and Alcohol Addiction Recovery Magazine, September 4, 2009.Google Scholar
  4. Berman, M., & Post, C. (2007). Second hand smoke and casinos. In T. C. L. Consortium (Ed.). Research finding: Macau employees are confident about employment in the coming five years (July 10, 2007). Macau China News.Google Scholar
  5. Bi, Y. G. (2007). Research finding: Macau employees are confident about employment in the coming five years. Macau: Macau China News.Google Scholar
  6. Bureau of Statistics and Census. (2011). Yearbook of statistics 2010. Macau: Bureau of Statistics and Census, Macao Special Administrative Region.Google Scholar
  7. Centers for Disease Control and Prevention. (2011). Alcohol and public health. Four major casinos, worst air quality in starworld. (2007, November 11, 2001). Apple Daily. Google Scholar
  8. Choi, Y. G. (2007). Four major casinos, worst air quality in Starworld. Apple Daily, Hong Kong.Google Scholar
  9. Drug abuse in the gaming industry. (2009, 02 Sep). Indian Country Today, p. 19.Google Scholar
  10. European Agency for Safety and Health at Work. (2005). Priorities for occupational safety and health research in the EU-25.Google Scholar
  11. Fletcher, J. M., Sindelar, J. L., & Yamaguchi, S. (2011). Cumulative effects of job characteristics on health. Health Economics, 20(5), 553–570.PubMedCrossRefGoogle Scholar
  12. Fong, D. K. C., & Ozorio, B. (2005). Gambling participation and prevalence estimates of pathological gambling in a far-east gambling City: Macao. UNLV Gaming Research and Review Journal, 9(2), 15–28.Google Scholar
  13. Gu, K., Maia Trindade, D., Cheng, B. S., & Sou, B. (2008). Macao health survey 2006. Macau: Health Bureau Government of Macao Special Administrative Region.Google Scholar
  14. Hing, N., & Breen, H. (2008). Risk and protective factors relating to gambling by employees of gaming venues. International Gambling Studies, 8(1), 1–23.CrossRefGoogle Scholar
  15. Hing, N., & Gainsbury, S. (2011). Risky business: Gambling problems among gaming venue employees in Queensland. Australia Journal of Gambling Issues, 25, 4–24.CrossRefGoogle Scholar
  16. Keith, M. M., Cann, B., Brophy, J. T., Hellyer, D., Day, M., Egan, S., et al. (2001). Identifying and prioritizing gaming workers’ health and safety concerns using mapping for data collection. American Journal of Industrial Medicine, 39(1), 42–51.PubMedCrossRefGoogle Scholar
  17. Lee, T. K., LaBrie, R. A., Rhee, H. S., & Shaffer, H. J. (2008). A study of South Korean casino employees and gambling problems. Occupational Medicine, 58, 191–197.PubMedCrossRefGoogle Scholar
  18. Leong, S. M., Van, Y. K., & Lei, W. I. (2006). Health condition of kindergarten and primary school teachers in Macau. Macau Journal of Nursing, 5(1), 11–17.Google Scholar
  19. Luime, J., Koes, B., Hendriksen, I., Burdorf, A., Verhagen, A., Miedema, H., et al. (2004). Prevalence and incidence of shoulder pain in the general population; a systematic review. Scandinavian Journal of Rheumatology, 33(2), 73–81.PubMedCrossRefGoogle Scholar
  20. Macau Worker’s Union. (2010). A study of stress facing casino workers in Macau. Macau: Author.Google Scholar
  21. NIOSH. (2009). Environmental and biological assessment of environmental tobacco smoke exposure among casino dealers. In C. W. Achutan, C. Mueller, C. Boudreau, & Y. Mead (Eds.), Health hazard evaluation report. Cincinnati, OH: U.S. Department of Health and Human Services, Centrers for Disease Control and Prevention, National Institute for Occupational Safety and Health.Google Scholar
  22. Office on Smoking and Health. (2006). The health consequences of involuntary exposure to tobacco smoke: A report of the surgeon general. Washington DC: US Department of Health and Human Services.Google Scholar
  23. Ricci, J., Chee, E., Lorandeau, A., & Berger, J. (2007). Fatigue in the US workforce: prevalence and implications for lost productive work time. Journal of Occupational and Environmental Medicine, 49(1), 1–10.PubMedCrossRefGoogle Scholar
  24. Shaffer, H. J., Bilt, J. V., & Hall, M. N. (1999). Gambling, drinking, smoking and other health risk activities among casino employees. American Journal of Industrial Medicine, 36(3), 365–378.PubMedCrossRefGoogle Scholar
  25. Stayner, L., Bena, J., Sasco, A., Smith, R., Steenland, K., Kreuzer, M., et al. (2007). Lung cancer risk and workplace exposure to environmental tobacco smoke. American Journal of Public Health, 97, 545–551.PubMedCrossRefGoogle Scholar
  26. Trout, D., Decker, J., Mueller, C., John, T., & Pirkle, J. (1998). Exposure of casino employees to environmental tobacco smoke. Journal of Occupational and Environmental Medicine, 40(3), 270–276.PubMedCrossRefGoogle Scholar
  27. UNI Gaming Global Union. (2004). Scottish casino workers gamble with their health. Nyon, Switzerland: UNI Global Union.Google Scholar
  28. Wakefield, M., Cameron, M., Inglis, G., Letcher, T., & Durkin, S. (2005). Secondhand smoke exposure and respiratory symptoms among casino, club and office workers in Victoria, Australia. Journal of Occupational and Environmental Medicine, 47(7), 698–703.PubMedCrossRefGoogle Scholar
  29. Wan, Y. K. P., & Pilkington, P. (2009). Knowledge, attitudes and experiences of Macao’s casino workers with regard to second-hand smoke exposure at work. International Gambling Studies, 9(3), 207–224.CrossRefGoogle Scholar
  30. Wu, A. M. S., & Wong, E. M. W. (2008). Disordered gambling among Chinese casino employees. Journal of Gambling Studies, 24(2), 207–217.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Sydney X. Hu
    • 1
  • Andrew Luk
    • 1
  • Carmen Leong
    • 1
  • Cecilia U
    • 1
  • Florence Van
    • 1
  1. 1.Kiang Wu Nursing College of MacauMacauPeople’s Republic of China

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