Impact of the Spanish Smoking Law on Exposure to Second-Hand Smoke and Respiratory Health in Hospitality Workers: A Cohort Study
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{"title"=>"Impact of the Spanish smoking law on exposure to second-hand smoke and respiratory health in hospitality workers: A cohort study", "type"=>"journal", "authors"=>[{"first_name"=>"Esteve", "last_name"=>"Fernández", "scopus_author_id"=>"35232801100"}, {"first_name"=>"Marcela", "last_name"=>"Fu", "scopus_author_id"=>"24474718500"}, {"first_name"=>"José A.", "last_name"=>"Pascual", "scopus_author_id"=>"57197724179"}, {"first_name"=>"María J.", "last_name"=>"López", "scopus_author_id"=>"37000868400"}, {"first_name"=>"Mónica", "last_name"=>"Pérez-Ríos", "scopus_author_id"=>"18438315500"}, {"first_name"=>"Anna", "last_name"=>"Schiaffino", "scopus_author_id"=>"7004016884"}, {"first_name"=>"Jose M.", "last_name"=>"Martínez-Sánchez", "scopus_author_id"=>"24475493800"}, {"first_name"=>"Carles", "last_name"=>"Ariza", "scopus_author_id"=>"35357795800"}, {"first_name"=>"Esteve", "last_name"=>"Saltó", "scopus_author_id"=>"6603790183"}, {"first_name"=>"Manel", "last_name"=>"Nebot", "scopus_author_id"=>"7004378913"}, {"first_name"=>"Anna", "last_name"=>"Martín", "scopus_author_id"=>"57196395350"}, {"first_name"=>"Josep Maria", "last_name"=>"Borràs", "scopus_author_id"=>"34967728000"}, {"first_name"=>"Stephanie", "last_name"=>"Rania", "scopus_author_id"=>"21735227400"}, {"first_name"=>"Jorge", "last_name"=>"Twose", "scopus_author_id"=>"6506127911"}, {"first_name"=>"Francesca", "last_name"=>"Sánchez-Martínez", "scopus_author_id"=>"21735394500"}, {"first_name"=>"Francesc", "last_name"=>"Centrich", "scopus_author_id"=>"6506709278"}, {"first_name"=>"Glòria", "last_name"=>"Muñoz", "scopus_author_id"=>"57198255011"}, {"first_name"=>"Eulàlia", "last_name"=>"Serrahima", "scopus_author_id"=>"6507424505"}, {"first_name"=>"Araceli", "last_name"=>"Valverde", "scopus_author_id"=>"21735238100"}, {"first_name"=>"Meia", "last_name"=>"Faixedas", "scopus_author_id"=>"21734293500"}, {"first_name"=>"Francesc", "last_name"=>"Abella", "scopus_author_id"=>"56439872500"}, {"first_name"=>"Enric", "last_name"=>"Rovira", "scopus_author_id"=>"57196913821"}, {"first_name"=>"Raúl", "last_name"=>"Pérez", "scopus_author_id"=>"55942315500"}, {"first_name"=>"Begoña", "last_name"=>"Alonso", "scopus_author_id"=>"18435918400"}, {"first_name"=>"María Isolina", "last_name"=>"Santiago", "scopus_author_id"=>"21735270800"}, {"first_name"=>"María Jesús", "last_name"=>"García", "scopus_author_id"=>"57201332519"}, {"first_name"=>"Míriam", "last_name"=>"Otero", "scopus_author_id"=>"7101927482"}, {"first_name"=>"Arturo", "last_name"=>"López", "scopus_author_id"=>"7401455280"}, {"first_name"=>"Elena", "last_name"=>"Tejera", "scopus_author_id"=>"21735377600"}, {"first_name"=>"Magdalena", "last_name"=>"Borrás", "scopus_author_id"=>"55942656700"}, {"first_name"=>"Juan A.", "last_name"=>"Ayensa", "scopus_author_id"=>"21734398300"}, {"first_name"=>"Ernesto", "last_name"=>"Pérez", "scopus_author_id"=>"55427822900"}, {"first_name"=>"Francisco", "last_name"=>"Carrión", "scopus_author_id"=>"7007069778"}, {"first_name"=>"Pepa", "last_name"=>"Pont", "scopus_author_id"=>"6506343430"}, {"first_name"=>"José A.", "last_name"=>"Lluch", "scopus_author_id"=>"21734989000"}, {"first_name"=>"Elena", "last_name"=>"Pérez", "scopus_author_id"=>"55942368000"}, {"first_name"=>"M. Eugenia", "last_name"=>"López", "scopus_author_id"=>"21534951400"}, {"first_name"=>"Sonia", "last_name"=>"Álvarez", "scopus_author_id"=>"11141923600"}, {"first_name"=>"M. Emma", "last_name"=>"del Castillo", "scopus_author_id"=>"12786048200"}, {"first_name"=>"Fernando", "last_name"=>"Martín", "scopus_author_id"=>"57200961255"}, {"first_name"=>"Blanca M.", "last_name"=>"Benito", "scopus_author_id"=>"21734366800"}, {"first_name"=>"José Antonio", "last_name"=>"Riesco", "scopus_author_id"=>"21735644900"}, {"first_name"=>"Isabel", "last_name"=>"Marta", "scopus_author_id"=>"21734723400"}, {"first_name"=>"Almudena", "last_name"=>"García", "scopus_author_id"=>"55452181200"}, {"first_name"=>"Carmen", "last_name"=>"Estrada", "scopus_author_id"=>"7006668510"}, {"first_name"=>"Virgilio", "last_name"=>"Blanco", "scopus_author_id"=>"21734312900"}, {"first_name"=>"Ana", "last_name"=>"Esteban", "scopus_author_id"=>"23134745700"}, {"first_name"=>"M. Ángeles", "last_name"=>"Hessel", "scopus_author_id"=>"21734963400"}, {"first_name"=>"José", "last_name"=>"Precioso", "scopus_author_id"=>"6507043071"}, {"first_name"=>"Margarida", "last_name"=>"Coll", "scopus_author_id"=>"7102780750"}], "year"=>2009, "source"=>"PLoS ONE", "identifiers"=>{"pmid"=>"19165321", "scopus"=>"2-s2.0-59349102396", "isbn"=>"1932-6203 (Electronic)\\r1932-6203 (Linking)", "doi"=>"10.1371/journal.pone.0004244", "issn"=>"19326203", "sgr"=>"59349102396", "pui"=>"354136211"}, "id"=>"6d855f8f-8b77-3b1d-b42e-44894b02aec7", "abstract"=>"BACKGROUND: A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban.\\n\\nMETHODS AND FINDING: We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned.\\n\\nCONCLUSIONS: Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.", "link"=>"http://www.mendeley.com/research/impact-spanish-smoking-law-exposure-secondhand-smoke-respiratory-health-hospitality-workers-cohort-s", "reader_count"=>53, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Professor > Associate Professor"=>6, "Librarian"=>3, "Student > Doctoral Student"=>4, "Researcher"=>11, "Student > Ph. D. Student"=>7, "Other"=>4, "Student > Master"=>9, "Student > Bachelor"=>3, "Lecturer"=>2, "Professor"=>3}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Professor > Associate Professor"=>6, "Librarian"=>3, "Student > Doctoral Student"=>4, "Researcher"=>11, "Student > Ph. D. Student"=>7, "Other"=>4, "Student > Master"=>9, "Student > Bachelor"=>3, "Lecturer"=>2, "Professor"=>3}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Agricultural and Biological Sciences"=>3, "Arts and Humanities"=>1, "Business, Management and Accounting"=>2, "Chemistry"=>1, "Computer Science"=>1, "Economics, Econometrics and Finance"=>1, "Engineering"=>1, "Environmental Science"=>5, "Mathematics"=>2, "Medicine and Dentistry"=>22, "Design"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Physics and Astronomy"=>1, "Psychology"=>1, "Social Sciences"=>4}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>22}, "Social Sciences"=>{"Social Sciences"=>4}, "Physics and Astronomy"=>{"Physics and Astronomy"=>1}, "Psychology"=>{"Psychology"=>1}, "Mathematics"=>{"Mathematics"=>2}, "Unspecified"=>{"Unspecified"=>6}, "Environmental Science"=>{"Environmental Science"=>5}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}, "Design"=>{"Design"=>1}, "Engineering"=>{"Engineering"=>1}, "Chemistry"=>{"Chemistry"=>1}, "Economics, Econometrics and Finance"=>{"Economics, Econometrics and Finance"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>2}}, "reader_count_by_country"=>{"United States"=>1, "Portugal"=>1, "Spain"=>3}, "group_count"=>3}

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/910330"], "description"=>"*<p>Defined as workers who reported they were former or never smokers in the baseline and follow-up interviews, and had salivary cotinine concentrations <20 ng/ml. (Workers who changed smoking status between surveys were considered smokers and hence excluded from this analysis.)</p>**<p>In Spain, smoking was permitted in all venues at baseline (before the law entered into effect), and was completely banned, permitted in designated areas, or permitted throughout the premises at follow-up. In Portugal and Andorra, smoking was allowed without restrictions at both baseline and follow-up.</p>†<p>Values are medians (interquartile ranges).</p>‡<p>p-values for comparison of medians (Wilcoxon's test for paired samples) and categorical variables (McNemar's chi-squared test).</p>¶<p>Percentage change derived from a simple linear regression model with random effects.</p>", "links"=>[], "tags"=>["second-hand", "hospitality", "workers", "reported", "baseline", "follow-up", "surveys", "spain", "portugal"], "article_id"=>580768, "categories"=>["Cancer", "Neuroscience", "Biotechnology"], "users"=>["Esteve Fernández", "Marcela Fu", "José A. Pascual", "María J. López", "Mónica Pérez-Ríos", "Anna Schiaffino", "Jose M. Martínez-Sánchez", "Carles Ariza", "Esteve Saltó", "Manel Nebot"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0004244.t002", "stats"=>{"downloads"=>1, "page_views"=>4, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Exposure_to_second_hand_smoke_in_nonsmoker_hospitality_workers_reported_in_baseline_and_follow_up_surveys_in_Spain_and_Portugal_Andorra_/580768", "title"=>"Exposure to second-hand smoke in nonsmoker<sup>*</sup> hospitality workers reported in baseline and follow-up surveys in Spain and Portugal & Andorra.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-01-23 00:12:48"}
  • {"files"=>["https://ndownloader.figshare.com/files/449876"], "description"=>"<div><h3>Background</h3><p>A smoke-free law came into effect in Spain on 1st January 2006, affecting all enclosed workplaces except hospitality venues, whose proprietors can choose among totally a smoke-free policy, a partial restriction with designated smoking areas, or no restriction on smoking on the premises. We aimed to evaluate the impact of the law among hospitality workers by assessing second-hand smoke (SHS) exposure and the frequency of respiratory symptoms before and one year after the ban.</p><h3>Methods and Finding</h3><p>We formed a baseline cohort of 431 hospitality workers in Spain and 45 workers in Portugal and Andorra. Of them, 318 (66.8%) were successfully followed up 12 months after the ban, and 137 nonsmokers were included in this analysis. We obtained self-reported exposure to SHS and the presence of respiratory symptoms, and collected saliva samples for cotinine measurement. Salivary cotinine decreased by 55.6% after the ban among nonsmoker workers in venues where smoking was totally prohibited (from median of 1.6 ng/ml before to 0.5 ng/ml, p<0.01). Cotinine concentration decreased by 27.6% (p = 0.068) among workers in venues with designated smoking areas, and by 10.7% (p = 0.475) among workers in venues where smoking was allowed. In Portugal and Andorra, no differences between cotinine concentration were found before (1.2 ng/ml) and after the ban (1.2 ng/ml). In Spain, reported respiratory symptom declined significantly (by 71.9%; p<0.05) among workers in venues that became smoke-free. After adjustment for potential confounders, salivary cotinine and respiratory symptoms decreased significantly among workers in Spanish hospitality venues where smoking was totally banned.</p><h3>Conclusions</h3><p>Among nonsmoker hospitality workers in bars and restaurants where smoking was allowed, exposure to SHS after the ban remained similar to pre-law levels. The partial restrictions on smoking in Spanish hospitality venues do not sufficiently protect hospitality workers against SHS or its consequences for respiratory health.</p></div>", "links"=>[], "tags"=>["spanish", "smoking", "second-hand", "respiratory", "hospitality", "cohort"], "article_id"=>148661, "categories"=>["Cancer", "Neuroscience", "Biotechnology"], "users"=>["Esteve Fernández", "Marcela Fu", "José A. Pascual", "María J. López", "Mónica Pérez-Ríos", "Anna Schiaffino", "Jose M. Martínez-Sánchez", "Carles Ariza", "Esteve Saltó", "Manel Nebot"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0004244", "stats"=>{"downloads"=>3, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/Impact_of_the_Spanish_Smoking_Law_on_Exposure_to_Second_Hand_Smoke_and_Respiratory_Health_in_Hospitality_Workers_A_Cohort_Study/148661", "title"=>"Impact of the Spanish Smoking Law on Exposure to Second-Hand Smoke and Respiratory Health in Hospitality Workers: A Cohort Study", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-01-23 02:24:21"}
  • {"files"=>["https://ndownloader.figshare.com/files/910280"], "description"=>"*<p>In Spain, smoking was permitted in all venues at baseline (before the law entered into effect), and was completely banned, permitted in designated areas, or permitted throughout the premises at follow-up. In Portugal and Andorra, smoking was allowed without restrictions at both baseline and follow-up.</p>**<p>Adjusted for sex, age, body mass index, self-reported second-hand smoke exposure at work and other settings, number of hours worked, geographical area, day and moth of saliva collection by generalized least squared regression with random effects.</p>†<p>Adjusted for sex, age, body mass index, self-reported second-hand smoke exposure at settings other than the workplace, number of hours worked, and geographical area by logistic regression with random effects. Percentage change corrected for baseline prevalence of any symptom.</p>", "links"=>[], "tags"=>["models", "changes", "salivary", "cotinine", "concentrations", "prevalence", "respiratory", "baseline", "follow-up", "spain", "portugal"], "article_id"=>580718, "categories"=>["Cancer", "Neuroscience", "Biotechnology"], "users"=>["Esteve Fernández", "Marcela Fu", "José A. Pascual", "María J. López", "Mónica Pérez-Ríos", "Anna Schiaffino", "Jose M. Martínez-Sánchez", "Carles Ariza", "Esteve Saltó", "Manel Nebot"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0004244.t004", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Multivariate_models_for_the_changes_in_salivary_cotinine_concentrations_and_prevalence_of_any_respiratory_symptom_between_baseline_and_follow_up_in_Spain_and_Portugal_amp_Andorra_/580718", "title"=>"Multivariate models for the changes in salivary cotinine concentrations and prevalence of any respiratory symptom between baseline and follow-up in Spain and Portugal & Andorra.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-01-23 00:11:58"}
  • {"files"=>["https://ndownloader.figshare.com/files/910382"], "description"=>"*<p>Defined as workers who reported they were former or never smokers in the baseline and follow-up interviews, and had salivary cotinine concentrations <20 ng/ml. (Workers who changed smoking status between surveys were considered smokers and hence excluded from this analysis.)</p>**<p>In Spain, smoking was permitted in all venues at baseline (before the law entered into effect), and was completely banned, permitted in designated areas, or permitted throughout the premises at follow-up. In Portugal and Andorra, smoking was allowed without restrictions at both baseline and follow-up.</p>†<p>Values are percentages and 95% confidence intervals.</p>‡<p>p values for comparison of categorical variables (McNemar's chi-squared test).</p>¶<p>Percentage change derived from a logistic regression model with random effects. Percentage change corrected for baseline prevalence of any symptom.</p>§<p>Any of the following: breathless while wheezing, woken up with a feeling of chest tightness, attack of shortness of breath at rest, woken by attack of shortness of breath, usually cough first thing in the morning in winter, usually cough during the day or night during winter, usually bring up phlegm during day or night in winter, had asthma attack.</p>", "links"=>[], "tags"=>["respiratory", "symptoms", "hospitality", "workers", "baseline", "follow-up", "spain", "portugal"], "article_id"=>580818, "categories"=>["Cancer", "Neuroscience", "Biotechnology"], "users"=>["Esteve Fernández", "Marcela Fu", "José A. Pascual", "María J. López", "Mónica Pérez-Ríos", "Anna Schiaffino", "Jose M. Martínez-Sánchez", "Carles Ariza", "Esteve Saltó", "Manel Nebot"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0004244.t003", "stats"=>{"downloads"=>1, "page_views"=>2, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Presence_of_respiratory_symptoms_in_nonsmoker_hospitality_workers_at_baseline_and_follow_up_in_Spain_and_Portugal_Andorra_/580818", "title"=>"Presence of respiratory symptoms in nonsmoker<sup>*</sup> hospitality workers at baseline and follow-up in Spain and Portugal & Andorra.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-01-23 00:13:38"}
  • {"files"=>["https://ndownloader.figshare.com/files/910433"], "description"=>"*<p>Defined as workers who reported they were former or never smokers in the baseline and follow-up interviews, and had salivary cotinine concentrations <20 ng/ml. (Workers who changed smoking status between surveys were considered smokers and hence excluded from this analysis.)</p>†<p>p-values for comparison of medians (Wilcoxon's test for independent samples) and categorical variables (Fisher's exact test).</p>‡<p>Any of the following: breathless while wheezing, woken up with a feeling of chest tightness, attack of shortness of breath at rest, woken by attack of shortness of breath, usually cough first thing in the morning in winter, usually cough during the day or night during winter, usually bring up phlegm during day or night in winter, had asthma attack.</p><p>IQR: interquartile range</p>", "links"=>[], "tags"=>["characteristics", "hospitality", "workers", "completed", "follow-up", "12"], "article_id"=>580871, "categories"=>["Cancer", "Neuroscience", "Biotechnology"], "users"=>["Esteve Fernández", "Marcela Fu", "José A. Pascual", "María J. López", "Mónica Pérez-Ríos", "Anna Schiaffino", "Jose M. Martínez-Sánchez", "Carles Ariza", "Esteve Saltó", "Manel Nebot"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0004244.t001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Baseline_characteristics_of_nonsmoker_hospitality_workers_who_completed_follow_up_at_12_months_/580871", "title"=>"Baseline characteristics of nonsmoker<sup>*</sup> hospitality workers who completed follow-up at 12 months.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2009-01-23 00:14:31"}

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Relative Metric

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