BMJ, doi:10.1136/bmj.38636.499225.55 (published 17 October 2005)

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Legislation for smoke-free workplaces and health of bar workers in Ireland: before and after study

Shane Allwright ^1*, Gillian Paul ¹, Birgit Greiner ², Bernie J Mullally ², Lisa Pursell ³, Alan Kelly ¹, Brendan Bonner ⁴, Maureen D'Eath ³, Bill McConnell ⁵, James P McLaughlin ⁶, Diarmuid O'Donovan ³, Eamon O'Kane ⁷, Ivan J Perry ²

¹ Department of Public Health and Primary Care, University of Dublin, Trinity College, Trinity College Centre for Health Sciences, AMNCH, Tallaght, Dublin 24, Republic of Ireland
² Department of Epidemiology and Public Health, University College Cork, Brookfield Health Sciences Complex, Cork, Republic of Ireland
³ Department of Health Promotion, National University of Ireland, Galway, Republic of Ireland
⁴ Western Investing for Health Partnership, Londonderry BT47 6FN, Northern Ireland
⁵ Department of Public Health Medicine, Western Health and Social Services Board, Londonderry BT47 6FN
⁶ School of Physics, University College Dublin, Belfield, Dublin 4
⁷ Derry Healthy Cities, The Old Nursing Home, Altnagelvin Hospital, Londonderry BT47 6SB

^* Correspondence to: sllwrght{at}tcd.ie.

Objectives To compare exposure to secondhand smoke and respiratory health in bar staff in the Republic of Ireland and Northern Ireland before and after the introduction of legislation for smoke-free workplaces in the Republic.

Design Comparisons before and after the legislation in intervention and control regions.

Setting Public houses in three areas in the Republic (intervention) and one area in Northern Ireland (control).

Participants 329 bar staff enrolled in baseline survey; 249 (76%) followed up one year later. Of these, 158 were non-smokers both at baseline and follow-up.

Main outcome measures Salivary cotinine concentration, self reported exposure to secondhand smoke, and respiratory and sensory irritation symptoms.

Results In bar staff in the Republic who did not themselves smoke, salivary cotinine concentrations dropped by 80% after the smoke-free law (from median 29.0 nmol/l (95% confidence interval 18.2 to 43.2 nmol/l)) to 5.1 nmol/l (2.8 to 13.1 nmol/l) in contrast with a 20% decline in Northern Ireland over the same period (from median 25.3 nmol/l (10.4 to 59.2 nmol/l) to 20.4 nmol/l (13.2 to 33.8 nmol/l)). Changes in self reported exposure to secondhand smoke were consistent with the changes in cotinine concentrations. Reporting any respiratory symptom declined significantly in the Republic (down 16.7%, -26.1% to -7.3%) but not in Northern Ireland (0% difference, -32.7% to 32.7%). After adjustment for confounding, respiratory symptoms declined significantly more in the Republic than in Northern Ireland and the decline in cotinine concentration was twice as great.

Conclusion The smoke-free law in the Republic of Ireland protects non-smoking bar workers from exposure to secondhand smoke.

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(Accepted 7 October 2005)

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