THE EFFECT OF A SMOKING BAN INTRODUCTION ON EXPOSURE AND CARDIO-RESPIRATORY HEALTH IN SWISS HOSPITALITY WORKERS

摘要

Background and Aims: In May 2010 Switzerland introduced a heterogeneous smoking ban in the hospitality sector. To evaluate the effect on workers' health, personal exposure and markers of cardio-respiratory health were measured repeatedly in 92 nonsmoking hospitality workers. Methods: Second-hand smoke (SHS) exposure was determined using nicotine specific badges and expressed as inhaled cigarette equivalents per day (ce/d). Heart rate variability (HRV), a quantitative marker of autonomic activity of the nervous system, and pulse wave velocity (PWV), a marker of arterial stiffness, were measured in 55 non-smoking hospitality workers before and after implementation of a smoking ban. Fractional exhaled Nitric Oxide (FeNO), a marker of airway inflammation, and pulmonary function were also assessed. 37 non-smokers were included in a control group that did not experience any change in exposure. Results: The smoking ban was associated with significantly lower SHS exposure among hospitality workers (2.56 (95% CI: 1.70 to 3.44) ce/d before the ban vs 0.16 (95% CI: 0.13 to 0.20) ce/d after the ban. The ban was also associated with a 2.3% (95% CI: 0.2 to 4.4; p=0.031) increase in RMSSD, a measure of the high frequency content of HRV per decrease in ce/d and a 15.1% (95% CI: 8.1 to 22.2; p＜0.001) decrease in PWV. Similar associations were not observed in the control group. FeNO levels decreased in the intervention group after the ban, compared to the control group (p＜0.001). Lung function parameters were below average at the beginning of the study and did not change in any group. Conclusions: Within a year after the smoking ban, non-smoking hospitality workers showed significant reductions in risk factors for myocardial infarction and arteriosclerosis. Markers of airway inflammation decreased as well. Lung function damage may take longer to recover or may be irreversible. These results support a positive effect of a smoking ban, mainly on cardiovascular health.