The health impacts of workplace exposure to tobacco smoke pollution are well documented. Hospitality workers are particularly vulnerable to tobacco smoke pollution in their workplaces. The concentration of cotinine in the saliva of non-smokers provides an accurate quantitative guide to the extent of exposure to tobacco smoke pollution. Objective: to identify the health impact, as measured by salivary cotinine levels, of restaurants and cafes with different smoking policies on their non-smoking staff. Methods: a two stage random sampling procedure was adopted to select London districts and restaurants and cafes within each district. West End districts were excluded. Selection was made using a publically available sampling frame. A sample size of 183 was advised, equally distributed between smokefree, zoned smoking and unrestricted smoking venues. Trained researchers visited each venue to seek management co-operation and identify an adult non-smoking volunteer. Each volunteer provided two saliva samples, at the beginning and end of their shift, and completed a questionnaire. All procedures were pilotted. Results: data was collected from 197 volunteers distributed equally between the three types of venue, average age 29 years (95% CI: 20-37 years). Average time between saliva collections was five hours. Saliva analyses from non-smoking volunteers working in venues in unrestricted smoking venues recorded a 30% increase in their cotinine scores from baseline whilst saliva analyses from non-smoking volunteers working in smokefree venues recorded no change. Mean differences between smokefree and unrestricted smoking venues at the second saliva collection were statistically significant (p=0.046). Conclusions: restaurants and cafes with different smoking policies expose their non-smoking waiters to different levels of tobacco smoke pollution during their shifts. Salivary cotinine provides a reliable and sensitive measure of these changes in risk.
Acknowledgement: funded by Smokefree London