title: The impact of clean indoor air exemptions and preemption policies on the prevalence of a tobacco-specific lung carcinogen among nonsmoking bar and restaurant workers.
abstract: OBJECTIVE
  We studied the impact of clean indoor air law exemptions and preemption policies on the prevalence of a tobacco-specific lung carcinogen-4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK)--among nonsmoking bar and restaurant workers.
  
  
  METHODS
  secondhand smoke were compared with results from participants who were exposed to it.
  
  
  RESULTS
  Participants exposed to workplace secondhand smoke were more likely to have any detectable level of NNAL (P=.005) and higher mean levels of NNAL (P < .001) compared with nonexposed participants. Increased levels of NNAL were also associated with hours of a single workplace exposure (P=.005).
  
  
  CONCLUSIONS
  Nonsmoking employees left unprotected from workplace secondhand smoke exposure had elevated levels of a tobacco-specific carcinogen in their bodies. All workers--including bar and restaurant workers--should be protected from indoor workplace exposure to cancer-causing secondhand smoke.
authors.affiliation: Program Design and Evaluation Services, Multnomah County Health Department and the Oregon Department of Human Services, Portland, OR 97232, USA. mike.j.stark@state.or.us
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stark
authors.forename: Kristen
authors.initials: K
authors.lastname: Rohde
authors.forename: Julie E
authors.initials: JE
authors.lastname: Maher
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pizacani
authors.forename: Clyde W
authors.initials: CW
authors.lastname: Dent
authors.forename: Ronda
authors.initials: R
authors.lastname: Bard
authors.forename: Steven G
authors.initials: SG
authors.lastname: Carmella
authors.forename: Adam R
authors.initials: AR
authors.lastname: Benoit
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Thomson
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Hecht
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000652:urine; D002273:Carcinogens / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009602:Nitrosamines / Q000652:urine*; D016273:Occupational Exposure / Q000331:legislation & jurisprudence / Q000517:prevention & control / Q000706:statistics & numerical data*; D009922:Oregon; D011640:Public Policy; D012044:Regression Analysis; D012147:Restaurants / Q000331:legislation & jurisprudence; D012306:Risk; D013997:Time Factors; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000331:legislation & jurisprudence / Q000517:prevention & control*
chemical_list: D015415:Biomarkers; D002273:Carcinogens; D009602:Nitrosamines; D014028:Tobacco Smoke Pollution; C016583:4-(N-methyl-N-nitrosamino)-1-(3-pyridyl)-1-butanone