title: Secondhand smoke (SHS) exposures: workplace exposures, related perceptions of SHS risk, and reactions to smoking in catering workers in smoking and nonsmoking premises.
abstract: BACKGROUND
  Smoke-free workplace legislation often exempts certain venues. Do smoking (exempted) and nonsmoking (nonexempted) catering premises' workers in Hong Kong report different perceptions of risk from and reactions to nearby smoking as well as actual exposure to secondhand smoke (SHS)?
  
  
  METHODS
  In a cross-sectional survey of 204 nonsmoking catering workers, those from 67 premises where smoking is allowed were compared with workers from 36 nonsmoking premises in Hong Kong on measures of perceptions of risk and behavioral responses to self-reported SHS exposure, plus independent exposure assessment using urinary cotinine.
  
  
  RESULTS
  Self-reported workplace SHS exposure prevalence was 57% (95% CI = 49%-65%) in premises prohibiting and 100% (95% CI = 92%-100%) in premises permitting smoking (p < .001). Workers in smoking-permitted premises perceived workplace air quality as poorer (odds ratio [OR] = 9.3, 95% CI = 4.2-20.9) with higher associated risks (OR = 3.7, 95% CI = 1.6-8.6) than workers in smoking-prohibited premises. Workers in smoking-prohibited premises were more bothered by (OR = 0.2, 95% CI = 0.1-0.5) and took more protective action to avoid SHS (OR = 0.2, 95% CI = 0.1-0.4) than workers in smoking-permitted premises. Nonwork exposure was negatively associated with being always bothered by nearby smoking (OR = 0.3, 95% CI = 0.1-0.9), discouraging nearby smoking (OR = 0.5, 95% CI = 0.2-1.1), and discouraging home smoking (OR = 0.4, 95% CI = 0.2-0.9). Urinary cotinine levels were inversely related to workers' avoidance behavior but positively related to their perceived exposure-related risks.
  
  
  CONCLUSIONS
  Different workplace smoking restrictions predicted actual SHS exposure, exposure-related risk perception, and protective behaviors. Workers from smoking-permitted premises perceived greater SHS exposure-related risks but were more tolerant of these than workers in smoking-prohibited premises. This tolerance might indirectly increase both work and nonwork exposures.
authors.affiliation: Department of Community Medicine, School of Public Health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong.
authors.forename: Sandy Qiuying
authors.initials: SQ
authors.lastname: Lu
authors.forename: Richard
authors.initials: R
authors.lastname: Fielding
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Hedley
authors.forename: Lai-Chin
authors.initials: LC
authors.lastname: Wong
authors.forename: Hak Kan
authors.initials: HK
authors.lastname: Lai
authors.forename: C M
authors.initials: CM
authors.lastname: Wong
authors.forename: James L
authors.initials: JL
authors.lastname: Repace
authors.forename: Sarah M
authors.initials: SM
authors.lastname: McGhee
mesh_terms: D000293:Adolescent; D000328:Adult; D000395:Air Pollutants, Occupational / Q000032:analysis* / Q000506:poisoning; D005260:Female; D005522:Food Services / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D006723:Hong Kong; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis; D010465:Perception; D012147:Restaurants / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D018570:Risk Assessment; D012907:Smoking / Q000331:legislation & jurisprudence; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000032:analysis; D055815:Young Adult
chemical_list: D000395:Air Pollutants, Occupational; D014028:Tobacco Smoke Pollution