The impact of Michigan's Dr Ron Davis smoke-free air law on levels of cotinine, tobacco-specific lung carcinogen and severity of self-reported respiratory symptoms among non-smoking bar employees.
OBJECTIVE
To determine the impact on bar employee's health and exposure to secondhand smoke (SHS) before and after the implementation of Michigan's Dr Ron Davis smoke-free air law that went into effect on 1 May 2010, prohibiting smoking in places of work, including bars.


METHODS
This study used a pre/postintervention experimental design. The setting was bars in 12 Michigan counties. Subjects were bar employees, recruited through flyers and individual discussions with local health department staff. Participants completed a screening questionnaire to determine eligibility. A total of 40 eligible employees completed a demographic survey, provided urine samples for analysis of cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and completed questionnaires on respiratory and general health status 6 weeks before and 6-10 weeks after the law went into effect. The main outcome measures were urine samples for total cotinine and total NNAL and data from a self-administered respiratory and general health status questionnaire collected during the pre-law and post-law study periods.


RESULTS
There was a significant decrease in the mean cotinine levels from 35.9 ng/ml to a non-quantifiable value (p<0.001), and there was a significant reduction in the mean NNAL level from 0.086 pmol/ml to 0.034 pmol/ml (p<0.001) 2 months after implementation of the law. There was also a significant improvement in all six self-reported respiratory symptoms (p<0.001) and general health status (p<0.001).


CONCLUSIONS
The reduction in the SHS biomarkers cotinine and NNAL and reported improvement in respiratory health demonstrates that the Michigan smoke-free workplace law is protecting bar employee health.
Michigan Department of Community Health, Tobacco Control Program, Lansing, Michigan 48913, USA. scorciawilsont@michigan.gov
Teri
T
Wilson
Farid
F
Shamo
Katherine
K
Boynton
Janet
J
Kiley
D000328:Adult; D000368:Aged; D003367:Cotinine / Q000652:urine; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008824:Michigan; D008875:Middle Aged; D009602:Nitrosamines / Q000652:urine; D009784:Occupational Diseases / Q000453:epidemiology / Q000503:physiopathology / Q000517:prevention & control; D016273:Occupational Exposure / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D016272:Occupational Health / Q000331:legislation & jurisprudence; D011725:Pyridines / Q000652:urine; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000503:physiopathology; D012147:Restaurants / Q000331:legislation & jurisprudence*; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects / Q000331:legislation & jurisprudence; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects / Q000331:legislation & jurisprudence / Q000517:prevention & control*; D055815:Young Adult
D009602:Nitrosamines; D011725:Pyridines; D014028:Tobacco Smoke Pollution; C099565:4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol; D003367:Cotinine