title: Secondhand smoke exposure within semi-open air cafes and tobacco specific 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) concentrations among nonsmoking employees.
abstract: OBJECTIVE
  Secondhand smoke (SHS) is a defined occupational hazard. The association though between SHS exposure in semi-open air venues and tobacco specific carcinogen uptake is an area of debate.
  
  
  METHODS
  A cross sectional survey of 49 semi-open air cafes in Athens, Greece was performed during the summer of 2008, prior to the adoption of the national smoke free legislation. All venues had at least 1 entire wall open to allow for free air exchange. Indoor concentrations of particulate matter smaller than 2.5 microns (PM2.5) attributable to SHS were assessed during a work shift, while 1 non-smoking employee responsible for indoor and outdoor table service from each venue provided a post work shift urine sample for analysis of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL).
  
  
  RESULTS
  Post work shift NNAL concentrations were correlated with work shift PM2.5 concentrations attributable to SHS (r = 0.376, p = 0.0076). Urinary NNAL concentrations among employees increased by 9.5%, per 10 μg/m(3) increase in PM2.5 concentrations attributable to SHS after controlling for the time of day and day of week.
  
  
  CONCLUSIONS
  These results indicate that the commonly proposed practice of maintaining open sliding walls as a means of free air exchange does not lead to the elimination of employee exposure to tobacco specific carcinogens attributable to workplace SHS.
authors.affiliation: Department of Social and Behavioral Sciences, Center for Global Tobacco Control, Harvard School of Public Health, Boston, MA, USA, vardavas@hsph.harvard.edu.
authors.forename: Constantine I
authors.initials: CI
authors.lastname: Vardavas
authors.forename: Maria
authors.initials: M
authors.lastname: Karabela
authors.forename: Israel T
authors.initials: IT
authors.lastname: Agaku
authors.forename: Yuko
authors.initials: Y
authors.lastname: Matsunaga
authors.forename: Antonis
authors.initials: A
authors.lastname: Myridakis
authors.forename: Antonis
authors.initials: A
authors.lastname: Kouvarakis
authors.forename: Euripides G
authors.initials: EG
authors.lastname: Stephanou
authors.forename: Maria
authors.initials: M
authors.lastname: Lymperi
authors.forename: Panagiotis K
authors.initials: PK
authors.lastname: Behrakis
mesh_terms: D000328:Adult; D000393:Air Pollutants / Q000032:analysis*; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009602:Nitrosamines / Q000032:analysis*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis*; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D011725:Pyridines / Q000032:analysis*; D012147:Restaurants; D014028:Tobacco Smoke Pollution / Q000032:analysis*
chemical_list: D000393:Air Pollutants; D009602:Nitrosamines; D052638:Particulate Matter; D011725:Pyridines; D014028:Tobacco Smoke Pollution; C099565:4-(methylnitrosamino)-1-(3-pyridyl)-1-butan-1-ol