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The Spokesman-Review Newspaper
Spokane, Washington  Est. May 19, 1883

Washington smoking ban improves workers’ health

Dr. Stacie Bering For The Spokesman-Review

Remember all the stink a year ago over Initiative 901? OK, you probably don’t remember what Initiative 901 was all about but breathe easy (that’s a hint). I’ll remind you. Thanks to the initiative, Washington state now requires all public places and workplaces to be 100 percent smoke free.

Smokers were pretty upset. Not only were they banned from the few workplaces that allowed them to smoke, now when they go outdoors for a smoke, they are required to be at least 25 feet from any doors, windows and air intakes.

Perhaps what was most upsetting, however, was the realization that restaurants and bars are workplaces for the servers, bartenders and dishwashers who spend their days serving our meals and mixing our drinks. No smoking in bars? Isn’t that un-American?

The rationale for the indoor smoking ban was the growing evidence of the harm of secondhand smoke. Studies began to accumulate regarding the association between exposure to secondhand smoke and the increased risk of heart disease, stroke, lung cancer and premature death. If the workers exposed to secondhand smoke are unlucky enough to suffer from a lung disease like asthma, their disease is harder to control and they end up hospitalized more often than nonexposed asthmatics.

The health of truly innocent bystanders, babies born to pregnant women exposed to secondhand smoke, also is affected. Those babies are more likely to develop asthma and impaired glucose tolerance, which can lead to diabetes.

So clearing the workplace air ought to make a difference in the health of workers who were exposed to secondhand smoke. But has it?

An interesting study out of Scotland gives us a glimpse into how a ban on indoor smoking can have fairly immediate results. That country’s indoor smoking ban went into effect on March 26 of this year. Some enterprising researchers from Ninewells Hospital and Medical School in Dundee saw a chance to do some before-and-after studies, looking for any change in symptoms, lung function tests and markers of inflammation in non-smoking bar workers. (Tobacco smoke is thought to have many of its detrimental effects because it increases inflammation in the lungs and in blood vessels throughout the body.)

Bars in the United Kingdom are undoubtedly as smoky as they are here in the states. The researchers studied bar workers who were non-smokers and who had no history of significant lung problems, except asthma and rhinitis (the allergies that lead to sneezing and runny noses). The workers were asked questions about respiratory symptoms such as wheezing, shortness of breath, cough and phlegm, and sensory symptoms such as irritated eyes, sore throat, runny nose and sneezing. The researchers also performed lung function tests on the participants.

The workers were questioned and tested a month before the ban, and at one and two months after the ban went into effect. Those with asthma had some extra tests done, and were also asked about medications and quality of life.

The employees tested had worked an average of nine years in the smoky environment before the ban. Despite that, there was marked improvement in symptoms, and lung function improved significantly. Asthmatics showed the greatest improvement in lung function. Their quality of life questionnaires also showed great improvement after the ban. All showed a drop in markers of inflammation.

What is gratifying about this study is how quickly clean air made a difference. This has huge public health implications. This study looked at nonsmokers, whose healthy nonsmoking behavior was compromised by the secondhand smoke in their work environment.

Of course we health professionals are constantly urging our smoking patients to walk the difficult road with the sign that says “This Way to Better Health.” Now, thanks to Washington voters, nonsmoking employees don’t have to walk away from their job in order to breathe healthy air.