bartenders from 25 bars were interviewed and underwent spirometry (forced
expired volumes of air) prior to and following institution of the smoking
ban in California bars and taverns. Exposure to ETS averaged 28 hours per
week before, and two hours per week after the ban.
was paid to (1) bronchial ("respiratory") symptoms of wheezing,
dyspnea (shortness of breath), morning cough, cough during the rest of
the day or night and phlegm production, and (2) "sensory irritation
symptoms" of red, teary or irritated eyes, runny nose, sneezing or
nose irritation, and sore or scratchy throat. These were noted during the
previous four weeks before the ban and in the first and second months afterwards.
Nine participants (17%) had a history of physician-diagnosed asthma, and
nearly half (45%) were current smokers.
The most dramatic
findings were the very significant reduction in cough, phlegm and sensory
irritation symptoms. Wheezing also occurred less often. Before the ban,
39 bartenders (74%) initially reported respiratory symptoms. At follow-up,
23 of these (59%) no longer had symptoms. Forty-one bartenders (77%) initially
reported sensory irritation symptoms.
At follow-up, 32 of these (78%) had
resolution of symptoms. Even smokers improved. There was also improvement
in mean forced vital capacity (FVC) of 0.189 L (4.2% change) and mean forced
expiratory volume in one second (FEV-1) of 0.039 L (1.2%). These increased
to 6.8 % and 4.5% where complete cessation of ETS exposure occurred. The
figures are consistent with many studies in smokers with values in a normal
range when simply quitting smoking.
It must be stressed that bars have four to six times higher peak levels of ETS than most other
non-smokefree workplaces. Hence these results represent the worst extreme.
Also, two deficiencies in the study are that interviewers could not be
blinded, and subjects might also have expected these results. Yet, the
fact that most subjects were initially biased against the ban somewhat
mitigates the latter criticism. This study will be a strong argument against
exposure to constant environmental tobacco smoke.
 Eisner MD, Smith AK, Blanc PD. Bartenders' respiratory health after
establishment of smoke-free bars and taverns. JAMA, Dec. 9, 1998, 280:
No. 22, 1909-1914.
Bartenders Breathe Easier In Smoke-Free Bars and Taverns
When Bars Say 'No' To Smoking
Health of Bartenders Improves Rapidly When Bars Become Smoke-free
Journal of the American Medical Association Abstract - December 9, 1998