Eisner M D, Smith A K, Blanc P D
Department of Medicine, Cardiovascular Research Institute, University of California, San Francisco, USA.
JAMA. 1998 Dec 9;280(22):1909-14. doi: 10.1001/jama.280.22.1909.
The association between environmental tobacco smoke (ETS) exposure and respiratory symptoms has not been well established in adults.
To study the respiratory health of bartenders before and after legislative prohibition of smoking in all bars and taverns by the state of California.
Cohort of bartenders interviewed before and after smoking prohibition.
Bartenders at a random sample of bars and taverns in San Francisco.
Interviews assessed respiratory symptoms, sensory irritation symptoms, ETS exposure, personal smoking, and recent upper respiratory tract infections. Spirometric assessment included forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) measurements.
Fifty-three of 67 eligible bartenders were interviewed. At baseline, all 53 bartenders reported workplace ETS exposure. After the smoking ban, self-reported ETS exposure at work declined from a median of 28 to 2 hours per week (P<.001). Thirty-nine bartenders (74%) initially reported respiratory symptoms. Of those symptomatic at baseline, 23 (59%) no longer had symptoms at follow-up (P<.001). Forty-one bartenders (77%) initially reported sensory irritation symptoms. At follow-up, 32 (78%) of these subjects had resolution of symptoms (P<.001). After prohibition of workplace smoking, we observed improvement in mean FVC (0.189 L; 95% confidence interval [CI], 0.082-0.296 L; 4.2% change) and, to a lesser extent, mean FEV1 (0.039 L; 95% CI, -0.030 to 0.107 L; 1.2% change). Complete cessation of workplace ETS exposure (compared with continued exposure) was associated with improved mean FVC (0.287 L; 95% CI, 0.088-0.486; 6.8% change) and mean FEV1 (0.142 L; 95% CI, 0.020-0.264 L; 4.5% change), after controlling for personal smoking and recent upper respiratory tract infections.
Establishment of smoke-free bars and taverns was associated with a rapid improvement of respiratory health.
环境烟草烟雾（ETS）暴露与成年人呼吸道症状之间的关联尚未完全明确。
研究加利福尼亚州所有酒吧和酒馆立法禁烟前后酒保的呼吸健康状况。
对酒保进行禁烟前后的队列访谈。
旧金山随机抽取的酒吧和酒馆中的酒保。
访谈评估呼吸道症状、感觉刺激症状、ETS暴露、个人吸烟情况以及近期上呼吸道感染情况。肺功能测定评估包括1秒用力呼气量（FEV1）和用力肺活量（FVC）测量。
67名符合条件的酒保中有53名接受了访谈。基线时，所有53名酒保均报告工作场所存在ETS暴露。禁烟后，自我报告的工作场所ETS暴露从每周中位数28小时降至2小时（P<0.001）。39名酒保（74%）最初报告有呼吸道症状。在基线时有症状的酒保中，23名（59%）在随访时不再有症状（P<0.001）。41名酒保（77%）最初报告有感觉刺激症状。随访时，这些受试者中有32名（78%）症状消失（P<0.001）。工作场所禁烟后，我们观察到平均FVC有所改善（0.189升；95%置信区间[CI]，0.082 - 0.296升；变化4.2%），平均FEV1也有较小程度改善（0.039升；95%CI，-0.030至0.107升；变化1.2%）。在控制个人吸烟和近期上呼吸道感染因素后，工作场所ETS暴露完全停止（与持续暴露相比）与平均FVC改善（0.287升；95%CI，0.088 - 0.486；变化6.8%）和平均FEV1改善（0.142升；95%CI，0.020 - 0.264升；变化4.5%）相关。
无烟酒吧和酒馆的设立与呼吸健康的快速改善相关。
