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CIS 95-156 Society of Occupational Medicine of the Provence-Alpes-Côte-d'Azur and Corsica regions - Meetings of 29 September and 25 November 1992, 19 January and 12 February 1993
Société de médecine du travail de la région Provence-Alpes-Côte-d'Azur et de la région Corse - Séances des 29 septembre et 25 novembre 1992, et des 19 janvier et 12 février 1993 [in French]
Papers presented at the meetings of the Society of Occupational Medicine of the Provence-Alpes-Côte-d'Azur and Corsica regions (France, 29 Sep. and 25 Nov. 1992, 19 Jan. and 12 Feb. 1993): collectors' badges and epoxy resins - investigation after the reporting of a case of an occupational disease; in-plant management of smoking under French legislation concerning smoking in the workplace; sleep disturbances and the working population; classification of sleep disturbances; sleep physiology and the faculties of adaptation; postural deficiency syndromes; neurophysiopathogenic aspects of the postural system; ophthalmic posture and occupational medicine.
Archives des maladies professionnelles et de médecine du travail, 1993, Vol.54, No.8, p.669-681.

CIS 94-1924 Hirota Y., Hirohata T., Fukuda K., Mori M., Yanagawa H., Ohno Y., Sugioka Y.I.
Association of alcohol intake, cigarette smoking, and occupational status with the risk of idiopathic osteonecrosis of the femoral head
The association of alcohol intake, cigarette smoking, occupation, and other factors with the development of idiopathic osteonecrosis of the femoral head was studied in Japan during the period 1988-1990, comparing 118 cases with no history of systemic corticosteroid use with 236 controls. The risks of developing femoral head necrosis associated with potential risk factors were estimated by adjusted relative odds. The elevated relative odds were observed for occasional and regular drinkers, with a significant dose-response relation (p<0.001). An increased risk was found for current smokers, but a linear increasing trend in the cumulative effect of smoking was not evident at 20 pack-years or over. A weak but significant dose-response relation was observed for daily occupational energy consumption (p<0.05). The present study confirmed the strong association of alcohol intake and positive association of cigarette smoking and suggested the role of heavy physical work.
American Journal of Epidemiology, 1 Mar. 1993, Vol.137, No.5, p.530-538. 35 ref.

CIS 94-1302 Górecka D., Górski T.
The influence of cigarette smoking on sister chromatid exchange frequencies in peripheral lymphocytes among nurses handling cytostatic drugs
Genotoxic compounds and various cancer chemotherapeutic agents can interact with tobacco smoke synergistically, especially among cigarette smoking nurses who handle cytostatic drugs. The aim of the study was to examine the hypothesis that tobacco smoking has a greater influence on sister chromatid exchange (SCE) frequencies among nurses than the influence of cytostatics in working conditions. The frequencies of SCE in lymphocytes investigated among hospital staff who handle anti-cancer drugs were higher than in a control group which did not handle them (smokers and non-smokers). The increase of SCE frequencies was observed more often among cigarette smoking nurses and less among non-smoking nurses who handle cytostatics 3 times a week.
Polish Journal of Occupational Medicine and Environmental Health, 1993, Vol.6, No.2, p.143-148. Illus. 11 ref.

CIS 94-1235 Greer J.R., Abbey D.E., Burchette R.J.
Asthma related to occupational and ambient air pollutants in non smokers
To determine the association of occupational and general air pollutant exposure with the development of adult asthma, a standardized respiratory questionnaire was administered to a cohort of 3914 non-smoking adults in 1977 and again in 1987. Ambient air pollution levels at place of work and residence over a 20-year period were established by interpolation from concentrations measured at fixed monitoring stations. Second-hand smoke exposure was significantly associated with the development of asthma. Airway obstructive disease before age 16 was related to marked increased risk. An increased risk of asthma in men was significantly associated with increased exposure to ozone.
Journal of Occupational Medicine, Sep. 1993, Vol.35, No.9, p.909-915. Illus. 42 ref.

CIS 94-1253 Jeffery R.W., Forster J.L., French S.A., Kelder S.H., Lando H.A., McGovern P.G., Jacobs D.R., Baxter J.E.
The healthy worker project - A work-site intervention for weight control and smoking cessation
A randomized trial was conducted to evaluate the effectiveness of a work-site health promotion programme in reducing obesity and cigarette smoking. Thirty-two worksites were randomized to treatment or no treatment for two years. Treatment consisted of health education classes combined with a payroll-based incentive system. Evaluation was based on cohort and cross-sectional surveys. Results showed that of 10,000 total employees in treatment worksites, 2,041 and 270 participated in weight control and smoking cessation programmes, respectively. Weight loss averaged 4.8lbs, and 43% of smoking participants quit. Net two-year reductions in smoking prevalence in treatment compared to control worksites were 4.0% and 2.1% in cross-sectional and cohort surveys, respectively. No treatment effect was found for weight. Treatment effects for smoking prevalence and weight were both positively correlated with participation rates in the intervention programmes (r=0.45 for smoking and r=0.55 for weight).
American Journal of Public Health, Mar. 1993, Vol.83, No.3, p.395-401. 54 ref.

CIS 94-1232 Senthilselvan A., Chen Y., Dosman J.A.
Predictors of asthma and wheezing in adults - Grain farming, sex, and smoking
Predictors for asthma and wheeze were investigated in 1,634 subjects in the 20-65 age group from a Saskatchewan (Canada) town. Subjects were classified as asthmatic (n=62), wheezing (n=444), asymptomatic (n=908), or symptomatic (n=220). After excluding the symptomatic group, it was found that significant predictors for asthma were grain farming (odds ratio (OR)=1.9, 95% confidence interval (CI): 1.1-3.5; p=0.03) and sex (OR=1.9, CI: 1.1-3.2; p=0.03; males compared with females). Significant predictors for wheezing were smoking (former smoker: OR=1.8, CI: 1.3-2.5, p<0.001; current smoker: OR=5.0, CI: 3.8-6.7, p<0.001; in comparison to non-smoker) and grain farming (OR=1.7, CI: 1.3-2.4, p<0.001). Age, level of education, and physical activity at work were not significant predictors for asthma or wheezing. Grain farming was a significant predictor of asthma in men but not in women. Nevertheless, smoking and grain farming were significant predictors of wheezing in both sexes.
American Review of Respiratory Disease, Sep. 1993, Vol.148, No.3, p.667-670. 18 ref.

CIS 94-1309 Hanaoka T., Ishizu S., Yamano Y.
Effects of cigarette smoking on lymphocyte subsets in office workers
Some immunotoxicological studies have applied the analysis of lymphocyte subsets to the detection of biological effects of chemical exposures. The purpose of this research was to examine the effects of cigarette smoking and alcohol drinking on lymphocyte subsets. Some lymphocyte subsets in healthy office workers (n=36) with no industrial exposure to chemicals were determined. A significant increase of the total peripheral white blood cell counts, the total lymphocyte counts, the percentages of CD4+CD45RA-cells and CD25 positive cells was found in smokers (n=16) compared to non-smokers (n=20). A positive correlation was also observed between the percentage of CD4+CD45RA-cells and the Brinkman index (p<0.05) and between the percentage of CD20 positive cells and the Brinkman index (p<0.1). Furthermore, a negative correlation was seen between the percentage of CD8+CD11b-cells and Brinkman index (p<0.05). On the other hand, no effects of alcohol drinking and age were observed on the percentages of lymphocyte subsets. Thus, it is necessary to take into account smoking habits in industrial toxicological studies using the analysis of lymphocyte subsets.
Journal of Science of Labour - Rōdō Kagaku, Oct. 1993, Vol.69, No.10, p.15-20. Illus. 19 ref.

CIS 94-1093 Jeffery R.W., Forster J.L., Dunn B.V., French S.A., McGovern P.G., Lando H.A.
Effects of work-site health promotion on illness-related absenteeism
This study examined the effects of work-site health promotion on employee absenteeism. Thirty-two work sites were randomized to programmes for weight control and smoking cessation or to no treatment for two years. The prevalence of self-reported absences from work was assessed at baseline and follow-up. Results using work site as the unit of analysis showed a reduction in the proportion of workers reporting a sick day in the last month in treatment versus control work sites. The rate of participation in smoking but not weight programmes was positively associated with change in sick day prevalence and this effect was strongest in baseline smokers. Work-site smoking cessation programmes may yield important short-term economic benefits by reducing employee absenteeism.
Journal of Occupational Medicine, Nov. 1993, Vol.35, No.11, p.1142-1146. 15 ref.

CIS 94-886 Society of Occupational Medicine and Hygiene - Meetings of 13 Oct., 10 Nov., 8 Dec. 1992 and 12 Jan. 1993
Société de médecine et d'hygiène du travail - Séances des 13 octobre, 10 novembre, 8 décembre 1992 et 12 janvier 1993 [in French]
Themes of papers presented at the meetings of 13 Oct., 10 Nov., 8 Dec. 1992 and 12 Jan. 1993 of the Society of Occupational Medicine and Hygiene (France): the clothing industry in the centre of Paris (recommendation to include arthrosis of the navicular bone of the hand in the French Schedule as an occupational disease among garment-cutters); protection of garbage workers against risks due to medical refuse present in domestic waste; occupational lead poisoning in connection with the renovation of an older building; cholinesterases: value of isolated variations of their levels; one case of thallium poisoning in a mineralogy laboratory; a case of chronic transfusion hepatitis affecting a nurse; occupational stress: in-plant experimental approach; sleep apnoea and aptitude to work in fire brigades; comments on the Decree of 29 May 1992 pertaining to the prohibition of smoking at work.
Archives des maladies professionnelles, 1993, Vol.54, No.7, p.587-606.

CIS 94-606 Kumagai S., Kurumatani N., Nakachi S., Nakagiri S., Hara K.
Occupational dust exposure and prevalence of respiratory symptoms among conduit repair workers
Suidōkyoku shokuin no funjin bakuro jōkyō to kokyūkishō jōshū soritsu [in Japanese]
Workers engaged in the repair of city water supply conduits are exposed to dust during excavation and the cutting of pavement and pipe. To quantify this exposure and its consequences, ambient dust levels were measured at 20 conduit repair sites in two cities; the concentration and composition of dust was compared with samples collected in 10 offices of the water supply authorities. Questionnaires concerning respiratory symptoms were then distributed to the conduit repair workers and office workers of 119 municipal water supply authorities. The mean dust concentration in conduit repair was 0.91mg/m3, or 4.6 times higher than the level in offices. X-ray analysis showed that soil was the main component, while in offices it was tobacco smoke. Among smokers, the prevalence of cough and phlegm was higher among conduit workers than in clerical or engineering staff; among non- and ex-smokers the difference was not significant.
Japanese Journal of Industrial Health - Sangyō-Igaku, Nov. 1993, Vol.35, No.6, p.540-549. Illus. 30 ref.

CIS 93-1945 Siegel M.
Involuntary smoking in the restaurant workplace: A review of employee exposure and health effects
Evidence from published studies of indoor air quality indicates that levels of environmental tobacco smoke in restaurants are approximately 1.6 to 2.0 times higher than in office workplaces of other businesses and 1.5 times higher than in residences with at least one smoker. Levels in bars are 3.9 to 6.1 times higher than in offices and 4.4 to 4.5 times higher than in residences. Published epidemiological evidence suggests that there may be a 50% increase in lung cancer risk among food-service workers that is in part attributable to tobacco exposure in the workplace.
Journal of the American Medical Association, 28 July 1993, Vol.270, No.4, p.490-493. 42 ref.


CIS 94-199 Brinkworth M.H., Yardley-Jones A., Edwards A.J., Hughes J.A., Anderson D.
A comparison of smokers and nonsmokers with respect to oncogene products and cytogenetic parameters
Human monitoring studies can be valuable tools for assessing the adverse effects of chemicals. Cytogenetic parameters have been frequently employed but are rarely related directly to possible adverse health effects. Recently, the measurement of oncoprotein levels in plasma has been proposed as a possible and more appropriate indicator of exposure and carcinogenic risk but, unlike chromosome damage, little is known about the effects of possible confounding factors. This study compared the effect of smoking on chromosome aberrations, sister chromatid exchange, and plasma rasoncoprotein levels, in 40 humans not otherwise known to be exposed to any specific chemical hazard. No effect was found on any of these end points, with the exception of a moderate, statistically non-significant elevation of sister chromatid exchange levels. It is concluded that smoking is unlikely to be a confounding factor in human monitoring studies using oncoprotein levels as an end point.
Journal of Occupational Medicine, Dec. 1992, Vol.34, No.12, p.1181-1188. Illus. 17 ref.

CIS 93-1930 Rando R.J., Menon P.K., Poovey H.G., Lehrer S.B.
Assessment of multiple markers of environmental tobacco smoke (ETS) in controlled, steady-state atmospheres in a dynamic test chamber
Controlled test atmospheres of sidestream and mixed mainstream/sidestream tobacco smoke were produced in a dynamic test chamber. For each target level of smoke, a "smoke index" was calculated as the number of cigarettes being smoked divided by the dilution flow rate. Ultraviolet light-absorbing particulate matter (UVPM); aerosol counts and size distribution; and concentrations of CO, NO2, NH3, formaldehyde, acetaldehyde, acrolein, and nicotine were determined in the test atmospheres and background dilution air. Parameters exhibiting the highest correlations with smoke index included UVPM, aerosol counts, formaldehyde, and acetaldehyde. The levels of acetaldehyde, formaldehyde, and CO were significantly higher in mixed mainstream/sidestream smoke than in sidestream atmospheres. The generation factors developed in this work can be used for estimating required ventilation rates for attainment of target air quality conditions in smoking rooms.
American Industrial Hygiene Association Journal, Nov. 1992. Vol.53, No.11, p.699-704. Illus. 18 ref.

CIS 93-1637 Gaffuri E., Maranelli G., Romeo L., Durigato S.
Exposure of office workers to tobacco smoke
Esposizione al fumo di tabacco degli impiegati di un'azienda telefonica [in Italian]
Smoking habits were studied in a group of employees of a telephone company. Of the subjects interviewed, 34% were smokers. The non-smokers said that they were bothered by other people smoking everywhere and also to a considerable extent at the workplace. Differences between smokers and non-smokers and between exposed and non-exposed non-smokers were studied by measuring expired CO and urinary cotinine. An expired CO concentration of 10ppm discriminated between smokers and non-smokers. A mean urinary cotinine concentration of about 16ng/mg creatinine was found in the exposed non-smokers, corresponding to the direct smoking of 1/10 of a cigarette per day. The search for the metabolic phenotype of dextromethorphan, which was taken as an indicator of susceptibility to contract lung cancer, showed that there were no differences between smokers and non-smokers since the rapid metabolisers, and therefore subjects potentially exposed to risk of lung cancer due to tobacco smoke, prevailed in both groups.
Medicina del lavoro, Nov.-Dec. 1992, Vol.83, No.86, p.596-604. Illus. 17 ref.

CIS 93-1574 Gamsky T.E., Schenker M.B., McCurdy S.A., Samuels S.J.
Smoking, respiratory symptoms, and pulmonary function among a population of Hispanic farmworkers
Hispanic Californian farmworkers were evaluated for the prevalence of respiratory symptoms, smoking status, and pulmonary function. The prevalences of current, former, and never-smokers (29, 17, and 54%, respectively) were comparable to rates in other studies of Hispanics, but daily cigarette consumption was lower than in comparison populations. Prevalences of chronic cough, chronic phlegm, and persistent wheeze were low (1.6, 5.1, and 2.8%, respectively). Current smoking, increased age, female sex, and working eight months per year or more in agriculture were associated with increased prevalence of respiratory symptoms. Adjusted lung function was higher than for reference populations. Lower respiratory symptom prevalences and higher pulmonary function are consistent with lower daily cigarette consumption and the healthy worker effect.
Chest, May 1992, Vol.101, No.5, p.1361-1368. Illus. 50 ref.

CIS 93-602 Lewit E.M.
Responses among New Jersey's largest employers to legislation restricting smoking at the worksite
In 1985, the state of New Jersey (USA) enacted a law requiring that employers with more than 50 employees implement policies to control smoking in places of employment. The 104 largest private employers in New Jersey were surveyed in 1988 to assess their worksite smoking policies. Of the 92 respondents, 97% had implemented restrictive workplace smoking policies. Only 12% of respondents had implemented such policies prior to the date required by the law, and 86% cited the law as the reason for restricting smoking in the workplace. Over two-thirds of respondents placed restrictions on smoking in open areas, while only one-third restricted smoking in private offices. Non-smoking employees were reported by 80% of respondents to be supportive of restrictive smoking policies, but 23% reported dissatisfaction by their smoking employees. The New Jersey law appears to have been an important factor in the adoption of workplace smoking restrictions by the state's largest employers.
American Journal of Industrial Medicine, Sep. 1992, Vol.22, No.3, p.385-393. Illus. 10 ref.

CIS 93-700 Grossman M., Price P.
Tobacco smoking and the law in Canada
This book deals with Canadian federal and provincial legislation as it relates to tobacco smoking. Information is also provided on the history, production, taxation, advertising, toxicology, and health effects of tobacco as well as the addictive nature of nicotine. Various theories as to why people smoke are discussed. Chapter six covers smoking in the workplace and how the law relates to this issue.
Butterworths Canada Ltd., 75 Clegg Road, Markham, Ontario L6G 1A1 and 409 Granville Street, Suite 1455, Vancouver, British Columbia V6C 1T2, Canada, 1992. 1 vol. (various pagination). Illus. Bibl.ref. Index.

CIS 93-603 Sasco A.J., Dalla-Vorgia P., Van der Elst P.
International Agency for Research on Cancer (IARC)
Comparative study of anti-smoking legislation in countries of the European Economic Community
This document examines both existing and proposed legislation and regulations involving tobacco use. Topics covered: advertising; labelling and limits on tar levels; protection of children; definition of tobacco products and prohibition of certain smokeless products; smoking in public places and workplaces. A table lists those countries with projected legislation or regulation for the workplace.
World Health Organization, Distribution and Sales Service, 1211 Genève 27, Switzerland, 1992. 82p. Bibl.ref. Price: CHF 30.00.

CIS 93-219 Borland R., Pierce J.P., Burns D.M., Gilpin E., Johnson M., Bal D.
Protection from environmental tobacco smoke in California. The case for a smoke-free workplace
A survey of 7,162 nonsmoking indoor workers in California showed that nonsmokers working where there was only a work-area ban were 2.8 times more likely to be exposed to environmental tobacco smoke (ETS) than those working in a smoke-free work site. In workplaces with no policy or a policy not covering the work area, nonsmokers were over eight times more likely to be exposed to ETS than those who worked in a smoke-free work site. Results indicate that adequate protection of nonsmokers from ETS exposure requires a smoke-free site.
Journal of the American Medical Association, 12 Aug. 1992, Vol.268, No.6, p.749-752. 32 ref.

CIS 93-160 Andjelkovich D.A., Mathew R.M., Yu R.C., Richardson R.B., Levine R.J.
Mortality of iron foundry workers: II. Analysis by work area
Plantwide analyses of the mortality experience of 8,147 foundrymen revealed excesses for several diseases including lung cancer. Using indirect measures of smoking, it appeared that most, if not all, of the excess of lung cancer deaths could be explained by smoking habits. To explore further the possible association between these mortality excesses and foundry exposures, jobs were grouped into six work areas on the basis of similarities in production processes. No evidence was found of a relationship between lung cancer and foundry exposures. The pattern of mortality from emphysema and cerebrovascular disease in the different work areas paralleled that of lung cancer, suggesting that mortality from these diseases may have been influenced by a common aetiologic agent, probably tobacco smoke. The data also reveal possible associations between metal pattern-making and colon cancer, silica or metal dust and stomach cancer, and carbon monoxide and ischaemic heart disease. For Part I of this study, see CIS 93-159.
Journal of Occupational Medicine, Apr. 1992, Vol.34, No.4, p.391-401. Illus. 39 ref.

CIS 93-130 Qun W.W., Dobson A.J.
Cigarette smoking and sick leave in an industrial population in Shanghai, China
A study of cigarette smoking and sick leave was conducted at a large Chinese petrochemical complex in 1988. Among a random sample of 1,856 men the smoking prevalence was 80% with the highest rate (84%) occurring in the 25-34 age group. Retrospective data were also collected on sick leave. In 1986 13% of men took sick leave, and 12% took it in 1987. The mean duration of sick leave was three days per year. In 1986 the odds ratios (OR) for taking sick leave were 2.37 for heavy smokers and 1.45 for light smokers compared to unity for non-smokers; the corresponding OR for 1987 were 1.70 and 1.28 for heavy and light smokers compared with non-smokers. Smoking was positively associated with sick leave even after adjustment for age, alcohol consumption, and exposure to chemicals; OR = 1.56 (95% confidence interval (CI): 1.06-2.31) in 1986 and OR = 1.32 (95% CI: 0.90-1.95) in 1987.
International Journal of Epidemiology, Apr. 1992, Vol.21, No.2, p.293-297. 13 ref.

CIS 93-128 Jöckel K.H., Ahrens W., Wichmann H.E., Becher H., Bolm-Audorff U., Jahn I., Molik B., Greiser E., Timm J.
Occupational and environmental hazards associated with lung cancer
In a hospital-based case control study in Germany, 194 lung cancer cases, 194 hospital controls, and 194 population controls were interviewed for smoking, occupational, and residential history. Case ascertainment took place in seven different hospitals. Lung cancer risk strongly increases with cumulative cigarette dose. For occupational risk, significantly increased risks were observed in the metal industry, particularly in smelter and foundry workers (odds ratio (OR) 4.8, 95% confidence limits (CL): 1.15, 20.16) and in turners, grinders, drillers, and cutters (OR 2.2, 95% CL: 1.05, 4.75). In the construction industry the risks were particularly high in road construction workers (OR 3.7, 95% CL: 1.06, 13.20) and in unskilled construction workers (OR 2.7, 95% CL: 1.24, 5.76). The risks in these occupational groups increased with duration and with latency. Quantification of air pollution was also done, on a district basis by time period.
International Journal of Epidemiology, Apr. 1992, Vol.21, No.2, p.202-213. 42 ref.

CIS 93-164 Das R., Tager I.B., Gamsky T., Schenker M.B., Royce S., Balmes J.R.
Atopy and airways reactivity in animal health technicians - A pilot study
Smoking, response to allergen skin testing, and non-specific airways reactivity in student animal health technicians (AHT) were studied to determine whether such persons provide a suitable cohort to overcome the selection biases accompanying investigations of occupational asthma. Previous occupational exposure to animals (65%) was associated positively with allergic symptoms but negatively with skin response to animal allergens and to airway hyperreactivity (AR). AHTs remaining in the programme were more likely than drop-outs to have: (1) worked with animals; (2) positive skin responsiveness to animal allergens; (3) AR. The latter was significantly associated with positive skin-test responses to animal allergen testing. This study demonstrates that significant exposure to animals may have occurred among workers entering animal-handling careers. Additionally, competing "healthy" and "resistant" worker effects operate among AHTs to influence the prevalence of occupational asthma in this population.
Journal of Occupational Medicine, Jan. 1992, Vol.34, No.1, p.53-60. 56 ref.


CIS 93-501 Ahlborg G., Bodin L.
Tobacco smoke exposure and pregnancy outcome among working women - A prospective study at prenatal care centers in Örebro County, Sweden
Among 4,687 women undergoing prenatal care in Sweden from 1980 to 1983, 678 non-smokers reported passive exposure to tobacco smoke. Of these women, 267 had been passively exposed at work, and the risk ratio (RR) for intra-uterine death (spontaneous abortion or stillbirth) among these pregnancies was increased to 1.53 compared with pregnancies of unexposed working women. The effect was confined to first-trimester foetal loss (adjusted RR=2.16), while active smoking was associated with intra-uterine death after the first trimester. Passive smoking in the workplace was weakly associated with preterm birth but not with low birth weight among full-term livebirths. Active smoking clearly increased the risk of both outcomes. However, passive exposure in the home only did not seem to affect pregnancy outcome. The lack of quantitative exposure data points to the need for more research before passive exposure to tobacco smoke can be regarded as an established hazard to foetal development and survival.
American Journal of Epidemiology, 15 Feb. 1991, Vol.133, No.4, p.338-347. 24 ref.

CIS 93-344 Milham S., Davis R.L.
Cigarette smoking during pregnancy and mother's occupation
The association between mother's occupation and cigarette smoking prevalence during pregnancy was analysed in over 350,000 Washington State births during the years 1984 through 1988. Smoking prevalence during pregnancy varied markedly by maternal age, race, marital status, and social class, with higher smoking rates found in unmarried women, women 25 through 29 years old, native Americans and whites, and women in low socio-economic classes. Women who worked in traditionally male occupations or in occupations where alcohol was served had the highest smoking rates. Occupational groups with exposure to toxic or carcinogenic substances (including second-hand smoke) also had elevated smoking rates. These data could be useful in planning intervention strategies, in studies of occupational morbidity and mortality, and in analysis of the reproductive effects of maternal occupational exposures.
Journal of Occupational Medicine, Apr. 1991, Vol.33, No.4, p.468-473. Illus. 6 ref.

CIS 92-1922 Iversen M.
Bronchial symptoms during work in a group of 124 Danish pig farmers
Bronchiale Symptome während der Arbeit in einer Gruppe von 124 dänischen Schweinezüchtern [in German]
A questionnaire survey of 124 randomly selected Danish pig farmers (average age 43, average exposure 12yrs) revelead that 48 suffered from work-related respiratory symptoms such as coughing, shortness of breath and asthma. In this group 33% were smokers whereas in the group of 76 farmers without respiratory symptoms 12% were smokers. Symptoms were found to develop in 75% within the first hour of work. In 50% they persisted up to 1h after work. The average exposure time to the appearance of first symptoms was 7 years. The percentages of non-smoking and smoking farmers with respiratory symptoms rose within the last six years prior to the study by 200 and 300%.
Zentralblatt für Arbeitsmedizin, Arbeitsschutz, Prophylaxe und Ergonomie, Nov. 1991, Vol.41, No.11, p.419-423. Illus. 16 ref.

CIS 92-1893 Moulin J.J.
Methods of assessing smoking effects in occupational cohort studies
Les études épidémiologiques de cohortes industrielles: comment prendre en compte le tabagisme? [in French]
This paper describes methods for the interpretation of the results of epidemiologic studies carried out in cohorts of workers aimed at assessing possible lung cancer risks related to occupational exposures. One such method, usable when a statistically significant lung cancer excess appears in a cohort study, enables the tobacco-attributable excess to be evaluated and, therefore, the occupational risk to be calculated. The theoretical model, as well as the practical applications, suggest that a possible tobacco overconsumption in the study cohort is unlikely to account entirely for a lung cancer excess higher than 1.50.
Archives des maladies professionnelles, 1991, Vol.52, No.5, p.319-326. 28 ref.

CIS 92-1910 Serre C.
The bladder: target organ of tobacco - Prevention and detection of cancer
La vessie, organe cible du tabac - Prévention et dépistage du cancer [in French]
Summary of papers presented at a Colloquium organised in Paris on 24 May 1991 concerning the prevention and detection of bladder cancer and the role of tobacco smoking on its development. Main topics discussed: classification and evolution of bladder cancers; risk factors (results of an epidemiological survey of 700 cases; risk factors recognised today; role of tobacco; case-control study of environmental factors); detection, diagnosis and prognosis; role of endoscopy; anti-smoking campaings; role of the occupational physician in preventive efforts. It was recommended that in a case of bladder cancer all possible (present or past) occupational factors should be investigated, even in heavy smokers, so that the disease can be declared as an occupational disease or as being of an occupational nature.
Documents pour le médecin du travail, 4th Quarter 1991, No.48, p.377-381.

CIS 92-1623 Järup L., Pershagen G.
Arsenic exposure, smoking, and lung cancer in smelter workers - A case-control study
A cohort of 3,916 Swedish copper smelter workers employed for at least 3 months between 1928 and 1967 was followed up through 1981. Arsenic exposure was estimated for different time periods at each workplace within the smelter. Detailed job records were linked to the exposure matrix, thus forming individual cumulative arsenic exposure measures for each smelter worker. Smoking history was collected for 107 lung cancer cases and 214 controls from the cohort. Lung cancer risks were positively related to cumulative arsenic exposure with smoking-standardised relative risks ranging from 0.7-8.7 in different exposure groups. A negative confounding by smoking was suggested in the higher exposure categories. The interaction between arsenic and smoking for the risk of developing lung cancer was intermediate between additive and multiplicative and appeared less pronounced among heavy smokers.
American Journal of Epidemiology, 15 Sep. 1991, Vol.134, No.6, p.545-551. 31 ref.

CIS 92-1048 Sorensen G., Rigotti N.A., Rosen A., Pinney J., Prible R.
Employee knowledge and attitudes about a work-site nonsmoking policy: Rationale for further smoking restrictions
This study examines employee knowledge of and satisfaction with a nonsmoking policy instituted at approximately 600 work sites of the New England Telephone company in 1986. A stratified random sample of employees was surveyed 20 months after the policy was implemented; 1120 (74.5%) returned surveys. Awareness of the rules about smoking in most areas was high, especially where smoking was totally banned. Respondents were highly satisfied with the policy, but half preferred additional restrictions on smoking. The policy was effective in reducing perceived environmental tobacco smoke exposure in work areas where smoking was banned but not in nonwork areas where smoking was allowed in designated areas. This study suggests that a highly restrictive nonsmoking policy--including a total ban on smoking--may be more easily and successfully implemented than are less restrictive policies.
Journal of Occupational Medicine, Nov. 1991, Vol.33, No.11, p.1125-1130. 16 ref.

CIS 92-1045 Serxner S., Catalano R., Dooley D., Mishra S.
Tobacco use: Selection, stress, or culture?
The effects of selection (personal characteristics), job stress, and culture models on the association between occupation and smoking were empirically estimated on a random sample of 2,362 employed adults in Orange County (California, USA), using data collected through the Orange County Health Survey. The largest proportion of smokers were blue-collar workers (32.4%). The logistic regression analysis results indicated that age, sex, education, ethnicity, job stress, and the industry in which employees work had significant impact on the risk of smoking. The findings imply that all three models contribute to smoking behaviour. Smoking cessation and prevention programmes may include elements that address both stress and environment in intervention design. Stress models imply that such programmes should focus on change in individual coping mechanisms; social environment models imply that change in group norms and attitudes is necessary.
Journal of Occupational Medicine, Oct. 1991, Vol.33, No.10, p.1035-1039. 25 ref.

CIS 92-816 Sorensen G., Rosen A., Pinney J., Rudolph J., Doyle N.
Work-site smoking policies in small businesses
This study describes the experiences of small work-sites in the US in implementing policies restricting smoking. Two hundred and sixteen work sites employing 120 or fewer persons were surveyed by telephone in 1987. Compared with companies without policies, companies with policies were larger and reported having fewer smokers and more management support for smoking policies. Seventy-three percent of work sites without a smoking policy said they would be very likely to implement a policy if it were required by law; 42% of work sites with a policy reported offering smoking cessation assistance to their employees. Overall satisfaction and compliance with the smoking policy was high among work sites with a policy. The findings of this study have key implications for other small businesses considering implementing a smoking policy.
Journal of Occupational Medicine, Sep. 1991, Vol.33, No.9, p.980-984. 17 ref.

CIS 92-861 Erfurt J.C., Foote A., Heirich M.A.
The cost-effectiveness of work-site wellness programs for hypertension control, weight loss, and smoking cessation
The cost-effectiveness of work-site wellness programmes for reducing cardiovascular disease risks of employees was examined at 3 manufacturing plants. A fourth plant was used as a control site to estimate levels of risk reduction achieved from wellness screening and pre-existing services, without further interventions. The disease risks studied were hypertension, obesity, and cigarette smoking. Two of the 3 experimental sites were more effective and cost effective than the other, both in terms of engaging employees at risk of cardiovascular disease into treatment or programme participation and of reducing their risks or preventing relapse. Programme costs were held constant in this report for comparison across programme models.
Journal of Occupational Medicine, Sep. 1991, Vol.33, No.9, p.962-970. 29 ref.

CIS 92-857 Chen Y., Horne S.L., McDuffie H.H., Dosman J.A.
Combined effect of grain farming and smoking on lung function and the prevalence of chronic bronchitis
The combined effect of grain farming and smoking on lung function and the prevalence of chronic bronchitis was examined in 1633 residents of Saskatchewan (Canada). Multiple multivariate analysis indicated that in women grain farming and smoking had a significant synergistic effect on ventilatory capacity. However, such combined effects were not statistically significant in men. Female non-smoking grain farmers had a similar prevalence of chronic bronchitis to non-smoking female non-farmers (2.0% and 2.1%, respectively). In women with a positive smoking history, however, the prevalence was 13.2% and 5.9%, respectively. The prevalence of chronic bronchitis increased more rapidly with increasing cigarette consumption in female grain farmers than in female non-farmers. In contrast, the effect of grain farming on the prevalence of chronic bronchitis was similar in men with and without a positive smoking history. The data suggest a positive interactive effect of grain farming exposure and smoking on lung function and the prevalence of chronic bronchitis in women.
International Journal of Epidemiology, June 1991, Vol.20, No.2, p.416-423. 36 ref.

CIS 92-462 Hessel P.A., Sluis-Cremer G.K., Lee S.L.
Distribution of silicotic collagenization in relation to smoking habits
A causal association between smoking and silicosis would seriously confound the association between silicosis and lung cancer. The analysis presented here assesses this association using data on deceased gold miners. There was a slight inverse relationship between smoking and silicotic collagenisation of the parenchyma and a stronger negative relationship between smoking and silicotic collagenisation of the pleura. No association between silicotic collagenisation of the hilar glands and smoking was detected. The data suggest that the lack of smoking histories in studies of the association between silicosis and lung cancer probably does not seriously confound risk estimates. The distribution of silicotic collagenisation in the lungs of smokers and non-smokers is consistent with enhanced mucous interception, more central deposition in the lungs, and proportionally more lymphatic clearance to the hilum (as opposed to the pleura) of silica particles in smokers compared to non-smokers.
American Review of Respiratory Disease, Aug. 1991, Vol.144, No.2, p. 297-301. 23 ref.

CIS 92-532 White J.R., Froeb H.F., Kulik J.A.
Respiratory illness in nonsmokers chronically exposed to tobacco smoke in the work place
CO levels as an index of cigarette smoke in the workplace were evaluated and diary entries on respiratory symptoms, eye irritation, chest colds and lost days from work due to respiratory illness in 40 passive smokers were analysed (non-smokers chronically exposed to tobacco smoke in the workplace) and 40 control subjects (non-smokers not exposed to tobacco smoke in the workplace) matched for age and sex. Passive smokers experienced greater CO levels during the workday. Also they reported significantly more cough, greater phlegm production, more shortness of breath, greater eye irritation, more chest colds and more days lost from work due to chest colds than control subjects. Non-smoking workers and their employers are likely to incur significant financial loss because of missed workdays due to illnesses resulting from exposure to second-hand tobacco smoke.
Chest, July 1991, Vol.100, No.1, p.39-43. 23 ref.

CIS 92-346 Stave G.M., Jackson G.W.
Effect of a total work-site smoking ban on employee smoking and attitudes
Three months after a smoking prohibition went into effect at a university medical centre, a randomly selected group of 400 employees were queried about their smoking habits and attitudes. An equal number of employees at the university campus were queried, where there was no such prohibition. Smoking cessation rates were 12.6% at the medical centre and 6.9% on the campus dating back 9 months to the time of the policy announcement. Mean cigarette consumption during work hours declined over the same period from 8.1 ± 6.8 (mean ± SD) to 4.3 ± 4.4 at the medical centre but showed little change on the campus (9.3 ± 7.5 v 8.7 ± 8.0). A follow-up survey of the cohort of current or recent ex-smokers identified on the initial survey was conducted 6 months later. The survey revealed a smoking cessation rate of 22.5% at the medical centre and 6.9% on the campus, dating back 15 months to the time of the policy announcement.
Journal of Occupational Medicine, Aug. 1991, Vol.33, No.8, p.884-890. 26 ref.

CIS 91-1641 NIOSH Current Intelligence Bulletin No.54 - Environmental tobacco smoke in the workplace - Lung cancer and other health effects
This bulletin reviews epidemiologic studies of nonsmokers exposed to environmental tobacco smoke (ETS) and the associated risk of lung cancer, heart disease and other adverse health effects. Recent studies support and reinforce the conclusions of reviews by the Surgeon General and the National Research Council demonstrating that exposure to ETS can cause lung cancer. Recent evidence also suggests a possible association between ETS exposure and an increased risk of heart disease in nonsmokers. There is insufficient data to draw conclusions about other health effects. Recommendations are given for controlling involuntary exposure to ETS.
National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Cincinnati, OH 45226, USA, 1991. ix, 18p. 56 ref.

CIS 91-1746 Hocking B., Borland R., Owen N., Kemp G.
A total ban on workplace smoking is acceptable and effective
The acceptability and effectiveness of a total workplace smoking ban by Telecom Australia was evaluated. Staff were surveyed before and after the ban. Sixty-six percent of staff reported that a total ban was operative, and 31% reported that a total ban except for a smoking room, leaving only 3% reporting lesser restriction. Smokers were smoking between three and four less cigarettes per work day, and the numbers of smokers had decreased by about double the community rate. The policy had little perceived effect on productivity but resulted in some tension between staff that progressively decreased and now is limited to the few areas where there were problems with compliance. A subsample of managers and staff were interviewed and factors relevant to successful implementation of the policy were identified. These included a clear statement of policy, strong managerial support via equipping managers with leadership and negotiating skills, and reliance on occupational health nurses. It is important to provide assistance to affected staff to help them adjust to the ban both before and after implementation.
Journal of Occupational Medicine, Feb. 1991, Vol.33, No.2, p.163-167. 17 ref.

CIS 91-1584 Morinaga K., Sakatani M., Yokoyama K., Yasui I., Hara I., Sera Y.
Silicosis and lung cancer - A retrospective cohort study of compensated patients with silicosis in Osaka
Keihai to haigan: Ōsaka ni okeru keihai nintei kanja no kohōto kenkyū [in Japanese]
A retrospective cohort study was conducted on 248 male silicotics who were approved as total disability or complicating disease compensation recipients between 1972 and 1976 in Osaka Prefecture (Japan). At the end of 1987, 76 were dead. The standardised mortality ratio (SMR) was calculated for 226 patients who survived for more than 3yrs from the date of health examination for compensation, based on the mortality rates of the Osaka population. SMR for all causes was 0.98 (55), but those for tuberculosis, lung cancer and respiratory diseases were 9.79 (14), 3.70 (10), and 4.11 (18) respectively, all statistically significant. Of 15 cases with lung cancer, including 5 cases of death within the 3-year observation period, 8 were squamous cell carcinomas, 2 small cell carcinomas, 1 undifferentiated type, 2 adenocarcinomas, and 2 unknown. Excluding 4 cases with unknown smoking history, all were smokers and ex-smokers. Thus, a large part of the lung cancer in this cohort was closely associated with smoking, but the observed excess risk may not be accounted for solely by smoking.
Japanese Journal of Traumatology and Occupational Medicine, 1 Mar. 1991, Vol.39, No.3, p.192-197. 24 ref.


CIS 94-1450
National Occupational Health and Safety Commission (Worksafe Australia)
National policy statement on smoking and the workplace
This document provides guidance on the development of policies on workplace smoking. Contents: health hazards and fire risks of smoking at work; development and implementation of a workplace program for a smoke-free work environment (consultation, education and information, designation of non-smoking areas); personnel policies.
Australian Government Publishing Service, GPO Box 84, Canberra ACT 2601, Australia, 1990. 8p. 9 ref.

CIS 93-1617 De Lorenzo F.
Tobacco smoking in the workplace - Letter of the Minister of Health addressed to the social partners in order to achieve a useful collaboration against the health hazard created by tobacco smoking
Il fumo di tabacco negli ambiente di lavoro: lettera del Ministero della Sanità ... alle forze sociali per una proficua collaborazione contro i danni da fumo di tabacco [in Italian]
Letter by the Italian Minister of Health addressed to the social partners (employers and workers) and aimed at the encouragement of smoking cessation in the workplace. Relevant statistics on deaths attributable to smoking (WHO), proportion of smokers in the population (ISTAT) and opinions regarding smoking and how it may be discouraged (EEC) are given.
Prevenzione oggi, Apr.-June 1990, Vol.2, No.2, p.4-8. 1 ref.

CIS 93-1051 Smoking in the Workplace Act, 1989 (Chapter 48, Statutes of Ontario, 1989) [Canada - Ontario]
The booklet contains the text of the Act to Restrict Smoking in Workplaces (effective 1 Jan. 1990), which prohibits smoking in enclosed workplaces except for areas used primarily by the public. Included is a brief guide to the legislation and a section for employers on methods for its implementation.
Publications Services Section, 5th Floor, 880 Bay Street, Toronto M7A 1N8, Ontario, Canada, 1990. 21p.

CIS 93-255 Kimura K., Shimakage K., Saitō M.
Estimation and control measures of indoor air pollution by smoking
Kitsuen ni yoru shitsunai kūki osen to sono taisaku [in Japanese]
The quantity of air pollutants generated by smoking in office rooms was estimated and measures to control air pollution were examined. Experimentally, a cigarette generated 15mg of particulate matter, 50mL of CO and 1mL of NO. The concentration of particulate matter generated varied depending on smoking situations and ventilation in the room concerned. In a series of rooms served by the same ventilation system, tobacco smoke generated in a smoking office invaded non-smoking offices through the ventilation system. Tobacco smoke accounted for 4-74% of the particulate matter in the air supplied by the ventilation system. The relative effectiveness of three methods of controlling air pollution due to smoking was demonstrated: complete banning of smoking; separation of smoking sites or time; and limitation on the number of persons smoking at any one time.
Journal of Science of Labour - Rōdō Kagaku, 10 Dec. 1990, Vol.66, No.12, p.545-567. Illus. 7 ref.

CIS 93-159 Andjelkovich D.A., Mathew R.M., Richardson R.B., Levine R.J.
Mortality of iron foundry workers: I. Overall findings
Report on a retrospective cohort mortality study of 8,147 men and 627 women employed in a Michigan (US) iron foundry for at least six months during 1950-1979. During the 35-year observation period, more than 1,700 deaths occurred among the workers observed. Significantly high Standardised Mortality Ratios (SMRs) occurred among non-white workers for lung cancer (SMR 132) and ischaemic heart disease (SMR 126). These high SMRs, as well as other, non-significant, increases in morality (for other diseases in non-whites, for all such increases in whites) may be attributed to smoking habits. A lack of a trend with length of employment suggests that lung cancer mortality may not be associated with exposure to the foundry environment. For Part II of this study, see CIS 93-160.
Journal of Occupational Medicine, June 1990, Vol.32, No.6, p.529-540. Illus. 68 ref.

CIS 92-922 Choudat D., Frisch C., Barrat G., El Kholti A., Conso F.
Occupational exposure to amorphous silica dust and pulmonary function
Respiratory manifestations among 41 workers exposed to amorphous silica dust were compared with a control group comprising 90 workers of equivalent socioeconomic state in the same plant. Flow volumes were determined, blood gas concentrations were measured at rest and during exercise, chest radiographs were obtained, and data about respiratory symptoms were collected by questionnaire. A dust exposure index was calculated for each exposed worker. It was not possible to differentiate between the 2 groups from the questionnaire, blood gas analysis, or chest radiographs. On the other hand, the tests of respiratory function showed a significant decrease in forced expiratory flow (FEF25-75, FEF50, and FEF75) in the exposed group compared with the controls, although no correlation was found between the exposure index and pulmonary function. It appears that smoking and exposure to amorphous silica synergise to induce small airway disease.
British Journal of Industrial Medicine, Nov. 1990, Vol.47, No.11, p.763-766. Illus. 5 ref.

CIS 92-182 Hnizdo E.
Combined effect of silica dust and tobacco smoking on mortality from chronic obstructive lung disease in gold miners
A sample of 2209 white South African gold miners aged 45-54 between 1968-71, who started to work in mines during 1936-43, was investigated from 1968-71 to Decembber 1986. The effect of silica dust and tobacco smoking on mortality from chronic obstructive lung disease (COLD) was assessed. The combined effect of dust exposure before 1950 and years of cigarette smoking on mortality from COLD was best estimated by the multiplicative model, indicating that the 2 exposures act synergistically. All those that died of the disease were smokers. According to the estimates of attributable risk about 5% of the deaths from COLD were from the effect of dust, 34% were from smoking, and 59% were from the combined effect of dust and smoking. In conclusion, the results indicate that workers exposed to silica dust who smoke are at higher risk of dying from COLD than smokers not exposed to silica dust, as the 2 exposures act synergistically in causing COLD.
British Journal of Industrial Medicine, Oct. 1990, Vol.47, No.10, p.656-664. Illus. 24 ref.

CIS 92-218 Neuberger M., Kundi M.
Individual asbestos exposure: smoking and mortality - A cohort study in the asbestos cement industry
A historical prospective cohort study comprised all persons employed from 1950 to 1981 for at least 3 years in the oldest asbestos cement factory in the world. From 2816 persons eligible for the study, record based estimates and measurements of dust and fibres and histories of smoking based on interviews were used to calculate individual exposures over time. After observation of 51,218 person-years and registration of 540 deaths, underlying causes of death for this cohort were compared with those for the regional population on the basis of death certificates. Deaths from lung cancer in asbestos cement workers were higher (standard mortality ratio (SMR) 1.7), but after adjustment for age and sex specific smoking habits this was not significant (SMR 1.04). The study had a probability of greater than 92% of detecting a smoking adjusted SMR of 1.5 or more. Using the best available evidence (including necropsy records) 52 deaths were assigned to lung cancer and 5 to mesothelioma. Life table analyses confirmed the predominant influence of smoking on lung cancer. Mesothelioma was associated with the use of crocidolite in pipe production. From present working conditions with much lower concentrations of chrysotile and no crocidolite no more occupational cancers are expected in the asbestos cement industry.
British Journal of Industrial Medicine, Sep. 1990, Vol.47, No.9, p.615-620. Illus. 26 ref.

CIS 92-119 Hnizdo E., Baskind E., Sluis-Cremer G.K.
Combined effect of silica dust exposure and tobacco smoking on the prevalence of respiratory impairments among gold miners
The combined effect of underground gold mining dust with a high content of free silica and tobacco smoking on the prevalence of respiratory impairment was examined among 2209 South African gold miners and 483 non-miners. The subjects were grouped as having normal function; minimal, moderate or marked obstruction; marked obstruction with restriction; or pure restriction on the basis of their lung function profiles. Each profile group was compared with the normal group for exposure prevalences, and additive and multiplicative relative risk models were applied to test for departure from the additivity of individual effects. Departure from additivity was found to increase progressively with the severity of obstructive impairment. The results indicated that approximately 94% of the cases with the most severe respiratory impairment (N=191) could have been prevented through the elimination of tobacco smoking. In conclusion, tobacco smoking was found to potentiate the effect of dust on respiratory impairments.
Scandinavian Journal of Work, Environment and Health, Dec. 1990, Vol.16, No.6, p.411-422. Illus. 30 ref.

CIS 91-1418 Non-smokers' Health Act - Non-smokers' Health Regulations [Canada]
Loi sur la santé des non-fumeurs - Règlements sur la santé des non-fumeurs [Canada] [in French]
These regulations made under the Non-smokers' Health Act (1989) set the following standards for employers: design and ventilation of designated smoking rooms and areas; signage requirements; notification requirements of smoking restrictions; rules for smoking areas on ships, trains and aircraft. The regulations include diagrams of approved signs and a schedule of fines. A regulatory impact analysis statement is included, but this is not an official part of the regulations.
Canada Gazette - Gazette du Canada, 3 Jan. 1990, Part II, Vol.124, No.1, p.121-136. Illus.

CIS 91-1594 Cummings K.M., Markello S.J., Mahoney M., Bhargava A.K., McElroy P.D., Marshall J.R.
Measurement of current exposure to environmental tobacco smoke
An epidemiological study was performed in a cancer screening clinic in Buffalo (NY, USA) in 1986 to determine the effects of exposure to environmental tobacco smoke among 663 never- and ex-smokers by using measurement of urinary cotinine levels and determining the prevalence of exposure to environmental tobacco smoke. The most frequently mentioned sources of exposure to environmental tobacco smoke were at work (28%) and at home (27%). Cotinine was found in the urine of 91% subjects. Cotinine values increased significantly with the number of exposures reported.
Archives of Environmental Health, Mar.-Apr. 1990, Vol.45, No.2, p.74-79. Illus. 15 ref.

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