The relationship between workers’ self-reported changes in health and their attitudes towards a workplace intervention: lessons from smoke-free legislation across the UK hospitality industry

BMC Public Health

Jon G Ayres¹  Ivan Gee⁴  Shona Hilton³  Scott Dempsey²  Martie Van Tongeren²  Karen S Galea²  Sean Semple⁵  Laura MacCalman² 

[1] Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK;Scottish Centre for Indoor Air, Institute of Occupational Medicine, Edinburgh, UK;MRC/CSO Social and Public Health Sciences Unit, Glasgow, UK;Centre for Public Health, Liverpool John Moore’s University, Liverpool, UK;Scottish Centre for Indoor Air, University of Aberdeen, Aberdeen, UK

关键词: ‘Public Health Intervention’;    ‘Workplace Intervention’;    Attitudes;    ‘Self-Reported Health’;   

Others  :  1163651
DOI  :  10.1186/1471-2458-12-324

 received in 2011-12-14, accepted in 2012-05-02,  发布年份 2012

【 摘 要 】

Background

The evaluation of smoke-free legislation (SFL) in the UK examined the impacts on exposure to second-hand smoke, workers’ attitudes and changes in respiratory health. Studies that investigate changes in the health of groups of people often use self-reported symptoms. Due to the subjective nature it is of interest to determine whether workers’ attitudes towards the change in their working conditions may be linked to the change in health they report.

Methods

Bar workers were recruited before the introduction of the SFL in Scotland and England with the aim of investigating their changes to health, attitudes and exposure as a result of the SFL. They were asked about their attitudes towards SFL and the presence of respiratory and sensory symptoms both before SFL and one year later. Here we examine the possibility of a relationship between initial attitudes and changes in reported symptoms, through the use of regression analyses.

Results

There was no difference in the initial attitudes towards SFL between those working in Scotland and England. Bar workers who were educated to a higher level tended to be more positive towards SFL. Attitude towards SFL was not found to be related to change in reported symptoms for bar workers in England (Respiratory, p = 0.755; Sensory, p = 0.910). In Scotland there was suggestion of a relationship with reporting of respiratory symptoms (p = 0.042), where those who were initially more negative to SFL experienced a greater improvement in self-reported health.

Conclusions

There was no evidence that workers who were more positive towards SFL reported greater improvements in respiratory and sensory symptoms. This may not be the case in all interventions and we recommend examining subjects’ attitudes towards the proposed intervention when evaluating possible health benefits using self-reported methods.

【 授权许可】

   
2012 MacCalman et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]European Commission: Overview of smoke-free legislation in EU. 2011. http://ec.europa.eu/health/tobacco/docs/tobacco_overview2011_en.pdf webcite
• [2]Smoking T: Health and Social Care (Scotland) Act 2005, Part 1. The Stationary Office Ltd: Edinburgh; 2005.
• [3]The Smoking (Northern Ireland) Order 2006, No. 2957 (N.I.20). The Stationery Office Limited, U.K; 2006.
• [4]Health Act: The Stationery Office Limited 2006. 2006.
• [5]Public Health (Tobacco) (Amendment) Act 2004. Irish Statute Book 2004. 2003. http://www.irishstatutebook.ie/2004/en/act/pub/0006/index.html webcite
• [6]Semple S, Creely K, Naji A, Miller BG, Ayres JG: Secondhand smoke levels in Scottish pubs: the effect of smoke-free legislation. Tob Control 2007, 16:127-132.
• [7]Gotz NK, van Tongeren M, Wareing H, Wallace LM, Semple S, MacCalman L: Changes in air quality and second-hand smoke exposure in hospitality sector businesses after introduction of the English Smoke-free legislation. J Public Health Med 2008, 30(4):421-428.
• [8]Gorini G, Moshammer H, Sbrogio L, Gasparrini A, Nebot M, Neuberger M, Tamang E, Lopez MJ, Galeone D, Serrahima E, Italy & Austria Before and After Study Working Group: Italy and Austria before and after study: second-hand smoke exposure in hospitality premises before and after 2 years from the introduction of the Italian smoking ban. Indoor Air 2008, 18:328-334.
• [9]Connolly GN, Carpenter CM, Travers MJ, Cummings M, Hyland A, Mulcahy M, Clancy L: How smoke-free laws improve air quality: a global study of Irish pubs. Nicotine Tob Res 2009, 11:600-605.
• [10]Haw SJ, Gruer L: Changes in exposure of adult non-smokers to second-hand smoke after implementation of smoke-free legislation in Scotland: national cross survey. BMJ 2007, 335:549-552.
• [11]Semple S, MacCalman L, Atherton Naji A, Dempsey S, Hilton S, Miller BG, Ayres JG: Bar workers’ exposure to second-hand smoke: the effect of Scottish smoke-free legislation on occupational exposure. Ann Occup Hyg 2007, 51(7):571-580.
• [12]Pearson J, Windsor R, El-Mohandes A, Perry DC: Evaluation of the immediate impact of the Washington, D.C., smoke-free indoor air policy on bar employee environmental tobacco smoke exposure. Public Health Rep 2009, 124(Suppl 1):134-142.
• [13]Allwright S, Paul G, Greiner B, Mullally BJ, Pursell L, Kelly A, Bonner B, D’Eath M, McConnell B, McLaughlin JP, O’Donovan D, O’Kane E, Perry IJ: Legislation for smoke-free workplaces and health of bar workers in Ireland: before and after study. BMJ 2005, 331(7525):1117.
• [14]Pell JP, Haw S, Cobbe S, Newby DE, Pell ACH, Fischbacher C, McConnachie A, Pringle S, Murdoch D, Dunn F, Oldroyd K, MacIntyre P, O’Rourke B, Borland W: Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med 2008, 359:482-491.
• [15]Sargent RP, Shepard RM, Glantz SA: Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004, 328:977-983.
• [16]Lightwood JM, Glantz SA: Declines in myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation 2009, 120:1373-1379.
• [17]Mackay D, Haw S, Ayres JG, Fischbacher C, Pell JP: Smoke-free Legislation and Hospitalizations for Childhood Asthma. N Engl J Med 2010, 363:1139-1145.
• [18]Akhtar PC, Currie DB, Currie CE, Haw SJ: Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey. BMJ 2007, 335:545-549.
• [19]Jiménez-Ruiz CA, Miranda JA, Hurt RD, Pinedo AR, Reina SS, Valero FC: Study of the impact of laws regulating tobacco consumption on the prevalence of passive smoking in Spain. Eur J Public Health 2008, 18(6):622-625.
• [20]Martínez-Sánchez JM, Fernández E, Fu M, Pérez-Ríos M, López MJ, Ariza C, Pascual JA, Schiaffino A, Pérez-Ortuño R, Saltó E, Nebot M: Impact of the Spanish smoking law in smoker hospitality workers. Nicotine Tob Res 2009, 11(9):1099-1106.
• [21]Ayres JG, Semple S, MacCalman L, Dempsey S, Hilton S, Hurley JF, Miller BG, Naji A, Patticrew M: Bar workers' health and environmental tobacco smoke exposure (BHETSE): symptomatic improvement in bar staff following smoke-free legislation in Scotland. Occup Environ Med 2009, 66:339-346.
• [22]Goodman PG, Haw S, Kabir Z, Clancy L: Are there health benefits associated with comprehensive smoke-free laws. Int J Public Health 2009, 54:367-378.
• [23]Larsson M, Boethius G, Axelsson S, Montgomery SM: Exposure to environmental tobacco smoke and health effects among hospitality workers in Sweden: before and after the implementation of a smoke-free law. Scand J Work Environ Health 2008, 34:267-277.
• [24]Eisner MD, Smith AK, Blanc PD: Bartenders' respiratory health after establishment of smoke-free bars and taverns. JAMA 1998, 280:1909-1914.
• [25]Davis RE, Couper MP, Janz NK, Caldwell CH, Resnicow K: Interviewer effects in public health surveys. Health Educ Res 2010, 25(1):14-26.
• [26]Lund I, Lund KE: Post-ban self-reports on economic impact of smoke-free bars and restaurants are biased by pre-ban attitudes. A longitudinal study among employees. Scand J Public Health 2011, 39(7):776-779.
• [27]Hilton S, Semple S, Miller BG, MacCalman L, Petticrew M, Dempsey S, Naji A, Ayres JG: Expectations and changing attitudes of bar workers before and after the implementation of smoke-free legislation in Scotland. BMC Publ Health 2007, 7:206. BioMed Central Full Text
• [28]Semple S, Van Tongeren M, Galea KS, MacCalman L, Gee I, Parry O, Naji A, Ayres JG: UK Smoke-Free Legislation: Changes in PM2.5 Concentrations in Bars in Scotland, England, and Wales. Ann Occup Hyg 2010, 3:272-280.
• [29]Semple S, van Tongeren M, Gee I, Ayres JG: Smoke-free bars 07; Changes in bar workers’ and customers’ exposure to second-hand smoke, health and attitudes: A report to the Department of Health on preliminary findings relating to air quality in English bars before and after implementation of smoke-free legislation. 2008. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_085815 webcite
• [30]Payne RW, Harding SA, Murray DA, Soutar DM, Baird DB, Glaser AI, Welham SJ, Gilmour AR, Thompson R, Webster R: The Guide to GenStat Release 14, Part 2: Statistics. VSN International, Hemel Hempstead, UK; 2011.