Airway disease risk from environmental tobacco smoke among coffeehouse workers in Turkey

Objectives: To examine the effect of ETS exposure on respiratory symptoms and pulmonary function and to compare workers in coffeehouses to those in other occupations in order to assess the risk of respiratory illness in this occupation. Design: Cross sectional study. Setting: The study area consisted of the three metropolitan districts of the city of Izmir, Turkey. 86 coffeehouses and 80 other small scale shops which had no known respiratory risk factor, located in the same area, were taken as the study group. Subjects: 207 workers were assessed. Main outcome measurements: Subjects answered a questionnaire about demographic and working characteristics, respiratory symptoms, and smoking behaviour. Physical examinations and spirometric measurements were carried out at the workplaces. Results: There was a significant increase in respiratory symptoms in coffeehouse workers. Working in a coffeehouse showed a significant risk for chronic bronchitis ( odds ratio ( OR) 4.3). In coffeehouse workers, forced expiratory volume in one second (FEV1) decreased 5.1%, forced vital capacity (FVC) 3.4%, FEV1/FVC 1.6%, peak expiratory flow (PEF) 6.45%, and forced expiratory flow (FEF25) 7.2%, FEF50 10%, and FEF25-75 9.8%. Among workers who were described as having an "airway disease", coffeehouse workers were significantly greater in number. When age, body mass index, and smoking behaviour were controlled, working in a coffeehouse was strongly associated with "airway disease" compared to other workers (OR 5.35, 95% confidence interval 2.41 to 11.87). Conclusions: Workers in coffeehouses showed significant increases in respiratory symptoms and decreased pulmonary function. All workers need to gain an awareness of these occupational risks and working conditions should be improved immediately.