02.09.08
Death from secondhand smoke
A young asthmatic woman who collapsed and died shortly after arriving for her shift as a waitress at a bar may be the first reported death to be reported nationally from acute asthma associated with environmental tobacco smoke.
This case report by a Michigan State University physician, published in the February edition of the American Journal of Industrial Medicine, not only outlines circumstances under which the woman died, but also raises a number of issues regarding safety in the workplace.
The report states the woman arrived at the bar in Michigan and, according to co-workers, seemed happy and healthy. About 15 or 20 minutes later she collapsed and within a few minutes died.
“This is the first reported acute asthma death associated with work-related ETS,” said Kenneth Rosenman, an MSU professor of medicine and chief of the Division of Occupational and Environmental Medicine. “Recent studies of air quality and asthma among bar and restaurant workers before and after smoking bans support this association.”
In 2006, the surgeon general’s report concluded that ETS causes coronary heart disease, lung cancer and premature death. But at that time there was little hard evidence linking ETS to the exacerbation of asthma in adults.
However, Rosenman and colleagues believe this case provides plenty of evidence to link secondhand smoke to this death.
“The autopsy clearly indicates she died from asthma,” Rosenman said. “There was no other cause of death. Her death is consistent with what we know about exposures in bars like this. We know asthmatics are more susceptible to irritants and other particulates in the air.
“We know that particulate levels from secondhand cigarette smoke in bars like this reach sufficient levels to set off an asthma attack.”
As an occupational and environmental health physician, Rosenman said he also is concerned about the long-term effects of ETS on all employees, not just those with pre-existing conditions like asthma.
“As a consumer, I don’t have to go into that bar,” he said. “But is it a safe environment for the employees? We have federal laws that say employers have to provide a safe and healthy workplace. This was clearly not a safe and healthy workplace for this employee.
“This death dramatizes the need to enact legal protections for workers in the hospitality industry from secondhand smoke.”
In the United States, 23 states have already banned smoking in restaurants and bars. A number of other states, including Michigan, are considering it.
While many bar and restaurant owners say a smoking ban would hurt business, Rosenman argues that just the opposite is true.
“Consider that 75 percent of the population doesn’t smoke,” he said. “Banning smoking could actually serve to increase business. Studies of restaurants and bars in Boston, New York City, San Francisco and Washington D.C. all show business up since they banned smoking. Chicago went smoke free the beginning of this year.
“We’re behind the times if we want to attract tourists and help businesses be more profitable.”
Three public health disease-tracking systems in Michigan were used to gather information for this case report.
j-damn said,
9 February 2008 at 11:46 pm
Interesting only insofar as its propaganda value.
You’ve got a woman who under-medicates, doesn’t bring her inhalers, is a life-long sufferer and STILL chooses to work in a bar? Give me a break.
Just because one person is too stupid to keep herself healthy, some “researcher” with an agenda pushes the smoking ban. What a joke. I’d hate to see this guy’s other “research”. He probably advocates repealing the law of gravity because some dolt fell off his roof, too.
LeisureGuy said,
10 February 2008 at 7:59 am
I don’t find in the account some of the facts you cite: that she under-medicated, didn’t bring her inhalers, and was a life-long sufferer. Could you give a source for those? Or are they simply your assumptions?
So far as her choosing to work in a bar, she may have based her decision on the myriad of sources that say that secondhand smoke has no ill effects, presents no dangers, and the like.
The rest of your comment also consists of assumptions.
If you’ll read the account more carefully and thoughtfully, you’ll see that the researchers are quite careful about drawing conclusions. For example:
So although ETS (environmental tobacco smoke, aka secondhand smoke) has been found to cause coronary heart disease, lung cancer, and premature death, there was a lack of hard evidence showing that ETS worses asthma in adults.
The point of the account is an actual case of a work-related asthma death from work-related ETS. As Rosenman states (and I believe that in this area he has more credibility than you) “‘Recent studies of air quality and asthma among bar and restaurant workers before and after smoking bans support this association’”—that is, the association between exacerbation of asthma and ETS. Unlike you, he works from evidence.
And, as he states, the evidence shows that, to provide a safe workplace, tobacco smoke should be banned. We do have laws that require employers to provide a safe workplace.
Your comment about “repealing the law of gravity” suggests your lack of seriousness in thinking about this issue.
j-damn said,
11 February 2008 at 10:17 pm
http://www.msnbc.msn.com/id/23075001/
*Rosenman said the woman had asthma since age 2. Her asthma was poorly controlled. She had made four visits to her doctor in the year before her death for flare-ups, and had been treated in a hospital emergency department two to three times that year.
Although she had prescriptions for an assortment of drugs to prevent and treat asthma attacks, she was reported to only use them when she was having breathing difficulty.
On the evening of her death, she had no inhaler with her. When she became sick, she told the bar manager she needed to go to the hospital, then collapsed on the dance floor. *
Another story I read regarding this girl quoted her father as stating she was having difficulty breathing even before arriving at work.
*—that is, the association between exacerbation of asthma and ETS. Unlike you, he works from evidence.*
Unlike most people with asthma, this stupid girl chose to work in a smoky bar. Genius, eh? So since one person was stupid, we need to take the rights away from millions of Americans. More genius.
*And, as he states, the evidence shows that, to provide a safe workplace, tobacco smoke should be banned*
Bank employees and cab drivers suffer higher fatality rates than barmaids. Oh, whatever can the federal government do to save them—repeal the 2nd amendment perhaps? Ban taxicabs?
Face it, this scare-mongering “news” item is simply agenda-driven propaganda—plain and simple.
The sensible thing to do would be to give bar owners the choice of allowing smoking or not and then allowing patrons to CHOOSE which establishments to frequent.
But then, this is America—and we can’t have sense ruling the day.
*Your comment about “repealing the law of gravity” suggests your lack of seriousness in thinking about this issue*
On the contrary—anyone lacking the ability to think seriously would, after reading this flimsy excuse for journalism, run about screaming that the sky was falling.
LeisureGuy said,
12 February 2008 at 7:42 am
You’re absolutely correct about the facts surrounding the girl’s death—her history of asthma, under-medication, failure to bring her meds, etc.
One aspect that you don’t address is the OSHA aspect. I believe that a business must provide workers protection from carcinogens and other toxins in the workplace, even though the effects may not be immediate.
That sounds as though it would apply as well to ETS. From the story above: “In 2006, the surgeon general’s report concluded that ETS causes coronary heart disease, lung cancer and premature death.”
That certainly sounds as though the law would require that workers be protected against exposure to ETS.
Notice that the law doesn’t allow a manufacturer of, say, paint and gasoline additives to say, “People don’t have to work here—they can choose to work elsewhere. If they work here, they’ll just have to live with the risks.” No. The manufacturer must provide a safe workplace. Period.
I don’t really think that it would make sense to ban taxicabs, but banning smoking in the workplace does (in my view) make sense and is practical—in fact, quite a few cities and states have done it, and the response is favorable.
j-damn said,
12 February 2008 at 10:27 pm
*I don’t really think that it would make sense to ban taxicabs, but banning smoking in the workplace does (in my view) make sense and is practical—in fact, quite a few cities and states have done it, and the response is favorable.*
From non-smokers, it might be favorable.
Now that you bring up gasoline additives, you’ve given me an even better idea…I think the sensible option here is to make all workers wear filtration devices of some sort if they want to work in a bar…or a coal mine…or [you get the picture].
Or just hire people who are already smokers, you know, that’d work too.
LeisureGuy said,
13 February 2008 at 8:03 am
You have a gift for unworkable solutions, I’ll give you that.
When I said “the response [to banning smoking in public places and workplaces] is favorable”, I meant the overall response of the public (not differentiating smokers from non-smokers). This is simply a fact.