Case links death to environmental tobacco 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.”

Source: Michigan State University

Related stories:

Guidelines for care of elderly patients ignored
Guidelines for the treatment of older patients with respiratory conditions are routinely ignored. Research published today in the open access journal BMC Health Services Research shows that recommended treatments are given to only a small minority of eligible patients.
Some moms quit cigarettes, marijuana, alcohol during pregnancy, but dads don't
Despite public health campaigns, a surprising number of women continue to use substances such as tobacco, marijuana and alcohol during pregnancy and their usage rebounds to pre-pregnancy levels within two years of having a baby, according to a new University of Washington study.
Smoking during pregnancy can put mums and babies at risk
A British report suggests smoking while pregnant may be less damaging to a fetus than many people have been led to believe.
Study confirms the risk of exposure to secondhand tobacco smoke outdoors
Tens of thousands of Americans die each year from secondhand tobacco smoke, according to a 2006 report by the U.S. Surgeon General. While the health risks associated with indoor secondhand smoke are well documented, little research has been done on exposure to toxic tobacco fumes outdoors.
New U.S. guidelines aim to boost awareness
All women who are able to become pregnant should treat themselves and be treated by healthcare professionals as being pre-pregnant, new U.S. guidelines say.
Creating lung cancer risk models for specific populations refines prediction
Lung cancer risk prediction models are enhanced by taking into account risk factors by race and by measuring DNA repair capacity, according to research teams led by epidemiologists at The University of Texas M. D. Anderson Cancer Center in two complementary papers appearing in the September issue of Cancer Prevention Research.
At risk for peripheral arterial disease? Simple quiz provides key so you can circulate better
Ten million Americans have peripheral arterial disease (PAD), and research shows that the highest risk populations include African-Americans (twice as likely to develop clogged leg arteries), seniors (12-20 percent develop PAD) and diabetics (one in three who are over the age of 50 develop PAD). Legs for Life®—a community health and public information program—recommends that older Americans take its free, online self-assessment quiz.
Innate immune system targets asthma-linked fungus for destruction
A new study shows that the innate immune system of humans is capable of killing a fungus linked to airway inflammation, chronic rhinosinusitis and bronchial asthma. Researchers at Mayo Clinic and the Virginia Bioinformatics Institute (VBI) have revealed that eosinophils, a particular type of white blood cell, exert a strong immune response against the environmental fungus Alternaria alternata. The groundbreaking findings, which shed light on some of the early events involved in the recognition of A. alternata by the human immune system, were published recently in the Journal of Immunology.

News discussion:

Medicine & Health news