Home health and community care workers' occupational exposure to secondhand smoke: A rapid literature review

Introduction While many workers are protected from exposure to second-hand tobacco smoke (SHS), home health and community care workers enter domestic settings where SHS is commonly present. Little is known about the extent of SHS exposure among this occupational group. Methods A rapid review to examine the literature on home health and community care workers’ exposure to SHS at work and identify research gaps. Systematic searches combining terms for SHS exposure (e.g. “tobacco smoke pollution”) with terms for home health and care workers, patients and settings (e.g. “home health nursing”) were run in CINAHL and Medline (with no date or language limitations). Website and backwards-forwards citation searches identified further papers for narrative review. Results Twenty relevant publications covering seventeen studies considered home health or community care workers’ exposure to SHS either solely or as part of an assessment of other workplace hazards. Eight studies provided data on either the proportion of home care workers exposed to SHS or the frequency of exposure to SHS. No studies provided quantification of SHS concentrations experienced by this group of workers. Conclusions Exposure to SHS is likely to be common for workers who enter private homes to provide care. There is a need for research to understand the number of workers exposed to SHS, and the frequency, duration and intensity of the exposure. Guidance should be developed to balance the rights and responsibilities of those requiring care alongside the need to prevent the harmful effects of SHS to workers providing care in domestic settings

"How do you know those particles are from cigarettes?": An algorithm to help differentiate second-hand tobacco smoke from background sources of household fine particulate matter

Background Second-hand smoke (SHS) at home is a target for public health interventions, such as air quality feedback interventions using low-cost particle monitors. However, these monitors also detect fine particles generated from non-SHS sources. The Dylos DC1700 reports particle counts in the coarse and fine size ranges. As tobacco smoke produces far more fine particles than coarse ones, and tobacco is generally the greatest source of particulate pollution in a smoking home, the ratio of coarse to fine particles may provide a useful method to identify the presence of SHS in homes. Methods An algorithm was developed to differentiate smoking from smoke-free homes. Particle concentration data from 116 smoking homes and 25 non-smoking homes were used to test this algorithm. Results The algorithm correctly classified the smoking status of 135 of the 141 homes (96%), comparing favourably with a test of mean mass concentration. Conclusions Applying this algorithm to Dylos particle count measurements may help identify the presence of SHS in homes or other indoor environments. Future research should adapt it to detect individual smoking periods within a 24 h or longer measurement period

A quantitative content analysis of UK newsprint coverage of proposed legislation to prohibit smoking in private vehicles carrying children

This project was funded by Cancer Research UK (MC_U130085862) and the Scottish School of Public Health Research. Cancer Research UK and the Scottish School of Public Health Research were not involved in the collection, analysis, and interpretation of data, writing of the manuscript or the decision to submit the manuscript for publication. Shona Hilton, Karen Wood and Chris Patterson were funded by the UK Medical Research Council as part of the Understandings and Uses of Public Health Research programme (MC_UU_12017/6) at the MRC/CSO Social and Public Health Sciences Unit, University of Glasgow. Thanks to Josh Bain and Alan Pollock for coding assistance.Peer reviewedPublisher PD

Measuring exposure to second-hand smoke in the home and car : UK, Ireland and Malaysia.

Background: Second-hand smoke(SHS)exposure in the private spaces of home and cars continues to be common even in countries with comprehensive smoke-free laws. There is little data available on the concentrations of SHS experienced within these micro-environment. Methods: Linked studies to measure concentration of fine particulate (PM2.5) as a marker for SHS within homes in Scotland, Ireland and Malaysia, and in cars in Scotland and England, were carried out. Sidepak AM510 Personal Aerosol Monitors or Dylos DC1700 devices were used to gather real-time data on PM2.5 in smoker's homes and cars. PM2.5 concentrations were compared to the World Health Organization limit of 25 ug/m3. Results: The mean PM2.5 concentration measured from more than 3800 hours of all data collected from 107 smoking households across all three countries were 76 ug/m3 (range 1-499). The average 1 minute peak level recorded was 507 ug/m3 (range 9-4767). In cars the mean journey concentration of PM2.5 was 85 ug/m3 (range 16-331) in journeys where smoking took place (n=49) compared to 7 ug/m3 (range 0.4-29) during non-smoking journeys (n=34). Conclusion: Concentration of SHS in home and cars can be considerable with the average smoking home exceeding the 24 h World Health Organization limit for PM2.5 by factors of 3: the respiratory and cardiovascular health effects of the daily exposure to these levels is likely to be substantial. Feedback of this air quality information may be a useful way of encouraging smokers to think about changing their behavior to protect their family from the harmful effects of SHS

Using air quality monitoring to reduce second-hand smoke exposure in homes : the AFRESH feasibility study

ACKNOWLEDGEMENTS This research was supported by a grant from the Medical Research Council’s Public Health Intervention Development scheme. The research team would like to thank Christine Foster and the staff and volunteers of Healthy Valleys, Lanarkshire, for their support in carrying out this work, and Beverley Scheepers and Joanne Buchan of ASH Scotland for their assistance in developing training material. FUNDING Medical Research Council PHIND Grant MR/M026159/1.Peer reviewedPublisher PD

An inexpensive particle monitor for smoker behaviour modification in homes

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Monitoring secondhand tobacco smoke remotely in real-time: A simple low-cost approach

Introduction: Secondhand smoke (SHS) in the home is a serious cause of ill-health, especially for children. SHS indoors can be indirectly measured using particulate matter monitors, and interventions have been developed using feedback from these monitors to encourage smoke-free homes. These interventions often use data that are several days out of date, as the data must be downloaded manually from monitors. It would be advantageous to access this information remotely in real-time to provide faster feedback to intervention participants. Methods: Using off-the-shelf computer components and the Dylos DC1700 air quality monitor, a portable internet-connected monitor was developed that can send data to a server remotely. Four of these monitors were tested in homes in Israel to test the reliability of the connection. Data were downloaded from the monitor’s onboard memory and compared to the data sent to the server. Results: Eight homes were monitored for 4 to 6 days, with a combined total count of 44 days. Less than 1% of data was lost, with no outage lasting longer than 1 hour 45 minutes. There was no significant difference in the mean concentrations measured in homes between mobile-transmitted data and data downloaded directly. Conclusions: This system appears to be a reliable way to monitor remotely home air quality for use in intervention studies, and could potentially have applications in other related research. Laboratories that own Dylos DC1700s may wish to consider converting them to such a system to obtain a cost-effective way of overcoming limitations in the Dylos design

Women and girls in resource poor countries experience much greater exposure to household air pollutants than men : Results from Uganda and Ethiopia

This work was funded by the Medical Research Council, UK (Grant no. MR/L009242/1) and is part of a larger project (BREATHE - Biomass Reduction and Environmental Air Towards Health Effects in Africa) focusing on quantifying and reducing the health effects of household air pollution.Peer reviewedPublisher PD

Second-hand smoke in public spaces : how effective has partial smoke-free legislation been in Malaysia?

Peer reviewedPublisher PD

Urban air quality citizen science. Project overview report

In early 2013, SEPA issued a call for proposals with the overall aim of designing a local air quality programme which would engage the public through the use of Citizen Science. Citizen Science involves the participation of the wider community (particularly non- scientists) in scientific projects. The benefits of Citizen Science include the facility for extensive data collection and the interaction between scientists and the community. In addition citizen scientists get a chance to inform scientists, and in the process, learn more about their environment. Information gained through Citizen Science projects can change public perceptions of the natural world, promote interaction with nature, and engage the community in the management of natural resources. The overall aim of the work was to help build further capabilities in the area of Citizen Science, as a follow-on to existing work in this area, building on existing projects and networks including Scotland’s Environment Web, CAMERAS and Scotland Counts. To carry out the work, SEPA commissioned a consortium of scientific organisations led by the Institute of Occupational Medicine (IOM) in collaboration with the NERC Centre for Ecology & Hydrology (CEH), The Conservation Volunteers (TCV) and the Respiratory Group within the University of Aberdeen (RGA)