• R Laranjeira, S Pillon, and J Dunn.
• UNIAD - Alcohol and drugs research unit, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.
• Sao Paulo Med J. 2000 Jul 6; 118 (4): 899289-92.

ContextExposure to environmental tobacco smoke is a health risk that is of concern to patrons and of particular concern to employees of restaurants and bars.ObjectiveTo assess environmental tobacco smoke exposure (using expired carbon monoxide levels) in non-smoking waiters before and after a normal day's shift and to compare pre-exposure levels with non-smoking medical students.DesignAn observational study.SettingRestaurants with more than 50 tables or 100 places in São Paulo.Subjects100 non-smoking restaurant waiters and 100 non-smoking medical students in São Paulo, Brazil.Main MeasurementsLevels of expired carbon monoxide, measured with a Smokerlyser (Bedfont EC 50 Scientific), before and after a normal day's work.ResultsWaiters' pre-exposure expired carbon monoxide levels were similar to those of medical students, but after a mean of 9 hours exposure in the workplace, median levels more than doubled (2.0 ppm vs. 5.0 ppm, P <0.001). Post-exposure carbon monoxide levels were correlated with the number of tables available for smokers (Kendall's tau = 0.2, P <0.0001).ConclusionsExposure to environmental tobacco smoke is the most likely explanation for the increase in carbon monoxide levels among these non-smoking waiters. These findings can be used to inform the ongoing public health debate on passive smoking.

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