Do indoor smoke-free laws provide bar workers with adequate protection from secondhand smoke?

Objective. To determine if bar workers are adequately protected from secondhand smoke by an Act that prohibits indoor smoking in public workplaces, including bars and restaurants, but allows smoking on unenclosed contiguous patios. Methods. A purposive sample of 25 bars with outdoor patios in Toronto, Canada was drawn. Air carcinogenic particulate polycyclic aromatic hydrocarbons (PPAH) were measured on patios and inside bars in August-September, 2006, 2-3 months after implementation of the Smoke-Free Ontario Act. Taking into account repeated measures, mixed model analysis was applied to examine the level of fine particle PPAH (ng/m(3)) by number of lit cigarettes per patio area. Results. Smoking on patios was common. With increasing numbers (0, 1.0-4.3, 4.4-8.7, 8.8-16.7 and 16.8-41.7) of lit cigarettes per 1000 ft(2) of patio area, there were increases in geometric mean (geometric standard deviation) PPAH levels, 4.7 (2.4), 9.1 (3.7), 16.9 (2.9). 19.1 (3.0) and 27.0 (2.9) ng/m(3) on patios. Mixed model analysis showed that PPAH levels increased significantly with number of lit cigarettes per patio area (p = 0.0004). High levels of PPAH on patios may be associated with sustained vascular injury. Conclusions. Complete smoking bans including outdoor workspaces are needed to adequately protect hospitality workers from secondhand smoke. (C) 2009 Elsevier Inc. All rights reserved.