HEART-DISEASE FROM PASSIVE SMOKING IN THE WORKPLACE

Objectives. This review sought to determine whether passive smoking in the workplace has roughly the same association with heart disease as passive smoking at home and to update a previous 1994 review on the ef fects of home-based passive exposure on the heart, Background. To pred ict the effects of passive smoking at work on heart disease, public ag encies have had to assume that workplace exposure to tobacco smoke was equivalent to home exposure, With the availability of more workplace exposure data, it is now possible to make a direct comparison, Methods . The odds ratios and relative risks (RRs) of the eight studies that c ontained data on workplace exposure (1,699 cases) were arranged in wha t was believed to be the order of the quality of their tobacco smoke e xposure measurements, A meta-analysis was performed to obtain combined RRs, Data from seven new studies on largely home-based exposure and h eart disease that were not included in the 1994 review were also evalu ated, Results. The combined RR for the three top-rated workplace studi es was 1.50 (95% confidence interval [CI] 1.12 to 2.01), Adding four l ower rated studies reduced the RR to 1.35 (95% CI 1.09 to 1.67), Addin g the largest study but the one with questionable exposure history red uced the combined RR to 1.18 (95% CI 1.04 to 1.34), Adding the seven n ew, largely home-based studies increased the home-based morbidity RR t o 1.49 (95% CI 1.29 to 1.72) compared with 1.42 in 1994 while leaving the mortality RR unchanged at 1.23 (95% CI 1.14 to 1.32), Conclusions. The RRs for heart disease from passive smoking at work are roughly eq ual to those from home based exposure. (C) 1998 by the American Colleg e of Cardiology.