Skip Navigation LinksHome > April 2011 - Volume 53 - Issue 4 > Environmental Tobacco Smoke Exposure Among Casino Dealers
Journal of Occupational & Environmental Medicine:
doi: 10.1097/JOM.0b013e318212235f
Original Articles: CME Available for this Article at

Environmental Tobacco Smoke Exposure Among Casino Dealers

Achutan, Chandran PhD; West, Christine MSN, RN, MPH; Mueller, Charles MS; Bernert, John T. PhD; Bernard, Bruce MD, MPH

Continued Medical Education
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Objective: This study quantified casino dealers’ occupational exposure to environmental tobacco smoke (ETS).

Methods: We measured casino dealers’ exposure to ETS components by analyzing full-shift air and preshift and postshift urine samples.

Results: Casino dealers were exposed to nicotine, 4-vinyl pyridine, benzene, toluene, naphthalene, formaldehyde, acetaldehyde, solanesol, and respirable suspended particulates. Levels of 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) in urine increased significantly during an 8-hour work shift both with and without adjustment for creatinine clearance. Creatinine-unadjusted cotinine significantly increased during the 8-hour shift, but creatinine-adjusted cotinine did not increase significantly.

Conclusions: Casino dealers at the three casinos were exposed to airborne ETS components and absorbed an ETS-specific component into their bodies, as demonstrated by detectable levels of urinary NNAL. The casinos should ban smoking on their premises and offer employee smoking cessation programs.

©2011The American College of Occupational and Environmental Medicine


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