The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #56161

Paula M. Minihan, PhD, MPH, Dept. of Family Medicine & Community Health, Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111, (617) 636-2461, paula.minihan@tufts.edu

Efforts to support vulnerable populations, like people with mental illness or mental retardation, in their homes and small community residences, instead of institutions, may have inadvertently created a direct support workforce that is vulnerable to secondhand smoke exposure on the job, due to elevated smoking rates among human service recipients, yet is ignored or exempt from most occupational health protections from secondhand smoke. This study examined the smoking policies in 49 state agencies for people with mental retardation - these agencies fund over 100,000 residences, directly or through contract, and employ about 375,000 direct support staff nationwide. Among 32 agencies with smoking policies, most policies protected the rights of clients to smoke inside residences; such policies mean that nonsmoking staff may be chronically exposed to secondhand smoke as a condition of their employment. State statutes and executive orders restricting smoking in state government buildings and worksites were the major determinants of agency policies but these and local ordinances generally exempted publicly-supported residences. Unions when involved in policymaking, tended to protect smoking, not nonsmoking, staff. It is unclear what occupational health and safety protections from secondhand smoke, if any, exist to protect this new and growing human service workforce that works within clients' residences. State human service agencies that allow smoking inside residences should offer "Right to Know" protection by notifying prospective employees in writing that they will be exposed to secondhand smoke as a condition of their employment, and face potential liability claims from employees exposed to secondhand smoke at work.

Learning Objectives:

At the conclusion of the session, the participant will be able to: 1.Recognize that direct support staff in community-oriented human service agencies are a new and expanding workforce that is invisible and warrants inclusion in occupational health and safety initiatives.
• Articulate why the human service direct support workforce is exposed to high levels of environmental tobacco smoke on the job.
• List five policy initiatives that state human service agencies can implement to protect direct support staff from involuntary exposure to environmental tobacco smoke at work.

Keywords: Occupational Exposure, Tobacco Policy

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Handout (.ppt format, 52.0 kb)

Handout (.ppt format, 70.0 kb)