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Tobacco-free Workplaces : Safer and Healthier

by N Islam
THE rate of smoking In the developing countries Is now on the Increase and by now II has surpassed that In the developed world. For example, the smoking rates are 30 — 40 per cent among males and 20 — 40 per cent among females tn the developed countries while the corresponding rates In the developing countries are 40 — 60 per cent and 2 —10 per cent respectively
For Bangladesh the situation is far worse. Among the males the smoking rate here is 60 — 70 per cent while In females this is 20 — 30 per cent, liven more unfortunate is that the lower the Income the higher Is the rate of smoking. About HO per cent of our rickshaw pullers smoke. Labourers and other low paid working groups smoke more than the educated rich. The theme for the World No-Tobacco Day 1992 is Tobacco-Free Workplaces : Safer and Healthier. In this article the hazards of smoking in workplaces are discussed In order to bring home some facts which shall explain the force behind the theme and hopefully encourage appropriate action.
It Is now definitely known that the risk of smoking Is not limited to the smoker himself You arc not safe even if you do not smoke. When someone smokes around you or in your room or workplace you arc a passive smoker. Smoking pol lutes environment and tobacco smoke is surprisingly the most common pollutant of the indoor air in the developed countries. In the developing countries the situation can therefore be well Imagined. Health aspec ts of industrial regulation is wc^k and many industries large or small do no I observe even the minimum
regulation or standard here Beside, filters used in norma! ventilation and air-conditioning systems cannot remove most of the noxious agents from tobacco smqkc in the environment. Consequently tbe erwironment becomes polluto^ with noxious agents and it Is) not as safe as it should be.
Around 4000 compounds have been identified in tobacco smoke some of which are highly toxic and can be found In the workplaces also. A worker who smokes therefore would receive these hazardous substances from both the sources with added risk For example, the workers In textile printing, hide preservations, hospitals and laboratories or those engaged in embalming arc exposed to formaldehyde. Those working in petrochemicals, rubber industry or who work with adhe slvcs solvents or In vapour, furniture finishing are exposed to benzene. These industries are associated with the Increased Incidence of chronic respiratory diseases notable among which is chronic bronchitis.
Airborne asbestos Is the best example for one hazard aggravating the other due to additive effect of smoking. This was recognised as a cause of lung cancer almost a century ago. way back in 1998. About 80 years later a study in 1979 covering 12000 workers ex • posed to asbestos showed the 272 of them died of lung
cancer of whom 268 were smokers and only four were non-smokers. Smokers have 80 times more risk for developing lung cancer than those who arc not exposed to either hazard viz. asbestos to tobacco ** In worimiaces generating , sMiea dust • g. rock drilling, grinding alone polishing or chipping, smoking adds to the risk and increases the prevalence of chronic obstructive lung diseases.
Similarly it has been found that smoking increases the risk of developing byssinosis, an Industrial lung diseases among textile Industry workers This Is of particular con ccrn for our sugar mill workers as dusts from sugarcane can lead to development of byssinosis.
Carbon monoxide is one of the important toxic agents in tobacco. Garage workers, fire lighters, foundry employees and workers in gas and coke are also exposed to this gas. This binds wilh haemoglobin, the carrier of oxygen and thus Interferes with oxygen supply lo the body tissues creating a critical situation In people who arc grossly anaemic and yet smoke. Reduced quantity of haemoglobin In these cases Is an ini|»cdrmcnt to their oxygen supply When carbon monoxide from smoking makes that limited haemoglobin Ineffective for carrying oxygen the organs suffer and the situation becomes worse.
In a poor country like
Bangladesh subnutrition or malnutrition Is a national problem. It Is a common phenomenon among the low income groups to which many of our workers belong. Whatever they may earn II t^much less than their need beaause of the higher cost of living and greater demand by increasing family size due lo lack of plan ntng. Anacma is as such one of the commonest problems. Smoking tn these workers is an added nsk Jet alone aggravated deficiency in family budget due to the misdirected fund for tobacco.
We hardly realise that most people spend major part of ihelr time In their workplaces and therefore exposure to environmental hazard for a prolonged period poses serious threat
From all that have been mentioned it is clear that smoking al workplaces is hazardous and this is more so for a developing, country like Bangladesh. The picture should not however be considered all that gloomy. We have examples before us and these are our hopes.
In the world today over 40 countries have introduced national legislation controlling smoking in some places. These are in both public and private sectors. Number of countries prohibiting smoking In government offices Is increasing, [’articular attention has been given to health care centres,
health institutions and also to schools.
tn Bangladesh the Ministry of Health has Issued Instrue tion lo health Institutions to keep the environment tobacco-free while Ministry of Education has Included articles on health hazards of. smoking in school textbooks The Ministry of Railways and Communication are contemplating to increase the space for non-smokers by reducing that for sntokers to minimum wilh an automate air of making the transports tobacco-free Bangabhaban Is a no-smoklng zone. Several schools have been declared tobacco-free and some colleges have earned the credit. Allcasl one media centre (UNU) is tobacco free and in one Press Club office (Chittagong) smoking is prohibited.
In Bhutan several districts and many government offices including the Ministry of Health have been declared smoke-free.
In the words of Dr U Ko Ko, Regional Director, WHO south-East Asia Region : "Despite these efforts, however, tobacco continues to take a heavy toil of Innocent lives. According to available estimates, tobacco kills at-lcast three million people each year world-wide. Used In smokeless form, either for chewing, snuff taking etc, tobacco is a major cause of oral cancer nnslly in countries in the Indian sub-continent where the habit is widespread.
Apart from these direct health risks, many Industrial, forest and residential fires are at tributable to smoking materi ala. causing Immeasurable loss 1n terms of socio-economic development. Unless concerted action is taken by the community and high-level commitments ft would be a long way to go before the tobacco menace is curbed let alone reaching the goal of lobacco-free world"
To quote Dr Hiroshi Nakajima. Director General of I he WHO : "In 1902 World No-To-bacco Day Is dedicated to the right of workers to exercise their skills In the cleanest possible atmosphere, unpolluted by tobacco smoke and free from the stress and bad feeling that conflict, between smokers and non-smokers In a closed workplace, can generate. The disease and mortality risks associated with smoking and passive smoking are compelling and It is no longer necessary to demonstrate the economic effects of smoking in terms of medical costs, absenteeism, reduced productivity, industrial accidents and fires ... The human, public health and economic consequences of smoking at work make its prohibition a priority In preventive health policy, for public health and for occupational health and safety. On this World NO-Tobacco Day, 31st May 1992, let us work together towards "tobacco-frec workplaces' In a bid for safer and healthier employment."
We In Bangladesh have an obligation to work together to attain this goal.
(The writer, a national professor, has been internationally recognised as a crusader of anti-smoking campaign.)