Objective:To determine the efficacy of designated “no smoking” areas in the hospitality industry as a means of providing protection from environmental tobacco smoke (ETS), and whether certain design features assist in achieving this end.Methodology:In the greater metropolitan region of Sydney, a representative group of 17 social and gaming clubs, licensed to serve alcoholic beverages and in which, apart from designated areas, smoking occurs, agreed to participate. In each establishment, simultaneous single measurements of atmospheric nicotine, particulate matter (10 μm; PM10) and carbon dioxide (CO2) levels were measured in a general use area and in a designated “no smoking” area during times of normal operation, together with the levels in outdoor air (PM10 and CO2only). Analyses were made of these data to assess the extent to which persons using the “no smoking” areas were protected from exposure to ETS.Results:By comparison with levels in general use areas, nicotine and particulate matter levels were significantly less in the “no smoking” areas, but were still readily detectable at higher than ambient levels. For nicotine, mean (SD) levels were 100.5 (45.3) μg/m3in the areas where smoking occurred and 41.3 (16.1) μg/m3in the “no smoking” areas. Corresponding PM10 levels were 460 (196) μg/m3and 210 (210) μg/m3, while outdoor levels were 61 (23) μg/m3. The reduction in pollutants achieved through a separate room being designated “no smoking” was only marginally better than the reduction achieved when a “no smoking” area was contiguous with a smoking area. CO2levels were relatively uninformative.Conclusion:Provision of designated “no smoking” areas in licensed (gaming) clubs in New South Wales, Australia, provides, at best, partial protection from ETS—typically about a 50% reduction in exposure. The protection afforded is less than users might reasonably have understood and is not comparable with protection afforded by prohibiting smoking on the premises.
The incident command system (ICS) provides a common structure to control and coordinate an emergency response, regardless of scale or predicted impact. The lessons learned from the application of an ICS for large infectious disease outbreaks are documented. However, there is scant evidence on the application of an ICS to manage a local multiagency response to a disease cluster with environmental health risks. The Sydney Local Health District Public Health Unit (PHU) in New South Wales, Australia, was notified of 5 cases of Legionnaires' disease during 2 weeks in May 2016. This unusual incident triggered a multiagency investigation involving an ICS with staff from the PHU, 3 local councils, and the state health department to help prevent any further public health risk. The early and judicious use of ICS enabled a timely and effective response by supporting clear communication lines between the incident controller and field staff. The field team was key in preventing any ongoing public health risk through inspection, sampling, testing, and management of water systems identified to be at-risk for transmission of legionella. Good working relationships between partner agencies and trust in the technical proficiency of environmental health staff aided in the effective management of the response. (Disaster Med Public Health Preparedness. 2018;12:539-542).
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