Abstract
IntroductionAlthough many workers are protected from exposure to secondhand tobacco smoke (SHS), home health and community care workers enter domestic settings where SHS is commonly present. Little is known about the extent of SHS exposure among this occupational group.MethodsA rapid review to examine the literature on home health and community care workers’ exposure to SHS at work and identify research gaps. Systematic searches combining terms for SHS exposure (eg, “tobacco smoke pollution”) with terms for home health and care workers, patients and settings (eg, “home health nursing”) were run in CINAHL and Medline (with no date or language limitations). Web site and backward-forward citation searches identified further papers for narrative review.ResultsTwenty relevant publications covering seventeen studies considered home health or community care workers’ exposure to SHS either solely or as part of an assessment of other workplace hazards. Eight studies provided data on either the proportion of home care workers exposed to SHS or the frequency of exposure to SHS. No studies provided quantification of SHS concentrations experienced by this group of workers.ConclusionsExposure to SHS is likely to be common for workers who enter private homes to provide care. There is a need for research to understand the number of workers exposed to SHS, and the frequency, duration, and intensity of the exposure. Guidance should be developed to balance the rights and responsibilities of those requiring care alongside the need to prevent the harmful effects of SHS to workers providing care in domestic settings.ImplicationsVery little is known about home health and community care workers’ exposure to SHS. There is a need for research to quantify how many workers are exposed, how often and for how long exposure occurs, and the concentrations of SHS experienced. In many countries, home health care workers may be one of the largest working groups that experience exposure to SHS as part of their employment. The public health community needs to engage in a debate about how home health care workers can be best protected from SHS.
Highlights
Many workers are protected from exposure to secondhand tobacco smoke (SHS), home health and community care workers enter domestic settings where SHS is commonly present
Acknowledging that some health care facilities still permit smoking or have poor enforcement of smoking restrictions, and home health and community care workers operating from these buildings may experience nontrivial exposure to SHS in these settings, the review was restricted to considering exposure to SHS that occurred in private homes
From 1134 publications identified in the search, 20 publications in academic and peer-reviewed practitioner journals were deemed eligible for inclusion in the review
Summary
Many workers are protected from exposure to secondhand tobacco smoke (SHS), home health and community care workers enter domestic settings where SHS is commonly present. Home health care workers may be one of the largest working groups that experience exposure to SHS as part of their employment. The introduction in many countries of smoke-free legislation in enclosed public spaces has helped protect workers from exposure to secondhand tobacco smoke (SHS).[1] Where smoke-free laws have been implemented there tend to be some exemptions and, as a result, some occupational groups continue to be exposed to SHS as part of their daily activity. Home health and care workers (including Home Health Care Professionals or Community Staff) are likely to be one of the largest remaining occupational groups that continue to experience frequent and high concentrations of SHS as part of their work activity. The workforce is predominantly female and estimates suggest the number of workers employed in this sector are likely to increase as life expectancy rises and elderly people are cared for within their own home.[5]
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