Background: The blood lead concentrations of workers in lead battery factories are more than 4 times higher than those of the general population in Taiwan. Therefore, efforts are needed to reduce lead exposure in this high‐risk population. A health promotion program on personal habits that reduce lead exposure has been carried out in a lead battery factory since 1991. This study investigated the longitudinal relationship of workers' blood lead concentrations and personal hygiene habits from 1991 through 1997. Methods: In each of the 7 years of the study, occupational physicians questioned workers regarding nine personal hygiene items, personal information, and medical history before their annual health examination. The relationship between blood lead concentrations and personal hygiene habits was analyzed by longitudinal multiple regression in a mixed effect model with adjustment for potential confounders. In addition, the risk ratio of a blood lead concentration exceeding 40 μg/dL in men and 30 μg/dL in women (the action levels set by the Department of Health, Taiwan) was estimated by generalized estimating equations. Results: Blood lead levels decreased significantly in the first 5 years of the study. The personal habits most closely related to blood lead concentrations were smoking at work sites (estimated coefficient = 3.13, P < 0.001), and eating at work sites (estimated coefficient = 1.38, P = 0.069). The risk ratio for workers with both these habits exceeding the action level of blood lead was 2.93 (95% CI 1.27–6.77). Difference in job titles, however, accounted for a major portion of the variance in blood lead. For example, working in “pasting” and “plate‐cutting” was associated with blood lead elevations >20 μg/dL in comparison to the “low‐ or no‐exposure jobs.” Conclusions: Health promotion programs can decrease exposure of lead workers; reducing the practices of smoking and eating at work sites should be the core of such programs. However, a major reduction in lead exposure for some jobs (e.g., “pasting” and “plate‐cutting”) in lead battery factories in Taiwan is unlikely to occur without major engineering changes. Am. J. Ind. Med. 35:595–603, 1999. © 1999 Wiley‐Liss, Inc.
ObjectivesIn 2002, Taiwan launched a program to encourage doctors to provide brief cessation counselling to their patients during routine outpatient visits. This study is to compare and analyse the annual prevalence rate of receiving advice to quit smoking from health professionals before (2004) and after (2005, 2006) the increase in funding and the withdrawal of additional funding (2007).MethodsWe analysed pooled data from 2004 to 2007 Taiwan Adult Tobacco Survey, an annual random digit dialling telephone survey, to estimate the prevalence of receiving quit advice among ever smokers across these years. Smoking characteristics and the socioeconomic factors of smokers associated with receipt of advice to quit smoking were also examined.ResultsThe prevalence rate of receiving quit advice increased from 21.1% in 2004 to 28.2% in 2006, and then decreased slightly to 27.6% in 2007 after the funds were cut. Multivariate analyses results indicated that increasing financing for smoking cessation services in 2005, being male, older, a daily cigarette user, having previously attempted to quit, perceiving oneself as having poor health and being aware of the benefits of smoking cessation services were significantly positively associated with receiving quit advice from health professionals. In contrast, smokers who were younger, female and occasional cigarette users were less likely to receive quit advice. Also, smokers with socioeconomic disadvantages were not less likely to receive quit advice.ConclusionsDuring the period of increased funding for smoking cessation services, the rates of receiving quit advice increased among all smokers and across different socioeconomic groups.
The present study evaluated the impact of Taiwan's graphic cigarette warning labels and smoke-free law on awareness of the health hazards of smoking and thoughts of quitting smoking. National representative samples of 1074 and 1094 people, respectively, were conducted successfully by telephone in July 2008 (pre-law) and March 2009 (post-law). Results reveal that the prevalence of thinking about the health hazards of smoking among smokers increased from 50.6% pre-law to 79.6% post-law, while the prevalence among non-smokers increased from 68.8 to 94.1% during the same period. The prevalence rates of smokers who reported thinking of quitting rose from 30.2% pre-law to 51.7% post-law. Multivariate analyses results indicated that the implementation of graphic warning labels and the smoke-free law significantly increased the odds of awareness about the health hazards of smoking [odds ratio (OR) = 6.39, 95% confidence interval (CI) = 4.84-8.44] and thoughts of quitting smoking (OR = 2.39, 95% CI = 1.48-3.87). In conclusion, the implementation of a smoke-free law in combination with graphic cigarette warning labels has been effective in increasing thoughts about the health hazards of smoking and quitting smoking.
This study evaluated the effect of Taiwan's smoke-free ordinance and media campaigns on public awareness and secondhand smoke exposure. The authors conducted 3 waves of research--in July 2008 (before media campaigns), in December 2008 (during media campaigns), and in March 2009 (3 months after implementation of the smoke-free law). National representative samples of 1074, 1084, and 1094 people, respectively, were interviewed successfully by telephone in the 3 surveys. The results showed that general awareness of smoke-free workplace legislation rose dramatically from 28.5% in July 2008 to 87.6% in December 2008 to 93.6% in March 2009. Exposure to secondhand smoke in the workplace fell from 28.5% in July 2008 to 24.9% in December 2008 to 7.3% in March 2009, and household secondhand smoke exposure decreased from 36.8% to 34.3% to 21.3%, respectively, during the same period. Multivariate analyses results indicated that media campaigns, smoke-free ordinance implementation, having higher education, and having higher income were associated with more awareness of the smoke-free workplace legislation. In addition, smoke-free ordinance implementation, being female, having higher education, and having higher income were associated with less likelihood of reporting secondhand smoke exposure in the workplace. In conclusion, smoke-free ordinance implementation and media campaigns were effective in raising public awareness of the new law and reducing secondhand smoke exposure in workplaces, in public places, and at home.
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