1. SMOKING CESSATION IN A GROUP OF FOUNDRY WORKERS AGED 40 + SMOKING CESSATION IN A GROUP OF FOUNDRY WORKERS AGED 40 + Elena-Ana Pauncu, PhD, MD, University of Medicine and Pharmacy “Victor Babes” Discipline of Occupational Health, Timisoara, Romania; Professor Dr. Dorin Bardac, Medical Faculty ”V.Papilian, Sibiu, Romania; Dr. Mihaela Stoia, Department of Public Health, Sibiu, Romania; Dr. Mihaela Hărătău, Public Health Specialist, Romtens Foundation, Bucharest, Romania

2. Healthy Life …… Healthy cities …… Healthy workplaces ……

3. Aim To present some results of a smoking cessation program developed in an enterprise, particularly in a foundry factory from Timisoara, Romania.

4. ROMANIA

5. ROMANIA (01.07.2003) Population – 21,733,556 Surface – 238,391 km 2 TotalUrbanRural M48.84849.7 F51.25250.3

6. TIMIS (01.07.2003) TotalMFU53.452.554.2 R46.647.545.8 Population – 661,171 (Timisoara – 308,019) Surface – 8,697 km 2

7. Medium duration of life, Timis county Period Both sexes MaleFemale 1990-199268,99 65,3272,82 1995-199768,65 64,6572,90 1998-200070,44 66,9373,97 1999-200171,05 67,3674,77 2000-200271,20 67,4974,91 2001-200371,2167,7074,70

8. Action Level The workplace, a foundry factory (medium size enterprise) in Timisoara (Timis county / Romania)

9. Setting The project took place in a foundry section of a metallurgic factory Duration – 1 year (+ 1 year optional) A local research was performed among the workers (questionnaire) The employees working in the factory were divided in two groups, according to their age (the age limit was 40 years).

10. Tools / Methods Questionnaire regarding the smoking habits applied to 186 workers. Health education sessions (performed by Pneumologist + Public Health specialist) Smoking cessation counseling – using the Counseling Medical Office established within the Pneumology Hospital very close to the enterprise) Health status evaluation of the workers included in the study (medical examination and comparison of the data before and after the implementation of the program) Tobacco Control Policy – elaboration and implementation

11. Why in a foundry ? Smoking habits (high prevalence, around 65 %) Nutrition habits (high cholesterol values) Concurrence of professional exposure and unhealthy lifestyle

12. Occupational exposure of workers Silica dust ClimateFumesPAHsFormaldehydes Physical effort Metal dust (iron, steel, non-ferrous, etc.) Cigarette smoking

13. The chromatogram of the resin extract from foundry (continuous line) compared with a standard mixture of PAHs and other compounds (interrupted line). Column C8 (Octyl), elution 80% MeOH, detection at 254 nm (B - benzene, T - toluene, N - naphthalene, X - xylene, A - anthracene, F - fluorantene, P - pirene and C - crisen)

14. Comparison between the chromatograms of the foundry dust extract from the filter, in two different days

15. PARAMETERG1 (n=112) Age 40 - 58 G2 (n=74) Age 18 - 39 Average age 47.125  10.12528.014  9.721 Seniority at work 24.857  9.6889.107  9.751 Seniority at work in the actual workplace 15.036  8.2236.034  9.121 Questionnaire Research - Characteristics of Studied Groups no persons with silicosis, same gender male

16. PARAMETERG1 (n=112)G2 (n=74) Smokers7365.17%4864.86% Ex-smokers (before starting the study) 108.90%45.40% Non-smokers (do include the ex- smokers) 3934.82%262635.14 Average consum of cigarettes / day 15.305  7.35016.175  7.993 Limit of cigarette consuming, per day 1 - 40 Average duration of smoking 15.207  9.6774.304  8.763 Starting smoking at … 18.624  8.20317.728  7.988 Questionnaire Research -Smoking Profile - Company Smoking Profile

17. Respiratory symptoms

18. Pulmonary function tests results

19. Respiratory pathology

20. Elaboration / Implementation of a Tobacco Control Policy Steps (entire process took 1 year and was coordinated by the Safety Officer): Establish a working group (Safety Officer, Occupational Health Physician, Human Resources Manager) Get support from the management Review existing regulations / initiatives Develop the Policy Reviewing the Policy with the management Agreeing the Policy with the workforce (continuous process) – more informing them rather than getting their feed-back Announcing the Policy Implementing the Policy (it is young – 1 year almost)

21. Results Initially, the percent of smokers was similar, 65%. The adherence to the program was good, in both groups. Only 3% of participants’ dropped out after one or two months of the program. The respiratory complains in the group aged 40 and older (G1) were more frequent, compared to those in the second group,(G2), younger than 40 years.

22. PARAMETERG1 (n=73)G2 (n=48) Initial participants7348 Dropped out21 Participants after 2 months7147 Number of smokers whom visited the Counseling Office (all smokers) 7348 Non-smokers after one month of program implementation 126 Reduced smoking after 6 months 1112 Non-smokers after 1 year including those from the (1 st month) 12 + 76+2Results

23. Results The actual results are satisfactory 12 persons in the G1 “older group” and 6 persons in the “younger group” G2 became non-smokers after one month of program implementation, and another 23 persons had a good response after six months of implementation.

24. Motivation of adherence at the cessation program Impossibility to solve himself the problem Need of saving money/personal reasons Health related problems Family attitude

25. Motivation to continuing smoking Immediate consequences of cessation / withdrawal syndrome The attitude of smokers – environment impact Imperious need to smoke Automatism related reasons Personality

26. Evaluation The results regarding the motivation for continuing smoking showed very diverse and interesting individual approaches. The smoke free workplace policy played had an important role in changing the reaction of workers towards non- smoking into a positive one.

27. THANK YOU SALUTE FROM ROMANIA