Home health and community care workers' occupational exposure to secondhand smoke: A rapid literature review

Abstract

Introduction While many workers are protected from exposure to second-hand 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. Methods A 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 (e.g. “tobacco smoke pollution”) with terms for home health and care workers, patients and settings (e.g. “home health nursing”) were run in CINAHL and Medline (with no date or language limitations). Website and backwards-forwards citation searches identified further papers for narrative review. Results Twenty 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. Conclusions Exposure 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.