Health impact of a smoke-free policy in small indoor sports facilities in Seoul: Workers’ subjective symptoms and indoor air related job environment in billiard halls and screen golf clubs

Abstract

Introduction: This study aimed to evaluate the health impact of a smoke free policy implemented in these facilities in the Seoul metropolitan area, focusing on workers’ subjective symptoms in relation to indoor air–related job environment. Materials and methods: Cross-sectional surveys were conducted among 589 workers employed in billiard halls and screen golf clubs located in Seoul in August 2017 (before policy implementation) and August 2018 (after implementation). Associations between job environment factors and work- time symptoms were examined using chi-squared tests or Fisher’s exact tests and multivariable logistic regression, sequentially adjusting for general and work-related characteristics. Across all symptoms, survey year (2018 vs. 2017) was consistently associated with reduced odds of symptom complaints. Results: Facilities operating mechanical ventilation only or combined natural and mechanical ventilation showed significantly lower odds of all symptoms than those relying solely on natural ventilation. In contrast, workers in facilities with a higher number of windows, facilities where cooking was conducted, or those with more smoking customers generally reported higher odds of symptoms. More frequent ventilation (≥5 times per day) tended to reduce respiratory complaints, whereas insufficient or intermittent ventilation was associated with higher symptom prevalence. Conclusion: Smoke-free regulations, appropriate mechanical ventilation and comprehensive indoor air quality management, including control of cooking and outdoor pollutant infiltration, are needed to further protect the health of workers in these environments. These findings support comprehensive indoor air quality management combining smoke-free policies with adequate mechanical ventilation systems in small indoor sports facilities