Smoky bar triggered deadly asthma attack: study

By Julie Steenhuysen

CHICAGO (Reuters) - A woman in her late teens died from an acute asthma attack triggered by secondhand cigarette smoke shortly after arriving at her job as a waitress in a bar in Michigan, researchers reported on Friday.

They said it was the first reported case of an immediate death caused by secondhand smoke.

"She didn't have any other possible known causes of death," said Dr. Kenneth Rosenman, a Michigan State University professor who oversees three state public health surveillance systems.

Cigarette smoke is known to trigger acute asthma attacks.

"We know that particulate levels from secondhand cigarette smoke in bars like this reach sufficient levels to set off an asthma attack," Rosenman said.

He said the woman was a student who had a job at a fast-food restaurant, and worked a second job as a waitress at the bar. "She was perfectly fine when she went to work," Rosenman said in a telephone interview.

"After about 15 minutes, she had an acute asthma attack and collapsed on the floor. The autopsy clearly indicates she died from asthma," said Rosenman, who would not disclose the woman's name or the precise place and time of her death for privacy reasons.

Rosenman said the woman had asthma since age 2. Her asthma was poorly controlled. She had made four visits to her doctor in the year before her death for flare-ups, and had been treated in a hospital emergency department two to three times that year.

Although she had prescriptions for an assortment of drugs to prevent and treat asthma attacks, she was reported to only use them when she was having breathing difficulty.

On the evening of her death, she had no inhaler with her. When she became sick, she told the bar manager she needed to go to the hospital, then collapsed on the dance floor.

Bar patrons offered an inhaler and the woman tried to use it, but could not. Emergency response workers were unable to revive her and she died shortly thereafter.

Rosenman, who wrote about the case in the American Journal of Industrial Medicine, said 24 U.S. states prohibit smoking in public places such as bars. A number of other states, including Michigan, are considering it.

He said a smoking ban could prevent future deaths.

Secondhand smoke causes about 3,400 lung cancer deaths and 46,000 heart disease deaths in adult non-smokers in the United States each year, according to the American Lung Association.

"There are a lot of statistics out there about secondhand smoke. Here is a human face. She died acutely. It is a tragic death," Rosenman said.