Journal of Immigrant and Minority Health

, Volume 18, Issue 1, pp 243–251 | Cite as

Knowledge of Occupational Chemical Exposure and Smoking Behavior in Korean Immigrant Drycleaners

Original Paper


To examine the association between knowledge of chemical exposure at work and cigarette smoking among Korean immigrant drycleaners. A cross-sectional survey was conducted with a total of 151 Korean immigrant drycleaners (mean age = 49 years, 64 % male) from 96 drycleaning shops in a Midwestern state. The data were collected on demographic and work-related characteristics, knowledge of occupational chemical exposure, health concerns associated with chemical exposure, and smoking status. Approximately 25 % of participants were current smokers. The multivariate regression showed that greater knowledge of occupational chemical exposures was significantly associated with a lower likelihood of current smoking [odds ratio (OR) .63; 95 % confidence interval (CI) .41–.95]. Furthermore, male gender (OR 6.32; 95 % CI 1.66–24.00), shorter-term residence in the US (OR .93; 95 % CI .88–.98), and having multiple duties (OR 2.76; 95 % CI 1.01–7.51) were important covariates associated with current smoking among Korean immigrant drycleaners. Knowledge on occupational chemical exposure was significantly associated with smoking among Korean immigrant drycleaners. Smoking cessation programs for this population should consider integrated approaches that incorporate work environment factors into individual and sociocultural components.


Smoking Occupational chemical exposure Korean immigrants Drycleaners 



This study is partially funded by the National Institute for Occupational Safety and Health (NIOSH) Pilot Research Project (Grant Number: T42 OH008455-01, PI: Hong). The authors thankfully acknowledge Ae-Suk Jeong for her contributions during the data collection, the Michigan Korean Drycleaners Association for their collaborations, and all of the study participants.

Conflict of interest

The authors declare no conflict of interest.


  1. 1.
    Rutkiewicz I, Jakubowska N, Polkowska Z, Namiesnik J. Monitoring of occupational exposure to volatile organohalogen solvents (VOXs) in human urine samples of dry-cleaner workers by TLHS-DAI-GC-ECD procedure. Ind Health. 2011;49(1):126–32.PubMedCrossRefGoogle Scholar
  2. 2.
    McDermott MJ, Mazor KA, Shost SJ, Narang RS, Aldous KM, Storm JE. Tetrachloroethylene (PCE, Perc) levels in residential dry cleaner buildings in diverse communities in New York City. Environ Health Perspect. 2005;113(10):1336–43.PubMedPubMedCentralCrossRefGoogle Scholar
  3. 3.
    Jo WK, Kim SH. Worker exposure to aromatic volatile organic compounds in dry cleaning stores. AIHAJ. 2001;62(4):466–71.PubMedCrossRefGoogle Scholar
  4. 4.
    Earnest GS. Evaluation and control of perchloroethylene exposures during dry cleaning. Appl Occup Environ Hyg. 1996;11(2):125–32.CrossRefGoogle Scholar
  5. 5.
    Azimi Pirsaraei SR, Khavanin A, Asilian H, Soleimanian A. Occupational exposure to perchloroethylene in dry-cleaning shops in Tehran, Iran. Ind Health. 2009;47(2):155–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Occupational Safety and Health Administration (OSHA). Guidance for reducing worker exposure to Perchloroethylene (PERC) in dry cleaning. Washington, DC: U.S. Department of Labor, OSHA; 2005.Google Scholar
  7. 7.
    Blair A, Petralia SA, Stewart PA. Extended mortality follow-up of a cohort of dry cleaners. Ann Epidemiol. 2003;13(1):50–6.PubMedCrossRefGoogle Scholar
  8. 8.
    Gallagher LG, Vieira VM, Ozonoff D, Webster TF, Aschengrau A. Risk of breast cancer following exposure to tetrachloroethylene-contaminated drinking water in Cape Cod, Massachusetts: reanalysis of a case-control study using a modified exposure assessment. Environ Health. 2011;10:47.PubMedPubMedCentralCrossRefGoogle Scholar
  9. 9.
    Travier N, Gridley G, De Roos AJ, Plato N, Moradi T, Boffetta P. Cancer incidence of dry cleaning, laundry and ironing workers in Sweden. Scand J Work Environ Health. 2002;28(5):341–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Benignus VA, Boyes WK, Geller AM, Bushnell PJ. Long-term perchloroethylene exposure: a meta-analysis of neurobehavioral deficits in occupationally and residentially exposed groups. J Toxicol Environ Health A. 2009;72(13):824–31.PubMedCrossRefGoogle Scholar
  11. 11.
    Echeverria D, White RF, Sampaio C. A behavioral evaluation of PCE exposure in patients and dry cleaners: a possible relationship between clinical and preclinical effects. J Occup Environ Med. 1995;37(6):667–80.PubMedCrossRefGoogle Scholar
  12. 12.
    Altmann L, Neuhann HF, Kramer U, Witten J, Jermann E. Neurobehavioral and neurophysiological outcome of chronic low-level tetrachloroethene exposure measured in neighborhoods of dry cleaning shops. Environ Res. 1995;69(2):83–9.PubMedCrossRefGoogle Scholar
  13. 13.
    Perrin MC, Opler MG, Harlap S, Harkavy-Friedman J, Kleinhaus K, Nahon D, et al. Tetrachloroethylene exposure and risk of schizophrenia: offspring of dry cleaners in a population birth cohort, preliminary findings. Schizophr Res. 2007;90(1–3):251–4.PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Tanios MA, El Gamal H, Rosenberg BJ, Hassoun PM. Can we still miss tetrachloroethylene-induced lung disease? The emperor returns in new clothes. Respiration. 2004;71(6):642–5.PubMedCrossRefGoogle Scholar
  15. 15.
    Palmer K, Inskip H, Martyn C, Coggon D. Dementia and occupational exposure to organic solvents. Occup Environ Med. 1998;55(10):712–5.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Gobba F, Righi E, Fantuzzi G, Predieri G, Cavazzuti L, Aggazzotti G. Two-year evolution of perchloroethylene-induced color-vision loss. Arch Environ Health. 1998;53(3):196–8.PubMedCrossRefGoogle Scholar
  17. 17.
    Calvert GM, Ruder AM, Petersen MR. Mortality and end-stage renal disease incidence among dry cleaning workers. Occup Environ Med. 2011;68(10):709–16.PubMedCrossRefGoogle Scholar
  18. 18.
    Brodkin CA, Daniell W, Checkoway H, Echeverria D, Johnson J, Wang K, et al. Hepatic ultrasonic changes in workers exposed to perchloroethylene. Occup Environ Med. 1995;52(10):679–85.PubMedPubMedCentralCrossRefGoogle Scholar
  19. 19.
    Shen T, Zhu QX, Yang S, Wu CH, Zhang HF, Zhou CF, et al. Trichloroethylene induced cutaneous irritation in BALB/c hairless mice: histopathological changes and oxidative damage. Toxicology. 2008;248(2–3):113–20.PubMedCrossRefGoogle Scholar
  20. 20.
    National Institute for Occupational Safety and Health (NIOSH). Control of exposure to perchloroethylene in commercial drycleaning (substitution). National Institute for Occupational Safety and Health. Appl Occup Environ Hyg. 1999;14(7):433–5.CrossRefGoogle Scholar
  21. 21.
  22. 22.
    U.S. Department of Health and Human Services (U.S. DHHS). The health consequences of smoking: A report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention (CDC); 2004.Google Scholar
  23. 23.
    Lew R, Tanjasiri SP. Slowing the epidemic of tobacco use among Asian Americans and Pacific Islanders. Am J Public Health. 2003;93(5):764–8.PubMedPubMedCentralCrossRefGoogle Scholar
  24. 24.
  25. 25.
    DC C. Cigarette smoking among adults-United States, 2007. MMWR Morb Mortal Wkly Rep. 2008;57(45):1221–6.Google Scholar
  26. 26.
    California Health Interview Survey. CHIS 2005 Adult publicuse file, release1 [computer file]. 2007.Google Scholar
  27. 27.
    Song YJ, Hofstetter CR, Hovell MF, Paik HY, Park HR, Lee J, et al. Acculturation and health risk behaviors among Californians of Korean descent. Prev Med. 2004;39(1):147–56.PubMedCrossRefGoogle Scholar
  28. 28.
    Hofstetter CR, Hovell MF, Lee J, Zakarian J, Park H, Paik HY, et al. Tobacco use and acculturation among Californians of Korean descent: a behavioral epidemiological analysis. Nicotine Tob Res. 2004;6(3):481–9.PubMedCrossRefGoogle Scholar
  29. 29.
    Survey CHI. CHIS 2007 adult public use file, release 1 [computer file]. Los Angeles, CA: UCLA Center for Health Policy Research; 2009.Google Scholar
  30. 30.
    Kim KK, Yu ES, Chen EH, Kim J, Brintnall R, Vance S. Smoking behavior, knowledge, and beliefs among Korean Americans. Cancer Pract. 2000;8(5):223–30.PubMedCrossRefGoogle Scholar
  31. 31.
    CDC. Current cigarette smoking among adults: United States, 2011. MMWR Morb Mortal Wkly Rep. 2012;61(44):889–94.Google Scholar
  32. 32.
    Survey CHI. CHIS 2001–2007 adult public use files, [computer files] Los Angeles. CA: UCLA Center for Health Policy Research; 2009.Google Scholar
  33. 33.
    U.S. Census Bureau. Census 2000 Brief; Table 4. Population by race and Hispanic or Latino Origin, for States, Puerto Rico, and Places of 100,000 or More Population: 2000. 2001. Accessed 20 Dec 2012.
  34. 34.
    U.S. Census Bureau. Race data. 2011. Accessed 20 Dec 2012.
  35. 35.
    Lee YM. Korean-American economic power resources. 2006.
  36. 36.
    Chin DL, Hong O, Gillen M, Bates MN, Okechukwu CA. Cigarette smoking in building trades workers: the impact of work environment. Am J Ind Med. 2012;55(5):429–39.PubMedPubMedCentralCrossRefGoogle Scholar
  37. 37.
    Sorensen G, Stoddard A, Hammond SK, Hebert JR, Avrunin JS, Ockene JK. Double jeopardy: workplace hazards and behavioral risks for craftspersons and laborers. Am J Health Promot. 1996;10(5):355–63.PubMedCrossRefGoogle Scholar
  38. 38.
    Sterling T, Weinkam J. The confounding of occupation and smoking and its consequences. Soc Sci Med. 1990;30(4):457–67.PubMedCrossRefGoogle Scholar
  39. 39.
    Okechukwu CA, Krieger N, Sorensen G, Li Y, Barbeau EM. Testing hypothesized psychosocial mediators: lessons learned in the MassBUILT study. Health Educ Behav. 2011;38(4):404–11.PubMedPubMedCentralCrossRefGoogle Scholar
  40. 40.
    Inc SPSS. IBM SPSS missing values 19. Chicago, IL: SPSS Inc.; 2010.Google Scholar
  41. 41.
    Nunnally JC, Bernstein IH. Psychometric theory. New York, NY: McGraw-Hill; 1994.Google Scholar
  42. 42.
    Rubin DB. Multiple imputation for nonresponse in surveys. New York, NY: Wiley; 1987.CrossRefGoogle Scholar
  43. 43.
    Allison PD. Missing data. Thousand Oaks, CA: Sage; 2002.Google Scholar
  44. 44.
    Rubin DB. Multiple imputation after 18+ years. J Am Stat Assoc. 1996;91(434):473–89.CrossRefGoogle Scholar
  45. 45.
    Schafer JL. Multiple imputation: a primer. Stat Methods Med Res. 1999;8(1):3–15.PubMedCrossRefGoogle Scholar
  46. 46.
    Hong O, Duffy SA, Choi SH, Chin DL. The association between occupational exposures and cigarette smoking among operating engineers. Arch Environ Occup Health. 2014;69(3):172–9.PubMedCrossRefGoogle Scholar
  47. 47.
    Westman M, Eden D, Shirom A. Job stress, cigarette smoking and cessation: the conditioning effects of peer support. Soc Sci Med. 1985;20(6):637–44.PubMedCrossRefGoogle Scholar
  48. 48.
    Peretti-Watel P, Constance J, Seror V, Beck F. Working conditions, job dissatisfaction and smoking behaviours among French clerks and manual workers. J Occup Environ Med. 2009;51(3):343–50.PubMedCrossRefGoogle Scholar
  49. 49.
    Radi S, Ostry A, Lamontagne AD. Job stress and other working conditions: relationships with smoking behaviors in a representative sample of working Australians. Am J Ind Med. 2007;50(8):584–96.PubMedCrossRefGoogle Scholar
  50. 50.
    Kouvonen A, Kivimaki M, Virtanen M, Pentti J, Vahtera J. Work stress, smoking status, and smoking intensity: an observational study of 46,190 employees. J Epidemiol Community Health. 2005;59(1):63–9.PubMedPubMedCentralCrossRefGoogle Scholar
  51. 51.
    Ponce N, Tseng W, Ong P, Shek YL, Ortiz S, Gatchell M. The state of Asian American, Native Hawaiian, and Pacific Islander health in California. Sacramento, CA: California Asian Pacific Islander Joint Legislative Caucus; 2009.Google Scholar
  52. 52.
    McDonnell DD, Lee H, Kazinets G, Moskowitz JM. Online recruitment of targeted populations: lessons learned from a smoking cessation study among Korean Americans. Soc Mark Q. 2010;16(3):2–22.CrossRefGoogle Scholar
  53. 53.
    Kim MT, Kim KB, Juon HS, Hill MN. Prevalence and factors associated with high blood pressure in Korean Americans. Ethn Dis. 2000;10(3):364–74.PubMedGoogle Scholar
  54. 54.
    Lee J, Demissie K, Lu SE, Rhoads GG. Cancer incidence among Korean-American immigrants in the United States and native Koreans in South Korea. Cancer Control. 2007;14(1):78–85.PubMedGoogle Scholar
  55. 55.
    Jee SH, Samet JM, Ohrr H, Kim JH, Kim IS. Smoking and cancer risk in Korean men and women. Cancer Causes Control. 2004;15(4):341–8.PubMedCrossRefGoogle Scholar
  56. 56.
    Ma GX, Tan Y, Toubbeh JI, Su X, Shive SE, Lan Y. Acculturation and smoking behavior in Asian-American populations. Health Educ Res. 2004;19(6):615–25.PubMedCrossRefGoogle Scholar
  57. 57.
    Juon HS, Kim M, Han H, Ryu JP, Han W. Acculturation and cigarette smoking among Korean American men. Yonsei Med J. 2003;44(5):875–82.PubMedCrossRefGoogle Scholar
  58. 58.
    Suinn RM, Ahuna C, Khoo G. The Suinn-Lew Asian self-identity acculturation scale: concurrent and factorial validation. Educ Psychol Meas. 1992;52(4):1041–6.CrossRefGoogle Scholar
  59. 59.
    Kim SS, Ziedonis D, Chen KW. Tobacco use and dependence in Asian Americans: a review of the literature. Nicotine Tob Res. 2007;9(2):169–84.PubMedCrossRefGoogle Scholar
  60. 60.
    Liao Y, Tsoh JY, Chen R, Foo MA, Garvin CC, Grigg-Saito D, et al. Decreases in smoking prevalence in Asian communities served by the racial and ethnic approaches to community health (REACH) project. Am J Public Health. 2010;100(5):853–60.PubMedPubMedCentralCrossRefGoogle Scholar
  61. 61.
    Kim SS, Son H, Nam KA. The sociocultural context of korean american men’s smoking behavior. West J Nurs Res. 2005;27(5):604–23 comment 24-7.PubMedCrossRefGoogle Scholar
  62. 62.
    Kim SS, Son H, Nam KA. Personal factors influencing Korean American men’s smoking behavior: addiction, health, and age. Arch Psychiatr Nurs. 2005;19(1):35–41.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Occupational and Environmental Health Nursing Graduate Program, School of NursingUniversity of California, San Francisco (UCSF)San FranciscoUSA
  2. 2.Nursing, Otolaryngology, Psychiatry and VA Center for Clinical Management Research, VA Ann Arbor Healthcare SystemUniversity of MichiganAnn ArborUSA

Personalised recommendations