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1. Day or overnight transfusion in critically ill patients: does it matter?

Author

Aubron, C., Kandane-Rathnayake, R., Andrianopoulos, N., Westbrook, A., Engelbrecht, S., Ozolins, I., Bailey, M., Murray, L., Cooper, D., Wood, E., McQuilten, Z., Pettilä, V., Nichol, A., Syres, G., Phillips, L., Street, A., French, C., Orford, N., Santamaria, J., Bellomo, R., Vallance, S., McArthur, C., McGuiness, S., Newby, L., Simmonds, C., Parke, R., Buhr, H., Goldsmith, D., O'Sullivan, K., Mercer, I., Gazzard, R., Tauschke, C., Hill, D., Fletcher, J., Boschert, C., Koch, G., Ernest, D., Eliott, S., Howe, B., Hawker, F., Ellem, K., Duff, K., Henderson, S., Mehrtens, J., Milliss, D., Wong, H., Arora, S., O'Bree, B., Shepherd, K., Ihle, B., Ho, S., Graan, M., Bernsten, A., Ryan, E., Botha, J., Vuat, J., Kinmonth, A., Fraser, M., Richards, B., Tallott, M., Whitbread, R., Freebairn, R., Thomas, L., Parr, M., Micallef, S., Deshpande, K., Wood, J., Williams, Teresa, Tai, J., Boase, A., Galt, P., King, B., Price, R., Tomlinson, J., Cole, L., Seppelt, I., Weisbrodt, L., Gresham, R., Nikas, M., Laing, J., Bell, J., McHugh, G., Hancock, D., Kirkham, S., Shehabi, Y., Campbell, M., Aubron, C., Kandane-Rathnayake, R., Andrianopoulos, N., Westbrook, A., Engelbrecht, S., Ozolins, I., Bailey, M., Murray, L., Cooper, D., Wood, E., McQuilten, Z., Pettilä, V., Nichol, A., Syres, G., Phillips, L., Street, A., French, C., Orford, N., Santamaria, J., Bellomo, R., Vallance, S., McArthur, C., McGuiness, S., Newby, L., Simmonds, C., Parke, R., Buhr, H., Goldsmith, D., O'Sullivan, K., Mercer, I., Gazzard, R., Tauschke, C., Hill, D., Fletcher, J., Boschert, C., Koch, G., Ernest, D., Eliott, S., Howe, B., Hawker, F., Ellem, K., Duff, K., Henderson, S., Mehrtens, J., Milliss, D., Wong, H., Arora, S., O'Bree, B., Shepherd, K., Ihle, B., Ho, S., Graan, M., Bernsten, A., Ryan, E., Botha, J., Vuat, J., Kinmonth, A., Fraser, M., Richards, B., Tallott, M., Whitbread, R., Freebairn, R., Thomas, L., Parr, M., Micallef, S., Deshpande, K., Wood, J., Williams, Teresa, Tai, J., Boase, A., Galt, P., King, B., Price, R., Tomlinson, J., Cole, L., Seppelt, I., Weisbrodt, L., Gresham, R., Nikas, M., Laing, J., Bell, J., McHugh, G., Hancock, D., Kirkham, S., Shehabi, Y., and Campbell, M.

Abstract

Background and objectives: The timing of blood administration in critically ill patients is first driven by patients' needs. This study aimed to define the epidemiology and significance of overnight transfusion in critically ill patients. Materials and methods: This is a post hoc analysis of a prospective multicentre observational study including 874 critically ill patients receiving red blood cells, platelets, fresh frozen plasma (FFP) or cryoprecipitate. Characteristics of patients receiving blood only during the day (8 am up until 8 pm) were compared to those receiving blood only overnight (8 pm up until 8 am). Characteristics of transfusion were compared, and factors independently associated with major bleeding were analysed. Results: The 287 patients transfused during the day only had similar severity and mortality to the 258 receiving blood products overnight only. Although bleeding-related admission diagnoses were similar, major bleeding was the indication for transfusion in 12% of patients transfused in daytime only versus 30% of patients transfused at night only (P < 0·001). Similar total amount of blood products were transfused at day and night (2856 versus 2927); however, patients were more likely to receive FFP and cryoprecipitate at night compared with daytime. Overnight transfusion was independently associated with increased odds of major bleeding (odds ratio, 3·16, 95% confidence interval, 2·00–5·01). Conclusion: Transfusion occurs evenly across day and night in ICU; nonetheless, there are differences in type of blood products administered that reflect differences in indication. Critically ill patients were more likely to receive blood for major bleeding at night irrespective of admission diagnosis.

Published
2018

2. Intensity of Continuous Renal-Replacement Therapy in Critically Ill Patients

Author

Bellomo, R, Cass, A, Norton, R, Gallagher, M, Lo, S, Su, S, Cole, L, Finfer, S, McArthur, C, McGuinness, S, Myburgh, J, Scheinkestel, C, Lee, J, Ali, D, Goldsmith, D, Banerjee, A, Bhonagiri, D, Blythe, D, Botha, J, Cade, J, Dobb, G, Eddington, J, Flabouris, A, French, C, Garrett, P, Henderson, S, Ihle, B, Joyce, C, Kalkoff, M, Lipman, J, Milliss, D, Mitchell, I, Morgan, J, Nair, P, Orford, N, Raza, A, Shehabi, Y, Tobin, A, Totaro, R, Turner, A, Wright, C, Little, L, Morrison, A, Regaglia, G, Shukla, R, Baigent, C, Emberson, J, Wheeler, D, Young, D, Billot, L, Bompoint, S, Heritier, S, Lo, SN, Pillai, A, Pandey, S, Ryan, S, Schmidt, M, Starzec, G, Vijayan, B, Ashley, R, Gissane, J, Malchukova, K, Ranse, J, Nand, K, Sara, T, Cheung, W, Fugaccia, E, Lawrence, P, Millis, D, Tan, J, Thankrishnan, G, Wong, H, Harrigan, P, Crowfoot, E, Hardie, M, Micallef, S, Brieva, J, Lintott, M, Seppelt, I, Gresham, R, Nikas, M, Weisbrodt, L, Bass, F, Boyle, M, Campbell, M, Hammond, N, Ankers, S, O'Connor, A, Potter, J, Rajbhandari, D, Dhiacou, V, Jovanovska, A, Munster, F, Breeding, J, Burns, C, Morrison, M, Pfeffercorn, C, Ritchie, A, Buhr, H, Eccleston, M, Parke, R, Bell, J, Newby, L, Mehrtens, J, West, C, Rudder, L, Sutton, J, Groves, N, McDonald, S, Jaspers, J, Harwood, M, Helyar, J, Mackie, B, Boots, R, Bertenshaw, C, Deans, R, Fourie, C, Lassig-Smith, M, Stuart, J, Edwards, J, O'Connor, S, Lewis, K, Rivett, J, Field, T, McAllister, R, Marsden, K, Mathlin, C, Mercer, I, O'Sullivan, K, Edington, J, Boschert, C, Smith, J, Graan, M, Ho, S, Fowler, N, McInness, J, Pratt, N, Elderkin, T, Fraser, M, Kinmonth, A, Barrett, J, Wilson, S, Galt, P, Burton, S, Culhane, C, Ioannidis, R, Roberston, M, Barge, D, Caf, T, Howe, B, Low, P, Holmes, J, Smith, R, Davies, A, Murray, L, Nevill, R, Vallance, S, Varley, S, White, V, Raunow, H, Palermo, A, Boardman, M, Chamberlain, J, Gould, A, McEntaggart, G, Perryman, S, Thomas, L, and In, RENALRTS

Subjects
Male, medicine.medical_specialty, Randomization, Critical Illness, medicine.medical_treatment, Hemodiafiltration, Kaplan-Meier Estimate, law.invention, Randomized controlled trial, law, Internal medicine, medicine, Humans, Prospective Studies, Renal replacement therapy, Prospective cohort study, Aged, business.industry, Acute kidney injury, General Medicine, Odds ratio, Acute Kidney Injury, Middle Aged, medicine.disease, Confidence interval, Surgery, Treatment Outcome, Female, business, Hypophosphatemia
Abstract

Background The optimal intensity of continuous renal-replacement therapy remains unclear. We conducted a multicenter, randomized trial to compare the effect of this therapy, delivered at two different levels of intensity, on 90-day mortality among critically ill patients with acute kidney injury. Methods We randomly assigned critically ill adults with acute kidney injury to continuous renal-replacement therapy in the form of postdilution continuous venovenous hemodiafiltration with an effluent flow of either 40 ml per kilogram of body weight per hour (higher intensity) or 25 ml per kilogram per hour (lower intensity). The primary outcome measure was death within 90 days after randomization. Results Of the 1508 enrolled patients, 747 were randomly assigned to higher-intensity therapy, and 761 to lower-intensity therapy with continuous venovenous hemodiafiltration. Data on primary outcomes were available for 1464 patients (97.1%): 721 in the higher-intensity group and 743 in the lower-intensity group. The two study groups had similar baseline characteristics and received the study treatment for an average of 6.3 and 5.9 days, respectively (P = 0.35). At 90 days after randomization, 322 deaths had occurred in the higher-intensity group and 332 deaths in the lower-intensity group, for a mortality of 44.7% in each group (odds ratio, 1.00; 95% confidence interval [CI], 0.81 to 1.23; P = 0.99). At 90 days, 6.8% of survivors in the higher-intensity group (27 of 399), as compared with 4.4% of survivors in the lower-intensity group (18 of 411), were still receiving renal-replacement therapy (odds ratio, 1.59; 95% CI, 0.86 to 2.92; P = 0.14). Hypophosphatemia was more common in the higher-intensity group than in the lower-intensity group (65% vs. 54%, P Conclusions In critically ill patients with acute kidney injury, treatment with higher-intensity continuous renal-replacement therapy did not reduce mortality at 90 days. (ClinicalTrials.gov number, NCT00221013.)

Published
2016

3. South African volunteers’ experiences of volunteering at the 2010 FIFA World CupTM South Africa

Author

Human, LH and Van Graan, M

Subjects
Fédération Internationale de Football Association (FIFA), 2010 FIFA World Cup TM, volunteers, descriptive phenomenology, Duquesne Phenomenological Research Method (DPRM), essence, experience
Abstract

In 2010 the Fédération Internationale de Football Association (FIFA) hosted the 2010 FIFA World Cup South AfricaTM, which is commonly referred to as the 2010 FIFA World Cup. With such a mega-sport event the focus is usually on the football players and their teams. However, there are various other role-players (e.g., volunteers, journalists, spectators) that contribute to the success of such a mega-sport event. The purpose of this research was to study the phenomenon of volunteering through South African volunteers’ experiences of volunteering at the 2010 FIFA World Cup, specifically in the City of Tshwane (COT) in the Tshwane Metropolitan Area (TMA). A qualitative research design was employed, with specific reference to descriptive phenomenology. Five female volunteers voluntarily participated in the research project. Two data gathering methods were used in the research, being a written essay and a personal interview. The data were analysed by means of the Duquesne Phenomenological Research Method (DPRM). The findings indicated that polarization was the essence of the volunteers’ experiences with reference to the application process, the preparation phase and their participation in the 2010 FIFA World Cup. However, the polarization was absent in the volunteer’s personal reflections on the 2010 FIFA World Cup.Keywords: Fédération Internationale de Football Association (FIFA), 2010 FIFA World Cup TM, volunteers, descriptive phenomenology, Duquesne Phenomenological Research Method (DPRM), essence, experience.

Published
2013

4. Calorie intake and patient outcomes in severe acute kidney injury: Findings from The Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study trial.

Author

Nair P., Kalkoff M., West C., Morgan J., Rudder L., Sutton J., Garrett P., Groves N., McDonald S., Jennifer Palmer a., Joyce C., Harwood M., Helyar J., Mackie B., Lipman J., Boots R., Bertenshaw C., Deans R., Fourie C., Lassig-Smith M., Flabouris A., Edwards J., O'Connor S., Rivett J., Turner A., Field T., Marsden K., Mathlin C., Goldsmith D., Mercer I., O'Sullivan K., Edington J., Boschert C., Smith J., Ihle B., Graan M., Ho S., Botha J., Fowler N., McInness J., Pratt N., Orford N., Elderkin T., Fraser M., Kinmonth A., Wright C., Burton S., Culhane C., Galt P., Rutzou R., Roberston M., Barge D., Caf T., Howe B., Low P., Tobin A., Holmes J., Smith R., Murray L., Nevill R., Vallance S., Varley S., White V., French C., Little L., Raunow H., Blythe D., Palermo A., Dobb G., Boardman M., Chamberlain J., Gould A., McEntaggart G., Perryman S., Thomas L., Bellomo R., Cass A., Cole L., Finfer S., Gallagher M., Lee J., Lo S., McArthur C., McGuinness S., Myburgh J., Norton R., Scheinkestel C., Mitchell I., Ashley R., Gissane J., Malchukova K., Ranse J., Raza A., Nand K., Sara T., Millis D., Tan J., Wong H., Harrigan P., Crowfoot E., Hardie M., Bhonagiri D., Micallef S., Brieva J., Lintott M., Gresham R., Nikas M., Weisbrodt L., Shehabi Y., Bass F., Campbell M., Stockdale V., Ankers S., O'Connor A., Potter J., Totaro R., Rajbhandari D., Dhiacou V., Jovanovska A., Munster F., Davies A., Breeding J., Burns C., Banerjee A., Morrison M., Pfeffercorn C., Ritchie A., Buhr H., Eccleston M., Parke R., Bell J., Newby L., Henderson S., Mehrtens J., Nair P., Kalkoff M., West C., Morgan J., Rudder L., Sutton J., Garrett P., Groves N., McDonald S., Jennifer Palmer a., Joyce C., Harwood M., Helyar J., Mackie B., Lipman J., Boots R., Bertenshaw C., Deans R., Fourie C., Lassig-Smith M., Flabouris A., Edwards J., O'Connor S., Rivett J., Turner A., Field T., Marsden K., Mathlin C., Goldsmith D., Mercer I., O'Sullivan K., Edington J., Boschert C., Smith J., Ihle B., Graan M., Ho S., Botha J., Fowler N., McInness J., Pratt N., Orford N., Elderkin T., Fraser M., Kinmonth A., Wright C., Burton S., Culhane C., Galt P., Rutzou R., Roberston M., Barge D., Caf T., Howe B., Low P., Tobin A., Holmes J., Smith R., Murray L., Nevill R., Vallance S., Varley S., White V., French C., Little L., Raunow H., Blythe D., Palermo A., Dobb G., Boardman M., Chamberlain J., Gould A., McEntaggart G., Perryman S., Thomas L., Bellomo R., Cass A., Cole L., Finfer S., Gallagher M., Lee J., Lo S., McArthur C., McGuinness S., Myburgh J., Norton R., Scheinkestel C., Mitchell I., Ashley R., Gissane J., Malchukova K., Ranse J., Raza A., Nand K., Sara T., Millis D., Tan J., Wong H., Harrigan P., Crowfoot E., Hardie M., Bhonagiri D., Micallef S., Brieva J., Lintott M., Gresham R., Nikas M., Weisbrodt L., Shehabi Y., Bass F., Campbell M., Stockdale V., Ankers S., O'Connor A., Potter J., Totaro R., Rajbhandari D., Dhiacou V., Jovanovska A., Munster F., Davies A., Breeding J., Burns C., Banerjee A., Morrison M., Pfeffercorn C., Ritchie A., Buhr H., Eccleston M., Parke R., Bell J., Newby L., Henderson S., and Mehrtens J.

Abstract

Introduction: Current practice in the delivery of caloric intake (DCI) in patients with severe acute kidney injury (AKI) receiving renal replacement therapy (RRT) is unknown. We aimed to describe calorie administration in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study and to assess the association between DCI and clinical outcomes. Method(s): We performed a secondary analysis in 1456 patients from the RENAL trial. We measured the dose and evolution of DCI during treatment and analyzed its association with major clinical outcomes using multivariable logistic regression, Cox proportional hazards models, and time adjusted models. Result(s): Overall, mean DCI during treatment in ICU was low at only 10.9 +/- 9 Kcal/kg/day for non-survivors and 11 +/- 9 Kcal/kg/day for survivors. Among patients with a lower DCI (below the median) 334 of 729 (45.8%) had died at 90-days after randomization compared with 316 of 727 (43.3%) patients with a higher DCI (above the median) (P = 0.34). On multivariable logistic regression analysis, mean DCI carried an odds ratio of 0.95 (95% confidence interval (CI): 0.91-1.00; P = 0.06) per 100 Kcal increase for 90-day mortality. DCI was not associated with significant differences in renal replacement (RRT) free days, mechanical ventilation free days, ICU free days and hospital free days. These findings remained essentially unaltered after time adjusted analysis and Cox proportional hazards modeling. Conclusion(s): In the RENAL study, mean DCI was low. Within the limits of such low caloric intake, greater DCI was not associated with improved clinical outcomes. © 2014 Bellomo et al.; licensee BioMed Central Ltd.

Published
2014

5. Calorie intake and patient outcomes in severe acute kidney injury: Findings from The Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study trial

Author

Bellomo, R, Cass, A, Cole, L, Finfer, S, Gallagher, M, Lee, J, Lo, S, McArthur, C, McGuinness, S, Myburgh, J, Norton, R, Scheinkestel, C, Mitchell, I, Ashley, R, Gissane, J, Malchukova, K, Ranse, J, Raza, A, Nand, K, Sara, T, Millis, D, Tan, J, Wong, H, Harrigan, P, Crowfoot, E, Hardie, M, Bhonagiri, D, Micallef, S, Brieva, J, Lintott, M, Gresham, R, Nikas, M, Weisbrodt, L, Shehabi, Y, Bass, F, Campbell, M, Stockdale, V, Ankers, S, O'Connor, A, Potter, J, Totaro, R, Rajbhandari, D, Dhiacou, V, Jovanovska, A, Munster, F, Nair, P, Breeding, J, Burns, C, Banerjee, A, Morrison, M, Pfeffercorn, C, Ritchie, A, Buhr, H, Eccleston, M, Parke, R, Bell, J, Newby, L, Henderson, S, Mehrtens, J, Kalkoff, M, West, C, Morgan, J, Rudder, L, Sutton, J, Garrett, P, Groves, N, McDonald, S, Jennifer Palmer, A, Joyce, C, Harwood, M, Helyar, J, Mackie, B, Lipman, J, Boots, R, Bertenshaw, C, Deans, R, Fourie, C, Lassig-Smith, M, Flabouris, A, Edwards, J, O'Connor, S, Rivett, J, Turner, A, Field, T, Marsden, K, Mathlin, C, Goldsmith, D, Mercer, I, O'Sullivan, K, Edington, J, Boschert, C, Smith, J, Ihle, B, Graan, M, Ho, S, Botha, J, Fowler, N, McInness, J, Pratt, N, Orford, N, Bellomo, R, Cass, A, Cole, L, Finfer, S, Gallagher, M, Lee, J, Lo, S, McArthur, C, McGuinness, S, Myburgh, J, Norton, R, Scheinkestel, C, Mitchell, I, Ashley, R, Gissane, J, Malchukova, K, Ranse, J, Raza, A, Nand, K, Sara, T, Millis, D, Tan, J, Wong, H, Harrigan, P, Crowfoot, E, Hardie, M, Bhonagiri, D, Micallef, S, Brieva, J, Lintott, M, Gresham, R, Nikas, M, Weisbrodt, L, Shehabi, Y, Bass, F, Campbell, M, Stockdale, V, Ankers, S, O'Connor, A, Potter, J, Totaro, R, Rajbhandari, D, Dhiacou, V, Jovanovska, A, Munster, F, Nair, P, Breeding, J, Burns, C, Banerjee, A, Morrison, M, Pfeffercorn, C, Ritchie, A, Buhr, H, Eccleston, M, Parke, R, Bell, J, Newby, L, Henderson, S, Mehrtens, J, Kalkoff, M, West, C, Morgan, J, Rudder, L, Sutton, J, Garrett, P, Groves, N, McDonald, S, Jennifer Palmer, A, Joyce, C, Harwood, M, Helyar, J, Mackie, B, Lipman, J, Boots, R, Bertenshaw, C, Deans, R, Fourie, C, Lassig-Smith, M, Flabouris, A, Edwards, J, O'Connor, S, Rivett, J, Turner, A, Field, T, Marsden, K, Mathlin, C, Goldsmith, D, Mercer, I, O'Sullivan, K, Edington, J, Boschert, C, Smith, J, Ihle, B, Graan, M, Ho, S, Botha, J, Fowler, N, McInness, J, Pratt, N, and Orford, N

Abstract

Introduction: Current practice in the delivery of caloric intake (DCI) in patients with severe acute kidney injury (AKI) receiving renal replacement therapy (RRT) is unknown. We aimed to describe calorie administration in patients enrolled in the Randomized Evaluation of Normal vs. Augmented Level of Replacement Therapy (RENAL) study and to assess the association between DCI and clinical outcomes.Methods: We performed a secondary analysis in 1456 patients from the RENAL trial. We measured the dose and evolution of DCI during treatment and analyzed its association with major clinical outcomes using multivariable logistic regression, Cox proportional hazards models, and time adjusted models.Results: Overall, mean DCI during treatment in ICU was low at only 10.9 ± 9 Kcal/kg/day for non-survivors and 11 ± 9 Kcal/kg/day for survivors. Among patients with a lower DCI (below the median) 334 of 729 (45.8%) had died at 90-days after randomization compared with 316 of 727 (43.3%) patients with a higher DCI (above the median) (P = 0.34). On multivariable logistic regression analysis, mean DCI carried an odds ratio of 0.95 (95% confidence interval (CI): 0.91-1.00; P = 0.06) per 100 Kcal increase for 90-day mortality. DCI was not associated with significant differences in renal replacement (RRT) free days, mechanical ventilation free days, ICU free days and hospital free days. These findings remained essentially unaltered after time adjusted analysis and Cox proportional hazards modeling.Conclusions: In the RENAL study, mean DCI was low. Within the limits of such low caloric intake, greater DCI was not associated with improved clinical outcomes. © 2014 Bellomo et al.; licensee BioMed Central Ltd.

Published
2014

7. Tracking the formation potential of vivianite within the treatment train of full-scale wastewater treatment plants.

Author

Amin L, Al-Juboori RA, Lindroos F, Bounouba M, Blomberg K, Viveros ML, Graan M, Azimi S, Lindén J, Mikola A, and Spérandio M

Subjects
Waste Disposal, Fluid methods, Phosphates chemistry, Ferrous Compounds chemistry, Iron chemistry, Phosphorus chemistry, Sulfur, Sewage chemistry, Ferric Compounds
Abstract

Phosphorus recovery is a vital element for the circular economy. Wastewater, especially sewage sludge, shows great potential for recovering phosphate in the form of vivianite. This work focuses on studying the iron, phosphorus, and sulfur interactions at full-scale wastewater treatment plants (Viikinmäki, Finland and Seine Aval, France) with the goal of identifying unit processes with a potential for vivianite formation. Concentrations of iron(III) and iron(II), phosphorus, and sulfur were used to evaluate the reduction of iron and the formation potential of vivianite. Mössbauer spectroscopy and X-ray diffraction (XRD) analysis were used to confirm the presence of vivianite in various locations on sludge lines. The results show that the vivianite formation potential increases as the molar Fe:P ratio increases, the anaerobic sludge retention time increases, and the sulfate concentration decreases. The digester is a prominent location for vivianite recovery, but not the only one. This work gives valuable insights into the dynamic interrelations of iron, phosphorus, and sulfur in full-scale conditions. These results will support the understanding of vivianite formation and pave the way for an alternative solution for vivianite recovery for example in plants that do not have an anaerobic digester., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Published
2024
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8. Effects of the Tobacco Products Control Amendment Act of 1999 on restaurant revenues in South Africa--a survey approach.

Author

van Walbeek C, Blecher E, and van Graan M

Subjects
Air Pollution, Indoor legislation & jurisprudence, Costs and Cost Analysis, Data Collection, Humans, Restaurants legislation & jurisprudence, Smoking Prevention, South Africa, Telephone, Tobacco Smoke Pollution legislation & jurisprudence, Air Pollution, Indoor prevention & control, Public Policy, Restaurants economics, Smoking legislation & jurisprudence, Tobacco Smoke Pollution economics
Abstract

Objective: To investigate the impact of the restrictions on smoking in indoor public places on the financial situation of the hospitality industry., Methods: A telephone survey was undertaken of 1011 restaurants, selected by searching public-access Internet databases., Results: Fifty per cent of surveyed restaurants spent an average of R67 000 (median of R25 000) to comply with the clean indoor air legislation. The capital cost for the remaining 50% of restaurants was zero. The impact on restaurant revenues was limited: 59% of restaurants reported no change in revenue, 22% an increase and 19% a decrease as a result of the legislation. Franchised restaurants experienced a net gain in revenue (34% reporting an increase, 16% reporting a decrease, and 50% reporting no change), although on average they incurred more costs to comply with the legislation than independent restaurants. On average, independent restaurants reported a decrease in their revenues as a result of the legislation (21% reporting a decrease, 13% reporting an increase, and 66% reporting no change). Ninety-two per cent of respondents believed that their restaurants complied with the legislation. The new smoking policies have been well accepted by nonsmokers (nearly 100%) and smokers (87%) alike., Conclusion: Despite the hospitality and tobacco industries' claim that the law restricting smoking in restaurants would have very detrimental financial consequences, the retrospective evidence does not support this.

Published
2007

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