Occupational exposures and associated risk factors among U.S. casino workers: a narrative review

We conducted a narrative literature review of U.S. casino occupational health and safety research based on the following inclusion criteria: 1) focused on workers, 2) provided information pertaining to exposures present in the occupational environment (e.g., hazards, stressors, etc.), and 3) pertained to casino, gaming, or gambling workers. Following a multi-step process, a total of 11 articles were identified that related to the occupational health and safety of U.S. casino workers. These articles primarily focused on environmental tobacco smoke (ETS) exposures (n = 7 articles), with the remaining articles related to casino worker risk behaviors (i.e., problem gambling and drinking) (n = 2), and psychosocial stressors (n = 2). Our results demonstrate that the overwhelming consensus in the literature is that ETS leads to high respirable particulate matter (PM2.5), tobacco toxin levels and exposures among gaming employees. Our results also suggest that harassment, low autonomy at work, and unsafe work conditions may be of concern, especially for female workers. We identified major gaps in the casino worker occupational safety literature including a lack of studies that evaluated noise exposure, injury data, ergonomics, psychosocial hazards, or long term respiratory health outcomes related to ETS exposure. Future research regarding the occupational safety and health of U.S. casino workers should address these gaps in the literature.