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Environ Int. 2019 Apr 10;127:495-502. doi: 10.1016/j.envint.2019.03.074. [Epub ahead of print]

Waterpipe tobacco smoke: Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees.

Author information

1
Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, United States of America. Electronic address: bkaplan9@jhu.edu.
2
U.S. Army Public Health Center, Toxicology Directorate, United States of America.
3
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, United States of America.
4
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, United States of America; Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, United States of America.
5
Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, United States of America; Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, United States of America; Department of Legal Medicine and Toxicology, School of Medicine, University of Granada, Granada, Spain.
6
Department of Psychology, Kadir Has University, Istanbul, Turkey.
7
Russian Cancer Research Center, Moscow, Russian Federation.
8
National Center for Environmental Health, Centers for Disease Control and Prevention, United States of America.
9
Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, United States of America.
10
Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, United States of America.

Abstract

INTRODUCTION:

Few studies have comprehensively characterized toxic chemicals related to waterpipe use and secondhand waterpipe exposure. This cross-sectional study investigated biomarkers of toxicants associated with waterpipe use and passive waterpipe exposure among employees at waterpipe venues.

METHOD:

We collected urine specimens from employees in waterpipe venues from Istanbul, Turkey and Moscow, Russia, and identified waterpipe and cigarette smoking status based on self-report. The final sample included 110 employees. Biomarkers of exposure to sixty chemicals (metals, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), nicotine, and heterocyclic aromatic amines (HCAAs)) were quantified in the participants' urine.

RESULTS:

Participants who reported using waterpipe had higher urinary manganese (geometric mean ratio (GMR): 2.42, 95% confidence interval (CI): 1.16, 5.07) than never/former waterpipe or cigarette smokers. Being exposed to more hours of secondhand smoke from waterpipes was associated with higher concentrations of cobalt (GMR: 1.38, 95% CI: 1.10, 1.75). Participants involved in lighting waterpipes had higher urinary cobalt (GMR: 1.43, 95% CI: 1.10, 1.86), cesium (GMR: 1.21, 95% CI: 1.00, 1.48), molybdenum (GMR: 1.45, 95% CI: 1.08, 1.93), 1-hydroxypyrene (GMR: 1.36, 95% CI: 1.03, 1.80), and several VOC metabolites.

CONCLUSION:

Waterpipe tobacco users and nonsmoking employees of waterpipe venues had higher urinary concentrations of several toxic metals including manganese and cobalt as well as of VOCs, in a distinct signature compared to cigarette smoke. Employees involved in lighting waterpipes may have higher exposure to multiple toxic chemicals compared to other employees.

KEYWORDS:

Carcinogen; Secondhand smoke; Toxicants; Waterpipe

PMID:
30981020
DOI:
10.1016/j.envint.2019.03.074
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