TY - JOUR
T1 - Waterpipe tobacco smoke
T2 - Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees
AU - Kaplan, Bekir
AU - Sussan, Thomas E
AU - Rule, Ana
AU - Moon, Katherine
AU - Grau-Perez, Maria
AU - Olmedo, Pablo
AU - Chen, Rui
AU - Carkoglu, Asli
AU - Levshin, Vladimir
AU - Wang, Lanqing
AU - Watson, Clifford
AU - Blount, Benjamin
AU - Calafat, Antonia M.
AU - Jarrett, Jeffery
AU - Caldwell, Kathleen
AU - Wang, Yuesong
AU - Breysse, Pattrick
AU - Strickland, Paul
AU - Cohen, Joanna
AU - Biswal, Shyam
AU - Navas Acien, Ana
N1 - Funding Information:
This study was supported by the Institute for Global Tobacco Control at the Johns Hopkins Bloomberg School of Public Health (#119187) with funding from the Bloomberg Initiative to Reduce Tobacco Use and the National Heart, Lung, and Blood Institute ( 1R01HL134149 ). Ana Navas-Acien was supported by the National Institute of Environmental Health Sciences ( 5P30ES009089 ). Pablo Olmedo was supported by the Alfonso Martín Escudero Foundation (Postdoctoral Fellowship 2014).
Publisher Copyright:
© 2019 The Authors
PY - 2019/6
Y1 - 2019/6
N2 - 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.
AB - 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.
KW - Carcinogen
KW - Secondhand smoke
KW - Toxicants
KW - Waterpipe
UR - http://www.scopus.com/inward/record.url?scp=85064068155&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85064068155&partnerID=8YFLogxK
U2 - 10.1016/j.envint.2019.03.074
DO - 10.1016/j.envint.2019.03.074
M3 - Article
C2 - 30981020
AN - SCOPUS:85064068155
SN - 0160-4120
VL - 127
SP - 495
EP - 502
JO - Environment international
JF - Environment international
ER -