Waterpipe tobacco smoke: Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees
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info:eu-repo/semantics/openAccessDate
2019Author
Kaplan, BekirSussan, Thomas
Rule, Ana M.
Moon, Katherine A.
Grau-Perez, Maria
Olmedo, Pablo
Chen, Rui
Çarkoğlu, Aslı
Levshin, Vladimir
Wang, Lanqing
Watson, Clifford
Blount, Benjamin
Calafat, Antonia M.
Jarrett, Jeffery
Caldwell, Kathleen
Wang, Yuesong
Breysse, Patrick N.
Strickland, Paul
Cohen, Joanna E.
Biswal, Shyam
Navas-Acien, Ana
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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.