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Zhu J, Liu J, He X, Wang L, Liu X, Yang J, Sun H, Azhar N, Oduro NB. Experimental study on the purification capacity of potted plants on low-concentration carbon monoxide in indoor environment. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:6316-6331. [PMID: 38146024 DOI: 10.1007/s11356-023-31497-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 12/07/2023] [Indexed: 12/27/2023]
Abstract
Indoor low-concentration carbon monoxide (CO) exposure is widespread worldwide, and potted plants may be a potential means for CO purification. The objective is to evaluate common indoor plants' CO purification and tolerance capacities. Epipremnum aureum (Linden ex André) G.S.Bunting, Chlorophytum comosum (Thunb.) Jacques, Spathiphyllum kochii Engl. & K.Krause, and Sansevieria trifasciata Hort. ex Prain with similar sizes were tested in the glass chamber with initial CO concentrations of 10, 25, 50, 100, 200, and 400 ppm, respectively. (1) The CO purification capacity of the four potted plants is ranked as Epipremnum aureum (Linden ex André) G.S.Bunting > Chlorophytum comosum (Thunb.) Jacques > Spathiphyllum kochii Engl. & K.Krause > Sansevieria trifasciata Hort. ex Prain. Under the purification effect of each plant, the CO concentration in the chamber decreases linearly and significantly (p < 0.05), and within a specific time period, the time-weighted average (TWA) CO concentrations can be reduced to below the corresponding permissible exposure limits specified by some countries and organizations. (2) With the increase of the stomatal number of each plant and the increase in CO concentration, the hourly and cumulative absorbed CO of each plant increase linearly and significantly (p < 0.05). (3) With the increase in CO concentration, the CO purification efficiency of each plant decreases exponentially and significantly (p < 0.05). (4) When the CO concentration was ≤ 50 ppm, all plants could effectively purify CO without damage. When the CO concentration was in the range of 100 ~ 400 ppm, within 2 weeks after the 48-h experiment, the leaf tips of Chlorophytum comosum (Thunb.) Jacques and Epipremnum aureum (Linden ex André) G.S.Bunting were damaged one after another, and the damaged leaf area increased with the increase of CO concentration. However, each plant as a whole still survived. This study demonstrated that different species of potted plants can effectively absorb low concentrations of CO to varying degrees, but higher concentrations of CO will damage the survival of specific species of potted plants.
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Affiliation(s)
- Jintuo Zhu
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Jinyu Liu
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Xinjian He
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China.
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China.
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China.
| | - Liang Wang
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Xuejing Liu
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Jin Yang
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Haisong Sun
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Noor Azhar
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
| | - Nkansah Benjamin Oduro
- Key Laboratory of Coal Methane and Fire Control, Ministry of Education, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- National Professional Laboratory for Fundamental Research of Mine Gas and Dust Control Technology, School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
- School of Safety Engineering, China University of Mining and Technology, Xuzhou, 221116, Jiangsu, China
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Shearston JA, Eazor J, Lee L, Vilcassim MJR, Reed TA, Ort D, Weitzman M, Gordon T. Effects of electronic cigarettes and hookah (waterpipe) use on home air quality. Tob Control 2023; 32:36-41. [PMID: 34021062 PMCID: PMC10787574 DOI: 10.1136/tobaccocontrol-2020-056437] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/30/2021] [Accepted: 04/06/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION A major site of secondhand smoke exposure for children and adults is the home. Few studies have evaluated the impact of e-cigarette or hookah use on home air quality, despite evidence finding toxic chemicals in secondhand e-cigarette aerosols and hookah smoke. We assessed the effect of e-cigarette and hookah use on home air quality and compared it with air quality in homes where cigarettes were smoked and where no smoking or e-cigarette use occurred. METHODS Non-smoking homes and homes where e-cigarettes, hookah or cigarettes were used were recruited in the New York City area (n=57) from 2015 to 2019. Particulate matter with diameter less than 2.5 µm (PM2.5), black carbon and carbon monoxide (CO) were measured during a smoking or vaping session, both in a 'primary' smoking room and in an adjacent 'secondary' room where no smoking or vaping occurred. Log transformed data were compared with postanalysis of variance Tukey simultaneous tests. RESULTS Use of hookah significantly increased PM2.5 levels compared with non-smoking homes, in both the primary and secondary rooms, while use of e-cigarettes increased PM2.5 levels only in primary rooms. Additionally, in-home use of hookah resulted in greater CO concentrations than the use of cigarettes in primary rooms. CONCLUSIONS Use of e-cigarettes or hookah increases air pollution in homes. For hookah, increases in PM2.5 penetrated even into rooms adjacent to where smoking occurs. Extending smoke-free rules inside homes to include e-cigarette and hookah products is needed to protect household members and visitors from passive exposure to harmful aerosols and gases.
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Affiliation(s)
- Jenni A Shearston
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York, USA
| | - James Eazor
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
| | - Lily Lee
- State University of New York Downstate Medical Center, New York, New York, USA
| | - M J Ruzmyn Vilcassim
- Department of Environmental Health Sciences, The University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Taylor A Reed
- Department of Social Welfare, University of California Los Angeles, Los Angeles, California, USA
| | - Deborah Ort
- Nemours Children's Urgent Care, Orlando, Florida, USA
| | - Michael Weitzman
- Department of Pediatrics, New York University School of Medicine, New York, New York, USA
- New York University College of Global Public Health, New York, New York, USA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, New York, USA
- New York University College of Global Public Health, New York, New York, USA
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Secondhand smoke exposure from the indoor and outdoor shisha centers located at the perimeter of educational institutions in Malaysia: a cross-sectional study. J Public Health Policy 2022; 43:77-88. [PMID: 35058568 PMCID: PMC8776358 DOI: 10.1057/s41271-021-00329-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/21/2022]
Abstract
Shisha is a centuries-old traditional smoking habit rapidly gaining popularity among the students and young adults in Malaysia. The present study evaluated secondhand smoke exposure (SHS) and characteristics of 25 indoor and 25 outdoor shisha centers (SC) operating around the educational institutes such as universities in Petaling Jaya, Malaysia. We observed a significantly higher particulate matter (PM)2.5 concentration in indoor than outdoor SC (3595.28 μg/m3 and 65.12 μg/m3, p < 0.001, respectively). SCs are offering different flavors to attract clients and exposing students and young professionals to a significantly high concentration of SHS. Such exposures may pose a serious health risk. Therefore, policymakers need to strengthen tobacco guidelines and eliminate loopholes in the sale of shisha by enforcing comprehensive and strict smoke-free laws.
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Zusman M, Gassett AJ, Kirwa K, Barr RG, Cooper CB, Han MK, Kanner RE, Koehler K, Ortega VE, Paine R, Paulin L, Pirozzi C, Rule A, Hansel NN, Kaufman JD. Modeling residential indoor concentrations of PM 2.5 , NO 2 , NO x , and secondhand smoke in the Subpopulations and Intermediate Outcome Measures in COPD (SPIROMICS) Air study. INDOOR AIR 2021; 31:702-716. [PMID: 33037695 PMCID: PMC8202242 DOI: 10.1111/ina.12760] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 09/12/2020] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
Increased outdoor concentrations of fine particulate matter (PM2.5 ) and oxides of nitrogen (NO2 , NOx ) are associated with respiratory and cardiovascular morbidity in adults and children. However, people spend most of their time indoors and this is particularly true for individuals with chronic obstructive pulmonary disease (COPD). Both outdoor and indoor air pollution may accelerate lung function loss in individuals with COPD, but it is not feasible to measure indoor pollutant concentrations in all participants in large cohort studies. We aimed to understand indoor exposures in a cohort of adults (SPIROMICS Air, the SubPopulations and Intermediate Outcome Measures in COPD Study of Air pollution). We developed models for the entire cohort based on monitoring in a subset of homes, to predict mean 2-week-measured concentrations of PM2.5 , NO2 , NOx , and nicotine, using home and behavioral questionnaire responses available in the full cohort. Models incorporating socioeconomic, meteorological, behavioral, and residential information together explained about 60% of the variation in indoor concentration of each pollutant. Cross-validated R2 for best indoor prediction models ranged from 0.43 (NOx ) to 0.51 (NO2 ). Models based on questionnaire responses and estimated outdoor concentrations successfully explained most variation in indoor PM2.5 , NO2 , NOx , and nicotine concentrations.
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Affiliation(s)
- Marina Zusman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Amanda J Gassett
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Kipruto Kirwa
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - R. Graham Barr
- Presbyterian Hospital, Columbia University Medical Center, New York, NY, United States
| | | | - MeiLan K. Han
- Division of Pulmonary and Critical Care Medicine, University of Michigan, United States
| | - Richard E. Kanner
- University of Utah Health Sciences Center, Department of Internal Medicine, Division of Respiratory, Critical Care & Occupational Medicine, Salt Lake City, Utah, United States
| | - Kirsten Koehler
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Victor E. Ortega
- Department of Internal Medicine, Section on Pulmonary, Critical Care, Allergy and Immunologic Diseases Center for Precision Medicine. Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Robert Paine
- Division of Pulmonary Medicine, University Of Utah Hospital, Salt Lake City, UT, United States
| | - Laura Paulin
- Pulmonary/Critical Care, Dartmouth Hitchcock Medical Center, Lebanon, NH, United States
| | - Cheryl Pirozzi
- University Of Utah Hospital, Salt Lake City, UT, United States
| | - Ana Rule
- Environmental Health and Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Nadia N. Hansel
- Department of Medicine, Johns Hopkins University, Baltimore, MD, United States
| | - Joel D. Kaufman
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
- Department of Medicine, University of Washington, Seattle, WA, United States
- Department of Epidemiology, University of Washington, Seattle, WA, United States
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Agaku IT, Egbe CO, Ayo-Yusuf OA. Geospatial spread of e-cigarette vape shops in South Africa and the relationship with tobacco product use among adults. Health Place 2021; 68:102507. [PMID: 33486331 DOI: 10.1016/j.healthplace.2021.102507] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/21/2020] [Accepted: 01/05/2021] [Indexed: 12/01/2022]
Abstract
We estimated the spatial distribution of e-cigarette vape shops in South Africa and measured associations with tobacco use among adults. We linked geocoordinates of identified vape shops to internet protocol addresses of individual participants in the 2018 Health 24 survey (n = 18,208). We used logistic regression to measure the associations between proximity to vape shops and tobacco-related behaviors. In total, we identified 240 vape shops; 49.6% of these were within a 5 km radius of a higher educational institution. Proximity to vape shops was associated with ever e-cigarette use among young adults aged 18-29 years (AOR = 1.33, 95%CI = 1.16-1.54). Efforts to regulate e-cigarette marketing can benefit public health.
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Affiliation(s)
- Israel T Agaku
- School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa; Department of Oral Health Policy and Epidemiology, Harvard School of Dental Medicine, Boston, MA, USA.
| | - Catherine O Egbe
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Pretoria, South Africa; Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Olalekan A Ayo-Yusuf
- Africa Centre for Tobacco Industry Monitoring and Policy Research, Sefako Makgatho Health Sciences University, Pretoria, South Africa
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Vinnikov D, Tulekov Z, Romanova Z, Krugovykh I, Blanc PD. Smoking practices in relation to exhaled carbon monoxide in an occupational cohort. BMC Public Health 2020; 20:1894. [PMID: 33298031 PMCID: PMC7725030 DOI: 10.1186/s12889-020-09997-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 12/01/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Exposure to carbon monoxide (CO) remains a leading occupational hazard in firefighters, but cigarette and waterpipe smoking likely contributes to the other sources of CO in such workers. The aim of this study was to estimate the contribution of self-reported active cigarette smoking, waterpipe use, and potential job-related sources of CO to the level of exhaled CO in firefighters. METHODS We surveyed the personnel of 18 fire stations (N = 842), median age 28 years, who participated at an annual screening not timed to coincide with recent firefighting. We surveyed smoking and waterpipe history, exposure to secondhand smoke (SHS), use of coal for health and biomass for cooking and time since last exposure to firefighting in the workplace. We measured exhaled CO with an instantaneous reading device (piCO Smokerlyzer). We used multivariable regression models to test the association of time since last smoked cigarette (≤12 h) and waterpipe (≤12 h) and time since last fire (≤6 h) with exhaled CO. RESULTS In analysis limited to men (93.5% of all surveyed), 42% were daily cigarette; 1% were waterpipe smokers; 94% were exposed to SHS, 29% used coal for heating and 4% used biomass for cooking. The median CO was 4 (interquartile range 3;8) ppm. Age (beta 0.74 per 10 years, p < 0.001), use of biomass fuel for cooking (beta 1.38, p = 0.05), cigarette smoked in the last 12 h (beta 8.22, p < 0.001), waterpipe smoked in the last 12 h (beta 23.10, p < 0.001) were statistically associated with CO, but not time since last fire (≤6 h) (beta 4.12, p = 0.12). There was a significant interaction between older age and firefighting for exhaled CO (p = 0.03). CONCLUSIONS Cigarette and recent waterpipe smoking are associated with increased exhaled CO in firefighters. Firefighting itself was a less potent contributor to exhaled CO when measured at an annual screening, but an age interaction was manifested.
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Affiliation(s)
- Denis Vinnikov
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
- Peoples’ Friendship University of Russia (RUDN University), 6 Miklukho-Maklaya Street, Moscow, Russian Federation 117198
- National Research Tomsk State University, 36 Lenin Avenue, Tomsk, Russian Federation 634050
| | - Zhangir Tulekov
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
| | - Zhanna Romanova
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
| | - Ilya Krugovykh
- Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, Kazakhstan 050040
| | - Paul D. Blanc
- University of California San Francisco, Suite 609, 350 Parnassus Avenue, San Francisco, CA 94117 USA
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Thorpe LE, Anastasiou E, Wyka K, Tovar A, Gill E, Rule A, Elbel B, Kaplan SA, Jiang N, Gordon T, Shelley D. Evaluation of Secondhand Smoke Exposure in New York City Public Housing After Implementation of the 2018 Federal Smoke-Free Housing Policy. JAMA Netw Open 2020; 3:e2024385. [PMID: 33151318 PMCID: PMC7645700 DOI: 10.1001/jamanetworkopen.2020.24385] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
IMPORTANCE Secondhand smoke (SHS) exposure is associated with many health conditions in children and adults. Millions of individuals in the US are currently exposed to SHS in their homes. OBJECTIVE To investigate whether a federal ban on smoking in public housing settings was associated with a decrease in indoor SHS levels in New York City public housing developments 12 months after the policy's implementation. DESIGN, SETTING, AND PARTICIPANTS This cohort study tracked indoor air quality longitudinally from April 2018 to September 2019 and used difference-in-differences analysis to examine SHS exposure before vs after implementation of the 2018 federal smoke-free housing (SFH) policy in 10 New York City Housing Authority (NYCHA) buildings vs 11 matched low-income buildings not subject to the SFH policy (ie, Section 8 buildings). EXPOSURES Federal SFH policy implementation, beginning July 30, 2018. MAIN OUTCOMES AND MEASURES Comparison of nicotine concentration levels from passive, bisulfate-coated filters before vs 12 months after implementation of the federal SFH policy. Secondary outcomes included changes in particulate matter less than 2.5 μm in diameter, measured with low-cost particle monitors, and counts of cigarette butts in common areas. RESULTS Air quality was measured repeatedly in a total of 153 NYCHA and 110 Section 8 nonsmoking households as well as in 91 stairwells and hallways. Before the SFH policy implementation, air nicotine was detectable in 19 of 20 stairwells (95.0%) in NYCHA buildings and 15 of 19 stairwells (78.9%) in Section 8 buildings (P = .19) and in 17 of 19 hallways (89.5%) in NYCHA buildings and 14 of 23 hallways (60.9%) in Section 8 buildings (P = .004). Nicotine was detected less frequently inside nonsmoking apartments overall (26 of 263 [9.9%]) but more frequently in NYCHA apartments (20 of 153 [13.1%]) than in Section 8 apartments (6 of 110 [5.5%]) (P = .04). One year after policy implementation, there was no differential change over time in nicotine concentrations measured in stairwells (DID, 0.03 μg/m3; 95% CI, -0.99 to 1.06 μg/m3) or inside nonsmoking households (DID, -0.04 μg/m3; 95% CI, -0.24 to 0.15 μg/m3). Larger decreases in nicotine concentration were found in NYCHA hallways than in Section 8 hallways (DID, -0.43 μg/m3; 95% CI, -1.26 to 0.40 μg/m3). CONCLUSIONS AND RELEVANCE The findings suggest that there was no differential change in SHS in NYCHA buildings 12 months after SFH policy implementation. Additional support may be needed to ensure adherence to SFH policies.
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Affiliation(s)
- Lorna E. Thorpe
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Elle Anastasiou
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Katarzyna Wyka
- Department of Epidemiology and Biostatistics, The City University of New York Graduate School of Public Health and Health Policy, New York
| | - Albert Tovar
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Emily Gill
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Ana Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Brian Elbel
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Sue A. Kaplan
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Nan Jiang
- Department of Population Health, NYU Grossman School of Medicine, New York
| | - Terry Gordon
- Department of Environmental Medicine, NYU Grossman School of Medicine, New York
| | - Donna Shelley
- Department of Public Health Policy and Management, NYU School of Global Public Health, New York
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Rostami R, Naddafi K, Arfaeinia H, Nazmara S, Fazlzadeh M, Saranjam B. The effects of ventilation and building characteristics on indoor air quality in waterpipe cafés. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:805-813. [PMID: 32555400 DOI: 10.1038/s41370-020-0240-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/02/2020] [Accepted: 06/03/2020] [Indexed: 05/05/2023]
Abstract
To determine the concentration of carbon monoxide (CO) and particulate matter (PMs), indoor air samples were collected from 60 waterpipe cafés in Ardabil city of Iran. Moreover, the influence of several structural, operational, and ventilation system were evaluated on the concentration of the selected pollutants. The results showed that the mean concentration of CO (12.0 ± 7.2 mg/m3) and PMs (PM1 = 171.5 ± 119.6 μg/m3, PM2.5 = 303.3 ± 201.9 μg/m3, PM10 = 440.3 ± 272.2 μg/m3) were notably higher than the guideline levels. According to the results, open face/café area was influenced by the natural ventilation rate and the mean air exchange rate was 3.1 ± 1.1 min-1. The natural ventilation has a functional role on air quality of the cafes, and fan-type mechanical ventilation was influencing factor on CO concentration when the natural ventilation was restricted. "Type of used charcoal" had the highest influence on the releasing of pollutants inside the cafés as the pollutant concentrations were lower for simple (raw) charcoal compared with the favored (aromatic) one. The results indicated that the building characteristics and natural ventilation considerably affect air quality of the cafes.
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Affiliation(s)
- Roohollah Rostami
- Research center for health sciences and technologies, Semnan University of medical sciences, Semnan, Iran
| | - Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Arfaeinia
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
- Department of Environmental Health Engineering, School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Shahrokh Nazmara
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Fazlzadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Behzad Saranjam
- Department of Occupational Health Engineering, School of Public Health, Ardabil University of Medical Sciences, Ardabil, Iran.
- Health Sciences Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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Rezk-Hanna M, Nelson MD, Rader F, Benowitz NL, Rosenberry R, Chang LC, Li N, Tashkin DP, Elashoff RM, Victor RG. Peripheral Blood Flow Changes to Cutaneous and Muscular Beds in Response to Acute Hookah Smoking. Am J Cardiol 2020; 125:1725-1731. [PMID: 32278465 DOI: 10.1016/j.amjcard.2020.02.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/26/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
Hookah (waterpipe) smoking is a growing tobacco epidemic. Though perceived as a safer tobacco alternative, hookah smoke contains, in addition to tobacco combustion products, large amounts of charcoal combustion products-implicated in cardiovascular disease-from the burning charcoal used to heat the flavored tobacco. To date, little is known on the vascular effects of hookah smoking. The aim of this study was to characterize the peripheral circulatory response to acute hookah smoking in cutaneous and muscular beds. In 21 healthy young adult habitual hookah smokers who did not smoke cigarettes (age 24 ± 1 years, mean ± SE), we measured plasma nicotine, exhaled carbon monoxide, skin blood flow (laser Doppler velocimetry) and calf muscle blood flow (strain-gauge plethysmography) before and for up to 60 minutes after ad lib hookah smoking. In nine subjects, nonsmoking time-control studies were performed. Hookah smoking, which increased plasma nicotine by 5.8 ng/ml (from 0.6 ± 0.1 to 6.4 ± 1.3, p <0.001) and exhaled carbon monoxide by 27 ppm (from 2.7 ± 0.2 to 29.5 ± 2.2, p <0.001), decreased skin blood flow by 23% (20.1 ± 2.8 to 14.8 ± 1.9 units, p <0.001) and increased skeletal muscle blood flow by 34% (2.3 ± 0.1 to 2.9 ± 0.2 units, p = 0.010). These responses required more than one hour to recover after smoking cessation. All cardiovascular parameters were unchanged in the nonsmoking time-control studies. Although perceived to be innocuous, hookah smoking produces acute cutaneous vasoconstriction with skeletal muscle vasodilation, a dissociated pattern of peripheral blood flow responses that is characteristic of nicotine and carbon monoxide. In conclusion, these findings provide objective evidence to challenge the perception that hookah smoking is a safer tobacco alternative.
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Feliu A, Fu M, Russo M, Martinez C, Sureda X, López MJ, Cortés N, Fernández E. Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM 2.5. ENVIRONMENTAL RESEARCH 2020; 184:109347. [PMID: 32179267 DOI: 10.1016/j.envres.2020.109347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 01/30/2020] [Accepted: 03/02/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Waterpipe tobacco smoking has grown in popularity worldwide, with the prevalence of use increasing in Spain from 6.2% to 10.8% in the last decade, despite the smoking ban enacted in 2010 for all hospitality premises. OBJECTIVE To assess exposure to second-hand smoke from waterpipes based on the concentrations of airborne nicotine and particulate matter ≤2.5 μm in diameter (PM2.5) in a sample of waterpipe cafés in the city of Barcelona (Spain). METHODS This cross-sectional study included a sample of 20 waterpipe cafés. Airborne nicotine and PM2.5 were sampled for 30 min in each venue using a nicotine sampling device connected by a tube to a pump and a TSI SidePak Personal Aerosol Monitor. Five outdoor control locations were also measured. We computed medians, interquartile ranges (IQRs), and maximum values and compared them according to venues' and sampling characteristics using the Kruskall-Wallis and U-Mann Whitney tests. Nicotine and PM2.5 were correlated by calculating the Spearman-rank correlation coefficient. RESULTS The median concentration of nicotine and PM2.5 were 1.15 and 230.50 μg/m3 in waterpipe cafés and 0.03 and 10.00 μg/m3 in control locations (p<0.05 in both cases). The Spearman correlation coefficient between both markers was 0.61 (95% confidence interval: 0.18-0.84). No differences were found in nicotine or PM2.5 concentration according to the venues' and sampling characteristics studied, with the exception of area. After stratifying for area, venues >100 m2, located in a tourist area, with >15 lit waterpipes, >8 waterpipes/100 m2, and a ratio of 2 users per waterpipe or less had significantly higher nicotine concentration. DISCUSSION Despite the current smoking ban, which includes hospitality venues, we found nicotine and PM2.5 levels in Barcelona waterpipe cafés that exceeded the threshold recommended by the World Health Organization. This exposure poses serious risks to the health of both workers and customers and constitutes a non-compliance of the legislation.
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Affiliation(s)
- Ariadna Feliu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Marcela Fu
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain
| | - Marta Russo
- School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain
| | - Cristina Martinez
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, USA
| | - Xisca Sureda
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, USA; Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Maria José López
- Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain
| | - Núria Cortés
- Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Esteve Fernández
- Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.
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11
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Smith JD, Barratt BM, Fuller GW, Kelly FJ, Loxham M, Nicolosi E, Priestman M, Tremper AH, Green DC. PM 2.5 on the London Underground. ENVIRONMENT INTERNATIONAL 2020; 134:105188. [PMID: 31787325 PMCID: PMC6902242 DOI: 10.1016/j.envint.2019.105188] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/09/2019] [Accepted: 09/13/2019] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Despite the London Underground (LU) handling on average 2.8 million passenger journeys per day, the characteristics and potential health effects of the elevated concentrations of metal-rich PM2.5 found in this subway system are not well understood. METHODS Spatial monitoring campaigns were carried out to characterise the health-relevant chemical and physical properties of PM2.5 across the LU network, including diurnal and day-to-day variability and spatial distribution (above ground, depth below ground and subway line). Population-weighted station PM2.5 rankings were produced to understand the relative importance of concentrations at different stations and on different lines. RESULTS The PM2.5 mass in the LU (mean 88 μg m-3, median 28 μg m-3) was greater than at ambient background locations (mean 19 μg m-3, median 14 μg m-3) and roadside environments in central London (mean 22 μg m-3, median 14 μg m-3). Concentrations varied between lines and locations, with the deepest and shallowest submerged lines being the District (median 4 μg m-3) and Victoria (median 361 μg m-3 but up to 885 μg m-3). Broadly in agreement with other subway systems around the world, sampled LU PM2.5 comprised 47% iron oxide, 7% elemental carbon, 11% organic carbon, and 14% metallic and mineral oxides. Although a relationship between line depth and air quality inside the tube trains was evident, there were clear influences relating to the distance from cleaner outside air and the exchange with cabin air when the doors open. The passenger population-weighted exposure analysis demonstrated a method to identify stations that should be prioritised for remediation to improve air quality. CONCLUSION PM2.5 concentrations in the LU are many times higher than in other London transport Environments. Failure to include this environment in epidemiological studies of the relationship between PM2.5 and health in London is therefore likely to lead to a large exposure misclassification error. Given the significant contribution of underground PM2.5 to daily exposure, and the differences in composition compared to urban PM2.5, there is a clear need for well-designed studies to better understand the health effects of underground exposure.
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Affiliation(s)
- J D Smith
- MRC Centre for Environment & Health, King's College London, UK
| | - B M Barratt
- MRC Centre for Environment & Health, King's College London, UK; NIHR Health Impact of Environmental Hazards HPRU, King's College London, UK
| | - G W Fuller
- MRC Centre for Environment & Health, King's College London, UK
| | - F J Kelly
- MRC Centre for Environment & Health, King's College London, UK; NIHR Health Impact of Environmental Hazards HPRU, King's College London, UK
| | - M Loxham
- Faculty of Medicine, University of Southampton, UK; NIHR Southampton Biomedical Research Centre, Southampton, UK
| | - E Nicolosi
- MRC Centre for Environment & Health, King's College London, UK
| | - M Priestman
- MRC Centre for Environment & Health, King's College London, UK
| | - A H Tremper
- MRC Centre for Environment & Health, King's College London, UK
| | - D C Green
- MRC Centre for Environment & Health, King's College London, UK.
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12
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Brinkman MC, Kim H, Buehler SS, Adetona AM, Gordon SM, Clark PI. Evidence of compensation among waterpipe smokers using harm reduction components. Tob Control 2020; 29:15-23. [PMID: 30377243 PMCID: PMC7350613 DOI: 10.1136/tobaccocontrol-2018-054502] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/26/2018] [Accepted: 10/01/2018] [Indexed: 01/13/2023]
Abstract
OBJECTIVES We examined two waterpipe tobacco smoking components advertised to reduce harm to determine if they result in lower levels of biomarkers of acute exposure. METHODS We conducted a crossover study of 34 experienced waterpipe smokers smoking a research-grade waterpipe in three configurations ad libitum in a controlled chamber: control (quick-light charcoal), electric (electric heating) and bubble diffuser (quick-light charcoal and bubble diffuser). We collected data on smoking topography, environmental carbon monoxide (CO), subjective effects, heart rate, plasma nicotine and exhaled CO and benzene. RESULTS Smokers' mean plasma nicotine, heart rate, and exhaled benzene and CO boost were all significantly lower for electric compared with control. However, smokers puffed more intensely and took significantly more and larger volume puffs for a larger total puffing volume (2.0 times larger, p<0.0001) when smoking electric; machine yields indicate this was likely due to lower mainstream nicotine. Smokers rated electric smoking experience less satisfying and less pleasant. For charcoal heating, the mean mass of CO emitted into the chamber was ~1 g when participants smoked for a mean of 32 minutes at a typical residential ventilation rate (2.3 hr-1). CONCLUSION Waterpipe smokers engaged in compensation (i.e., increased and more intense puffing) to make up for decreased mainstream nicotine delivery from the same tobacco heated two ways. Waterpipe components can affect human puffing behaviours, exposures and subjective effects. Evidence reported here supports regulation of waterpipe components, smoking bans in multifamily housing and the use of human studies to evaluate modified or reduced risk claims.
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Affiliation(s)
- Marielle C Brinkman
- College of Public Health, The Ohio State University, Columbus, Ohio, USA
- School of Public Health, Tobacco Center of Regulatory Science, University of Maryland, College Park, Maryland, USA
| | - Hyoshin Kim
- Battelle Public Health Center for Tobacco Research, Battelle, Seattle, Washington, USA
| | - Stephanie S Buehler
- Battelle Public Health Center for Tobacco Research, Battelle, Columbus, Ohio, USA
| | - Anna M Adetona
- Battelle Public Health Center for Tobacco Research, Battelle, Columbus, Ohio, USA
| | - Sydney M Gordon
- Battelle Public Health Center for Tobacco Research, Battelle, Columbus, Ohio, USA
| | - Pamela I Clark
- School of Public Health, Tobacco Center of Regulatory Science, University of Maryland, College Park, Maryland, USA
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13
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Martins SR, Santos UDP. Waterpipe smoking, a form of tobacco consumption that is on the rise. J Bras Pneumol 2019; 45:e20190315. [PMID: 31618292 PMCID: PMC7247768 DOI: 10.1590/1806-3713/e20190315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Stella Regina Martins
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Ubiratan de Paula Santos
- . Divisão de Pneumologia, Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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Naddafi K, Nabizadeh R, Rostamy R, Ebrahimi Kalan M, Hassanvand MS, Fazlzadeh M. Indoor air quality in waterpipe cafés: exposure level to particulate matter. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:26605-26616. [PMID: 31290048 DOI: 10.1007/s11356-019-05546-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 05/21/2019] [Indexed: 05/11/2023]
Abstract
Waterpipe is increasingly being used worldwide. Despite waterpipe cafés gaining popularity among Iranian population, there is a paucity of research measuring exposures and assessing the health effects of waterpipe smoke in these places. The objective of the current study was to investigate the exposure to PM10, PM2.5, and PM1 concentrations and risk assessment of PM2.5 exposures in different age groups in the indoor air of waterpipe cafés. The study samples were taken from indoor air of 50 waterpipe cafés in Ardabil, Iran. The PM10, PM2.5, and PM1 concentrations were assessed using a portable GRIMM dust monitors. The mean (±SD) concentrations of indoor air PM10, PM2.5, and PM1 were 765 ± 352, 624 ± 327, and 500 ± 305 μg/m3, respectively. The mean of HQ (hazard quotient) for PM2.5 in all age groups of 16 and older was > 1, which corresponds to an unacceptably high risk for human health. Also, the mean of ELCRs (excess lifetime cancer risk) for PM2.5 in different age groups exceeded the limit value by the USEPA. The results indicated that the PM concentration is significantly influenced by the number of waterpipe smokers, type of ventilation system, and kind of tobacco. Therefore, waterpipe cafés are a potential source for exposure to PM10, PM2.5, and PM1 and increase the risk of respiratory diseases and cardiovascular problems among waterpipe smokers.
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Affiliation(s)
- Kazem Naddafi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Roohollah Rostamy
- Research Center for Health Sciences and Technologies, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohammad Ebrahimi Kalan
- Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami, FL, USA
| | - Mohammad Sadegh Hassanvand
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mehdi Fazlzadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran.
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15
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Moon KA, Rule AM, Magid HS, Ferguson JM, Susan J, Sun Z, Torrey C, Abubaker S, Levshin V, Çarkoglu A, Radwan GN, El-Rabbat M, Cohen JE, Strickland P, Breysse PN, Navas-Acien A. Biomarkers of Secondhand Smoke Exposure in Waterpipe Tobacco Venue Employees in Istanbul, Moscow, and Cairo. Nicotine Tob Res 2019; 20:482-491. [PMID: 28582531 DOI: 10.1093/ntr/ntx125] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 05/30/2017] [Indexed: 11/12/2022]
Abstract
Background Most smoke-free legislation to reduce secondhand smoke (SHS) exposure exempts waterpipe (hookah) smoking venues. Few studies have examined SHS exposure in waterpipe venues and their employees. Methods We surveyed 276 employees of 46 waterpipe tobacco venues in Istanbul, Moscow, and Cairo. We interviewed venue managers and employees and collected biological samples from employees to measure exhaled carbon monoxide (CO), hair nicotine, saliva cotinine, urine cotinine, urine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL), and urine 1-hydroxypyrene glucuronide (1-OHPG). We estimated adjusted geometric mean ratios (GMR) of each SHS biomarker by employee characteristics and indoor air SHS measures. Results There were 73 nonsmoking employees and 203 current smokers of cigarettes or waterpipe. In nonsmokers, the median (interquartile) range concentrations of SHS biomarkers were 1.1 (0.2, 40.9) µg/g creatinine urine cotinine, 5.5 (2, 15) ng/mL saliva cotinine, 0.95 (0.36, 5.02) ng/mg hair nicotine, 1.48 (0.98, 3.97) pg/mg creatinine urine NNAL, 0.54 (0.25, 0.97) pmol/mg creatinine urine 1-OHPG, and 1.67 (1.33, 2.33) ppm exhaled CO. An 8-hour increase in work hours was associated with higher urine cotinine (GMR: 1.68, 95% CI: 1.20, 2.37) and hair nicotine (GMR: 1.22, 95% CI: 1.05, 1.43). Lighting waterpipes was associated with higher saliva cotinine (GMR: 2.83, 95% CI: 1.05, 7.62). Conclusions Nonsmoking employees of waterpipe tobacco venues were exposed to high levels of SHS, including measurable levels of carcinogenic biomarkers (tobacco-specific nitrosamines and PAHs). Implications Smoke-free regulation should be extended to waterpipe venues to protect nonsmoking employees and patrons from the adverse health effects of SHS.
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Affiliation(s)
- Katherine A Moon
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Hoda S Magid
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jacqueline M Ferguson
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Jolie Susan
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Zhuolu Sun
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Christine Torrey
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Salahaddin Abubaker
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | | | - Asli Çarkoglu
- Department of Psychology, Kadir Has University, Istanbul, Turkey
| | - Ghada Nasr Radwan
- Department of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Maha El-Rabbat
- Department of Psychology, Kadir Has University, Istanbul, Turkey
- Department of Public Health, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Joanna E Cohen
- Institute for Global Tobacco Control, Department of Health, Behavior, and Society, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Paul Strickland
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Patrick N Breysse
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
| | - Ana Navas-Acien
- Department of Environmental Health and Engineering, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY
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16
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Chen R, Aherrera A, Isichei C, Olmedo P, Jarmul S, Cohen JE, Navas-Acien A, Rule AM. Assessment of indoor air quality at an electronic cigarette (Vaping) convention. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2018; 28:522-529. [PMID: 29288255 DOI: 10.1038/s41370-017-0005-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 08/22/2017] [Indexed: 05/04/2023]
Abstract
E-cigarette (vaping) conventions are public events promoting electronic cigarettes, in which indoor use of e-cigarettes is allowed. The large concentration of people using e-cigarettes and poor air ventilation can result in indoor air pollution. In order to estimate this worst-case exposure to e-cigarettes, we evaluated indoor air quality in a vaping convention in Maryland (MD), USA. Real-time concentrations of particulate matter (PM10) and real-time total volatile organic compounds (TVOCs), CO2 and NO2 concentrations were measured. Integrated samples of air nicotine and PM10 concentrations were also collected. The number of attendees was estimated to range from 75 to 600 at any single observation time. The estimated 24-h time-weighted average (TWA) PM10 was 1800 μg/m3, 12-fold higher than the EPA 24-h regulation (150 μg/m3). Median (range) indoor TVOCs concentration was 0.13 (0.04-0.3) ppm. PM10 and TVOC concentrations were highly correlated with CO2 concentrations, indicating the high number of people using e-cigarettes and poor indoor air quality. Air nicotine concentration was 125 μg/m3, equivalent to concentrations measured in bars and nightclubs. E-cigarette aerosol in a vaping convention that congregates many e-cigarette users is a major source of PM10, air nicotine and VOCs, impairing indoor air quality. These findings also raise occupational concerns for e-cigarette vendors and other venue staff workers.
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Affiliation(s)
- Rui Chen
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Angela Aherrera
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chineye Isichei
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Pablo Olmedo
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Stephanie Jarmul
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanna E Cohen
- Department of Health, Behavior and Society and Institute for Global Tobacco Control, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA
| | - Ana M Rule
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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Agaku I, Odani S, Armour B, Glover-Kudon R. Social Aspects of Hookah Smoking Among US Youth. Pediatrics 2018; 142:peds.2018-0341. [PMID: 29967055 DOI: 10.1542/peds.2018-0341] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/18/2018] [Indexed: 11/24/2022] Open
Abstract
UNLABELLED : media-1vid110.1542/5789657771001PEDS-VA_2018-0341Video Abstract BACKGROUND: We investigated 3 social dimensions of youth hookah smoking: frequency, places smoked, and descriptive social norms. METHODS Data were from the 2016 National Youth Tobacco Survey of US sixth- to 12th-graders (n = 20 675). Hookah smoking frequency was classified as never, former, current occasional, and current frequent. Places where past 30-day hookah smoking occurred and students' perceptions of their classmates' hookah smoking prevalence were assessed. Descriptive and multivariable analyses were performed (P < .05). RESULTS Overall, 10.5% reported smoking hookah ≥1 time in their lifetime. Of these, 65.8% were former, 26.3% were current occasional, and 7.9% were current frequent smokers. Overall, 59.3% of students overestimated hookah smoking prevalence in their grade. Current occasional smoking was predicted by female sex (adjusted odds ratio [aOR] = 1.54) and peer hookah-smoking overestimation (aOR = 9.30). Current frequent smoking was most strongly predicted by living with a hookah smoker (aOR = 20.56), speaking a second language other than English (aOR = 2.17), and co-use of mentholated cigarettes (aOR = 19.94) or other flavored noncigarette tobacco products (aOR = 17.59). The top 3 places hookah was smoked were a friend's house (47.7%), the respondent's own house (31.8%), and another family member's house (20.8%). CONCLUSIONS The home environment was the most common place for youth hookah smoking. Home-tailored interventions that encourage voluntary smoke-free rules and warn about the dangers of social smoking could help denormalize hookah smoking.
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Affiliation(s)
- Israel Agaku
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Satomi Odani
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Armour
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Rebecca Glover-Kudon
- Office on Smoking and Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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18
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Seidenberg AB, Orlan EN, Travers MJ, Sutfin EL. Air quality and presence of air ventilation systems inside waterpipe cafés in North Carolina. Tob Control 2018; 28:356-358. [PMID: 30042230 DOI: 10.1136/tobaccocontrol-2018-054361] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/15/2018] [Accepted: 06/19/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND After North Carolina (NC) fire inspectors detected unsafe carbon monoxide (CO) levels inside several waterpipe cafés, the state fire code was amended to include provisions regulating waterpipe cafés, adding a requirement for air ventilation. These regulations apply to new buildings constructed after 1 January 2016, but can be enforced for older buildings where there exists a distinct hazard to life. We measured air quality at a sample of waterpipe cafés before and after the starting date of this regulation and collected information on presence of air ventilation. METHODS Air quality (CO, fine particulate matter (PM2.5)) monitoring was conducted inside and outside of six waterpipe cafés in NC in September of 2015 (time 1) and September of 2016 (time 2). In addition, questionnaires were administered to managers from each waterpipe café at time 2 to determine the presence of air ventilation systems. RESULTS Elevated levels of CO and PM2.5 were found inside waterpipe cafés at time 1 (median CO=42 ppm; median PM2.5=379.3 µg/m3) and time 2 (median CO=65 ppm; median PM2.5=484.0 µg/m3), with no significant differences between time periods (p>0.05). Indoor levels were significantly higher than levels outside cafés at both time periods (p<0.05). All waterpipe cafés reported having an air ventilation system that was installed prior to time 1 air monitoring. CONCLUSIONS Unsafe levels of CO and PM2.5 were observed in waterpipe cafés in NC, despite reported use of air ventilation systems. Prohibiting indoor waterpipe smoking may be necessary to ensure clean air for employees and patrons.
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Affiliation(s)
- Andrew B Seidenberg
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth N Orlan
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Mark J Travers
- Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, New York, USA
| | - Erin L Sutfin
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Al-Faham Z, LeBouf RF, Nett RJ. Tobacco and other occupational exposures among hookah bar workers. Am J Ind Med 2018; 61:543-544. [PMID: 29655207 PMCID: PMC6522221 DOI: 10.1002/ajim.22829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2018] [Indexed: 11/12/2022]
Affiliation(s)
- Zaid Al-Faham
- Department of Occupational and Environmental Medicine, West Virginia University, Morgantown, West Virginia
| | - Ryan F. LeBouf
- Division of Respiratory Health, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
| | - Randall J. Nett
- Division of Respiratory Health, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia
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Abstract
Tobacco use and exposure to tobacco smoke remain major but avoidable causes of premature mortality and disease worldwide. Although the age-standardized prevalence of daily smoking has declined for both men and women in many countries, the number of smokers continues to increase because of global population growth. Although cigarettes are the most commonly used tobacco product, the tobacco epidemic has become tremendously complex with the emergence and popularity of alternative products such as waterpipes and electronic cigarettes (also known as e-cigarettes). Exposure sciences play a major role in characterizing the tobacco epidemic as well as in the promotion, enactment, and implementation of tobacco control initiatives including legislation and voluntary measures in countries worldwide. We reviewed several studies in Latin America and other regions, showing how high-quality exposure assessment has contributed to smoke-free policies. Although there are many toxicants in tobacco products, metals could be playing an important role in tobacco-related disease. Tobacco plants accumulate cadmium and lead from soil. In e-cigarettes, a metallic coil heats the e-liquid to produce the aerosol that is inhaled by the vaper, and studies have found high aerosol levels of nickel, chromium, lead, and zinc. Despite many tobacco control successes, including the enactment of the Framework Convention on Tobacco Control, which has been ratified by 181 countries, tobacco control faces many challenges globally. Given the continuing increase in the number of smokers worldwide and the rapid emergence of new tobacco products, additional creative efforts are needed to achieve a smoke-free world, help smokers to quit, and protect youth from initiating tobacco use.
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Affiliation(s)
- Ana Navas-Acien
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, New York
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21
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Travers MJ, Kulak JA, Vogl L. Waterpipe cafés are hazardous to your health: Determination of a waterpipe specific calibration factor. Int J Hyg Environ Health 2018; 221:48-53. [DOI: 10.1016/j.ijheh.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 09/29/2017] [Accepted: 10/04/2017] [Indexed: 11/28/2022]
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22
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Soneja SI, Tielsch JM, Khatry SK, Zaitchik B, Curriero FC, Breysse PN. Characterizing Particulate Matter Exfiltration Estimates for Alternative Cookstoves in a Village-Like Household in Rural Nepal. ENVIRONMENTAL MANAGEMENT 2017; 60:797-808. [PMID: 28801708 DOI: 10.1007/s00267-017-0915-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 07/14/2017] [Indexed: 06/07/2023]
Abstract
Alternative stoves are an intervention option to reduce household air pollution. The amount of air pollution exiting homes when alternative stoves are utilized is not known. In this paper, particulate matter exfiltration estimates are presented for four types of alternative stoves within a village-like home, which was built to reflect the use of local materials and common size, in rural Nepal. Four alternative stoves with chimneys were examined, which included an alternative mud brick stove, original Envirofit G3355 model, manufacture altered Envirofit G3355, and locally altered Envirofit G3355. Multiple linear regression was utilized to determine estimates of PM2.5 exfiltration. Overall exfiltration fraction average (converted to a percent) for the four stoves were: alternative mud brick stove with chimney 56%, original Envirofit G3355 model with chimney 87%, manufacture altered Envirofit G3355 model with chimney 69%, and locally altered Envirofit G3355 model with chimney 69%. Alternative cookstoves resulted in higher overall average exfiltration due to direct and indirect ventilation relative to traditional, mud-based stoves. This contrast emphasizes the need for an improved understanding of the climate and health implications that are believed to come from implementing alternative stoves on a large scale and the resultant shift of exposure burden from indoors to outdoors.
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Affiliation(s)
- Sutyajeet I Soneja
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA.
| | - James M Tielsch
- Department of Global Health, Milken School of Public Health and Health Services, George Washington University, Washington, DC, 20037, USA
| | | | - Benjamin Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, MD, 21218, USA
| | - Frank C Curriero
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
| | - Patrick N Breysse
- Department of Environmental Health Sciences, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, 21205, USA
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23
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Eichhorn L, Michaelis D, Kemmerer M, Jüttner B, Tetzlaff K. Carbon monoxide poisoning from waterpipe smoking: a retrospective cohort study. Clin Toxicol (Phila) 2017; 56:264-272. [PMID: 28906147 DOI: 10.1080/15563650.2017.1375115] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Waterpipe smoking may increasingly account for unintentional carbon monoxide poisoning, a serious health hazard with high morbidity and mortality. We aimed at identifying waterpipe smoking as a cause for carbon monoxide poisoning in a large critical care database of a specialty care referral center. METHODS This retrospective cohort study included patients with a history of exposure to waterpipe smoking and carbon monoxide blood gas levels >10% or presence of clinical symptoms compatible with CO poisoning admitted between January 2013 and December 2016. Patients' initial symptoms and carbon monoxide blood levels were retrieved from records and neurologic status was assessed before and after hyperbaric oxygen treatment. RESULTS Sixty-one subjects with carbon monoxide poisoning were included [41 males, 20 females; mean age 23 (SD ± 6) years; range 13-45] with an initial mean carboxyhemoglobin of 26.93% (SD ± 9.72). Most common symptoms included syncope, dizziness, headache, and nausea; 75% had temporary syncope. Symptoms were not closely associated with blood COHb levels. CONCLUSION CO poisoning after waterpipe smoking may present in young adults with a wide variability of symptoms from none to unconsciousness. Therefore diagnosis should be suspected even in the absence of symptoms.
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Affiliation(s)
- Lars Eichhorn
- a Department of Anesthesiology and Intensive Care Medicine , University Hospital of Bonn , Bonn , North Rhine-Westphalia , Germany
| | - Dirk Michaelis
- b Asklepios Paulinen Klinik Wiesbaden , Wiesbaden , Hessen , Germany.,c Druckkammerzentrum RMT GmbH , Wiesbaden , Hessen , Germany
| | | | - Björn Jüttner
- d Department of Anesthesiology , Hanover Medical School , Hannover , Niedersachsen , Germany
| | - Kay Tetzlaff
- e Department of Sports Medicine , University of Tübingen , Tübingen , Baden-Württemberg , Germany
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Loffredo CA, Tang Y, Momen M, Makambi K, Radwan GN, Aboul-Foutoh A. PM2.5 as a marker of exposure to tobacco smoke and other sources of particulate matter in Cairo, Egypt. Int J Tuberc Lung Dis 2017; 20:417-22. [PMID: 27046726 DOI: 10.5588/ijtld.15.0316] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Cairo and Giza governorates of Egypt. BACKGROUND Particulate matter under 2.5 μm in diameter (PM2.5) arises from diverse sources, including tobacco smoke from cigarettes and waterpipes, and is recognized as a cause of acute and chronic morbidity and mortality. OBJECTIVE To measure PM2.5 in workplaces with different intensities of smoking and varying levels of smoking restrictions. DESIGN We conducted an air sampling study to measure PM2.5 levels in a convenience sample of indoor and outdoor venues in 2005-2006. RESULTS Using a calibrated SidePak instrument, 3295 individual measurements were collected at 96 venues. Compared to indoor venues where tobacco smoking was banned (PM2.5 levels 72-81 μg/m(3)), places offering waterpipes to patrons of cafes (478 μg/m(3)) and Ramadan tents (612 μg/m(3)) had much higher concentrations, as did venues such as public buildings with poor enforcement of smoking restrictions (range 171-704 μg/m(3)). Both the number of waterpipe smokers and the number of cigarette smokers observed at each venue contributed significantly to the overall burden of PM2.5. CONCLUSION Such data will support smoke-free policies and programs aimed specifically at reducing environmental tobacco exposure and improving air quality in general, and will provide a baseline for monitoring the impact of tobacco control policies.
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Affiliation(s)
- C A Loffredo
- Georgetown University, 3970 Reservoir Rd NW, Washington, DC 20057, USA.
| | - Y Tang
- Georgetown University, Washington, District of Columbia, USA
| | - M Momen
- Ain Shams University, Cairo, Egypt
| | - K Makambi
- Georgetown University, Washington, District of Columbia, USA
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Die Wasserpfeife (Shisha) – Innenraumluftqualität, Human-Biomonitoring und Gesundheitseffekte. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2016; 59:1593-1604. [DOI: 10.1007/s00103-016-2462-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
OBJECTIVE To review the importance of and evidence-based strategies to prevent tobacco use and promote tobacco cessation in the pediatric setting. DATA SOURCES Literature review of evidence-based resources on tobacco use and prevention/cessation interventions in the pediatric/adolescent population. CONCLUSION Knowledge of the impact of tobacco use on cancer risk, second- and third-hand smoke carcinogenesis, and newer methods of tobacco delivery is necessary to select appropriate and effective prevention and cessation strategies. IMPLICATIONS FOR NURSING PRACTICE Systematic evaluation of both parents and children for tobacco use can identify patients that will benefit from tobacco cessation interventions. Patients and families need education and support so they can make good decisions and adhere to recommendations for prevention and cessation of tobacco use.
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Nelson MD, Rezk-Hanna M, Rader F, Mason OR, Tang X, Shidban S, Rosenberry R, Benowitz NL, Tashkin DP, Elashoff RM, Lindner JR, Victor RG. Acute Effect of Hookah Smoking on the Human Coronary Microcirculation. Am J Cardiol 2016; 117:1747-54. [PMID: 27067622 DOI: 10.1016/j.amjcard.2016.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 03/10/2016] [Accepted: 03/10/2016] [Indexed: 12/29/2022]
Abstract
Hookah (water pipe) smoking is a major new understudied epidemic affecting youth. Because burning charcoal is used to heat the tobacco product, hookah smoke delivers not only nicotine but also large amounts of charcoal combustion products, including carbon-rich nanoparticles that constitute putative coronary vasoconstrictor stimuli and carbon monoxide, a known coronary vasodilator. We used myocardial contrast echocardiography perfusion imaging with intravenous lipid shelled microbubbles in young adult hookah smokers to determine the net effect of smoking hookah on myocardial blood flow. In 9 hookah smokers (age 27 ± 5 years, mean ± SD), we measured myocardial blood flow velocity (β), myocardial blood volume (A), myocardial blood flow (A × β) as well as myocardial oxygen consumption (MVO2) before and immediately after 30 minutes of ad lib hookah smoking. Myocardial blood flow did not decrease with hookah smoking but rather increased acutely (88 ± 10 to 120 ± 19 a.u./s, mean ± SE, p = 0.02), matching a mild increase in MVO2 (6.5 ± 0.3 to 7.6 ± 0.4 ml·minute(-1), p <0.001). This was manifested primarily by increased myocardial blood flow velocity (0.7 ± 0.1 to 0.9 ± 0.1 second(-1), p = 0.01) with unchanged myocardial blood volume (133 ± 7 to 137 ± 7 a.u., p = ns), the same pattern of coronary microvascular response seen with a low-dose β-adrenergic agonist. Indeed, with hookah, the increased MVO2 was accompanied by decreased heart rate variability, an indirect index of adrenergic overactivity, and eliminated by β-adrenergic blockade (i.v. propranolol). In conclusion, nanoparticle-enriched hookah smoke either is not an acute coronary vasoconstrictor stimulus or its vasoconstrictor effect is too weak to overcome the physiologic dilation of coronary microvessels matching mild cardiac β-adrenergic stimulation.
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28
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Zhou S, Weitzman M, Vilcassim R, Wilson J, Legrand N, Saunders E, Travers M, Chen LC, Peltier R, Gordon T. Air quality in New York City hookah bars. Tob Control 2015; 24:e193-8. [PMID: 25232045 PMCID: PMC4390442 DOI: 10.1136/tobaccocontrol-2014-051763] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 08/26/2014] [Indexed: 11/03/2022]
Abstract
BACKGROUND Hookahs are increasingly being used in the USA and elsewhere. Despite the popularity of hookah bars, there is a paucity of research assessing the health effects of hookah smoke, and although New York City (NYC) bans indoor tobacco smoking, hookah lounges claim that they only use herbal products without tobacco. This study investigated levels of multiple indices of indoor air pollution in hookah bars in NYC. METHODS Air samples were collected in 8 hookah bars in NYC. Along with venue characteristics, real-time measurements of fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO), and total gravimetric PM, elemental carbon (EC), organic carbon (OC), and nicotine were collected in 1-2 hour sessions. RESULTS Overall, levels of indoor air pollution increased with increasing numbers of active hookahs smoked. The mean (SD) real time PM2.5 level was 1179.9 (939.4) µg/m(3), whereas the filter-based total PM mean was 691.3 (592.6) µg/m(3). The mean real time BC level was 4.1 (2.3) µg/m(3), OC was 237.9 (112.3) µg/m(3), and CO was 32 (16) ppm. Airborne nicotine was present in all studied hookah bars (4.2 (1.5) µg/m(3)). CONCLUSIONS These results demonstrate that despite the ban on smoking tobacco products, at the very least, some NYC hookah bars are serving tobacco-based hookahs, and have elevated concentrations of indoor air pollutants that may present a health threat to visitors and employees. Therefore, there is an urgent need for better air quality monitoring in such establishments and policies to combat this emerging public health threat.
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Affiliation(s)
- Sherry Zhou
- New York University School of Medicine, New York, NY
| | - Michael Weitzman
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
- Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Ruzmyn Vilcassim
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | | | | | - Eric Saunders
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | | | - Lung-Chi Chen
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
| | - Richard Peltier
- Division of Environmental Health Science, University of Massachusetts, Amherst, MA
| | - Terry Gordon
- Department of Environmental Medicine, New York University School of Medicine, New York, NY
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29
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Moon KA, Magid H, Torrey C, Rule AM, Ferguson J, Susan J, Sun Z, Abubaker S, Levshin V, Çarkoğlu A, Radwan GN, El-Rabbat M, Cohen J, Strickland P, Navas-Acien A, Breysse PN. Secondhand smoke in waterpipe tobacco venues in Istanbul, Moscow, and Cairo. ENVIRONMENTAL RESEARCH 2015; 142:568-74. [PMID: 26298558 PMCID: PMC4609287 DOI: 10.1016/j.envres.2015.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 05/26/2023]
Abstract
OBJECTIVE The prevalence of waterpipe tobacco smoking has risen in recent decades. Controlled studies suggest that waterpipe secondhand smoke (SHS) contains similar or greater quantities of toxicants than cigarette SHS, which causes significant morbidity and mortality. Few studies have examined SHS from waterpipe tobacco in real-world settings. The purpose of this study was to quantify SHS exposure levels and describe the characteristics of waterpipe tobacco venues. METHODS In 2012-2014, we conducted cross-sectional surveys of 46 waterpipe tobacco venues (9 in Istanbul, 17 in Moscow, and 20 in Cairo). We administered venue questionnaires, conducted venue observations, and sampled indoor air particulate matter (PM2.5) (N=35), carbon monoxide (CO) (N=23), particle-bound polycyclic aromatic hydrocarbons (p-PAHs) (N=31), 4-methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) (N=43), and air nicotine (N=46). RESULTS Venue characteristics and SHS concentrations were highly variable within and between cities. Overall, we observed a mean (standard deviation (SD)) of 5 (5) waterpipe smokers and 5 (3) cigarette smokers per venue. The overall median (25th percentile, 75th percentile) of venue mean air concentrations was 136 (82, 213) µg/m(3) for PM2.5, 3.9 (1.7, 22) ppm for CO, 68 (33, 121) ng/m(3) for p-PAHs, 1.0 (0.5, 1.9) ng/m(3) for NNK, and 5.3 (0.7, 14) µg/m(3) for nicotine. PM2.5, CO, and p-PAHs concentrations were generally higher in venues with more waterpipe smokers and cigarette smokers, although associations were not statistically significant. CONCLUSION High concentrations of SHS constituents known to cause health effects indicate that indoor air quality in waterpipe tobacco venues may adversely affect the health of employees and customers.
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Affiliation(s)
- Katherine A Moon
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Hoda Magid
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Christine Torrey
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana M Rule
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jacqueline Ferguson
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jolie Susan
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Zhuolu Sun
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Salahaddin Abubaker
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | | | - Joanna Cohen
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Paul Strickland
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ana Navas-Acien
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Patrick N Breysse
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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Soneja SI, Tielsch JM, Curriero FC, Zaitchik B, Khatry SK, Yan B, Chillrud SN, Breysse PN. Determining particulate matter and black carbon exfiltration estimates for traditional cookstove use in rural Nepalese village households. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2015; 49:5555-62. [PMID: 25844815 PMCID: PMC4538597 DOI: 10.1021/es505565d] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A majority of black carbon (BC) emitted to the atmosphere in the Indo-Gangetic Plain (IGP) region is from burning biomass fuel used in traditional, open-design cookstoves. However, BC and particulate matter (PM) household emissions are not well characterized. Household emission information is needed to develop emission profiles to validate regional climate change models and serve as a baseline for assessing the impact of adopting improved stove technology. This paper presents field-based household PM and BC exfiltration (amount exiting) estimates from village homes in rural Nepal that utilize traditional, open-design cookstoves. Use of these stoves resulted in a 26% mean PM exfiltration, ranging from 6% to 58%. This is a significant departure from an 80% estimate cited in previous reports. Furthermore, having a window/door resulted in an 11% increase in exfiltration when an opening was present, while fuel type had a marginally significant impact on emission. Air-exchange rates (AER) were determined with average (95% CI) AER of 12 (10-14) per hour, consistent with previous studies. In addition, BC to PM2.5 mass-ratio composition during cooking was ascertained, with an average (95% CI) of 31% (24-39), agreeing with previous biomass fuel emission composition literature.
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Affiliation(s)
- Sutyajeet I. Soneja
- Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - James M. Tielsch
- Department of Global Health, Milken School of Public Health and Health Services, George Washington University, Washington, D.C. 20037, United States
| | - Frank C. Curriero
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21205, United States
| | - Benjamin Zaitchik
- Department of Earth and Planetary Sciences, Johns Hopkins University, Baltimore, Maryland 21218, United States
| | - Subarna K. Khatry
- Nepal Nutrition Intervention Project - Sarlahi, Harioun 45804, Nepal
| | - Beizhan Yan
- Division of Geochemistry, Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York 10964, United States
| | - Steven N. Chillrud
- Division of Geochemistry, Lamont-Doherty Earth Observatory, Columbia University, Palisades, New York 10964, United States
| | - Patrick N. Breysse
- Department of Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland 21205, United States
- Corresponding Author: Phone: 1-410-955-3608. Fax: 1-410-955-9334.
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Chaouachi K. Use & Misuse of Water-filtered Tobacco Smoking Pipes in the World. Consequences for Public Health, Research & Research Ethics. THE OPEN MEDICINAL CHEMISTRY JOURNAL 2015; 9:1-12. [PMID: 25861403 PMCID: PMC4384226 DOI: 10.2174/1874104501509010001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 12/27/2014] [Accepted: 01/22/2015] [Indexed: 01/07/2023]
Abstract
BACKGROUND The traditional definition of an "epidemic" has been revisited by antismoking researchers. After 400 years, Doctors would have realized that one aspect of an ancient cultural daily practice of Asian and African societies was in fact a "global "epidemic"". This needed further investigation particularly if one keeps in his mind the health aspects surrounding barbecues. METHOD Here, up-to-date biomedical results are dialectically confronted with anthropological findings, hence in real life, in order to highlight the extent of the global confusion: from the new definition of an "epidemic" and "prevalence" to the myth of "nicotine "addiction"" and other themes in relation to water filtered tobacco smoking pipes (WFTSPs). RESULTS We found that over the last decade, many publications, -particularly reviews, "meta-analyses" and "systematic reviews"- on (WFTSPs), have actually contributed to fuelling the greatest mix-up ever witnessed in biomedical research. One main reason for such a situation has been the absolute lack of critical analysis of the available literature and the uncritical use of citations (one seriously flawed review has been cited up to 200 times). Another main reason has been to take as granted a biased smoking robot designed at the US American of Beirut whose measured yields of toxic chemicals may differ dozens of times from others' based on the same "protocol". We also found that, for more than one decade, two other main methodological problems are: 1) the long-lived unwillingness to distinguish between use and misuse; 2) the consistent unethical rejection of biomedical negative results which, interestingly, are quantitatively and qualitatively much more instructive than the positive ones. CONCLUSION the great majority of WFTSP toxicity studies have actually measured, voluntarily or not, their misuse aspects, not the use in itself. This is in contradiction with both the harm reduction and public health doctrines. The publication of negative results should be encouraged instead of being stifled.
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Affiliation(s)
- Kamal Chaouachi
- Address correspondence to this author at the DIU Tabacologie, Université
Paris XI, 63 avenue Gabriel Peri, 94276 Le Kremlin-Bicêtre, France;
Tel: 33 1 4959 6617; Fax: 33 1 5839 3695; E-mail:
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Meo SA, AlShehri KA, AlHarbi BB, Barayyan OR, Bawazir AS, Alanazi OA, Al-Zuhair AR. Effect of shisha (waterpipe) smoking on lung functions and fractional exhaled nitric oxide (FeNO) among Saudi young adult shisha smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:9638-48. [PMID: 25233010 PMCID: PMC4199040 DOI: 10.3390/ijerph110909638] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Revised: 09/02/2014] [Accepted: 09/03/2014] [Indexed: 12/15/2022]
Abstract
Shisha (waterpipe) smoking is becoming a more prevalent form of tobacco consumption, and is growing worldwide, particularly among the young generation in the Middle East. This cross-sectional study aimed to determine the effects of shisha smoking on lung functions and Fractional Exhaled Nitric Oxide (FeNO) among Saudi young adults. We recruited 146 apparently healthy male subjects (73 control and 73 shisha smokers). The exposed group consisted of male shisha smokers, with mean age 21.54 ± 0.41 (mean ± SEM) range 17-33 years. The control group consisted of similar number (73) of non-smokers with mean age 21.36 ± 0.19 (mean ± SEM) range 18-28 years. Between the groups we considered the factors like age, height, weight, gender, ethnicity and socioeconomic status to estimate the impact of shisha smoking on lung function and fractional exhaled nitric oxide. Lung function test was performed by using an Spirovit-SP-1 Electronic Spirometer. Fractional Exhaled Nitric Oxide (FeNO) was measured by using Niox Mino. A significant decrease in lung function parameters FEV1, FEV1/FVC Ratio, FEF-25%, FEF-50%, FEF-75% and FEF-75-85% was found among shisha smokers relative to their control group. There was also a significant reduction in the Fractional Exhaled Nitric Oxide among Shisha smokers compared to control group.
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Affiliation(s)
- Sultan Ayoub Meo
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia.
| | - Khaled Ahmed AlShehri
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia.
| | - Bader Bandar AlHarbi
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia.
| | - Omar Rayyan Barayyan
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia.
| | - Abdulrahman Salem Bawazir
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia.
| | - Omar Abdulmohsin Alanazi
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia.
| | - Ahmed Raad Al-Zuhair
- Department of Physiology, College of Medicine, King Saud University, P.O. Box 2925, Riyadh 11461 Saudi Arabia
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McKelvey K, Attonito J, Madhivanan P, Jaber R, Yi Q, Mzayek F, Maziak W. Determinants of waterpipe smoking initiation among school children in Irbid, Jordan: a 4-year longitudinal analysis. Drug Alcohol Depend 2014; 142:307-13. [PMID: 25060962 PMCID: PMC4138134 DOI: 10.1016/j.drugalcdep.2014.06.038] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 06/12/2014] [Accepted: 06/28/2014] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Guided by the Attitude-Social influence-self Efficacy (ASE) theory, this study identified predictors of waterpipe (WP) smoking initiation in a WP naïve cohort of Jordanian school children. METHODS A school-based cohort of all 7th grade students (N=1781) in 19 of 60 schools in Irbid, Jordan, was followed from 2008 to 2011. Generalized linear mixed modeling was used to examine predictors of WP initiation among WP-naïve students (N=1243). RESULTS During the 3-year study, WP initiation was documented in 39% of boys and 28% of girls. Prior cigarette smoking (boys: odds ratio 7.41; 95% confidence interval 4.05-12.92 and girls: 8.48; 4.34-16.56) and low WP refusal self-efficacy (boys: 26.67; 13.80-51.53 and girls: 11.49; 6.42-20.55) were strongly predictive of initiating WP. Boys were also more likely to initiate WP smoking if they had siblings (2.30; 1.14-4.64) or teachers (2.07; 1.12-3.84) who smoked and girls if they had friends (2.96; 1.59-5.54) who smoked. CONCLUSION There is a sizeable incidence of WP initiation among students of both sexes. These findings will help in designing culturally responsive prevention interventions against WP smoking. Gender-specific factors, refusal skills, and cigarette smoking need to be important components of such initiatives.
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Affiliation(s)
- Karma McKelvey
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC II - Room 595-1, Miami, FL 33099, USA.
| | - Jennifer Attonito
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 Street, AHC II - Room 595, Miami, FL 33099 USA
| | - Purnima Madhivanan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 Street, AHC II - Room 595-1, Miami, FL, 33099 USA
| | - Rana Jaber
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 Street, AHC II - Room 595-1, Miami, FL, 33099 USA
| | - Qilong Yi
- ScienceDocs Inc., 10940 SW Barnes Rd. #270 Portland, OR 97225 USA
| | - Fawaz Mzayek
- Department of Epidemiology and Biostatistics, School of Public Health, University of Memphis, 3720 Alumni Ave, Memphis, TN 38152 USA
| | - Wasim Maziak
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8 Street, AHC II - Room 595-1, Miami, FL, 33099 USA,Syrian Center for Tobacco Studies, Aleppo, Syria
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34
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Pepper JK, Eissenberg T. Waterpipes and electronic cigarettes: increasing prevalence and expanding science. Chem Res Toxicol 2014; 27:1336-43. [PMID: 25338174 PMCID: PMC4137989 DOI: 10.1021/tx500200j] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
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The
prevalence of noncigarette tobacco product use is on the rise
across the globe, especially for waterpipes (also known as hookah,
narghile, and shisha) and electronic cigarettes (e-cigarettes). The
scientific literature reveals that waterpipe tobacco smoking is associated
with exposure to a variety of toxicants that can cause short- and
long-term adverse health events. In contrast, there is far less evidence
of health harms related to e-cigarette use, although the variety of
products in this category makes it difficult to generalize. We searched
the PubMed database for all publications on waterpipes and e-cigarettes
from January 2000 to March 2014. The number of publications on waterpipes
rose in a slow, linear pattern during this time, while the number
of publications on e-cigarettes showed exponential growth. The different
trends suggest there may be more interest in studying a novel nicotine
product (the e-cigarette) over a traditional tobacco product (the
waterpipe). We posit that, although the specific research needs for
these products are different, public health would be served best by
a more equitable research approach. Scientists should continue to
devote attention to understanding the unknown long-term health effects
of e-cigarettes and their potential to serve as harm reduction or
smoking cessation tools while simultaneously investigating how to
reduce waterpipe smoking given that it exposes users to toxicants
known to cause harm to health. Recent regulatory action in the United
States, which proposes to include waterpipes and e-cigarettes under
some of the same regulations as tobacco cigarettes, makes such research
particularly timely.
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Affiliation(s)
- Jessica K Pepper
- Center for Regulatory Research on Tobacco Communication, Lineberger Comprehensive Cancer Center, University of North Carolina , 319D Rosenau Hall, CB #7400, Chapel Hill, North Carolina 27599, United States
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