Biomarkers of secondhand smoke exposure in waterpipe tobacco venue employees in Istanbul, Moscow, and Cairo

Katherine A. Moon, Ana M. Rule, Hoda S. Magid, Jacqueline M. Ferguson, Jolie Susan, Zhuolu Sun, Christine Torrey, Salahaddin Abubaker, Vladimir Levshin, Asli Çarkoglu, Ghada Nasr Radwan, Maha El-Rabbat, Joanna E. Cohen, Paul Strickland, Patrick N. Breysse, Ana Navas-Acien

Research output: Contribution to journalArticlepeer-review

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).

Original languageEnglish (US)
Pages (from-to)482-491
Number of pages10
JournalNicotine and Tobacco Research
Volume20
Issue number4
DOIs
StatePublished - Mar 6 2018

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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