Waterpipe tobacco smoke

Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees

Bekir Kaplan, Thomas Sussan, Ana M Rule, Katherine Moon, Maria Grau-Perez, Pablo Olmedo, Rui Chen, Asli Carkoglu, Vladimir Levshin, Lanqing Wang, Clifford Watson, Benjamin Blount, Antonia M. Calafat, Jeffery Jarrett, Kathleen Caldwell, Yuesong Wang, Patrick N Breysse, Paul Timothy Strickland, Joanna E Cohen, Shyam Biswal & 1 others Ana Navas-Acien

Research output: Contribution to journalArticle

Abstract

Introduction: Few studies have comprehensively characterized toxic chemicals related to waterpipe use and secondhand waterpipe exposure. This cross-sectional study investigated biomarkers of toxicants associated with waterpipe use and passive waterpipe exposure among employees at waterpipe venues. Method: We collected urine specimens from employees in waterpipe venues from Istanbul, Turkey and Moscow, Russia, and identified waterpipe and cigarette smoking status based on self-report. The final sample included 110 employees. Biomarkers of exposure to sixty chemicals (metals, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), nicotine, and heterocyclic aromatic amines (HCAAs)) were quantified in the participants' urine. Results: Participants who reported using waterpipe had higher urinary manganese (geometric mean ratio (GMR): 2.42, 95% confidence interval (CI): 1.16, 5.07) than never/former waterpipe or cigarette smokers. Being exposed to more hours of secondhand smoke from waterpipes was associated with higher concentrations of cobalt (GMR: 1.38, 95% CI: 1.10, 1.75). Participants involved in lighting waterpipes had higher urinary cobalt (GMR: 1.43, 95% CI: 1.10, 1.86), cesium (GMR: 1.21, 95% CI: 1.00, 1.48), molybdenum (GMR: 1.45, 95% CI: 1.08, 1.93), 1-hydroxypyrene (GMR: 1.36, 95% CI: 1.03, 1.80), and several VOC metabolites. Conclusion: Waterpipe tobacco users and nonsmoking employees of waterpipe venues had higher urinary concentrations of several toxic metals including manganese and cobalt as well as of VOCs, in a distinct signature compared to cigarette smoke. Employees involved in lighting waterpipes may have higher exposure to multiple toxic chemicals compared to other employees.

Original languageEnglish (US)
Pages (from-to)495-502
Number of pages8
JournalEnvironment International
Volume127
DOIs
StatePublished - Jun 1 2019

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confidence interval
biomarker
cobalt
volatile organic compound
smoke
urine
manganese
cesium
molybdenum
smoking
tobacco
tobacco smoke
exposure
metabolite
PAH
metal
chemical
lighting

Keywords

  • Carcinogen
  • Secondhand smoke
  • Toxicants
  • Waterpipe

ASJC Scopus subject areas

  • Environmental Science(all)

Cite this

Waterpipe tobacco smoke : Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees. / Kaplan, Bekir; Sussan, Thomas; Rule, Ana M; Moon, Katherine; Grau-Perez, Maria; Olmedo, Pablo; Chen, Rui; Carkoglu, Asli; Levshin, Vladimir; Wang, Lanqing; Watson, Clifford; Blount, Benjamin; Calafat, Antonia M.; Jarrett, Jeffery; Caldwell, Kathleen; Wang, Yuesong; Breysse, Patrick N; Strickland, Paul Timothy; Cohen, Joanna E; Biswal, Shyam; Navas-Acien, Ana.

In: Environment International, Vol. 127, 01.06.2019, p. 495-502.

Research output: Contribution to journalArticle

Kaplan, B, Sussan, T, Rule, AM, Moon, K, Grau-Perez, M, Olmedo, P, Chen, R, Carkoglu, A, Levshin, V, Wang, L, Watson, C, Blount, B, Calafat, AM, Jarrett, J, Caldwell, K, Wang, Y, Breysse, PN, Strickland, PT, Cohen, JE, Biswal, S & Navas-Acien, A 2019, 'Waterpipe tobacco smoke: Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees', Environment International, vol. 127, pp. 495-502. https://doi.org/10.1016/j.envint.2019.03.074
Kaplan, Bekir ; Sussan, Thomas ; Rule, Ana M ; Moon, Katherine ; Grau-Perez, Maria ; Olmedo, Pablo ; Chen, Rui ; Carkoglu, Asli ; Levshin, Vladimir ; Wang, Lanqing ; Watson, Clifford ; Blount, Benjamin ; Calafat, Antonia M. ; Jarrett, Jeffery ; Caldwell, Kathleen ; Wang, Yuesong ; Breysse, Patrick N ; Strickland, Paul Timothy ; Cohen, Joanna E ; Biswal, Shyam ; Navas-Acien, Ana. / Waterpipe tobacco smoke : Characterization of toxicants and exposure biomarkers in a cross-sectional study of waterpipe employees. In: Environment International. 2019 ; Vol. 127. pp. 495-502.
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abstract = "Introduction: Few studies have comprehensively characterized toxic chemicals related to waterpipe use and secondhand waterpipe exposure. This cross-sectional study investigated biomarkers of toxicants associated with waterpipe use and passive waterpipe exposure among employees at waterpipe venues. Method: We collected urine specimens from employees in waterpipe venues from Istanbul, Turkey and Moscow, Russia, and identified waterpipe and cigarette smoking status based on self-report. The final sample included 110 employees. Biomarkers of exposure to sixty chemicals (metals, volatile organic compounds (VOCs), polycyclic aromatic hydrocarbons (PAHs), nicotine, and heterocyclic aromatic amines (HCAAs)) were quantified in the participants' urine. Results: Participants who reported using waterpipe had higher urinary manganese (geometric mean ratio (GMR): 2.42, 95{\%} confidence interval (CI): 1.16, 5.07) than never/former waterpipe or cigarette smokers. Being exposed to more hours of secondhand smoke from waterpipes was associated with higher concentrations of cobalt (GMR: 1.38, 95{\%} CI: 1.10, 1.75). Participants involved in lighting waterpipes had higher urinary cobalt (GMR: 1.43, 95{\%} CI: 1.10, 1.86), cesium (GMR: 1.21, 95{\%} CI: 1.00, 1.48), molybdenum (GMR: 1.45, 95{\%} CI: 1.08, 1.93), 1-hydroxypyrene (GMR: 1.36, 95{\%} CI: 1.03, 1.80), and several VOC metabolites. Conclusion: Waterpipe tobacco users and nonsmoking employees of waterpipe venues had higher urinary concentrations of several toxic metals including manganese and cobalt as well as of VOCs, in a distinct signature compared to cigarette smoke. Employees involved in lighting waterpipes may have higher exposure to multiple toxic chemicals compared to other employees.",
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AU - Kaplan, Bekir

AU - Sussan, Thomas

AU - Rule, Ana M

AU - Moon, Katherine

AU - Grau-Perez, Maria

AU - Olmedo, Pablo

AU - Chen, Rui

AU - Carkoglu, Asli

AU - Levshin, Vladimir

AU - Wang, Lanqing

AU - Watson, Clifford

AU - Blount, Benjamin

AU - Calafat, Antonia M.

AU - Jarrett, Jeffery

AU - Caldwell, Kathleen

AU - Wang, Yuesong

AU - Breysse, Patrick N

AU - Strickland, Paul Timothy

AU - Cohen, Joanna E

AU - Biswal, Shyam

AU - Navas-Acien, Ana

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KW - Carcinogen

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