Secondhand smoke from hookah pipes is an under-recognized health hazard to workers, medical researchers say, citing evidence collected from studies conducted in hookah bars, which are growing in popularity and number throughout the U.S.
“Hookah use is often exempt from clean indoor air laws that protect people from secondhand smoke. Ours is the first study that links poor hookah bar air quality to damaging effects in workers, and the results recommend closer monitoring of this industry to protect the public,” wrote lead researcher Dr. Terry Gordon of the New York University School of Medicine.
Testing markers of active smoking and secondhand smoke in 10 New York City hookah bar workers who do not smoke cigarettes, researchers found that the average level of carbon monoxide exhaled increased significantly after their shifts.
Two of the workers tested had carbon monoxide levels greater than 90 parts per million, which is the level usually seen in heavy smokers. Saliva cotinine levels, levels of selected inflammatory cytokines, and heart rate, all markers of smoke exposure, were also elevated, researchers found.
Adding to the problem is the young age group that hookah bars tend to attract. The 2013 National Youth Tobacco Survey, which gauges tobacco trends and use among youth in all forms, found that 14 percent of high school students reported having tried smoking tobacco from a hookah. Five percent of those reported having smoked a hookah within the most recent month.
Researchers found that the number of people smoking hookahs in any particular bar and the number of water pipes being used influenced air pollutant concentration, as did the ventilation in the bars. Many of the hookah bars, they found, did not have open windows or other significant means of ventilation, exacerbating secondhand exposures.
Researchers also said that “Most hookah users erroneously believe that hookah water pipes are safer and less addictive alternatives to cigarettes.” Multiple previous studies, they said, have documented the adverse health effects associated with exposure to tobacco smoke from hookahs.