Air quality in New York City hookah bars

Abstract

Background Hookahs (e.g., water pipes) are increasingly being used in the U.S. 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 and are exempt. This study investigated levels of multiple indices of air pollution in the indoor air of hookah bars in NYC. Methods Air samples were collected in 8 hookah bars in NYC during the summer and fall of 2013. Along with venue characteristics, real-time measurements of fine particulate matter (PM2.5), black carbon (BC), and carbon monoxide (CO), and integrated samples of 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/m3, whereas the filter-based total PM mean was 691.3 (592.6) µg/m3. The mean real time BC level was 4.1 (2.3) µg/m3, OC was 237.9 (112.3) µg/m3, and CO was 32 (16) ppm. Airborne nicotine was present in all studied hookah bars (4.2 (1.5) µg/m3). 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 and toxicants that may present significant 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.

Effects of hookah smoking on indoor air quality in homes

“…Interestingly, air quality levels in the smoking rooms and adjacent rooms in hookah-smoking homes were found to be similar with those of hookah bars with multiple smokers and little to no ventilation 25 30…”

“…CO poisoning after hookah smoking has already been found in a number of case reports, with users presenting carboxyhaemoglobin levels 34% higher than normal after hookah use,43 44 syncope45 and confusion 46. It has been suggested that CO intoxication due to hookah smoking is likely to be more common than that was realised due to inefficient charcoal burning 30 47. These findings suggest that the substitution of the burning charcoal with an electronic heating source may be beneficial in reducing CO levels during the use of hookahs.…”

“…It is a global problem, primarily emanating from the Middle East,4 and as a result, countries like the UAE have enacted a number of laws concerning tobacco use and hookah use in the past decade 32. Virtually all that we know to date about air quality and health effects of hookah use and exposure to hookah-related SHS, however, comes from studies conducted in settings other than homes where hookah is smoked 20 25 29 30. This is the first study that we are aware of that investigates multiple air pollutants in homes where hookahs are smoked, demonstrating potentially hazardously high levels of all pollutants assessed in rooms where hookah was smoked and in the adjacent rooms.…”

“…The primary measurements were airborne particles <2.5 µm in aerodynamic diameter (PM 2.5 ) and CO. Both pollutants are associated with adverse health effects and are of major concern in the SHS produced by hookahs 21 23 30…”

PM<SUB>2.5</SUB> as a marker of exposure to tobacco smoke and other sources of particulate matter in Cairo, Egypt

“…Even in municipalities in which cigarette smoking in cafes, bars, and restaurants has been banned, regulatory loopholes have resulted in a flourishing trend of waterpipe smoking in such venues, e.g., Baltimore, MD, and New York City, NY, USA, where investigators have recently measured unacceptably high levels of PM 2.5 , carbon monoxide (CO), and other pollutants released from waterpipes. 23,24 …”