Challenging the belief that second hand exposure to hookah smoke is safe, a team of US researchers in a new study, has revealed that it may increase the risk of lung cancer and heart disease.
Second hand smoke exposure is the third leading preventable cause of death in the US, responsible for 3,000 lung cancer deaths and 35,000 heart disease deaths annually among Americans that never smoked, the study revealed.
The study also recommended closer monitoring of the hookah bar industry to protect the public.
"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," said Terry Gordon, a toxicologist and professor at the New York University.
Beyond health consequences, the new study also identified airborne nicotine in the four hookah bars surveyed even though tobacco-based shisha is banned in these venues in New York City, the researchers said.
Many of them had no open windows or doors to ventilate the smoke, as hookah use is often exempt from clean indoor air laws that protect people from second hand smoke, the study authors said.
The research team found that indoor air pollutant concentrations in the hookah lounges varied, but they were directly proportional to the number of people smoking and water pipes used.
The researchers hoped that the findings lead to larger studies of indoor air quality and regulations that protect workers and patrons.
Tested as they left their shifts, ten hookah bar employees were found to have elevated levels of toxins and identifiable markers of inflammation that are linked to airway and heart diseases, the researchers revealed in the study published online in Tobacco Control.
Specifically, the researchers found that the average level of exhaled carbon monoxide rose markedly after the workers' shifts.
Additionally, blood levels of inflammatory signalling proteins were found to be higher in workers after their shifts.
Such proteins are part of normal immune responses, but also central to heart disease and cancer when present in too high levels.
