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Inhalation Toxicology
International Forum for Respiratory Research
Volume 22, 2010 - Issue 13
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Original Article

Direct measurement of toxicants inhaled by water pipe users in the natural environment using a real-time in situ sampling technique

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Pages 1101-1109 | Received 23 Jul 2010, Accepted 13 Sep 2010, Published online: 09 Nov 2010
 

Abstract

While narghile water pipe smoking has become a global phenomenon, knowledge regarding its toxicant content and delivery, addictive properties, and health consequences is sorely lagging. One challenge in measuring toxicant content of the smoke in the laboratory is the large number of simplifying assumptions that must be made to model a “typical” smoking session using a smoking machine, resulting in uncertainty over the obtained toxicant yields. In this study, we develop an alternative approach in which smoke generated by a human water pipe user is sampled directly during the smoking session. The method, dubbed real-time in situ sampling (RINS), required developing a self-powered portable instrument capable of automatically sampling a fixed fraction of the smoke generated by the user. Instrument performance was validated in the laboratory, and the instrument was deployed in a field study involving 43 ad libitum water pipe use sessions in Beirut area cafés in which we measured inhaled nicotine, carbon monoxide (CO), and water pipe ma’ssel-derived “tar.” We found that users drew a mean of 119 L of smoke containing 150 mg of CO, 4 mg of nicotine, and 602 mg of ma’ssel-derived “tar” during a single use session (mean duration = 61 min). These first direct measurements of toxicant delivery demonstrate that ordinary water pipe use involves inhaling large quantities of CO, nicotine, and dry particulate matter. Results are compared with those obtained using the Beirut method smoking machine protocol.

Acknowledgements

Mr. Joseph Nassif and his staff at the AUB Engineering Shops are gratefully acknowledged for their assistance in fabricating the RINS instrument. Mr. Samir Berjaoui provided key insights in refining the controller algorithm and troubleshooting the electronic circuitry. Dr. Thomas Eissenberg provided insightful comments on an early draft of the manuscript.

Declaration of interest

This study was supported by grants from the American University Research Board and Research for International Tobacco Control, a secretariat of the IDRC (Canada). The authors have no competing interests related to this work.

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