Evaluation of carboxyhemoglobin levels in narghile smokers

Introduction Carbon monoxide (CO) poisoning, which can be treated and avoided, is a major public health problem. CO can lead to death when neglected and it is responsible for a significant percentage of poisoning deaths all over the world. CO poisoning primarily results from fires and suicide attempts in developed countries, whereas in Turkey fossil-fuels used for heating systems such as stoves and central heating boilers are main causes of CO poisoning. Narghile smoke contains significant amounts of CO, nicotine, tar and heavy metals. A narghile smoker inhales 0.15-1 liter of smoke during a single smoking session and this is 100-fold higher than the amount of smoke inhaled from one cigarette. The aim of this study is to compare the basal carboxyhemoglobin (COHb) levels and post-narghile smoking COHb levels. We also aim to determine whether narghile smoking is a potential cause of CO poisoning by identifying the symptoms associated with it. Materials and Methods The study was conducted at a narghile café around the Hospital of Gazi University, Faculty of Medicine, between December 2012 and January 2013. This is a cross- sectional prospective study. Blood samples were taken on the 1st hour of a narghile smoking session for venous blood gas testing. COHb, lactate and pH levels were studied. The potential symptoms were questioned after narghile smoking. Vital signs were recorded. The second venous blood samples were taken from the volunteers at least 24 hours after narghile smoking. The volunteers were asked not to smoke cigarettes for at least 6 hours. The same parameters were studied again with these samples. COHb, blood pH and lactate levels in venous blood gas and vital signs on the 1st hour of narghile smoking was compared with those determined 24 hours after smoking. Results 45 volunteers participated in the study. 24 of them were cigarette smokers and 21 were not. The COHb levels of volunteers after narghile smoking were significantly higher than their basal COHb levels. Systolic blood pressures and pulse rates were also significantly higher after narghile smoking. COHb levels of the cigarette smokers after narghile smoking were significantly higher than the levels of non-cigarette smokers. Conclusion Narghile smoking causes significantly increased COHb levels. This increase is higher than that found in cigarette smokers. Keywords: Narghile, carbon monoxide poisoning