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Multiple Patients with Carbon Monoxide Toxicity from Water-Pipe Smoking

Published online by Cambridge University Press:  19 September 2012

Simon F.J. Clarke*
Affiliation:
Emergency Department, Frimley Park NHS Foundation Trust, Camberley, Surrey, United Kingdom Centre for Radiation, Chemical and Environmental Hazards, London, Health Protection Agency, United Kingdom
Caroline Stephens
Affiliation:
Emergency Department, St Mary's Hospital, London, United Kingdom
Maisse Farhan
Affiliation:
Emergency Department, St Mary's Hospital, London, United Kingdom
Patricia Ward
Affiliation:
Emergency Department, St Mary's Hospital, London, United Kingdom
Catherine Keshishian
Affiliation:
Centre for Radiation, Chemical and Environmental Hazards, London, Health Protection Agency, United Kingdom
Virginia Murray
Affiliation:
Centre for Radiation, Chemical and Environmental Hazards, London, Health Protection Agency, United Kingdom
Dominik Zenner
Affiliation:
Health Protection Services, Colindale, London, Health Protection Agency, United Kingdom
*
Correspondence: Simon Clarke, DA, FRCS, FCEM Emergency Department, Frimley Park NHS Foundation Trust Portsmouth Road, Frimley, Camberley, Surrey, GU16 7UJ United Kingdom E-mail sfjclarke@doctors.org.uk

Abstract

This case report describes carbon monoxide toxicity from prolonged shisha (water-pipe) smoking. The evidence base for the source and pathway of toxicity is discussed. This practice has been increasing in the UK in recent years, and emergency physicians need to be aware of the high levels of CO, with the consequent risk of clinical poisoning from water-pipe smoking.

ClarkeSFJ, StephensC, FarhanM, WardP, KeshishianC, MurrayV, ZennerD. Multiple Patients with Carbon Monoxide Toxicity from Water-Pipe Smoking. Prehosp Disaster Med. 2012;27(6):1-3.

Type
Case Report
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2012

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References

1.Mohamed, MK, Loffredo, CA, Israel, E, eds. Tobacco Use in Shisha. Studies on Waterpipe Smoking in Egypt. Cairo, Egypt: World Health Organization, Regional Office for the Eastern Mediterranean, Egyptian Smoking Prevention Research Institute; 2006.Google Scholar
2.Knishkowy, B, Amitai, Y. Water-pipe (narghile) smoking: an emerging health risk behaviour. Pediatrics. 2005;116(1):e113-e119.CrossRefGoogle Scholar
3.El-Nachef, WN, Hammond, SK. Exhaled carbon monoxide with waterpipe use in US students. JAMA. 2008;299(1):36-38.CrossRefGoogle ScholarPubMed
4.Chaouachi, K. The medical consequences of narghile (hookah, shisha) use in the world. Rev Epidemiol Sante Publique. 2007;55(3):165-170.CrossRefGoogle ScholarPubMed
5.Monn, C, Kindler, P, Meile, A, Brändli, O. Ultrafine particle emissions from waterpipes. Tob Control. 2007;16(6):390-393.CrossRefGoogle ScholarPubMed
6.Jackson, D, Aveyard, P. Waterpipe smoking in students: prevalence, risk factors, symptoms of addiction, and smoke intake. Evidence from one British University. BMC Public Health. 2008;8:174.CrossRefGoogle ScholarPubMed
7.Bacha, Z, Salameh, P, Waked, M. Saliva cotinine and exhaled carbon monoxide levels in natural environment waterpipe smokers. Inhal Toxicol. 2007;19(9):771-777.CrossRefGoogle ScholarPubMed
8.Daher, N, Saleh, R, Jaroudi, E, et al. Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: Sidestream smoke measurements and assessment of second-hand smoke emission factors. Atmos Environ. 2010;44(1):8-14.CrossRefGoogle ScholarPubMed
9.Zahran, F, Yousef, AA, Baig, MH. A study of carboxyhaemoglobin levels of cigarette and sheesha smokers in Saudi Arabia. Am J Public Health. 1982;72(7):722-724.CrossRefGoogle ScholarPubMed
10.Zahran, F, Ardawi, M, Al-Fayez, S. Carboxyhemoglobin concentrations in smokers of sheesha and cigarettes in Saudi Arabia. Br Med J (Clin Res Ed). 1985;291(6511):1768-1770.CrossRefGoogle ScholarPubMed
11.Eissenberg, T, Shihadeh, A. Waterpipe tobacco and cigarette smoking. Direct comparison of toxicant exposure. Am J Prev Med. 2009;37(6):518-523.CrossRefGoogle ScholarPubMed
12.Theron, A, Schultz, C, Ker, JA, Falzone, N. Carboxyhaemoglobin levels in water-pipe and cigarette smokers. S Afr Med J. 2010;100(2):122-124.CrossRefGoogle ScholarPubMed
13.Sajid, KM, Akhter, M, Malik, GQ. Carbon monoxide fractions in cigarette and hookah (hubble bubble) smoke. J Pak Med Assoc. 1993;43(9):179-182.Google ScholarPubMed
14.Monzer, B, Sepetdjian, E, Saliba, N, Shihadeh, A. Charcoal emissions as a source of CO and carcinogenic PAH in mainstream narghile waterpipe smoke. Food Chem Toxicol. 2008;46(9):2991-2995.CrossRefGoogle ScholarPubMed
15.Lim, BL, Lim, GH, Seow, E. Case of carbon monoxide poisoning after smoking shisha. Int J Emerg Med. 2009;2(2):121-122.CrossRefGoogle ScholarPubMed