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Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM2.5.
Environ Res. 2020 05; 184:109347.ER

Abstract

BACKGROUND

Waterpipe tobacco smoking has grown in popularity worldwide, with the prevalence of use increasing in Spain from 6.2% to 10.8% in the last decade, despite the smoking ban enacted in 2010 for all hospitality premises.

OBJECTIVE

To assess exposure to second-hand smoke from waterpipes based on the concentrations of airborne nicotine and particulate matter ≤2.5 μm in diameter (PM2.5) in a sample of waterpipe cafés in the city of Barcelona (Spain).

METHODS

This cross-sectional study included a sample of 20 waterpipe cafés. Airborne nicotine and PM2.5 were sampled for 30 min in each venue using a nicotine sampling device connected by a tube to a pump and a TSI SidePak Personal Aerosol Monitor. Five outdoor control locations were also measured. We computed medians, interquartile ranges (IQRs), and maximum values and compared them according to venues' and sampling characteristics using the Kruskall-Wallis and U-Mann Whitney tests. Nicotine and PM2.5 were correlated by calculating the Spearman-rank correlation coefficient.

RESULTS

The median concentration of nicotine and PM2.5 were 1.15 and 230.50 μg/m3 in waterpipe cafés and 0.03 and 10.00 μg/m3 in control locations (p<0.05 in both cases). The Spearman correlation coefficient between both markers was 0.61 (95% confidence interval: 0.18-0.84). No differences were found in nicotine or PM2.5 concentration according to the venues' and sampling characteristics studied, with the exception of area. After stratifying for area, venues >100 m2, located in a tourist area, with >15 lit waterpipes, >8 waterpipes/100 m2, and a ratio of 2 users per waterpipe or less had significantly higher nicotine concentration.

DISCUSSION

Despite the current smoking ban, which includes hospitality venues, we found nicotine and PM2.5 levels in Barcelona waterpipe cafés that exceeded the threshold recommended by the World Health Organization. This exposure poses serious risks to the health of both workers and customers and constitutes a non-compliance of the legislation.

Authors+Show Affiliations

Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain.School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain.Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, USA.Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain; Department of Epidemiology and Biostatistics, Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, USA; Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.Agència de Salut Pública de Barcelona, Barcelona, Spain; CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain; Institut d'Investigació Biomèdica (IIB Sant Pau), Barcelona, Spain.Public Health and Epidemiology Research Group, School of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, Institut Català d'Oncologia-ICO, L'Hospitalet de Llobregat, Barcelona, Spain; Tobacco Control Research Group, Institut d'Investigació Biomèdica de Bellvitge-IDIBELL, l'Hospitalet de Llobregat, Barcelona, Spain; School of Medicine and Health Sciences, Campus de Bellvitge, Universitat de Barcelona, l'Hospitalet del Llobregat, Barcelona, Spain; CIBER of Respiratory Diseases (CIBERES), Madrid, Spain. Electronic address: efernandez@iconcologia.net.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

32179267

Citation

Feliu, Ariadna, et al. "Exposure to Second-hand Tobacco Smoke in Waterpipe Cafés in Barcelona, Spain: an Assessment of Airborne Nicotine and PM2.5." Environmental Research, vol. 184, 2020, p. 109347.
Feliu A, Fu M, Russo M, et al. Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM2.5. Environ Res. 2020;184:109347.
Feliu, A., Fu, M., Russo, M., Martinez, C., Sureda, X., López, M. J., Cortés, N., & Fernández, E. (2020). Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM2.5. Environmental Research, 184, 109347. https://doi.org/10.1016/j.envres.2020.109347
Feliu A, et al. Exposure to Second-hand Tobacco Smoke in Waterpipe Cafés in Barcelona, Spain: an Assessment of Airborne Nicotine and PM2.5. Environ Res. 2020;184:109347. PubMed PMID: 32179267.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Exposure to second-hand tobacco smoke in waterpipe cafés in Barcelona, Spain: An assessment of airborne nicotine and PM2.5. AU - Feliu,Ariadna, AU - Fu,Marcela, AU - Russo,Marta, AU - Martinez,Cristina, AU - Sureda,Xisca, AU - López,Maria José, AU - Cortés,Núria, AU - Fernández,Esteve, Y1 - 2020/03/08/ PY - 2019/11/21/received PY - 2020/01/30/revised PY - 2020/03/02/accepted PY - 2020/3/18/pubmed PY - 2020/11/21/medline PY - 2020/3/18/entrez KW - Health hazard KW - Legislation compliance KW - Second-hand smoke KW - Tobacco control policies KW - Waterpipe SP - 109347 EP - 109347 JF - Environmental research JO - Environ Res VL - 184 N2 - BACKGROUND: Waterpipe tobacco smoking has grown in popularity worldwide, with the prevalence of use increasing in Spain from 6.2% to 10.8% in the last decade, despite the smoking ban enacted in 2010 for all hospitality premises. OBJECTIVE: To assess exposure to second-hand smoke from waterpipes based on the concentrations of airborne nicotine and particulate matter ≤2.5 μm in diameter (PM2.5) in a sample of waterpipe cafés in the city of Barcelona (Spain). METHODS: This cross-sectional study included a sample of 20 waterpipe cafés. Airborne nicotine and PM2.5 were sampled for 30 min in each venue using a nicotine sampling device connected by a tube to a pump and a TSI SidePak Personal Aerosol Monitor. Five outdoor control locations were also measured. We computed medians, interquartile ranges (IQRs), and maximum values and compared them according to venues' and sampling characteristics using the Kruskall-Wallis and U-Mann Whitney tests. Nicotine and PM2.5 were correlated by calculating the Spearman-rank correlation coefficient. RESULTS: The median concentration of nicotine and PM2.5 were 1.15 and 230.50 μg/m3 in waterpipe cafés and 0.03 and 10.00 μg/m3 in control locations (p<0.05 in both cases). The Spearman correlation coefficient between both markers was 0.61 (95% confidence interval: 0.18-0.84). No differences were found in nicotine or PM2.5 concentration according to the venues' and sampling characteristics studied, with the exception of area. After stratifying for area, venues >100 m2, located in a tourist area, with >15 lit waterpipes, >8 waterpipes/100 m2, and a ratio of 2 users per waterpipe or less had significantly higher nicotine concentration. DISCUSSION: Despite the current smoking ban, which includes hospitality venues, we found nicotine and PM2.5 levels in Barcelona waterpipe cafés that exceeded the threshold recommended by the World Health Organization. This exposure poses serious risks to the health of both workers and customers and constitutes a non-compliance of the legislation. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/32179267/Exposure_to_second_hand_tobacco_smoke_in_waterpipe_cafés_in_Barcelona_Spain:_An_assessment_of_airborne_nicotine_and_PM2_5_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(20)30240-1 DB - PRIME DP - Unbound Medicine ER -