Waterpipe cafés are hazardous to your health: Determination of a waterpipe specific calibration factor

The use of a waterpipe to smoke tobacco has emerged as a popular trend in the United States. Waterpipe smoking establishments have had an increasing presence in the U.S., despite smoke-free air legislation. Dangers of waterpipe smoking have been documented, but less data has been gathered about the waterpipe café itself. This project sought to determine a waterpipe-specific calibration factor (CF) for measuring waterpipe aerosol, and field-test this CF by conducting surveillance on the existing waterpipe cafés of western and central New York.

Nine laboratory-controlled experiments were conducted to determine a waterpipe-specific CF. In the lab, two TSI SidePak AM510 Personal Aerosol Monitors and two sampling trains for gravimetric PM_2.5 sampling were present during waterpipe smoking sessions (lasting 1-3h). Indoor air quality was assessed in 7 waterpipe cafés in three counties of New York, and real-time measurements of particulate matter (PM_2.5) and carbon monoxide (CO) were obtained.

Results from the 9 controlled waterpipe experiments determined a calibration factor of 0.38 (SD 0.08), which should be used to convert SidePak measurements to true PM_2.5 measurements. When applying the CF to the measurements taken in the 7 public waterpipe venues, the mean PM_2.5 concentration was 515μg/m³ micrograms per cubic meter (SD=338.8) while the mean ambient CO was 20.5ppm (SD=18.3). The mean active smoking density was 2.41 waterpipes per 100m³ of air. The PM_2.5 levels increased with increasing active smoking density (rho=0.68, p=0.09).

Applying the waterpipe-specific CF for the SidePak, 0.38, allowed for field assessments to be conducted in locations with waterpipe smoke to determine accurate particle exposure concentrations. The concentrations of both particulate matter and carbon monoxide were above established air quality standards and therefore increase the health risks of both patrons and workers of these establishments.