RT Journal Article SR Electronic T1 Alarming carboxyhemoglobin and nicotine levels after a single session of indoor group narghile smoking JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP P1048 VO 42 IS Suppl 57 A1 Lea Bentur A1 Elias Hellou Hellou A1 Aviv Goldbart A1 Giora Piller A1 Einat Monovich A1 Maram Salameh A1 Yedidia Bentur YR 2013 UL http://erj.ersjournals.com/content/42/Suppl_57/P1048.abstract AB Introduction: Group indoor water pipe smoking (WPS), especially in coffee shops, has become increasingly popula.Objectives:Evaluation of the effect of a single session of indoor WPS on carboxyhemoglobin (COHb), nicotine, and cotinine concentrations; exhaled breath condensate (EBC) cytokines; endothelial function; cardio-respiratory parameters; and clinical assessment in active and passive WPS.Design: Prospective study evaluating outcome parameters before and after 30 minutes of WPS.Statistics: Paired and non-paired Student's t-test, Wilcoxon test, Fisher exact test, ANOVA, and Neuman–Keuls where relevant.Results: Sixty-two volunteers (47 active;15 passive smokers). Post-WPS there was an alarming increase in COHb (2.0±2.9 vs.17.6±8.8),Plasma nicotine increased significantly (1.2±4.3 vs.18.8±13.9 ng/mL) and was associated with increase in plasma cotinine and increase in urinary nicotine and cotinine. Exhaled breath condensate revealed significant decrease in IL4, IL5, IL10, IL17, and gamma interferon. Endothelial function did not change after smoking. These were associated with changes of multiple cardio-respiratory parameters, decreased visual analog score of general feeling, and multiple clinical symptoms. In passive smokers carboxyhemoglobin increased (0.8±0.25 vs. 1.2±0.8%, p=0.003); increased respiratory rate and decline in visual analog score.Conclusions: One session of group indoor active WPS resulted in significant increases in COHband serum nicotine levels (8- and 18-fold, respectively) and was associated with cardio-respiratory changes. The results of our call for interventions to limit the continuing global spread of coffee shops and bars.