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Radiological Hazards of Narghile (Hookah, Shisha, Goza) Smoking: Activity Concentrations and Dose Assessment

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Radiological Hazards of Narghile (Hookah, Shisha, Goza) Smoking: Activity Concentrations and Dose Assessment Journal of Environmental Radioactivity 99 (2008) 1808–1814 Contents lists available at ScienceDirect Journal of Environmental Radioactivity journal homepage: www.elsevier.com/locate/jenvrad Radiological hazards of Narghile (hookah, shisha, goza) smoking: activity concentrations and dose assessment Ashraf E.M. Khater a,b,*, Nawal S. Abd El-Aziz a, Hamed A. Al-Sewaidan b, Kamal Chaouachi c a National Center for Nuclear Safety and Radiation Control, Atomic Energy Authority, Cairo, Egypt b Physics Department, College of Sciences, King Saud University, P.O. Box 2455, 11451 Riyadh, Saudi Arabia c DIU Tobaccology, University of Paris XI–XII, France article info abstract Article history: Narghile (hookah, shisha, goza, ‘‘water-pipe’’) smoking has become fashionable worldwide. Its tobacco Received 6 March 2008 pastes, known as moassel and jurak, are not standardized and generally contain about 30–50% (some- Received in revised form 13 June 2008 times more) tobacco, molasses/juice of sugarcane, various spices and dried fruits (particularly in jurak) Accepted 20 July 2008 and, in the case of moassel, glycerol and flavoring essences. Tobacco contains minute amounts of Available online 2 September 2008 radiotoxic elements such as 210Pb, 210Po and uranium, which are inhaled via smoking. Only very few data have been published on the concentrations of natural radionuclides in narghile tobacco mixtures. Keywords: Consequently, the aim of this study was to draw first conclusions on the potential hazards of radioactivity Narghile Hookah in moassel tobacco in relation to narghile smoking. The results indicate the existence of a wide range in 238 234 226 210 Shisha the radioactivity contents where the average (range) activity concentrations of U, Th Ra, Pb, 210 232 40 Tobacco Po, Th and K, in Bq/kg dry weight were 55 (19–93), 11 (3–23), 3 (1.2–8), 14 (3–29), 13 (7–32), 7 (4– Smoking 10) and 719 (437–1044) Bq/kg dry weight, respectively. The average concentrations of natural radionu- Radionuclides clides in moassel tobacco pastes are comparable to their concentration in Greek cigarettes and tobacco Dose assessment leaves, and lower than that of Brazilian tobacco leaves. The distribution pattern of these radionuclides Moassel after smoking, between smoke, ash and filter, is unknown, except for 210Po during cigarette smoking and from one existing study during moassel smoking. Radiological dose assessment due to intake of natural radionuclides was calculated and the possible radio-toxicity of the measured radionuclides is briefly discussed. Ó 2008 Elsevier Ltd. All rights reserved. 1. Introduction It has been claimed and repeated in the open peer-reviewed scientific literature that more than 100 million people worldwide Tobacco is used for smoking in many ways (e.g. cigarette, cigar, smoke narghile daily (Maziak et al., 2007). However, the origin of pipe and narghile) and the health consequences vary accordingly such an estimate cannot be traced in any scientific database. As for (Funck-Brentano et al., 2006). The cigarette is the most popular and the historical background of the narghile, it is not Indian as often worldwide consumed tobacco product. Narghile (hookah, shisha, stated but more probably African (Chaouachi, 2006). water pipe) smoking is very popular in Middle East and North There are different names and types of narghile (shisha, hookah, Africa countries and recently became fashionable worldwide. goza, madaˆ’a, etc.) that vary in size, shape, structure, etc. The word A narghile is a sophisticated pipe of 0.5–1.5 m in height. A ‘‘water-pipe’’ is arbitrarily used in some of the available literature. suction hose of the same length is attached to a (glass) base Certainly, it would be easier, for modern scientific information partially filled with a quantity of 0.5–1 L of water. The user draws management, to have only one word describing a given apparatus. the smoke to his mouth by forcing it to go down – from the bowl Unfortunately, each of the existing different names generally refers containing the smoking mixture at the very top of the pipe – to different devices with different shapes, sizes, common tobacco- through a hollow vertical tube and then bubble through water based mixtures, smoking patterns, etc. In these conditions, inside the airtight base before entering the hose. reducing such a striking physical, social and cultural diversity under a functionalist arbitrary neologism like ‘‘water-pipe’’ (Maziak et al., 2007) has unavoidably led researchers to a great confusion (Chaouachi, 2007b). * Corresponding author. Physics Department, College of Sciences, King Saud Tobacco used for narghile smoking has three main forms: University, P.O. Box 2455, 11451 Riyadh, Saudi Arabia. Tel.: þ966 50 241 8292; fax: þ996 1 4676379. moassel (‘‘mu’assel’’ as a proper transliteration, meaning E-mail address: [email protected] (A.E.M. Khater). ‘‘honeyed’’ in Arabic – although we will use ‘‘moassel’’ in this 0265-931X/$ – see front matter Ó 2008 Elsevier Ltd. All rights reserved. doi:10.1016/j.jenvrad.2008.07.005 A.E.M. Khater et al. / Journal of Environmental Radioactivity 99 (2008) 1808–1814 1809 study), jurak and tumbak. Their compositions are variable and not 3. Experimental work well standardized. Moassel contains about 30% tobacco and up to 70% honey or molasses/sugar cane, in addition to glycerol and 3.1. Sampling and samples preparation flavoring essences. The nicotine content varies significantly with a median value of 3.4 mg/g (Hadidi and Mohammed, 2004). Jurak Thirty eight moassel tobacco samples of three different moassel contains about 30% tobacco, 50% juice of sugarcane, 20–25% various tobacco brands from Egypt and Saudi Arabia were randomly spices and dried fruits. collected from the local markets of Cairo City and Riyadh City. Four The bulk of moassel and jurak is usually made of dark, fire- moassel tobacco packs from each source, 50 g weight each, were cured or sun-cured tobacco. It is also mixed with other imported mixed to form composite sample of 200–250 g weight. Samples varieties such as Burley (Chaouachi, 2007c). The dark tobacco is were dried at about 80 C, then pulverized and homogenized. For also the one used as tumbak (ajamy); however, it is prepared in total uranium analysis, a few grams of some dried samples were a different way and not analyzed in this study. It would belong to ashed at 550 C for about 12 h. the Petunioides sub-genus/Nicotiana Alata Persica variety (Izard and Chouteau, 1982). However, it was also suggested that given 3.2. Analytical techniques its resemblance to Russian Makhorka, it would relevantly be classified under the Nicotiana Rustica sub-genus (Rakower and 3.2.1. Gamma spectrometric analysis Fatal, 1962). The dried samples were transferred to polyethylene containers of 100 cm3 capacity and sealed at least for 4 weeks to reach secular 2. Health effects equilibrium between radium and thorium, and their progenies. The 226Ra (238U) series, 232Th series, 40K, 137Cs and 210Pb activity An overview of what sound research says today about narghile concentrations were measured using well calibrated gamma smoking and health is necessary. Caution is needed and quick spectrometry based on hyper-pure germanium (HpGe) detectors. statements should be avoided. Further to finding that when passed The HpGe detector had a relative efficiency of 40% and full width at through water (50 cm3), the combustion gases of cigarette smoke half maximum (FWHM) of 1.95 keV for 60Co gamma energy line at had no inhibitory effect on the respiratory epithelium cilia, French 1332 keV. The gamma transmissions used for activity calculations researchers concluded, 47 years ago, that narghile users could are 352.9 (214Pb), 609.3, 1120.3 and 1764.5 keV (214Bi) for 226Ra therefore ‘‘without apparent disorders, smoke dramatically greater (238U) series, 338.4, 911.1 and 968.9 keV (228Ac) for 232Th series, quantities of tobacco than ours [i.e. in Europe] in our countries’’ 1460.7 keV for 40K, 661.6 keV for 137Cs, 63 keV for 234Th and (Guillerm et al., 1961). 46.5 keV for 210Pb. The gamma spectrometers were calibrated for An apparently weak risk for lung cancer has been early high energy range (186–2500 keV) using both 226Ra point source noticed (BMJ, 1955). According to a prestigious Syrian lung and potassium chloride standard solutions and for low energy specialist, this would be due to the low temperatures and range (30–180 keV) using reference samples in the same geometry filtration of part of the tar (Mohammad, 2000). A recent study as the samples (El-Tahawy et al., 1992). The lower limit of detection, on carcinoembryonic antigen (CEA) levels in Pakistani hookah with 95% confidence, for 226Ra, 232Th and 40K is 0.28, 0.16 and smokers using several times a day huge amounts of a tobacco– 1.0 Bq/kg, respectively, for 20 h counting time and 1 L sample molasses mixture (the weight equivalent of up to 60 cigarettes) volume (Currie, 1968). tends to support such a hypothesis to a certain extent (Sajid et al., 2008). The only consensus is on CO levels though the diverse types of charcoal, tobacco-based mixtures and degrees 3.2.2. Polonium-210 analysis of ventilation (indoors, outdoors), etc, should be taken into Samples of known weights (3.3–6.4 g) were spiked with 209Po account (Chaouachi, 2007a). Mean expired CO (expired tidal CO, (Ea ¼ 4.9 MeV) as a tracer in order to calculate the chemical i.e. CO in the lungs) may thus reach values as high as 48 mg/m3 recovery of polonium from the analyzed samples after chemical at the end of a session (with quick-lighting charcoal) (Bacha treatment. The samples were dissolved in a rounded flask using et al., 2007). three portions of a 50 mL HNO3 (65%) and evaporated to near Concerning nicotine, the already existing confusion, particularly dryness on a sand bath at a temperature of about 90 C.
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