Abstract
INTRODUCTION: Waterpipe smoking has become popular in East Asia and other regions. However, few studies have investigated the indoor air quality, including the presence of carcinogens, in waterpipe bars (WBs). This study aimed to compare indoor air quality between WBs and non-WBs in Hong Kong, focusing on differences observed during weekdays and weekends. METHODS: Air samples from 8 WBs and 6 non-WBs were collected to investigate levels of fine particulate matter (PM2.5), carbon monoxide (CO), nicotine, volatile organic compounds (VOCs), and polycyclic aromatic hydrocarbons (PAHs) in the ambient air of these bars. Samples were collected for 2 h in each bar during both a weekday and a weekend evening. Data were analyzed using descriptive statistics, the Wilcoxon rank-sum test, and Wilcoxon signed-rank test. RESULTS: The median PM2.5 levels in WBs was 332.1 μg/m3 on weekdays and 1001 μg/m3 on weekends. Similarly, CO levels in WBs were 22.5 ppm on weekdays 27.9 ppm on weekends. The comparison showed that PM2.5 (p = .0019) and CO (p = .0019) levels in WBs were significantly higher than those in non-WBs on weekdays. Airborne nicotine levels were 3.2 μg/m3 on weekdays and 16.1 μg/m3 on weekends. Most VOCs and PAHs levels were higher during weekends, with benzo[a]pyrene at 15.3 ng/m3 (weekday) and 22.5 ng/m3 (weekend), and Formaldehyde at 57 μg/m3 (weekday) and 66.5 μg/m3 (weekend)-Group 1 carcinogens. CONCLUSION: This study revealed alarmingly high levels of airborne PM2.5, CO, nicotine, and carcinogens such as Benzo[a]pyrene and Formaldehyde in WBs in Hong Kong, especially on weekends. IMPLICATIONS: This study provides the first evidence of air quality in waterpipe establishments in Asia, demonstrating extremely poor air quality that pose significant health risks to both patrons and staff. These results can serve as evidence for the strict enforcement of tobacco control policies, such as total waterpipe bans. It is also crucial to assess compliance with occupational safety regulations in WBs and to ensure employees exposed to high levels of harmful substances such as PM2.5, CO, nicotine, and carcinogens are offered education and health screenings and education. These measures are vital to ensuring the safety and health of workers.