Yazeed Toukan1,2, Fahed Hakim1,2,3, Yedidia Bentur2,4,5, Judith Aharon-Peretz2,6, Ameer Elemy7, Michal Gur1,2, Moneera Hanna1, Tali Fisher6, Inna Scherb5, Lea Bentur1,2. 1. Pediatric Pulmonary Institute, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel. 2. The Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. 3. Nazareth Hospital EMMS, Nazareth, Israel. 4. Israel Poison Information Center, Rambam Health Care Campus, Haifa, Israel. 5. Toxicology and Pharmacology Laboratory, Rambam Health Care Campus, Haifa, Israel. 6. Neuro-Cognitive Unit, Rambam Health Care Campus, Haifa, Israel. 7. Department of Pediatrics A, Ruth Children's Hospital, Rambam Health Care Campus, Haifa, Israel.
Abstract
INTRODUCTION: One session of water-pipe tobacco smoking (WPS) can increase carboxyhemoglobin (COHb) to levels comparable to those reported in carbon monoxide poisoning, which may cause memory impairment and confusion. METHODS: A prospective study evaluating healthy volunteers pre- and post- 30-minutes of WPS session. Primary outcome parameters were executive cognitive measures [digit span test and Paced Auditory Serial Addition Test (PASAT)]. The effect of repeated cognitive testing 30 minutes apart without WPS was evaluated in age and sex matched healthy volunteers. Secondary outcome parameters included cardio-pulmonary, COHb, serum nicotine and cytokines changes. RESULTS: Thirty-five subjects aged 25.6±4.5 years smoked water-pipe for a 30-minute session. Control group included 20 subjects aged 25.2±5.1 years. Digit span test median score decreased after WPS (16 and 15, respectively, p=0.003); insignificant decrease in controls. Median PASAT score increased after WPS (49 and 52, respectively, p=0.009); however, a much larger significant increase was observed in controls (p=<0.001). One WPS session resulted in significant increases in heart and respiratory rates, and significant decrease in FEF25-75%. Post WPS, median COHb levels increased (from 2.2% to 10.7%, p<0.0001) as did median serum nicotine levels (from 1.2 to 26.8 ng/mL, p<0.0001). Serum cytokines levels: IL-2 and IL-6 increased (p<0.0001 for each), and IL-10 and IL-5 decreased (p<0.0001 and p=0.04, respectively). CONCLUSIONS: One session of WPS resulted in significant negative effects on cognitive executive measures, significant increases in COHb and serum nicotine levels, and significant changes in serum cytokines. Our findings call for increasing awareness towards the possible consequences of cognitive alterations following a 30-minute session of WPS. IMPLICATIONS: One 30-minute session of water-pipe smoking resulted in negative effects on executive cognitive measures, increased carboxyhemoglobin and serum nicotine, and significant changes in serum cytokine levels.
INTRODUCTION: One session of water-pipe tobacco smoking (WPS) can increase carboxyhemoglobin (COHb) to levels comparable to those reported in carbon monoxidepoisoning, which may cause memory impairment and confusion. METHODS: A prospective study evaluating healthy volunteers pre- and post- 30-minutes of WPS session. Primary outcome parameters were executive cognitive measures [digit span test and Paced Auditory Serial Addition Test (PASAT)]. The effect of repeated cognitive testing 30 minutes apart without WPS was evaluated in age and sex matched healthy volunteers. Secondary outcome parameters included cardio-pulmonary, COHb, serum nicotine and cytokines changes. RESULTS: Thirty-five subjects aged 25.6±4.5 years smoked water-pipe for a 30-minute session. Control group included 20 subjects aged 25.2±5.1 years. Digit span test median score decreased after WPS (16 and 15, respectively, p=0.003); insignificant decrease in controls. Median PASAT score increased after WPS (49 and 52, respectively, p=0.009); however, a much larger significant increase was observed in controls (p=<0.001). One WPS session resulted in significant increases in heart and respiratory rates, and significant decrease in FEF25-75%. Post WPS, median COHb levels increased (from 2.2% to 10.7%, p<0.0001) as did median serum nicotine levels (from 1.2 to 26.8 ng/mL, p<0.0001). Serum cytokines levels: IL-2 and IL-6 increased (p<0.0001 for each), and IL-10 and IL-5 decreased (p<0.0001 and p=0.04, respectively). CONCLUSIONS: One session of WPS resulted in significant negative effects on cognitive executive measures, significant increases in COHb and serum nicotine levels, and significant changes in serum cytokines. Our findings call for increasing awareness towards the possible consequences of cognitive alterations following a 30-minute session of WPS. IMPLICATIONS: One 30-minute session of water-pipe smoking resulted in negative effects on executive cognitive measures, increased carboxyhemoglobin and serum nicotine, and significant changes in serum cytokine levels.
Authors: Stephanie Klosterhalfen; Daniel Kotz; Benjamin Kuntz; Johannes Zeiher; Anne Starker Journal: Int J Environ Res Public Health Date: 2020-10-22 Impact factor: 3.390