NEW YORK, Jan. 25 (UPI) -- Despite it being illegal to smoke in bars, restaurants, jails and some public places in New York City, employees at hookah bars are exposed to dangerous levels of secondhand smoke as the businesses fly under the radar based on allowances for non-tobacco-based smoking material.
Hookah smoking has gained popularity in recent years, including among teenagers who believe it to be safer than smoking tobacco or cigarettes.
Non-tobacco material is thought to be safer, however employee health and air quality at the bars were shown to mirror the effects of heavy smoking and extended exposure to secondhand smoke.
Shisha, which is smoked in water pipes called hookahs, comes in fruit and other flavors, and often is tobacco-based but can also made with herbs and molasses. A coal is lit and placed on top of the shisha to keep it burning while people smoke it through hoses connected to the hookah.
New York City has restricted smoking since 1998, when the city banned smoking in taxicabs, places of employment, and required restaurants to have non-smoking sections, with bans on smoking in all bars, restaurants, and other enclosed spaces approved in 2003, and in public places such as parks, beaches, and Times Square in 2011.
The city's Department of Health has already shut down several hookah bars this year for selling tobacco-based shisha rather than herb- and molasses-based, violating the law allowing them to sell only the latter.
"Hookah use is often exempt from clean indoor air laws that protect people from secondhand smoke," said Dr. Terry Gordon, a professor at NYU Langone Medical Center, in a press release. "Ours is the first study that links poor hookah bar air quality to damaging effects in workers, and the results recommend closer monitoring of this industry to protect the public."
For the study, published in the journal Tobacco Control, researchers collected air samples during work shifts of 10 people employed at hookah bars in New York. They measured for fine particulate matter, fine black carbon, carbon monoxide and nicotine. The workers also were tested before and after shifts for blood pressure, heart rate, markers of smoking and secondhand smoke, inflammatory cytokines in blood, and tumor necrosis factor.
Air from the bars showed substances in the air typical of indoor smoking, including nicotine particulates, and the employees showed the effects of secondhand smoke such as significantly higher levels of exhaled carbon dioxide. The amount of pollutants in the air was found to proportional to the number of people smoking and how many water pipes were in use, researchers reported.
The bars in the study appeared to be using tobacco-based shisha, researchers said, making it less surprising for the Department of Health in New York City to have busted 13 bars in early January. And officials think there are many more -- which explains the results of the NYU study.
"I would suspect that if you went into the vast majority of hookah places it's going to be tobacco," Thomas Merrill, general counsel for the health department, told amNewYork. "I'm not surprised these are the results we got."