Situation: 
Carbon monoxide poisoning associated with hookah use and preparation
In recent months, the Georgia Poison Center has been notified of two cases of carbon monoxide poisoning among hookah lounge employees.

 

Background: 
How can carbon monoxide poisoning result from hookah use?
Hookah pipes utilize charcoal, which, when ignited, releases carbon monoxide (CO) gas. The colorless, odorless, carbon monoxide gas is then inhaled with tobacco smoke. Low levels of CO are not life-threatening; in fact, cigarette smokers have low blood levels of CO at baseline. The risk of CO poisoning increases as CO levels in the air and body increase. This depends on how large the space is in which you are smoking, the number of people smoking in the same space, and the space’s ventilation.

Given the risks associated with carbon monoxide exposure, particularly in enclosed spaces, it is vital to ensure proper ventilation when using hookah pipes. Indoor air quality products designed for ventilation can significantly mitigate these risks. These products work to enhance air circulation, reduce CO levels, and improve overall air quality, making the smoking environment safer. Proper ventilation not only disperses harmful gases but also helps maintain a comfortable and healthy indoor atmosphere for all occupants.

Hookah lounge employees who are responsible for starting hookah pipes are particularly at risk of CO poisoning if they are repeatedly igniting the charcoal in a poorly ventilated space (eg. small room with no windows).

What are the symptoms and health implications of carbon monoxide poisoning?
Typical symptoms of low-level poisoning are headache, sleepiness, confusion and irritability. These symptoms can be easily dismissed as a cold or the flu, so it is crucial to recognize them if you are smoking hookah or if you work in a hookah lounge. At higher levels, poisoning may cause nausea, vomiting, fainting, abnormal heart rhythm, permanent brain damage, and even death.

 

Assessment: 
CO poisoning is serious a medical emergency. Unsafe hookah pipe use and preparation increases the risk of CO poisoning.

 

Recommendation:
Hookah pipes should only be used in large, well-ventilated areas. If you visit a hookah lounge, ask about carbon monoxide detectors.

Seek help immediately if you suspect someone was exposed to carbon monoxide. If the person is unconscious, not breathing, difficult to wake, or having a seizure, call 9-1-1. Otherwise, call the Georgia Poison Center at 1-800-222-1222.

 

Reference:
Verbanas, P. (2018, March 15). Poison control warns of carbon monoxide risk from hookah smoking. Rutgers University. Retrieved January 30, 2023, from https://www.rutgers.edu/news/poison-control-warns-carbon-monoxide-risk-hookah-smoking#:~:text=Any%20type%20of%20tobacco%20use,inquire%20about%20carbon%20monoxide%20detectors.