The findings of a study show that workers at New York City hookah bars are inhaling hazardous levels of carbon monoxide and nicotine at work.

This is the finding of the study, “Secondhand hookah smoke: an occupational hazard for hookah bar employees,” led by researchers at New York University’s College of Global Public Health (CGPH) and Langone Medical Center, published online January 25, 2016 in Tobacco Control.

Tested as they left their shifts, ten hookah bar employees were found to have elevated levels of toxins and identifiable markers of inflammation that are linked to airway and heart diseases. In fact, some of those tested had results akin to those seen in heavy cigarette smokers, an ironic result given that many young people see hookah pipe smoking as a “safe,” hip alternative to cigarettes.

According to the study authors, New York City now has approximately 140 hookah bars and lounges, traditionally frequented by people of Middle Eastern and Indian descent, and increasingly, by young people of all backgrounds. The practice involves smoking shisha, a fruit-flavored, often tobacco-based material using a water pipe or hookah.

“Hookah use is often exempt from clean indoor air laws that protect people from secondhand smoke,” says toxicologist and senior study author Terry Gordon, PhD, a professor in the Department of Environmental Medicine at NYU Langone and at the university’s CGPH. “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.”

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