title: When water does not clear the smut from the smoke.
abstract: Water-pipe (shisha) smoking is increasingly popular among young people in Europe and North America. The proponents claim that smoking water-pipe is much 'cleaner' than cigarettes. Although, a recent analysis of toxicant yields during 1-2 h water-pipe smoking resulted comparable to 100-200 cigarettes. We report a case of a 25-year-old patient with elevated haemoglobin, impaired concentration and reduced physical performance. Molecular investigations for JAK2 mutations and BCR-ABL fusion transcripts were negative and the arterial blood gas analysis revealed an elevated carboxyhaemoglobin of 6.1%. In a follow-up visit, the patient disclosed excessive shisha smoking. Secondary polycythaemia was diagnosed caused by chronic carbon monoxide poisoning. After cessation of shisha smoking all blood values returned to normal ranges within 6 weeks. Owing to the increasing popularity of water-pipe smoking and the anticipated health risks, our report should help to enhance awareness and advocate more information in tobacco prevention programmes on its potential toxicities.
authors.affiliation: Department of Internal Medicine and Haematology, University Hospital Basel, Basel, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Bonadies
authors.forename: André
authors.initials: A
authors.lastname: Tichelli
authors.forename: Alicia
authors.initials: A
authors.lastname: Rovó
mesh_terms: D000328:Adult; D002249:Carbon Monoxide Poisoning / Q000097:blood / Q000150:complications / Q000209:etiology; D004906:Erythrocyte Count; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D008297:Male; D011086:Polycythemia / Q000097:blood / Q000209:etiology*; D012907:Smoking / Q000009:adverse effects* / Q000097:blood; D016540:Smoking Cessation
chemical_list: D006454:Hemoglobins