Transcript Factor Analysis Basics

Opportunistic insights into
occupational health hazards
associated with the waterpipe
tobacco industry in the United
Kingdom
Ali Al-Bakri, [email protected]
Mohammed Jawad, [email protected]
Mustafa al’Absi, [email protected]
Pascal Salameh, [email protected]
Saba Kassim, [email protected]
Introduction
 Waterpipe tobacco smoking (WP) is getting
popular in Europe with negative health effects
and occupational health hazards (1)
 200% increase in WP premises between 2007
and 2012 in the UK (over 400 in London) (2,3)
 WP under Smoke free laws in the UK but poor
compliance (3)
 No study in occupational health hazard of
employees in WP premises !
Methodology

Primary study about investigating WP dependency in
customers in 7 WP premises (6)

During data collection, researcher (AA) observed and
interacted culturally with premises staff

Another researcher (MJ) interviewed the data collector
(AA) to explore the participant observation experience
(4-5).

Exhaled Carbon Monoxide (CO) taken from 9 staff
members

Study approved by QMUL ethics committee
Results
Exhaled CO in WP staff
WP premises
Employee types
CO (ppm)
COHb (%)
1
Serving WP
24
27
4.5
5.0
Serving food
6
1.5
Serving WP
55
42
9.4
7.4
Serving food
2
0.8
Serving WP
28
21
5.1
4.0
Serving food
4
1.2
2
3
CO: carbon monoxide , ppm: part per million, COHb (%): percentage of Carboxyhemoglobin
Results
Interview findings


Arabic culture embodiment in WP premises

Occupational health hazards noticed (i.e. igniting and
cleaning WP, walking and moving holder)

Self reported deteriorating physical health since working in
WP premises

Self reported mental health problems of staff (i.e. stress,
long working hours, lack of educational and professional
development)
Smoke free laws were perceived as an attack to the Middle
Eastern Culture
Results
Quote from a staff worker
“Dr, if you want to do research, please do research on us
[WP premise employees]. We have lots of difficulties,
mainly financial ones because our payment is not good,
and we always work with smoke. I sometimes feel scared
when I think about my future in 20 years and how this
smoke will affect my health”.
Discussion
 First study to investigate occupational health
hazards in WP premises in the UK.
 Previous Studies measured CO in WP premises (7-9)
 Comparable results in studies measuring exhaled
CO in patrons of WP premises (10)
 Igniting WP and greatest increase in COHb in first 5
mins of smoking (11)
 First 5 minutes of WP session produce different size
of particles (12)
Future research
 Investigating occupational health hazards of
WP premises in a larger scale
 Investigating the exhaled CO of the staff
during different time in their shifts
Conclusion
 High level of CO identified in WP-serving staff
 Occupational, physical and mental problems
associated with working in WP premises
 Future research to investigate the occupational
risks including second-hand smoking in WP
premises.
References
1- MAZIAK, W. 2011. The global epidemic of waterpipe smoking. Addict Behav, 36, 1-5
2- British Heart Foundation (BHF). (2012). Rise in ‘shisha bars’ prompts warning on dangers of waterpipe smoking
[online]. Available at: http://www.bhf.org.uk/default.aspx?page=14417. [Date of access 29 June 2013]. from
http://www.bhf.org.uk/default.aspx?page=14417
3- Jawad, M. (2014). Legislation Enforcement of the Waterpipe Tobacco Industry: A Qualitative Analysis of the London
Experience. Nicotine & Tobacco Research. doi: 10.1093/ntr/ntu022
4- Kawulich, Barbara B. (2005). Participant Observation as a Data Collection Method [81 paragraphs]. Forum Qualitative
Sozialforschung / Forum: Qualitative Social Research, 6(2), Art. 43, http://nbn-resolving.de/urn:nbn:de:0114-fqs0502430.
5- Pearson Educaton (1995-2005). Participant Observation [online]. Available at
http://wps.pearsoned.co.uk/ema_uk_he_plummer_sociology_3/40/10342/2647687.cw/content/ Date of access 25 May
2014
6- Kassim, S., Al-Bakri, A., al’Absi, M., & Croucher, R. (2014). Waterpipe Tobacco Dependence in U.K. Male Adult
Residents: A Cross-Sectional Study. Nicotine & Tobacco Research, 16(3), 316-325. doi: 10.1093/ntr/ntt148
7- Cobb, C. O. ;Vansickel, A. R. ;Blank, M. D. ;Jentink, K. ;Travers, M. J. ;Eissenberg, T. Indoor air quality in Virginia
waterpipe cafes. 2013. Tob Control. 2013; 22: 338-43
8- Zhang, B. ;Haji, F. ;Kaufman, P. ;Muir, S. ;Ferrence, R. 'Enter at your own risk': a multimethod study of air quality and
biological measures in Canadian waterpipe cafes. 2013. Tob Control
9- Torrey, C. M. ;Moon, K. A. ;Williams, D. A. ;Green, T. ;Cohen, J. E. ;Navas-Acien, A. ;Breysse, P. N. Waterpipe cafes in
Baltimore, Maryland: Carbon monoxide, particulate matter, and nicotine exposure. 2014. J Expo Sci Environ Epidemiol
10- Barnett TE, Curbow BA, Soule EK, et al. Carbon monoxide levels among patrons of hookah cafes. Am J Prev Med.
2011;40:324-8
11-. Monn C, Kindler P, Meile A, et al. Ultrafine particle emissions from waterpipes. Tob Control. 2007;16:390-3.
12-Chaouachi K. Hookah (shisha, narghile, "water pipe") indoor air contamination in German unrealistic experiment.
Serious methodological biases and ethical concern. Food Chem Toxicol. 2010;48:992-5; author reply 6-7.
Acknowledgment
 Special thanks for Peninsula Dental School for funding my
participation
 The contribution of the owners and staff of the WP premises
in the study is appreciated
Thank you for listening