Comparative Assessment of Heavy Metals and pH in Shisha Water and Blood of Smokers

Background: Shisha smoking is an emerging public health concern that poses significant health risks, particularly among young adults. Smokers can be predisposed to various toxicants, including heavy metals. Objective: This study assessed the level of heavy metal content and pH in shisha water and blood of smokers. Methods: A cross-sectional study design comprised of 150 subjects categorized into five groups of thirty each: shisha smokers, cigarette smokers, both shisha and cigarette smokers, secondhand smokers, and non-smokers, to enable a comprehensive comparison of different levels and types of tobacco smoke exposure in relation to heavy metal bioaccumulation in the body. Blood samples were collected for the measurement of the heavy metals using atomic absorption spectrophotometry. Shisha water samples were collected before smoking (pre-smoking water) and after smoking (post-smoking water) five consecutive smoking sessions without replacing the water, and pH was determined using a pH meter. Statistical analysis was done using SPSS. Results: The results showed significantly (p<0.001) elevated levels of lead, cadmium, and zinc in post-smoking water compared to pre-smoking water. Serum Pb and Cd levels were significantly elevated in all smokers compared to non-smokers, while serum zinc levels were significantly reduced. Shisha smokers exhibited lower levels of Pb, Cd, and Zn than cigarette smokers. Secondhand shisha smokers exhibited higher serum Pb, Cd, and Zn levels compared to the primary shisha smokers. The pH of the smoked shisha water shifted from 6.5 to 3.4 after smoking five consecutive shisha sessions. Conclusion: The study established that the water used in shisha traps or filters significant amounts of heavy metals such as lead, cadmium, and zinc in shisha smoke. The acidic pH of the shisha water correlates with higher levels of the dissolved metals, supporting the conclusion that water serves as a partial filter.