Comparative Analysis of Heavy Metal Exposure and Liver Enzyme Levels in Hookah and Cigarette Smokers
Heavy Metal Exposure and Liver Enzyme Levels in Hookah and Cigarette Smokers
DOI:
https://doi.org/10.63841/iue24510Keywords:
Cigarette, Heavy metal, Hookah, Liver enzyme, SmokerAbstract
Tobacco consumption, including cigarettes and hookah, remains a major global health concern. This study investigates the impact of cigarette and hookah smoking on liver function and the levels of heavy metals in serum among smokers compared to non-smokers. This project was executed from October 2024 to February 2025 in the Kurdistan area. This time was used to assess the impact of cigarette and hookah smoking on the deposition of heavy metals in blood and liver parameters of smokers compared to nonsmokers. The study involved 200 participants, comprising 80 non-smokers and 120 smokers (60 cigarette and 60 hookah users) aged between 18-70 years. Blood samples were collected, and serum levels of liver enzymes (ALT, AST, ALP, GGT), bilirubin, albumin, were analyzed using a fully automated biochemical analyzer (Mindray BS 240) and trace elements (Ni, Fe, Hg, As, Pb, Cd) were analyzed using Inductively Coupled Plasma Optical Emission spectroscopy (ICP-OES). The findings revealed that hookah and cigarette smokers exhibited significantly higher levels of liver enzymes (ALT, AST, GGT) and heavy metals (Hg, Pb, Cd) compared to non-smokers. Conversely, ALP and albumin levels were significantly lower among smokers. Notably, the levels of Ni showed no significant differences between groups. The study highlights the heightened exposure to toxic heavy metals and liver dysfunction associated with tobacco use, with hookah smoking posing comparable or even greater risks than cigarette smoking. These results underscore the need for increased awareness and regulatory measures to mitigate the health risks of both cigarette and hookah smoking.
References
H. He, Z. Pan, J. Wu, C. Hu, L. Bai, and J. Lyu, "Health effects of tobacco at the global, regional, and national levels: results from the 2019 global burden of disease study," Nicotine and Tobacco Research, vol. 24, no. 6, pp. 864-870, 2022.
Y. Romero, "World Cancer Day 2021: Prevention, awareness and accountability in tobacco control," Tobacco Prevention & Cessation, vol. 7, p. 8, 2021.
C. Monn, P. Kindler, A. Meile, and O. Brändli, "Ultrafine particle emissions from waterpipes," Tobacco Control, vol. 16, no. 6, pp. 390-393, 2007.
P. Jacob III et al., "Nicotine, carbon monoxide, and carcinogen exposure after a single use of a water pipe," Cancer epidemiology, biomarkers & prevention, vol. 20, no. 11, pp. 2345-2353, 2011.
M. Badran and I. Laher, "Waterpipe (shisha, hookah) smoking, oxidative stress and hidden disease potential," Redox biology, vol. 34, p. 101455, 2020.
G. A. Giovino et al., "Tobacco use in 3 billion individuals from 16 countries: an analysis of nationally representative cross-sectional household surveys," The Lancet, vol. 380, no. 9842, pp. 668-679, 2012.
E. S. Jang et al., "Effects of coffee, smoking, and alcohol on liver function tests: a comprehensive cross-sectional study," BMC gastroenterology, vol. 12, pp. 1-12, 2012.
H. Kuper, H. O. Adami, and P. Boffetta, "Tobacco use, cancer causation and public health impact," Journal of internal medicine, vol. 251, no. 6, pp. 455-466, 2002.
V. Momenabadi, S. Y. Hashemi, and V. R. Borhaninejad, "Factors affecting hookah smoking trend in the society: A review article," Addiction & health, vol. 8, no. 2, p. 123, 2016.
B. A. Primack, M. Walsh, C. Bryce, and T. Eissenberg, "Water-pipe tobacco smoking among middle and high school students in Arizona," Pediatrics, vol. 123, no. 2, pp. e282-e288, 2009.
E. Sepetdjian, A. Shihadeh, and N. A. Saliba, "Measurement of 16 polycyclic aromatic hydrocarbons in narghile waterpipe tobacco smoke," Food and Chemical Toxicology, vol. 46, no. 5, pp. 1582-1590, 2008.
B. Monzer, E. Sepetdjian, N. Saliba, and A. Shihadeh, "Charcoal emissions as a source of CO and carcinogenic PAH in mainstream narghile waterpipe smoke," Food and Chemical Toxicology, vol. 46, no. 9, pp. 2991-2995, 2008.
W. N. El-Nachef and S. K. Hammond, "Exhaled carbon monoxide with waterpipe use in US students," JAMA, vol. 299, no. 1, pp. 36-38, 2008.
M. Al Rashidi, A. Shihadeh, and N. Saliba, "Volatile aldehydes in the mainstream smoke of the narghile waterpipe," Food and Chemical Toxicology, vol. 46, no. 11, pp. 3546-3549, 2008.
Y. Elsayed, S. Dalibalta, and N. Abu-Farha, "Chemical analysis and potential health risks of hookah charcoal," Science of the Total Environment, vol. 569, pp. 262-268, 2016.
M. Jaishankar, T. Tseten, N. Anbalagan, B. B. Mathew, and K. N. Beeregowda, "Toxicity, mechanism and health effects of some heavy metals," Interdisciplinary toxicology, vol. 7, no. 2, p. 60, 2014.
G. A. Engwa, P. U. Ferdinand, F. N. Nwalo, and M. N. Unachukwu, "Heavy Metal Toxicity in Humans," Poisoning in the modern world: new tricks for an old dog?, p. 77, 2019.
K. K. Lawal, I. K. Ekeleme, C. M. Onuigbo, V. O. Ikpeazu, and S. O. Obiekezie, "A review on the public health implications of heavy metals," World Journal of Advanced Research and Reviews, vol. 10, no. 3, pp. 255-265, 2021.
M. M. Atta, S. G. Hussain, and A. J. Ahmed, "Effect of cigarette smoking on the activity of liver enzyme (AST, ALT, ALP)," Plant Archives, vol. 19, no. 1, pp. 1874-1880, 2019.
M. Balali-Mood, K. Naseri, Z. Tahergorabi, M. R. Khazdair, and M. Sadeghi, "Toxic mechanisms of five heavy metals: mercury, lead, chromium, cadmium, and arsenic," Frontiers in pharmacology, vol. 12, p. 643972, 2021.
M. Ściskalska, M. Zalewska, A. Grzelak, and H. Milnerowicz, "The influence of the occupational exposure to heavy metals and tobacco smoke on the selected oxidative stress markers in smelters," Biological trace element research, vol. 159, no. 1, pp. 59-68, 2014.
A. Ghaderi et al., "Examining of Heavy Metal Concentrations in Hookah Smokers," Biological Trace Element Research, vol. 201, no. 7, pp. 3185-3192, 2023/07/01 2023, doi: 10.1007/s12011-022-03422-0.
S. Nakhaee et al., "Comparison of serum concentrations of essential and toxic elements between cigarette smokers and non-smokers," Environmental Science and Pollution Research, vol. 28, no. 28, pp. 37672-37678, 2021/07/01 2021, doi: 10.1007/s11356-021-13290-1.
A. Vivek, R. M. Kaushik, and R. Kaushik, "Tobacco smoking-related risk for iron deficiency anemia: a case-control study," Journal of addictive diseases, vol. 41, no. 2, pp. 128-136, 2023.
A. Nakhaee, F. Shahabizadeh, and M. Erfani, "Protein and lipid oxidative damage in healthy students during and after exam stress," Physiology & behavior, vol. 118, pp. 118-121, 2013.
S. K. Sinha and M. N. Haider, "Tobacco and health effects," Tobacco & Public Health: Tobacco and Community Well-being: A Worldwide Health Crisis, vol. 101, 2024.
P. J. Hać, B. M. Cieślik, and P. Konieczka, "Review of cigars and cigar-type products as potential sources of consumer exposure to heavy metals," Journal of Environmental Science and Health, Part C, vol. 40, no. 2, pp. 172-196, 2022.
S. A. Shehata, E. A. Toraih, E. A. Ismail, A. M. Hagras, E. Elmorsy, and M. S. Fawzy, "Vaping, environmental toxicants exposure, and lung cancer risk," Cancers, vol. 15, no. 18, p. 4525, 2023.
R. Rostami et al., "Characteristics and health risk assessment of heavy metals in indoor air of waterpipe cafés," Building and Environment, vol. 190, p. 107557, 2021.
M. Dehvari and A. Babaei, "Analysis of heavy metals and PAHs in the waste resulting from hookah consumption: Ahvaz City, Iran," Environmental Science and Pollution Research, vol. 29, no. 22, pp. 33130-33137, 2022.
I. Krzywy, E. Krzywy, J. Peregud-Pogorzelski, K. Łuksza, and A. Brodkiewicz, "Cadmium--is there something to fear?," in Annales Academiae Medicae Stetinensis, 2011, vol. 57, no. 3, pp. 49-63.
N. Verma and A. Sharma, "Biological Interventions in Bioremediation of Cadmium Poisoning," in Cadmium Toxicity Mitigation: Springer, 2024, pp. 121-145.
Y. Qing et al., "Dose–response evaluation of urinary cadmium and kidney injury biomarkers in Chinese residents and dietary limit standards," Environmental Health, vol. 20, pp. 1-9, 2021.
H.-C. Lin, W.-M. Hao, and P.-H. Chu, "Cadmium and cardiovascular disease: An overview of pathophysiology, epidemiology, therapy, and predictive value," Revista Portuguesa de Cardiologia (English Edition), vol. 40, no. 8, pp. 611-617, 2021.
K. Ganguly, B. Levänen, L. Palmberg, A. Åkesson, and A. Lindén, "Cadmium in tobacco smokers: a neglected link to lung disease?," European Respiratory Review, vol. 27, no. 147, 2018.
A. E. Charkiewicz, W. J. Omeljaniuk, K. Nowak, M. Garley, and J. Nikliński, "Cadmium toxicity and health effects—a brief summary," Molecules, vol. 28, no. 18, p. 6620, 2023.
H. Qasim, A. B. Alarabi, K. H. Alzoubi, Z. A. Karim, F. Z. Alshbool, and F. T. Khasawneh, "The effects of hookah/waterpipe smoking on general health and the cardiovascular system," Environmental health and preventive medicine, vol. 24, pp. 1-17, 2019.
P. Mukti, "Health risk assessment related to cadmium and lead exposure from cigarette smoking among Indonesian smokers in Surakarta, Indonesia: a cross-sectional study," 2021.
M. Yaseen, S. Alkubaisy, and M. M. Saleh, "Effects of hookah smoking on liver functions, lipid profile, and adult blood count," Biomedicine, vol. 41, no. 4, pp. 763-767, 2021.
S. M. Rutledge and A. Asgharpour, "Smoking and liver disease," Gastroenterology & Hepatology, vol. 16, no. 12, p. 617, 2020.
J. Baj et al., "Magnesium, calcium, potassium, sodium, phosphorus, selenium, zinc, and chromium levels in alcohol use disorder: a review," Journal of clinical medicine, vol. 9, no. 6, p. 1901, 2020.
R. Didehdar, F. A. Malayeri, A. Ghaljaeipour, S. Saeedian, and N. KhaliliAghdam, "Effect of Smoking and Type of Nutrition on the Activity of Liver Alanine Aminotransferase and Aspartate Aminotransferase," Tobacco and Health, vol. 1, no. 4, pp. 183-190, 2022.
M. Galazyn-Sidorczuk, M. M. Brzóska, and J. Moniuszko-Jakoniuk, "Estimation of Polish cigarettes contamination with cadmium and lead, and exposure to these metals via smoking," (in eng), Environ Monit Assess, vol. 137, no. 1-3, pp. 481-93, Feb 2008, doi: 10.1007/s10661-007-9783-2.
P. D. Adamis, S. C. Mannarino, and E. C. Eleutherio, "Glutathione and gamma-glutamyl transferases are involved in the formation of cadmium-glutathione complex," (in eng), FEBS Lett, vol. 583, no. 9, pp. 1489-92, May 6 2009, doi: 10.1016/j.febslet.2009.03.066.
T. S. Nawrot et al., "Cadmium exposure in the population: from health risks to strategies of prevention," (in eng), Biometals, vol. 23, no. 5, pp. 769-82, Oct 2010, doi: 10.1007/s10534-010-9343-z.
S. J. Kim, S. W. Han, D. J. Lee, K. M. Kim, and N. S. Joo, "Higher Serum Heavy Metal May Be Related with Higher Serum gamma-Glutamyltransferase Concentration in Koreans: Analysis of the Fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1, 2, 2010, 2011)," (in eng), Korean J Fam Med, vol. 35, no. 2, pp. 74-80, Mar 2014, doi: 10.4082/kjfm.2014.35.2.74.
K. S. Alsalhen and R. D. Abdalsalam, "Effect of cigarette smoking on liver functions: a comparative study conducted among smokers and non-smokers male in El-beida City, Libya," International Current Pharmaceutical Journal, vol. 3, no. 7, pp. 291-295, 06/07 2014, doi: 10.3329/icpj.v3i7.19077.
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