Abstract
ObjectiveTo determine whether the consumption of tobacco used in Water-Pipe by drivers increases the risk of a motor vehicle collision as a consequence of hypoxia.DesignAnalytical case–control study.Data sourcesSeventy exclusive Water-Pipe smokers (Experimental Group - EG) - mean age ± SD: 29.47 ± 10.45 years; mean number of weekly WPS, (6.9 ± 3.7); mean duration of WPS (WPS) is (7.5 ± 2.1 years) - and thirty non-smoker (Control Group – CG; mean age ± SD: 36.33 ± 13.92 years) were recruited during 2011 from two Arab villages located in the Galilee, northern Israel.MethodsWe performed a case–control study exclusively among Water-Pipe smokers with an appropriate non smokers control group. Demographic questionnaire, Pulse Oxymeter for blood oxygenation measure and a driver simulator for measuring various participants driving behaviors were utilized. Statistical analysis for analyzing the different variables, Pearson’s x2 analysis for the comparison of categorical variables, continuous variable is compared using Student’s t-test and for testing the correlation between the different variables and bivariate correlation analysis were applied.ResultsIn the (EG) following WPS, we observed increase in the pulse rate - from 80 to 95 (t = 11.84, p < 0.05) and decrease in saturation level from 97.9 to 97.32, the decrease is statistically significant (t = 3.01, p < 0.05) versus no change in (CG). An increased number of accidents among EG (OR is 1.333 with CI of 1.008–1.776), while in CG, an insignificantly decrease (t = 3.08, p < 0.05). In EG an increase in centerline crossings (OR is 1.306 with CI of 1.016–1.679), also the total time not being within the lane was increased and the estimated (OR: 1.329; CI: 1.025–1.722). WPS increases the number of accidents by 33% and Hypoxia can cause driving behavioral turbulences.ConclusionThe results show that WPS has a significant impact on driving behavior and on the risk of being involved in road accidents and causing driving to become riskier and less careful and stable. To the best of our knowledge, this is the first time such relationships have been tested. After WPS the total number of traffic accidents and driving violations increase. The results show a significant increase in the pulse rate immediately after WPS with a decrease in the saturation rate (the level of blood oxygenation); these changes continue half an hour after WPS.
Highlights
Water-Pipe is a device for smoking, which operates by water filtration and indirect heat of tobacco
WPS increases the number of accidents by 33% and Hypoxia can cause driving behavioral turbulences
The results show that WPS has a significant impact on driving behavior and on the risk of being involved in road accidents and causing driving to become riskier and less careful and stable
Summary
Water-Pipe is a device for smoking, which operates by water filtration and indirect heat of tobacco. WPS is a major public health challenge and its use is growing in popularity but despite its highly hazardous toxic behavior has spread globally to include the African and Asian continents, Australia, Europe, and North America [1,2,3] This dangerous phenomenon no more monopoly or confined to the Eastern Mediterranean regions as reported before [2] (Figure 1). Studies that have examined Water-Pipe smokers and the aerosol of Water-Pipe smoke have reported high concentrations of CO, nicotine, “tar,” and heavy metals. These concentrations were as high as or higher than those among cigarette smokers. Other studies reported elevated CO levels among Water-Pipe smokers, and the level of carboxyhemoglobin concentrations were higher among Water-Pipe smokers (10.1%) than among cigarette smokers (6.5%) or nonsmokers (1.6%), and a linear relationship was found between smoking intensity and carboxyhemoglobin concentration [5, 6, 7]
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