RT Journal Article SR Electronic T1 A Naturalistic Study of Carbon Monoxide, Heart Rate, Oxygen Saturation, and Perfusion Index in Hookah Lounge Patrons JF Respiratory Care FD American Association for Respiratory Care SP respcare.08056 DO 10.4187/respcare.08056 A1 Mary Martinasek A1 Allison Calvanese A1 Briana Lipski YR 2020 UL http://rc.rcjournal.com/content/early/2020/07/07/respcare.08056.abstract AB Introduction: Waterpipe (also known as “hookah”) smokers are exposed to several toxicants, heavy metals, and carcinogens. This study assessed physiologic data from hookah bar participants in an urban area in Florida. We hypothesized that hookah lounge patrons would have a decreased oxygen saturation and perfusion index, as well as an increased heart rate and exhaled carbon monoxide levels upon exiting the bars.Methods: Exhaled carbon monoxide (CO) levels, heart rate, pulse oximetry for carboxyhemoglobin and perfusion index were obtained immediately before entering the hookah lounges and after exiting hookah lounges on a sample size of 200 patrons attending hookah lounges. Averages were then used for Wilcoxon Signed Rank Tests to assess differences across means using data entered into SPSS statistical software. This study was approved by the IRB.Results: Combining both hookah smokers and concurrent smokers’ data, the mean CO (ppm) measurements went from 5.7 ppm pre-lounge entry to 66.5 ppm post-lounge visit (p < .001). Conversion to carboxyhemoglobin for all hookah smokers represents an increase from 1.5% to 10.6% (p < .001). Pulse oximeter, using a Masimo Rad 57™ oximeter carboxyhemoglobin mean values increased from 1.4% pre-lounge visit to 7.2% post-lounge visit (p < .001). The mean heart rate for the participants also increased from 90.3 bpm to 94.2 bpm (p < .001). The oxygen saturation levels decreased from 98.4% to 97.8% (p < .001). Similarly, the mean perfusion index decreased from 3.1 to 2.7% (p = .002).Conclusion: U.S. hookah lounge smokers are exposed to high levels of carbon monoxide that have the potential for detrimental health effects evidenced by rapid negative changes in physiological parameters. Respiratory Therapists should be aware of potential cardiovascular changes in hookah lounge patrons who enter emergency rooms and health facilities due to recent exposures.