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. 2021 Jul 3;13(4):344-349.
doi: 10.1093/inthealth/ihaa078.

Microbial contamination in the communal-use Lao tobacco waterpipe

Ryan G Sinclair  1 , Khamphithoun Somsamouth  2 , Demetria Sahar  1 , Robyn Englert  1 , Pramil Singh  1
Affiliations

Microbial contamination in the communal-use Lao tobacco waterpipe

Ryan G Sinclair et al. Int Health. .

Abstract

Background: The use of the Asian tobacco waterpipe (TWP) in the Lao People's Democratic Republic represents a potential communal source of infectious disease. This practice of smoking can lead to weakened defences of a smoker's respiratory epithelium, making the smoker vulnerable to respiratory diseases such as coronavirus disease 2019, tuberculosis and others.

Methods: This study evaluated the water quality and hygiene factors among 43 smokers of five villages in rural Luang Namtha Province. Water samples were collected from participant's TWPs and assessed for the presence of Escherichia coli, coliforms and aerobic plate count (APC) bacteria using the 3M Petrifilm.

Results: The microbial indicator testing results were 95% positive for the APC, 38% positive for coliforms and 17% positive for the E. coli indicator. The concentrations were highest for the APC, with an average of 106 colony forming units (cfu)/ml, followed by coliforms with <100 cfu/ml and lowest for E. coli with <10 cfu/ml. Most TWPs were infrequently cleaned, heavily used and contained a warm, brown-coloured water.

Conclusions: The warm, dark and moist internal water container may facilitate microbial survival and growth. The use of a TWP adds several unstudied modes of transmission to a complex and common biobehavioural and environmental pathogen exposure. Future TWP cessation activities should be tailored to consider risks of infectious disease transmission.

Keywords: infectious disease; tobacco waterpipe; tuberculosis; water quality.

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Figures

Figure 1.
Figure 1.
Characteristics of the Asian (left) and Eastern Mediterranean (right) waterpipe.
Figure 2.
Figure 2.
A field laboratory technician pouring water from the TWP into a sample collection bottle.
Figure 3.
Figure 3.
The appearance of water in most of the TWP water samples.
Figure 4.
Figure 4.
Average concentrations of indicator bacteria in TWPs in rural Luang Namtha, with an upper standard deviation line.
Figure 5.
Figure 5.
Some of the TWPs collected in one village during the study including bamboo, PVC and aluminium TWPs.
See this image and copyright information in PMC

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