Exposure assessment of children living in homes with hookah smoking parents to polycyclic aromatic hydrocarbons: urinary level, exposure predictors, and risk assessment.

Children are extremely liable to indoor air pollutants as their physiology and a few metabolic pathways are different from those of adults. The present cross-sectional study aimed to assess exposure of children living with parents who use hookah tobacco smoke to polycyclic aromatic hydrocarbons (PAHs) using a biomonitoring approach. The study was conducted on 25 children (7-13 years of age) exposed to hookah smoke at home and 25 unexposed age-matched children. Urinary levels of five metabolites of PAHs were quantified via headspace gas chromatography-mass spectrometry (GC-MS). Urinary malondialdehyde (MDA) was measured, as well. Information regarding the sociodemographic and lifestyle conditions was collected through interviews using managed questionnaires. The urinary 1-OH-NaP and 9-OH-Phe concentrations were respectively 1.7- and 4.6-folds higher in the case samples compared to the control group (p < 0.05). In addition, urinary MDA levels were 1.4 times higher in the exposed children than in the unexposed group, but the difference was not statistically significant (p > 0.05). Increasing the consumption of grilled and meat food in the diet increased the participants' urinary 2-OH-Flu and 1-OH-Pyr levels, respectively. Moreover, sleeping in the living room instead of the bedroom at night was a significant predictor of high 1-OH-NaP and 2-OH-NaP concentrations in the children's urine. Overall, the findings confirmed that children living in their homes with hookah-smoking parents were significantly exposed to naphthalene and phenanthrene. Hence, implementing protective measures is critical to reduce the exposure of this group of children.