A literature review addressing midwakh and e-cigarette use in the Gulf region.

A notable decrease in conventional cigarette smoking has been witnessed on a global scale. However, this decrease has been accompanied by an equally striking global increase in the consumption of alternative tobacco products (ATPs), namely e-cigarettes and midwakh in the Arabian Gulf region. A literature review was used to outline the chemical composition of these two ATPs and review their impacts on health. The study was conducted using databases like PubMed, Google Scholar, MDPI, and WorldCat. The literature search included terms such as "e-cigarettes," "midwakh," "dokha," "heath impacts," "psychological effects," "social influences," and "cigarette smoking" with emphasis on literature from the Arabian Gulf region. Data shows that midwakh contains markedly high levels of tar, nicotine, and various compounds of notable effects on the human body. Similarly, it was found that e-cigarettes contain non-negligible amounts of nicotine and other chemical compounds that may not have been extensively investigated. Alarming reports of system-specific effects brought about by midwakh, and e-cigarette consumption, have been reported, although further research is needed to deduce the mechanism. We also discussed some of the social and psychological factors leading to their consumption within this population. Hence, this review raises questions around the safety of these two types of ATPs and encourages comprehensive studies globally and regionally.

Genomic Analysis of Waterpipe Smoke-Induced Lung Tumor Autophagy and Plasticity.

The role of autophagy in lung cancer cells exposed to waterpipe smoke (WPS) is not known. Because of the important role of autophagy in tumor resistance and progression, we investigated its relationship with WP smoking. We first showed that WPS activated autophagy, as reflected by LC3 processing, in lung cancer cell lines. The autophagy response in smokers with lung adenocarcinoma, as compared to non-smokers with lung adenocarcinoma, was investigated further using the TCGA lung adenocarcinoma bulk RNA-seq dataset with the available patient metadata on smoking status. The results, based on a machine learning classification model using Random Forest, indicate that smokers have an increase in autophagy-activating genes. Comparative analysis of lung adenocarcinoma molecular signatures in affected patients with a long-term active exposure to smoke compared to non-smoker patients indicates a higher tumor mutational burden, a higher CD8+ T-cell level and a lower dysfunction level in smokers. While the expression of the checkpoint genes tested-PD-1, PD-L1, PD-L2 and CTLA-4-remains unchanged between smokers and non-smokers, B7-1, B7-2, IDO1 and CD200R1 were found to be higher in non-smokers than smokers. Because multiple factors in the tumor microenvironment dictate the success of immunotherapy, in addition to the expression of immune checkpoint genes, our analysis explains why patients who are smokers with lung adenocarcinoma respond better to immunotherapy, even though there are no relative differences in immune checkpoint genes in the two groups. Therefore, targeting autophagy in lung adenocarcinoma patients, in combination with checkpoint inhibitor-targeted therapies or chemotherapy, should be considered in smoker patients with lung adenocarcinoma.

Midwakh: Assessment of Levels of Carcinogenic Polycyclic Aromatic Hydrocarbons and Nicotine in Dokha Tobacco Smoke.

Midwakh, which originated in the Middle East, has started to spread globally with different brands commercialized online and in local stores across Europe and the USA. Dokha is the tobacco used in midwakh. To this day, risk of midwakh smoking is poorly understood. Three different types of dokha were evaluated in this study, classified as cold, medium, and hot using gas chromatography-mass spectrometry (GC-MS). The concentrations of nicotine and polycyclic aromatic hydrocarbons (PAHs) in raw and smoked dokha samples were measured, and the results were compared to data in the literature on different types of tobacco products. PAH concentrations were used to estimate the toxic equivalency quotient, daily exposures, incremental lifetime cancer risk, and hazard quotient. The level of nicotine in raw dokha exceeded by far the levels reported in cigarettes, cigar, waterpipe, and chewing tobacco. Although only a portion of the nicotine is released into the smoke, the amount of nicotine in dokha smoke exceeded those reported for cigarettes. Two PAHs were found in raw dokha at trace amounts and 12 PAHs were detected in dokha smoke in amounts that exceeded those reported for cigarette smoke. The PAHs distribution showed a specific pattern in the smoke and a higher risk factor than that obtained for cigarettes and other tobacco products. Dokha products present a potential higher risk and immediate action should be taken to avoid its global consumption.

Junk food: Polymer composition of macroplastic marine debris ingested by green and loggerhead sea turtles from the Gulf of Oman.

Pollution of the marine environment by plastic marine debris has become one of the most pervasive threats impacting marine environments. In this study, for the first time, we evaluate the polymer types of the plastic marine debris ingested by 49 green and 14 loggerhead sea turtle strandings in the Gulf of Oman. Plastic marine debris was ingested by 73.5% of green and 42.9% of loggerhead sea turtles in this study. Overall, evidence suggested that green sea turtles from the Gulf of Oman coast of the United Arab Emirates ingested high levels of plastic marine debris, predominantly Polypropylene (PP) & Polyethylene (PE), followed by Nylon, PP-PE mixture, Polystyrene (PS), Poly vinyl chloride (PVC) and Ethylene vinyl acetate (EVA), respectively. Loggerhead sea turtles also ingested high levels of plastic marine debris, which also predominantly consisted of PP & PE, followed by PP-PE mixture, Nylon and PS. While recent studies were directed into polymer characterization of micro-plastics in aquatic life, our study focuses on macro-plastics which impose significantly greater risks.

Meteorological patterns, technical validation, and chemical comparison of atmospheric dust depositions and bulk sand in the Arabian Gulf region.

This study reports seasonal variations of meteorological parameters, atmospheric dust and dust-borne heavy metals concentrations measured, over a period of two years, next to two major airports (Dubai International Airport and Abu Dhabi International Airport) in the Gulf Cooperation Council (GCC) region. On-line monitoring stations were installed at each location next to dust samplers used to frequently collect PM2.5 and PM10 on Teflon filters for metal analysis. Clear seasonal variation in meteorological parameters were identified. The particulate matter concentrations depicted from the two locations were continuously monitored. The PM2.5 concentration ranged from 50 to 100 µg/m3 on normal days but reached 350-400 µg/m3 per day during mild storms. The PM10 levels ranged between 100 and 250 µg/m3 during normal days and spiked to 750 µg/m3 during mild storms. Energy Dispersive X-Ray Analysis (EDS) revealed the presence of significant amounts of alkali and alkaline earth metals, which pose potential harm to aircraft engines. ICP analysis showed the presence of heavy and toxic metals in concentrations that may pose harm to human health. Bulk sand samples from Abu Dhabi sites showed chemical similarities to the atmospheric dust samples. The concentrations of heavy metals, PM2.5, and PM10 are at levels that require further monitoring due to their impact on human health. The two years meteorological monitoring, with the seasonal variations, provided additional regional data in the Arabian Gulf. Furthermore, the study concluded that Sand and Dust storms (SDS) occur more frequently at the northern Arabian Gulf compared to its southern region. The chemical correlation between atmospheric dust and regional desert sand suggests the localized origin of the smaller dust particles that may form by breaking apart of the ground sand grains. As a result of the ongoing urbanization in the region, it is essential to collect additional data from various locations for a longer period of time.

Immunity-Boosting Spices and the Novel Coronavirus.

Although there is no reported genetic predisposition in contracting coronavirus disease 2019 (COVID-19), the mortality rate varies among different ethnic groups. Here we determined potential correlation between COVID-19 and spice consumption. The data from 163 countries including total cases, total deaths, and total recovered were analyzed. It was observed that there is a clear interrelated prevalence between the total number of COVID-19 cases per million population tested and the gram of spice supply per capita per day. Nations with lower consumptions of spices per capita showed greater number of COVID-19 cases per million population. This is not surprising as herbs and spices are well-known to boost immunity. Although the precise molecular mechanisms associated with spices and immunity are not completely understood, our findings led us to hypothesize that spice consumption plays a role in our ability to fight COVID-19; however, intensive research is needed to determine the translational value of these findings.

Chemical characterization and safety assessment of dokha: An emerging alternative tobacco product.

Dokha is known to be one of the most rapidly spreading alternative tobacco products (ATPs) in the Middle East and North Africa (MENA) region. It is smoked using a pipe known as Midwakh. There is no scientific research published on the chemical composition of dokha and only very little was done to investigate its impact on human health. Three different types of dokha were included in this study. The trace metals content in the dokha samples were analyzed using inductively-coupled plasma-optical emission spectroscopy and energy-dispersive X-ray spectroscopy-scanning electron microscope. Dokha smoke was generated using a device that simulates human smoking/puffing. The smoke samples were collected on Tenax and activated carbon adsorbent tubes followed by chemical analysis using thermal desorption-gas chromatography-mass spectrometry. The results showed the presence of toxic metals in dokha samples such as cobalt, cadmium, chromium, and lead in amounts classified as harmful to human health. In addition, the presence of several potentially harmful and even toxic organic compounds in dokha smoke was identified based on the available clinical data. These included 22 irritants, 3 known carcinogens, and 5 central nervous system (CNS) depressants in addition to several other compounds with miscellaneous effects. The findings of this work demonstrate evidence for the presence of potentially harmful and toxic metals and compounds in dokha tobacco as well as dokha smoke. More research is required to further investigate the clinical impact of dokha on human health.

Chemical and biological assessment of sediments and water of Khalid Khor, Sharjah, United Arab Emirates.

Water and sediments were collected on March 2013 and April 2014 from Khalid Khor creek area in United Arab Emirates to assess their quality parameters. The pH and alkalinity of the water samples were measured and their values were similar to those of shallow saltwater ecosystems. In addition, elemental analyses and organic compounds were done using Inductively Coupled Plasma-Optical Emission Spectroscopy (ICP-OES) and Gas Chromatography-Mass Spectroscopy (GC-MS), respectively. The concentration of heavy and trace metals in the water samples were within the acceptable limits except for lead which showed high values, while the concentrations of metals in the sediment samples were relatively high and ranged from 6517 to 13,768mg/kg. GC-MS analysis showed the presence of polyaromatic heterocyclic (PAHs) compounds in sediments near the shipping area and in amounts classified as highly carcinogenic; however, no polychlorinated biphenyls (PCB) were identified. Moreover, fecal bacterial contamination in water was detected in concentrations that range between 300 and 10,140 organisms/100mL.

Chemical analysis and potential health risks of hookah charcoal.

Hookah (waterpipe) smoking is a very common practice that has spread globally. There is growing evidence on the hazardous consequences of smoking hookah, with studies indicating that its harmful effects are comparable to cigarette smoking if not worse. Charcoal is commonly used as a heating source for hookah smoke. Although charcoal briquettes are thought to be one of the major contributors to toxicity, their composition and impact on the smoke generated remains largely unidentified. This study aims to analyze the elemental composition of five different raw synthetic and natural charcoals by using Carbon-Hydrogen-Nitrogen (CHN) analysis, inductively coupled plasma (ICP), and scanning electron microscopy coupled with energy dispersive X-Ray spectrometry (SEM-EDS). Elemental analysis showed that the raw charcoals contain heavy metals such as zinc, iron, cadmium, vanadium, aluminum, lead, chromium, manganese and cobalt at concentrations similar, if not higher than, cigarettes. In addition, thermal desorption-gas chromatography-mass spectrometry (TD-GC-MS) was used to analyze the chemical composition of the smoke produced from burning the charcoal samples. The smoke emitted from charcoal was found to be the source of numerous compounds which could be hazardous to health. A total of seven carcinogens, 39 central nervous system depressants and 31 respiratory irritants were identified.

A health risk assessment of Arabian incense (Bakhour) smoke in the United Arab Emirates.

Burning Arabian incense (Bakhour) is a common practice in the Middle East and Arabian Gulf. Although the incense generates large amounts of chemicals and air pollutants, little is known with regard to the nature of these chemicals and their potential health risks. The aim of this study is to provide a comprehensive characterization of the chemical constituents emitted in Bakhour smoke, and subsequently to examine the associated health implications of these components. Thermo-gravimetric analysis was used to investigate the presence and the thermal profile of volatile organic compounds in three different samples of Bakhour smoke. Thermal desorption-gas chromatography-mass spectrometry was then applied to isolate all the volatile and semi-volatile compounds present in the Bakhour smoke samples. Using a spectral library and an extensive literature search, all organic compounds detected were analyzed for potential health risks. A total of 859 compounds were emitted from burning the different Bakhour samples. The novel finding of this research shows that 42 detected compounds are suspected/known carcinogens, 20 are known to have toxic effects, and at least 200 compounds are known irritants to the eyes, skin, respiratory and digestive tracts, as reported in human and/or animal studies. Our study suggests that inhaled Bakhour smoke contains a substantial number of adverse compounds, which are known to be detrimental to human health. Moreover, the evidence presented shows that incense burning is a significant source of environmental pollution; with the potential of significant health concerns particularly with long term exposure. As the majority of the compounds detected have no reported clinical data, there is an urgent need for significant research in this field.