ABSTRACT
SETTING: Waterpipe smoking is an emerging topic in tobacco research that may have unrecognised health hazards. OBJECTIVE: To determine whether waterpipes are a source of bacterial contamination. METHODS: A total of 15 restaurants and waterpipe cafés were randomly selected from the list of locations serving waterpipe tobacco in Kerman city, Iran. Different parts of the waterpipe devices were sampled, including the disposable mouthpiece, the mouthpiece of the hose and the water in the bowl of the waterpipe. The samples were smeared onto bacterial culture media, including eosin methylene blue, blood agar and MacConkey agar growth media, and incubated at 37°C. After 24-48 h, they were examined for colony growth. RESULTS: Of 285 samples from different parts of the waterpipes, 236 (82.8%) showed positive cultures; the rate of contamination ranged from 69% in the fixed mouthpiece to 96% in bowl water. Coagulase-negative staphylococci (32.9%), Streptococcus spp (26.9%), Neisseria spp (13.7%) and Escherichia coli (9.4%) were the most frequent contaminants. CONCLUSION: Waterpipes are frequently contaminated with microorganisms. This study revealed potential microbial hazards in waterpipes that may contribute to respiratory tract colonisation.