Hookah Pipe Smoking and Secondary Polycythaemia

A recent article in the South African Medical Journal highlighted the risk of secondary polycythaemia from hookah pipe smoking (see link). This is a phenomenon that the WCBS Medical Department has also identified in some regular blood donors who present with very high haemoglobin levels.

It is our policy to perform full blood count testing for donors whose Hemocue® screening result is higher than 20 g/dl. The donor is then provided with the results and a brief telephonic interview is performed. We regularly find that the donors with markedly elevated haemoglobin and haematocrit values confirm that they are hookah pipe users, although none have disclosed having clinical sequelae such as thrombosis. These donors are typically male and fall within the age group of 18-40 years. The full blood count results are provided to the donor who is encouraged to consult with their own doctor for further investigation, and enrol in the WCBS therapeutic phlebotomy programme for management.

Our anecdotal discussion with local haematologists has shown that hookah pipe smoking is not a well-known cause of secondary polycythaemia in the medical community. There is also a false perception by the public that hookah pipe smoking poses fewer risks than cigarette smoking.

For more information about the WCBS therapeutic phlebotomy programme, please contact Sister Tania Paarman, Manager – Specialised Donations (tania@wcbs.org.za) or Dr Caroline Hilton, Head – Medical Division (caroline@wcbs.org.za).


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