Skip to main content

Assessment of DNA damage using chromosomal aberrations assay in lymphocytes of waterpipe smokers



The aim of this study was to investigate the genotoxicity of waterpipe smoking in the lymphocytes of waterpipe smokers using chromosomal aberrations (CAs) assay.

Materials and Methods

Fifty waterpipe smokers and 18 healthy non-smokers volunteered to participate in the study. Additionally, 18 heavy cigarette smokers were recruited for comparison. Chromosomal aberrations (CAs) assay was used to evaluate DNA damage in the lymphocytes.


The results showed that similarly to cigarette smoking, waterpipe smoking significantly increased the frequencies of CAs (p < 0.01). In addition, the frequencies of CAs increased with more waterpipe use.


Waterpipe smoking causes DNA damage to lymphocytes and the damage increases with more waterpipe use.

This is a preview of subscription content, access via your institution.


  1. 1.

    WHO. The Tobacco Epidemic. A Global Public Health Emergency. Tobacco or Health Programme on Substance Abuse. Geneva: WHO; 2009.

    Google Scholar 

  2. 2.

    Rogers JM. Tobacco and pregnancy: overview of exposures and effects. Birth Defects Res C Embryo Today 2008;84(1): 1–15.

    PubMed  Article  CAS  Google Scholar 

  3. 3.

    Jha P. Avoidable global cancer deaths and total deaths from smoking. Nat Rev Cancer 2009;9(9):655–664.

    PubMed  Article  CAS  Google Scholar 

  4. 4.

    Lee PN, Hamling J. The relation between smokeless tobacco and cancer in Northern Europe and North America. A commentary on differences between the conclusions reached by two recent reviews. BMC Cancer 2009;9:256. DOI: 10.1186/1471-2407-9-256.

    PubMed  Article  Google Scholar 

  5. 5.

    Sasco AJ, Secretan MB, Straif K. Tobacco smoking and cancer: A brief review of recent epidemiological evidence. Lung Cancer 2004;45Suppl 2:S3–9.

    PubMed  Article  Google Scholar 

  6. 6.

    Azab M, Khabour OF, Alkaraki AK, Eissenberg T, Alzoubi KH, Primack BA. Water pipe tobacco smoking among university students in Jordan. Nicotine Tob Res 2010;12(6): 606–612.

    PubMed  Article  Google Scholar 

  7. 7.

    Eissenberg T, Ward KD, Smith-Simone S, Maziak W. Waterpipe tobacco smoking on a U.S. College campus: prevalence and correlates. J Adolesc Health 2008;42(5):526–529.

    PubMed  Article  Google Scholar 

  8. 8.

    Maziak W. The waterpipe: time for action. Addiction 2008;103(11):1763–1767.

    PubMed  Article  Google Scholar 

  9. 9.

    Primack BA, Sidani J, Agarwal AA, Shadel WG, Donny EC, Eissenberg TE. Prevalence of and associations with waterpipe tobacco smoking among U.S. university students. Ann Behav Med 2008;36(1):81–86.

    PubMed  Article  Google Scholar 

  10. 10.

    Warren CW, Lea V, Lee J, Jones NR, Asma S, McKenna M. Change in tobacco use among 13–15 year olds between 1999 and 2008: findings from the Global Youth Tobacco Survey. Glob Health Promot 2009;16Suppl 2:38–90.

    PubMed  Article  Google Scholar 

  11. 11.

    Kandela P. Nargile smoking keeps Arabs in Wonderland. Lancet 2000;356(9236):1175.

    PubMed  Article  CAS  Google Scholar 

  12. 12.

    Kiter G, Ucan ES, Ceylan E, Kilinc O. Water-pipe smoking and pulmonary functions. Respir Med 2000;94(9):891–894.

    PubMed  Article  CAS  Google Scholar 

  13. 13.

    Shihadeh A. Investigation of mainstream smoke aerosol of the argileh water pipe. Food Chem Toxicol 2003;41(1): 143–152.

    PubMed  Article  CAS  Google Scholar 

  14. 14.

    Shihadeh A, Saleh R. Polycyclic aromatic hydrocarbons, carbon monoxide, “tar”, and nicotine in the mainstream smoke aerosol of the narghile water pipe. Food Chem Toxicol 2005;43(5):655–661.

    PubMed  Article  CAS  Google Scholar 

  15. 15.

    DeMarini DM, Gudi R, Szkudlinska A, Rao M, Recio L, Kehl M, et al. Genotoxicity of 10 cigarette smoke condensates in four test systems: comparisons between assays and condensates. Mutat Res 2008;650(1):15–29.

    PubMed  Article  CAS  Google Scholar 

  16. 16.

    Assis KR de, Ladeira MS, Bueno RC, Dos Santos BF, Dalben I, Salvadori DM. Genotoxicity of cigarette smoking in maternal and newborn lymphocytes. Mutat Res 2009; 679 (1–2):72–78.

    PubMed  Google Scholar 

  17. 17.

    DeMarini DM. Genotoxicity of tobacco smoke and tobacco smoke condensate: a review. Mutat Res 2004;567(2–3): 447–474.

    PubMed  CAS  Google Scholar 

  18. 18.

    Karaoguz MY, Cosar B, Arikan Z, Basaran F, Menevse A, Menevse S. Increased frequency of sister chromatid exchanges in peripheral lymphocytes of alcoholics and cigarette smokers. Cell Biol Int 2005;29(2):165–168.

    PubMed  Article  CAS  Google Scholar 

  19. 19.

    Lu Y, Morimoto K. Exposure level to cigarette tar or nicotine is associated with leukocyte DNA damage in male Japanese smokers. Mutagenesis 2008;23(6):451–455.

    PubMed  Article  CAS  Google Scholar 

  20. 20.

    Rowland RE, Harding KM. Increased sister chromatid exchange in the peripheral blood lymphocytes of young women who smoke cigarettes. Hereditas 1999;131(2):143–146.

    PubMed  Article  CAS  Google Scholar 

  21. 21.

    Tawn EJ, Whitehouse CA. Frequencies of chromosome aberrations in a control population determined by G banding. Mutat Res 2001;490(2):171–177.

    PubMed  Article  CAS  Google Scholar 

  22. 22.

    Khabour OF, Alsatari ES, Azab M, Alzoubi KH, Sadiq MF. Assessment of genotoxicity of waterpipe and cigarette smoking in lymphocytes using the sister-chromatid exchange assay: a comparative study. Environ Mol Mutagen 2011;52(3): 224–228.

    PubMed  Article  CAS  Google Scholar 

  23. 23.

    El-Setouhy M, Loffredo ChA, Radwan G, Rahman RA, Mahfouz E, Israel E, et al. Genotoxic effects of waterpipe smoking on the buccal mucosa cells. Mutat Res 2008; 655(1–2):36–40.

    PubMed  CAS  Google Scholar 

  24. 24.

    Sadiq MF, Khabour OF, el-Shanti HE, Samawi HM. The effect of trifluoperazine on the genotoxicity of bleomycin in cultured human lymphocytes. Drug Chem Toxicol 2000;23(2): 361–369.

    PubMed  Article  CAS  Google Scholar 

  25. 25.

    Saleh N, Khabour OF, Esmadi FT, Al-Kofahi E. In vivo cytogenetic studies on rat’s bone-marrow cells of structurally related Schiff base complexes. Drug Chem Toxicol 2011;34(1): 92–99.

    PubMed  Article  CAS  Google Scholar 

  26. 26.

    M’Bemba-Meka P, Lemieux N, Chakrabarti SK. Role of oxidative stress and intracellular calcium in nickel carbonate hydroxide-induced sister-chromatid exchange, and alterations in replication index and mitotic index in cultured human peripheral blood lymphocytes. Arch Toxicol 2007;81(2):89–99.

    PubMed  Article  Google Scholar 

  27. 27.

    Kao-Shan CS, Fine RL, Whang-Peng J, Lee EC, Chabner BA. Increased fragile sites and sister chromatid exchanges in bone marrow and peripheral blood of young cigarette smokers. Cancer Res 1987;47(23):6278–6282.

    PubMed  CAS  Google Scholar 

  28. 28.

    Norppa, H., Bonassi S, Hansteen I-L, Hagmar L, Strömberg U, Rössner P, et al. Chromosomal aberrations and SCEs as biomarkers of cancer risk. Mutat Res 2006;600(1–2):37–45.

    PubMed  CAS  Google Scholar 

  29. 29.

    Ray GN, Shahid M, Husain S.A. Status of chromosome breaks and gaps in breast cancer. A follow-up study. Cancer Genet Cytogenet 2001;130(2):155–159.

    CAS  Google Scholar 

  30. 30.

    Yadav JS, Thakur S. Genetic risk assessment in hookah smokers. Cytobios 2000;101(397):101–113.

    PubMed  CAS  Google Scholar 

  31. 31.

    Boulos DN, Loffredo CA, El Setouhy M, Abdel-Aziz F, Israel E, Mohamed MK. Nondaily, light daily, and moderate-to-heavy cigarette smokers in a rural area of Egypt: a population-based survey. Nicotine Tob Res 2009;11(2):134–138.

    PubMed  Article  Google Scholar 

  32. 32.

    Prabhavathi PA, Fatima SK, Rao MS, Reddy PP. Analysis of chromosomal aberration frequencies in the peripheral blood lymphocytes of smokers exposed to uranyl compounds. Mutat Res 2000;466(1):37–41.

    PubMed  Article  CAS  Google Scholar 

  33. 33.

    Milic M, Kasuba V, Orescanin V, Zeljezic D, Kopjar N, Rozgaj R. Chromosome damage in workers in cigarette manufacturing industry. J Appl Toxicol 2008;28(3):399–404.

    PubMed  Article  CAS  Google Scholar 

  34. 34.

    Larramendy ML, Knuutila S. Increased frequency of micronuclei in B and T8 lymphocytes from smokers. Mutat Res 1991;259(2):189–195.

    PubMed  Article  CAS  Google Scholar 

  35. 35.

    Akbas E, Soylemez F, Derici E, Borekci G, Kanik A. Effects of X-rays and cigarette smoking on leukocyte, lymphocyte and mitotic index values and SCE rates: the relationship between mitotic index and lymphocyte count. Toxicol Ind Health 2003;19(2–6):81–91.

    PubMed  Article  CAS  Google Scholar 

  36. 36.

    Monzer B, Sepetdjian E, Saliba N, Shihadeh A. Charcoal emissions as a source of CO and carcinogenic PAH in mainstream narghile waterpipe smoke. Food Chem Toxicol 2008;46(9):2991–2995.

    PubMed  Article  CAS  Google Scholar 

  37. 37.

    Sepetdjian E, Shihadeh A, Saliba NA. Measurement of 16 polycyclic aromatic hydrocarbons in narghile waterpipe tobacco smoke. Food Chem Toxicol 2008;46(5):1582–1590.

    PubMed  Article  CAS  Google Scholar 

  38. 38.

    Al Rashidi M, Shihadeh A, Saliba NA. Volatile aldehydes in the mainstream smoke of the narghile waterpipe. Food Chem Toxicol 2008;46(11):3546–3549.

    PubMed  Article  Google Scholar 

  39. 39.

    Bacha ZA, Salameh P, Waked M. Saliva cotinine and exhaled carbon monoxide levels in natural environment waterpipe smokers. Inhal Toxicol 2007;19(9):771–777.

    PubMed  Article  CAS  Google Scholar 

  40. 40.

    Eissenberg T, Shihadeh A. Waterpipe tobacco and cigarette smoking: direct comparison of toxicant exposure. Am J Prev Med 2009;37(6):518–523.

    PubMed  Article  Google Scholar 

  41. 41.

    Maziak W, Rastam S, Ibrahim I, Ward KD, Shihadeh A, Eissenberg T. CO exposure, puff topography, and subjective effects in waterpipe tobacco smokers. Nicotine Tob Res 2009;11(7):806–811.

    PubMed  Article  CAS  Google Scholar 

  42. 42.

    Akl EA, Gaddam S, Gunukula SK, Honeine R, Jaoude PA, Irani J. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. Int J Epidemiol 2010;39(3):834–857.

    PubMed  Article  Google Scholar 

  43. 43.

    Koul PA, Hajni MR, Sheikh MA, Khan UH, Shah A, Khan Y, et al. Hookah smoking and lung cancer in the Kashmir valley of the Indian subcontinent. Asian Pac J Cancer Prev 2011;12(2):519–524.

    PubMed  Google Scholar 

  44. 44.

    Shinmura K, Iwaizumi M, Igarashi H, Nagura K, Yamada H, Suzuki M, et al. Induction of centrosome amplification and chromosome instability in p53-deficient lung cancer cells exposed to benzo[a]pyrene diol epoxide (B[a]PDE). J Pathol 2008;216(3):365–374.

    PubMed  Article  CAS  Google Scholar 

  45. 45.

    Daher N, Saleh R, Jaroudi E, Sheheitli H, Badr T, Sepetdjian E, et al. Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: Sidestream smoke measurements and assessment of second-hand smoke emission factors. Atmos Environ 2010;44(1):8–14.

    PubMed  Article  CAS  Google Scholar 

  46. 46.

    Lorenti Garcia C, Mechilli M, Proietti De Santis L, Schinoppi A, Kobos K, Palitti F. Relationship between DNA lesions, DNA repair and chromosomal damage induced by acetaldehyde. Mutat Res 2009;662(1–2):3–9.

    PubMed  CAS  Google Scholar 

  47. 47.

    Jose Zocche J, Dimer Leffa D, Paganini Damiani A, Carvalho F, Avila Mendonça R, Dos Santos CE, et al. Heavy metals and DNA damage in blood cells of insectivore bats in coal mining areas of Catarinense coal basin, Brazil. Environ Res 2010;110(7):684–691.

    PubMed  Article  Google Scholar 

  48. 48.

    Salmon TB, Evert BA, Song B, Doetsch PW. Biological consequences of oxidative stress-induced DNA damage in Saccharomyces cerevisiae. Nucleic Acids Res 2004;32(12): 3712–3723.

    PubMed  Article  CAS  Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Mohammad Azab.

About this article

Cite this article

Alsatari, E.S., Azab, M., Khabour, O.F. et al. Assessment of DNA damage using chromosomal aberrations assay in lymphocytes of waterpipe smokers. IJOMEH 25, 218–224 (2012).

Download citation

Key words

  • Waterpipe
  • Smoking
  • Cigarette
  • Chromosomal aberrations