We thank Stangl and Voigt for reminding us of the indoor carbon monoxide concentrations in shisha bars, which are potentially hazardous to health.
It is our view too that the risk potential is substantial, especially for the staff working in such establishments. The symptoms of chronic carbon monoxide poisoning include neurological (polyneuropathy), psychiatric (depression), and gastrointestinal (diarrhea) symptoms (2, 3); the indoor threshold of carbon monoxide concentration that would cause such symptoms is not known and depends on diverse comorbidities and factors of influence.
Because of the known risk potential of carbon monoxide, and the fact that measuring concentrations is fairly simple when using CO alarms, we support the call for further systematic studies and would make a plea for the compulsory fitting of suitable carbon monoxide alarms in shisha bars.
Med. prakt. Joscha von Rappard
Kantonsspital St.Gallen, St.Gallen, Schweiz
Conflict of interest statement
The authors of both contributions declare that no conflict of interest exists.
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|2.||Pepe G, Castelli M, Nazerian P, Vanni S, Panta MD, Gambassi F, Grifoni S: Delayed neuropsychological sequelae after carbon monoxide poisoning: predictive risk factors in the Emergency Department . A retrospective study. Scandinavian Scand J Trauma Resusc Emerg Med 2011; 19: 16 CrossRef MEDLINE PubMed Central|
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