A shisha bar needs an efficient, technical ventilation system. Efficient means that in the guest area at least 130 cubic metres of air per hour and per burning hookah must be removed and replaced by fresh air. This was identified by the German Social Accident Insurance Institution for the foodstuffs and catering industry (BGN) in practice tests. Ventilation through open windows and doors is usually not sufficient.

Glowing coals from shihas produce carbon monoxide. The gas is odourless and highly toxic. Carbon monoxide poses a danger to the lives of staff and guests because the gas impairs or stops the transport of oxygen in the blood. The consequences are headaches, dizziness, sickness, respiratory paralysis as well as damage of unborn life. Without a sufficiently dimensioned ventilation system, there can be a danger to life in shisha bars.

Update May 2023:

In the course of the coming months, the limit value for carbon monoxide will be lowered from 30 ppm to 20 ppm due to European regulations. This will increase the required fresh air rate per hookah from 130 to 200 m³/h.

However, for cost reasons and also because of technical feasibility, it will make more sense to start at the source and make the smoking process itself low in carbon monoxide. For this purpose, three tested methods are described in the BGN's shisha flyer: One-Cube head, catalytic converter and electric heating head. Operators of shisha bars are strongly advised to convert their businesses to these new techniques already now.