This study aimed to evaluate the health effects of exposure to particulate matter (PM2.5 and PM10) and gaseous pollutants, including carbon dioxide (CO2), carbon monoxide (CO), nitrogen dioxide (NO2), and sulfur dioxide (SO2), on the hematological parameters of workers exposed to charcoal grilling emissions in restaurants. Air pollutant concentrations were measured in six barbecue restaurants located in Al-Rusafa District, Baghdad, during December 2024 and January 2025. Nine measurements were recorded monthly during morning and evening peak cooking periods. Blood samples were collected from two groups: grilling workers exposed directly to charcoal smoke (n = 30) and customers from dining areas as the control group (n = 30). Hematological analyses included white blood cells (WBC), red blood cells (RBC), hemoglobin (HGB), hematocrit (HCT), platelets (PLT), and other blood indices. Statistical analyses were performed using independent t-tests and stepwise multiple linear regression analysis. The results showed that pollutant concentrations were consistently higher in grilling areas than in dining areas, especially during evening hours, due to intensive cooking activity and insufficient ventilation. PM2.5 and PM10 concentrations frequently exceeded World Health Organization (WHO) permissible limits in grilling areas, while CO, NO2, and SO2 also reached elevated levels. Significant increases (p ≤ 0.05) were observed in WBC, RBC, HGB, HCT, mean corpuscular volume (MCV), and PLT among exposed workers compared with the control group. Stepwise regression analysis demonstrated that CO2 was positively associated with WBC, HGB, RBC, MCV, and PLT, whereas PM10 and PM2.5 showed negative associations with several hematological parameters after adjustment for co-pollutants. These findings suggest that chronic exposure to indoor air pollutants generated from charcoal grilling may induce systemic inflammation, oxidative stress, and physiological adaptation to hypoxic conditions among restaurant workers.
