Dust exposure and chronic respiratory symptoms among coffee curing workers in Kilimanjaro: a cross sectional study

Background: Coffee processing causes organic dust exposure which may lead to development of respiratory symptoms. Previous studies have mainly focused on workers involved in roasting coffee in importing countries. This study was carried out to determine total dust exposure and respiratory health of workers in Tanzanian primary coffee-processing factories. Methods: A cross sectional study was conducted among 79 workers in two coffee factories, and among 73 control workers in a beverage factory. Personal samples of total dust (n = 45 from the coffee factories and n = 19 from the control factory) were collected throughout the working shift from the breathing zone of the workers. A questionnaire with modified questions from the American Thoracic Society questionnaire was used to assess chronic respiratory symptoms. Differences between groups were tested by using independent t-tests and Chi square tests. Poisson Regression Model was used to estimate prevalence ratio, adjusting for age, smoking, presence of previous lung diseases and years worked in dusty factories. Results: All participants were male. The coffee workers had a mean age of 40 years and were older than the controls (31 years). Personal total dust exposure in the coffee factories were significantly higher than in the control factory (geometric mean (GM) 1.23 mg/m³, geometric standard deviation (GSD) (0.8) vs. 0.21(2.4) mg/m³). Coffee workers had significantly higher prevalence than controls for cough with sputum (23% vs. 10%; Prevalence ratio (PR); 2.5, 95% CI 1.0 - 5.9) and chest tightness (27% vs. 13%; PR; 2.4, 95% CI 1.1 - 5.2). The prevalence of morning cough, cough with and without sputum for 4 days or more in a week was also higher among coffee workers than among controls. However, these differences were not statistically significant. Conclusion: Workers exposed to coffee dust reported more respiratory symptoms than did the controls. This might relate to their exposure to coffee dust. Interventions for reduction of dust levels and provision of respiratory protective equipment are recommended.publishedVersio

Status of Occupational Health and Safety and Related Challenges in Expanding Economy of Tanzania.

Occupational health and safety is related with economic activities undertaken in the country. As the economic activities grow and expand, occupational injuries and diseases are more likely to increase among workers in different sectors of economy such as agriculture, mining, transport, and manufacture. This may result in high occupational health and safety services demand, which might be difficult to meet by developing countries that are prioritizing economic expansion without regard to their impact on occupational health and safety. To describe the status of occupational health and safety in Tanzania and outline the challenges in provision of occupational health services under the state of an expanding economy. Tanzania's economy is growing steadily, with growth being driven by communications, transport, financial intermediation, construction, mining, agriculture, and manufacturing. Along with this growth, hazards emanating from work in all sectors of the economy have increased and varied. The workers exposed to these hazards suffer from illness and injuries and yet they are not provided with adequate occupational health services. Services are scanty and limited to a few enterprises that can afford it. Existing laws and regulations are not comprehensive enough to cover the entire population. Implementation of legislation is weak and does not protect the workers. Most Tanzanians are not covered by the occupational health and safety law and do not access occupational health services. Thus an occupational health and safety services strategy, backed by legislations and provided with the necessary resources (competent experts, financial and technological resources), is a necessity in Tanzania. The existing legal provisions require major modifications to meet international requirements and standards. OHS regulations and legislations need refocusing, revision, and strengthening to cover all working population. Capacities should be improved through training and research to enable enforcement. Finally the facilities and resources should be made available for OHS services to match with the growing economy

Personal Exposure to Dust and Endotoxin in Robusta and Arabica Coffee Processing Factories in Tanzania

Introduction: Endotoxin exposure associated with organic dust exposure has been studied in several industries. Coffee cherries that are dried directly after harvest may differ in dust and endotoxin emissions to those that are peeled and washed before drying. The aim of this study was to measure personal total dust and endotoxin levels and to evaluate their determinants of exposure in coffee processing factories. Methods: Using Sidekick Casella pumps at a flow rate of 2l/min, total dust levels were measured in the workers’ breathing zone throughout the shift. Endotoxin was analyzed using the kinetic chromogenic Limulus amebocyte lysate assay. Separate linear mixed-effects models were used to evaluate exposure determinants for dust and endotoxin. Results: Total dust and endotoxin exposure were significantly higher in Robusta than in Arabica coffee factories (geometric mean 3.41 mg/m³ and 10 800 EU/m3 versus 2.10 mg/m³ and 1400 EU/m³, respectively). Dry pre-processed coffee and differences in work tasks explained 30% of the total variance for total dust and 71% of the variance for endotoxin exposure. High exposure in Robusta processing is associated with the dry pre-processing method used after harvest. Conclusions: Dust and endotoxin exposure is high, in particular when processing dry preprocessed coffee. Minimization of dust emissions and use of efficient dust exhaust systems are important to prevent the development of respiratory system impairment in workers

Variability of Exposure and Estimation of Cumulative Exposure in a Manually Operated Coal Mine

This study aims at estimating variability in exposure to respirable dust and assessing whether the a priori grouping by job team is appropriate for an exposure-response study on respiratory effects among workers in a manually operated coal mine in Tanzania. Furthermore, estimated exposure levels were used to calculate cumulative exposure. Full-shift personal respirable dust samples (n = 204) were collected from 141 randomly chosen workers at underground and surface work sites. The geometric mean exposure for respirable dust varied from 0.07 mg m À3 for office workers to 1.96 mg m À3 for the development team. The analogous range of respirable quartz exposure was 0.006-0.073 mg m À3 . Variance components were estimated using random effect models. For most job teams the within-worker variance component was considerably higher than the between-worker variance component. For respirable dust the estimated attenuation of the linear exposure-response relationship was low (5.9%) when grouping by job team. Grouping by job team was considered appropriate for studying the association between current dust exposure and respiratory effects. Based on the estimated worker-specific mean exposure in the job teams, the arithmetic mean cumulative exposure for the 299 workers who participated in the epidemiological part of the study was 38.1 mg · yr m À3 for respirable dust and 2.0 mg · yr m À3 for quartz

Dust exposure and respiratory health problems in a labour-intensive coal mine in Tanzania

Dust exposure and respiratory health problems were studied among randomly selected workers in a coal mine in Tanzania. The aim of the study was to assess the personal respirable dust and quartz exposure and the prevalence of respiratory problems and to present recommendations on how to improve the situation. An epidemiological cross-sectional study was carried out at the Kiwira Coal Mine in Tanzania. Dust exposure was measured during two periods in 2003 and 2004. In total, 204 dust samples were taken from 141 workers. The surveys involved 299 workers randomly selected from 8 job teams including development, mine, underground maintenance, underground transport, washing plant, boiler and turbine, ash and cinders and office workers. The study conducted a face-to-face standardized interview to collect information on demographic characteristics, work history, previous diseases, acute respiratory symptoms, chronic respiratory symptoms and smoking habits. Lung functioning was assessed using a Vitalograph Alpha III portable spirometer according to American Thoracic Society (1995) recommendations. Personal respirable dust was sampled using a SKC Sidekick pump with a flow rate of 2.2 l · min–1. Respirable dust samples were analysed for quartz by X-ray diffraction on a silver membrane filter using the US National Institute for Occupational Health and Safety method 7500. The individual cumulative exposure to respirable dust or quartz (mg · year · m–3) for each worker was estimated. Nitrogen dioxide (NO2), ammonia (NH3), carbon monoxide (CO) and sulphur dioxide (SO2) gas concentrations were assessed using electrochemical sensors (Dräger PAC III) and using Dräger detector tubes. The statistical methods used in analysing the data included Student’s t-test, analysis of variance, the chi-square test, multiple linear regression models, logistic regression modelling and one- and two-way random effects models. The workers in the development team had the highest exposure to respirable dust and quartz (geometric means 1.80 mg · m–3 and 0.073 mg · m–3, respectively). The percentages of samples exceeding the threshold limit values of 0.9 mg · m–3 for respirable (bituminous) coal dust and 0.05 mg · m–3 for respirable quartz, respectively, were higher in the development team (55% and 47%) than in the mining team (20% and 9%). Drilling in the development team was the work task associated with the highest exposure to respirable dust and quartz (17.37 mg · m–3 and 0.611 mg · m–3, respectively). The exposure models for the development section showed that blasting and pneumatic drilling time were the major determinants of respirable dust and quartz, explaining 45.2% and 40.7% of the variance, respectively. In the mining team, only blasting significantly determined respirable dust. For most a priori job teams, the within-worker variance component was considerably higher than the between-worker variance component. The high contrast in exposure between the teams together with the estimated low attenuation of the theoretical curve led to the conclusion that grouping by job team would be appropriate for studying the association between current dust exposure and respiratory effects. Based on the estimated worker-specific mean exposure in the job teams and the job history, the arithmetic mean cumulative exposure for workers who participated in the epidemiological part of the study was 38.1 mg · year · m–3 for respirable dust and 2.0 mg · year · m–3 for quartz. The prevalence of the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) being less than 0.7 among the workers was 17.3%. Workers in the development team (20.5%) had the highest prevalence of FEV1% <80%. The estimates of the effects of cumulative exposure on FEV1/FVC were 0.015% per (mg · year · m–3) for respirable dust and –0.3% per (mg · year · m–3) for respirable quartz. In logistic regression models, the odds ratios for airway limitation (FEV1/FVC <0.7) for the workers in the highest decile of cumulative dust and quartz exposure versus the referents were 4.36 (95% confidence interval (CI): 1.06, 17.96) for dust and 3.49 (95% CI 0.92, 13.21) for quartz. The upper 10% of workers grouped by cumulative dust and quartz exposure also had higher odds ratios (OR) for predicted FEV1% <80% than the reference group OR: 10.38 (95% CI 1.38, 78.13) for dust and 14.18 (95% CI 1.72, 116.59) for quartz. The workers from the development team had a higher self-reported prevalence of acute symptoms of breathlessness (OR = 2.96, 95% CI 1.44–6.11) and blocked nose (OR = 2.47, 95% CI 1.10–5.56) than the other production workers. In addition, development workers had more chronic symptoms of breathlessness (17.0%) than the other production workers (3.9%) (P = 0.001). The highest decile of exposure to respirable dust was associated with cough (OR = 2.91, 95% CI 1.06–7.97), as was the highest decile of exposure to respirable quartz (OR = 2.87 (95% CI 1.05, 7.88), compared with the reference. This study showed that workers in a coal mine are exposed to high levels of respirable dust and quartz, especially drillers and blasters. This study also showed that the development workers had more acute and chronic respiratory symptoms than other production workers. It also revealed an exposure–response relationship between respirable coal mine dust and quartz and airway limitation measured by spirometry. Immediate actions that could improve the situation include implementing effective dust control together with improved training and education programmes for the workers. Priority should be given to workers performing drilling and blasting in the development sections of the mine. Further needs include policies on exposure and health surveillance and appropriate enforcement mechanisms in Tanzania

Endotoxin, dust and exhaled nitrogen oxide among hand pickers of coffee; a cross-sectional study

Background Primary coffee processing takes place in countries where coffee is grown, and may include hand picking of coffee to remove low quality beans. Hand picking is mostly performed by women. No previous studies on dust and respiratory health have been performed in this occupational group, although studies indicate respiratory problems among other coffee production workers. Findings Our aim was to assess dust and endotoxin exposure among hand pickers in a coffee factory and compare the levels with limit values. In addition we wanted to examine the fraction of exhaled nitric oxide (FeNO) as a possible inflammatory marker in the airways among the hand pickers and evaluate the association between FeNO and years of hand picking. All hand pickers in a factory were examined during 1 week. The response was 100 %; 69 participated. FeNO was measured using an electrochemistry-based NIOX MINO device. Nine out of 69 workers (13 %) had levels of FeNO above 25 ppb, indicating presence of respiratory inflammation. A significant positive association was found between increasing FeNO and years of hand picking. Nine personal samples of total dust and endotoxin were taken. None of the dust samples exceeded the occupational limit value for total organic dust of 5 mg/m3. Three samples of endotoxin (33 %) were above the recommended value of 90 EU/m3. Conclusions Levels of endotoxin were higher than recommended standards among hand pickers, and there was a positive association between the level of exhaled nitrogen oxide and years of work with hand picking coffee

Esophageal and Head and Neck Cancer Patients Attending Ocean Road Cancer Institute in Tanzania from 2019 to 2021: An Observational Study

Background: Cancer in Africa is an emerging public health problem that needs urgent preventive measures, particularly in workplaces where exposure to carcinogens may occur. In Tanzania, the incidence rate of cancer and mortality rates due to cancers are increasing, with approximately 50,000 new cases each year. This is estimated to double by 2030. Methods: Our hospital-based cross-sectional study describes the characteristics of newly diagnosed patients with head and neck or esophageal cancer from the Ocean Road Cancer Institute (ORCI), Tanzania. We used an ORCI electronic system to extract secondary data for these patients. Results: According to the cancer registration, there were 611 head and neck and 975 esophageal cancers recorded in 2019–2021. Two-thirds of these cancer patients were male. About 25% of the cancer patients used tobacco and alcohol, and over 50% were involved in agriculture. Conclusion: Descriptions of 1586 head and neck cancer patients and esophageal cancer patients enrolled in a cancer hospital in Tanzania are given. The information may be important for designing future studies of these cancers and may be of value in the development of cancer prevention measures

Respiratory Inflammation Among Workers Exposed to Airborne Dust With Endotoxins in a Coffee Curing Factory.

OBJECTIVE: To study dust exposure and inflammatory reactions in the respiratory tract among coffee curing workers in Tanzania. METHODS: A cross-sectional study was conducted in a Tanzanian coffee curing factory. Coffee workers (n = 15) were compared with unexposed controls (n = 18); all workers were nonsmokers. Exhaled nitric oxide was examined using an electrochemistry-based NIOX MINO device. Personal air samples were analyzed for total dust and endotoxins, using gravimetric analysis and the chromogenic Limulus amebocyte lysate endpoint assay, respectively. RESULTS: Total dust levels ranged from 0.2 to 27.9 mg/m, and endotoxin levels ranged from 42 to 75,083 endotoxin units/m. Concentrations of exhaled nitric oxide, analyzed by linear regression and adjusted for age (β = 0.57; 95% confidence interval, 0.08 to 1.06; P = 0.02), was higher among coffee workers than among the control group. CONCLUSION: The results indicate a relationship between the coffee dust and signs of respiratory inflammation