High Prevalence of Respiratory Symptoms among Particleboard Workers in Ethiopia: A Cross-Sectional Study

Work in the wood industry might be associated with respiratory health problems. The production of particleboard used for furniture making and construction is increasing in many countries, and cause dust, endotoxin and formaldehyde exposure of the workers. The aim of the study was to assess the prevalence of respiratory symptoms and to measure lung function among Ethiopian particleboard workers using Eucalyptus trees as the raw material. In total 147 workers, 74 from particleboard production and 73 controls, participated in the study. Mean wood dust in the particleboard factories was measured to be above recommended limit values. Particleboard workers had a mean age of 28 years and the controls were 25 years. They had been working for 4 and 2 years, respectively. Lung function test was done using spirometry following American Thoracic Society (ATS) recommendations. Respiratory symptoms were collected using a standard questionnaire of ATS. Particleboard workers had higher prevalence of wheezing, cough, cough with sputum production, phlegm, and shortness of breath compared to controls. Lung function status was similar in the two groups. The symptoms might be related to the work in the factories. Longitudinal studies are recommended to explore the chronic impact of work in particleboard factories on respiratory health.publishedVersio

Poor provision of sanitary facilities in markets of lusaka district Zambia

Background: Although provision of sanitary facilities in workplaces is an important issue, very few studies have been undertaken in this regard. Objective: This study assessed the provision of sanitary facilities for market traders and their perceptions of the provided facilities in Lusaka district Zambia. Methods: A cross-sectional study of workplace observations in 12 randomly selected markets and interviews with 386 traders, conducted in Lusaka district. Findings: The study revealed that eleven of the twelve markets provided toilets, hand-washing and drying facilities, water, urinals, soap, and toilet paper. However, most of the markets did not comply with the Zambian laws in terms of the adequacy and privacy of facilities. One market did not have any of the listed facilities. Most traders perceived facilities to be unsatisfactory and used them only because of the lack of alternatives. Poor provision of sanitary facilities was observed at markets thus predisposing its workforce and trading population to multiple public health hazards. Conclusions: The findings of this study call for urgent investments in sanitary structures and surveillance systems to guarantee the safety of the population and to promote the health of market traders as well as the community at large.publishedVersio

Respiratory health among hand pickers in primary coffee processing factories of Ethiopia

Objective: The aim of this study was to assess chronic respiratory symptoms and lung function among female hand pickers. Methods: A total of 374 hand pickers exposed to coffee dust and 175 female controls from water bottling factories were included. The symptoms were assessed using a standardized questionnaire. Personal total dust exposure and lung function tests were performed. Results: Hand pickers experienced a higher dust exposure, displayed a higher prevalence ratio for cough [prevalence ratio (PR) = 3.0, 95% confidence interval (95% CI): 1.4 to 6.2] and work-related shortness of breath (PR = 2.5, 95% CI: 1.1 to 5.6), and had a lower FEF25–75 than controls. Hand pickers without tables had a significantly higher prevalence ratio of cough with sputum (PR = 3.9, 95% CI: 1.6 to 9.5) and lower forced vital capacity, forced expiratory volume in 1 second, and mean forced expiratory flow between 25% and 75% of the FVC than hand pickers with tables. Conclusion: Hand pickers show a range of adverse symptoms and lung function impairments that warrant efforts to improve working conditions.publishedVersio

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

Respiratory Health among Pesticide Sprayers at Flower Farms in Ethiopia

Background: Pesticide use in Ethiopia has become a common practice in which large-scale flower farms are the main consumers. Workers on flower farms might be exposed to pesticides while spraying or while performing other tasks related to pesticide use and management. It is unclear whether working as a flower farm sprayer is associated with respiratory health problems. Objective: The objective of this study was to compare respiratory symptoms and lung function indices between pesticide sprayers and non-spraying workers. Method: A cross-sectional study was conducted on 15 flower farms, involving all-male sprayers as the pesticide-exposed group and all other male workers as a control group. Data were collected using a standard questionnaire for respiratory symptoms developed by the British Medical Research Council and the American Thoracic Society. Lung function tests were performed to determine forced vital capacity (FVC), forced expiratory volume at one second (FEV1), mid 50 expiratory flow, and the ratio of FEV1 to FVC. Chi-squared tests and Poisson regression analyses were used to compare respiratory symptoms between the two working groups. General linear regression models were used to compare lung function test indices between spraying and non-spraying working groups. The significance level was set to 0.05. Results: A total of 285 male workers participated (152 sprayers and 133 non-spraying workers). The mean age of the workers was 25 years for sprayers and 24 years for non-sprayers. The proportions of cough, cough with sputum, breathlessness, and wheezing were similar in the two groups, while chest tightness was significantly high in the non-spraying group. Sprayers had significantly higher FVC and FEV1 than the non-spraying group. Conclusions: Respiratory symptoms were not different between the sprayers and non-spraying workers except that the non-spraying workers had increased chest tightness. FVC and FEV1 were significantly higher among sprayers relative to non-sprayers. The results must be interpreted with caution, as the sprayers used respiratory protective equipment, which probably reduced their exposure to the pesticides. Also, the workers were young, and a healthy worker effect might be present among the sprayers.publishedVersio

Registered health problems and demographic profile of integrated textile factory workers in Ethiopia: a cross-sectional study

Background Textile and garment factories are growing in low and middle-income countries as worldwide demand for inexpensive clothing increases each year. These integrated textile and garment production factories are often built-in areas with few workplaces and environmental regulations, and employees can be regularly exposed to workplace hazards with little regulatory oversight. Consequently, workers’ health may be significantly affected due to long term exposure to hazards. This study describes registered health problems and their association to work-related and personal factors among workers in integrated textile factories in Ethiopia. Methods Institution-based cross-sectional study design was employed for this analysis. A one-year recording of worker’s clinical diagnoses (between March 2016 and February 2017) was gathered from the factory clinics of three integrated textile factories. Clinical diagnosis data was obtained as factory workers visited the clinics if feeling unwell. Sociodemographic characteristics and work-related information were obtained from the factory’s human resource departments. The sociodemographic and clinical diagnosis statuses of 7992 workers were analyzed. The association between the registered diagnoses and workplace factors (work in textile production, garment production and support process) and personal factors (age, sex and educational status) were studied using logistic regression analysis. Results The average employee age and years of service were 40 years and 11 years respectively. 60% of workers were females, comprising of 4778 women. 66% of all workers (5276) had 27,320 clinical diagnoses. In total, this caused 16,993 absent working days due to sick leave. Respiratory diseases (34%) and musculoskeletal disorders (29%) were the most prevalent diagnoses, while bodily injuries were the cause of most work absences. Work department, sex and educational status are variables that were most significantly associated with higher prevalence of disease groups. Conclusions About two-thirds of the integrated textile factory workers were diagnosed with different types of disease. The textile and garment production department workers were affected at a greater rate than the support process workers, indicating that some diseases may be related to workplace exposure. Further study should investigate rare chronic diseases such as cancer, heart diseases, renal diseases and diabetes.publishedVersio

Evaluation of exposure biomarkers in offshore workers exposed to low benzene and toluene concentrations

Purpose: Characterize ethylbenzene and xylene air concentrations, and explore the biological exposure markers (urinary t,t-muconic acid (t,t-MA) and unmetabolized toluene) among petroleum workers offshore. Offshore workers have increased health risks due to simultaneous exposures to several hydrocarbons present in crude oil. We discuss the pooled benzene exposure results from our previous and current studies and possible co-exposure interactions. Methods: BTEX air concentrations were measured during three consecutive 12-h work shifts among 10 tank workers, 15 process operators, and 18 controls. Biological samples were collected pre-shift on the first day of study and post-shift on the third day of the study. Results: The geometric mean exposure over the three work shifts were 0.02ppm benzene, 0.05ppm toluene, 0.03ppm ethylbenzene, and 0.06ppm xylene. Benzene in air was significantly correlated with unmetabolized benzene in blood (r=0.69, p<0.001) and urine (r=0.64, p<0.001), but not with urinary t,t-MA (r=0.27, p=0.20). Toluene in air was highly correlated with the internal dose of toluene in both blood (r=0.70, p<0.001) and urine (r=0.73, p<0.001). Co-exposures were present; however, an interaction of metabolism was not likely at these low benzene and toluene exposures. Conclusion: Urinary benzene, but not t,t-MA, was a reliable biomarker for benzene at low exposure levels. Urinary toluene was a useful biomarker for toluene exposure. Xylene and ethylbenzene air levels were low. Dermal exposure assessment needs to be performed in future studies among these worker

Bacterial contamination of coffee and personal exposure to inhalable dust and endotoxin in primary coffee processing factories in Ethiopia

Introduction and objective: Endotoxins from gram-negative bacteria might be released when the coffee cherries are processed and may cause respiratory health problems among workers in the coffee industry. The relationship between bacterial contamination and occupational exposure to endotoxin levels has not been thoroughly explored previously in primary coffee processing factories in Ethiopia, or elsewhere. The aim of this study was to characterize the level of personal endotoxin exposure and its relations with bacterial contamination of coffee cherries in such factories in Ethiopia. Material and methods: A cross-sectional study was conducted from March 2020 – February 2021 in 9 primary coffee processing factories in 3 regions in Ethiopia. A total of 180 personal air samples were collected to analyze workers’ exposure to inhalable dust and endotoxin. Correlation tests were performed to assess the relationship between total bacteria and endotoxin levels and between inhalable dust and endotoxin levels. Results: The geometric mean (GM) of personal inhalable dust exposure among machine room workers and hand pickers were 9.58 mg/m3 and 2.56 mg/m3, respectively. The overall GM of endotoxin exposure among machine room workers and hand pickers were 10,198 EU/m3 and 780 EU/m3, respectively. Gram-negative bacteria were found in all 54 coffee samples. The correlation between inhalable dust and endotoxin exposure was significant (r=0.80; P <0.01). Conclusions: About 92% of the samples from hand pickers and all samples from machine room workers exceeded the occupational exposure limit of 90 EU/m3 recommended by the Dutch Expert Committee on Occupational Standards. Prevention and control of bacterial contamination of the coffee in primary coffee processing are suggested to reduce endotoxin exposure that might cause respiratory health problems among coffee workers.publishedVersio

Temporary Threshold Shifts among Iron and Steel Factory Workers in Tanzania: A Pre-Interventional Study

Background: Workers in iron and steel factories in Tanzania are exposed to noise levels above recommended limit values, without using hearing protection devices. Exposure to noise levels above 85 dB(A) is associated with temporary threshold shifts (TTS) of human hearing. Nevertheless, there are few studies of noise and hearing from African countries. Objective: To determine whether the normal hearing workers in Tanzania experiences TTS after full-shift occupational noise exposure of 85 dB(A) and above. Methods: A total of 55 workers were included. Full-shift personal noise measurements were conducted. Pre- and post-shifts pure-tone audiometry were conducted for each worker. TTS was defined as a 10 dB or greater change at 1000, 2000, 3000 or 4000 Hz in either ear. Results: We found that 85.5% of the workers developed TTS across the work shift. There was significant increase in mean hearing thresholds across shift at 1000, 2000, 3000 and 4000 Hz among the workers exposed to an average personal noise exposure (LAeq,8h) of 90.4 dB(A) (SD = 2.7). The difference in mean hearing thresholds was higher at 4000 Hz [Arithmetic Mean (AM) = 10 dB SD = 4 dB] compared to that of 1000 Hz (AM = 4 dB SD = 3 dB), 2000 Hz (AM = 4 dB SD = 4 dB), and 3000 Hz (AM = 9 dB SD = 6 dB), respectively. Conclusions: Interventions to reduce occupational personal noise exposure are warranted to reduce the high risk of developing a permanent threshold shift with persistent high noise exposure. An intervention study is planned for this group of workers.publishedVersio

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