Exposure to higher respiratory problem among jute, textile industry workers in eastern Nepal

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Excerpts from “descriptive cross-sectional  study” of 315 workers each from textile and jute industry of Eastern Nepal, “Respiratory Disorders among Dust Exposed Workers”, by Suman Bahadur Singh, Swotantra Gautam and Narendra Bhatta (BP Koirala Institute of Health Sciences, Dharan, Nepal), Gambhir Shrestha (Department of Cancer Prevention, Control and Research, BP Koirala Memorial Cancer Hospital, Bharatpur, Nepal), Rabin Gautam  (HERD International, Thapathali, Kathmandu, Nepal), and Sagar Poude (All India Institute of Medical Sciences, New-Delhi):

Exposure to high levels of dusts among industrial workers is common in developing and newly industrialized countries. Pulmonary response to hazardous airborne particles at workplaces produces airway disorders. Occupational exposures to airborne particulates is estimated to cause 12% of deaths due to chronic obstructive pulmonary disease and occupational health is of major concern in the South-East Asia Region.

Cough, expectoration, breathlessness, headache and nasal blockage were found to be the main complaints among workers in jute mill and was suspected in workers with more than six years employment in textile industry. Studies have revealed Peak Expiratory Rate (PEFR) significantly lower in high dust exposure group in comparison to less exposure group. Current occupational safety, health and working conditions in Nepal are indicative of potential risks of health hazards at workplaces in the industrial establishments.

Sample size was calculated by taking the lower prevalence of respiratory problems among workers in jute mill industry i.e. 16%. Adding 20% for non-responsive participants, the final sample size was 630 participants.  Equal number of participants was enrolled from the jute industry (315) and the textile industry (315).

Measurement of height and weight was done. The weight of the workers was taken in minimum clothing and without shoes. Peak expiratory flow rate (PEFR) was measured by a vitalograph Peak expiratory flow meter.

Higher proportions of workers were males in both the industries, 269 (85.4%) workers in jute industry and 301 (95.6%) workers in textile industry respectively. Majority of the workers were married, 261 (82.9%) workers in jute industry and 243 (77.1%) workers in textile industry. About 53 (16.8)% and 42 (13.3%) workers were illiterate in the jute and textile industry respectively.

Most of the workers had the working experience of less than five years in both the industries [134 (42.5%) vs. 180 (57.1%)]. There was no participant with working experience of more than 15 years in the jute industry where as about 36 (11.4%) workers had working experience of 15 to 20 years and 12 (3.8%) workers had working experience of more than 20 years in the textile industry.

Majority of workers were non-smokers in both the industries [230 (73%) vs. 223 (70.8%)]. Half of the workers in the industries had reported of chewing tobacco [152 (48.3%) vs. 145 (46%)]. Majority of the workers were not using personal protective equipment as mask to protect from dust at their workplaces in both the industries [261 (82.9%) vs. 238 (75.6%)].

The workers with their peak expiratory flow rate less or more than 80% of their predicted one. The proportion of workers having less than 80% of their predicted peak expiratory flow rate was far less in both the industries. About 26 (8.3%) and 23 (7.3%) workers produced the hardest blow to measure peak expiratory flow rate less than 80% of their predicted one in jute and textile industry respectively.

Cough was reported by more than one-fourth of workers in the jute industry while it was reported by less than one-tenth of workers in the textile industry. Upper respiratory disorder was prevalent among more than one fifth of workers in the jute industry while it was prevalent among around one twentieth of workers in the textile industry.

Increase in means of PEFR of workers was seen according to the increase in height, and weight. However, the means of PEFR also increased with age except in category 20-30 years.

Difficulty in breathing, representing lower respiratory tract symptoms was prevalent among 16 (5.1%) workers in the jute industry while it was prevalent among 6 (1.9%) workers in the textile industry. As much as 4 (1.3%) and 17 (5.4%) workers in the jute and textile industry reported chest tightness as lower respiratory tract problem respectively. Only one worker was diagnosed as chronic bronchitis in the jute industry. Two workers were diagnosed as chronic bronchitis in the textile industry.

Mean score of PEFR of workers in jute mill was lower than the workers of textile industry. Likewise, means of PEFR of workers was higher among males than females; PPE users than non-users at work place.

Difference in proportion of workers was found between jute and textile industry in terms of gender, marital status, literacy status, smoking status, alcohol intake, age category and body mass index category. Cough (27.3%), upper respiratory problem (21.6%), difficulty in breathing (5.1%), chest tightness (1.3%), chronic bronchitis (0.3%) were found in jute industry while cough (8.3%), upper respiratory problem (5.7%), difficulty in breathing (1.9%), chest tightness (5.4%), chronic bronchitis (1.6%), asthma (0.3%) and tuberculosis (0.3%) were found in textile industry.

Byssinosis (2.3%), chronic bronchitis (4.5%) and upper respiratory infections (7.2%) were found among cotton textile workers.15 Acute upper respiratory infection (14.2%), chronic bronchitis (0.3%), acute lower respiratory infections (0.77%), asthma (0.4%) were revealed among the workers.11 Textile mill workers in Bangladesh were shown to suffer from chronic bronchitis and/or asthma (5.7%) and chest tightness or breathlessness (4.3%).

Higher respiratory problem among workers (38%) was found in a jute mill. In another study conducted among 95 workers of a jute mill, chest pain (34.7%), cough with sputum (11.58%), dry cough (7.37%), nasal catarrh (3.16%), breathlessness (2.11%) were major respiratory symptoms. Less than 80% predicted PEFR was seen among 8.3% workers in jute industry and 7.3% workers in textile industry.

Use of personal protected equipment was found to be neglected in both the industry. Use of protective equipment was lower in jute industry than in textile industry. The workers in both the industry were at risk of respiratory problems because of the low practice of personal protective equipment as mask and the synergistic effect of smoking habit.

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