EFFECT OF COTTON DUST EXPOSURE ON RESPIRATORY HEALTH OUTCOMES AMONG TEXTILE WORKERS
Keywords:Textile Industries, Byssinosis, Lung Function Tests, Cotton Fiber
AbstractBackground: Cotton dust is generated during various textile manufacturing processes. Only a few studies from Pakistan assessed cotton dust exposure and explored the relationship of duration of work in the textile industry with respiratory health outcomes. We aimed to assess cotton dust exposure and its association with lung function and respiratory symptoms among textile workers in Pakistan. Methods: We report findings from the baseline cross- sectional survey of the larger study, MultiTex, among 498 adult male textile workers from six mills conducted between Oct 2015-March 2016 in Karachi, Pakistan. Data collection included the use of standardized questionnaires; spirometry, and area dust measurements through UCB-PATS. Multivariable logistic and linear regression models were developed to assess the association of risk factors with respiratory symptoms and illnesses. Results: We found the mean age of workers to be 32.5 (±10) years; around 25% were illiterate. The prevalence of COPD, asthma, and byssinosis in our study was 10%, 17%, and 2%, respectively. The median cotton dust exposure was 0.33 mg/m3 (IQR;0.12-0.76). Increased duration of work among non-smokers was associated with a decline in lung function, FVC (-245 ml; 95% CI -385.71, -104.89) and FEV1 (-200 ml; 95 % CI -328.71, -84.11). Workers with certain job titles (machine operators, helpers, and jobbers), those with greater duration of work, and higher dust exposure, were more likely to report respiratory symptoms and illnesses. Conclusion: We report a high prevalence of asthma and COPD and a low prevalence of byssinosis. Cotton dust exposure and duration of employment were associated with respiratory health outcomes. Our findings highlight the need for preventive interventions in the textile industry in Pakistan.
United States Department of Labour, Occupational Safety and Health Administration. [Internet]. [cited 2021 Aug 22]. Available from: https://www.osha.gov/SLTC/cottondust
WHO. Hazard prevention and control in the work environment: airborne dust. Geneva: World Health Organization; 1999.
Department of Health and Human Services, NIOSH. National Institute of Occupational Safety and Health Pocket Guide to Chemical Hazards. 3rd ed. Columbia Parkway: NIOSH Publication, 2007; p.345–50.
Patel PH, Yarrarapu SNS, Anjum F. Byssinosis. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. [cited 2021 Aug 22] Available from: https://www.ncbi.nlm.nih.gov/books/NBK519549/
Memon I, Panhwar A, Rohra DK, Azam SI, Khan N. Prevalence of byssinosis in spinning and textile workers of Karachi, Pakistan. Arch Environ Occup Health 2008;63(3):137–42.
Khan M. "The Health Burden of Dust Pollution in the Textile Industry of Faisalabad, Pakistan,". South Asian Network for Development and Environmental Economics (SANDEE). [Internet]. Working Paper No. 123–17. Working Papers id:11920. [cited 2021 Aug 22]. Available from: http://www.sandeeonline.org/
Frederick S, Daly J, Center DG. Pakistan in the Apparel Global Value Chain Pakistan in the Apparel Global Value Chain 2019. [Internet]. Duke Global Value Chains Center, Duke University. [cited 2021 Aug 22]. Available from: https://documents1.worldbank.org/curated/es/933691570165490189/pdf/Pakistan-in-the-Apparel-Global-Value-Chain.pdf
International Labour Organization (ILO). Pakistani Textile Sector In International Arena. [Internet]. 2014, p.2–12. [cited 2021 Aug 21] Available from: https://www.ilo.org/wcmsp5/groups/public/---asia/---ro-bangkok/---ilo-islamabad/documents/publication/wcms_245786.pdf
Farooque MI, Khan B, Aziz E, Moosa M, Raheel M, Kumar S, et al. Byssinosis: as seen in cotton spinning mill workers of Karachi. J Pak Med Assoc 2008;58(2):95–8.
Nafees AA, Fatmi Z, Kadir MM, Sathiakumar N. Pattern and predictors for respiratory illnesses and symptoms and lung function among textile workers in Karachi, Pakistan. Occup Environ Med 2013;70(2):99–107.
Ali NA, Nafees AA, Fatmi Z, Azam SI. Dose-response of Cotton Dust Exposure with Lung Function among Textile Workers: MultiTex Study in Karachi, Pakistan. Int J Occup Environ Med 2018;9(3):120–9.
Comstock GW, Tockman MS, Helsing KJ, Hennesy KM. Standardized Respiratory Questionnaires Comparison of the Old with the New. Am J Respir Crit Care Med 1979;119(1):45–53.
Jamali T, Nafees AA. Validation of respiratory questionnaire for lung function assessment among an occupational group of textile workers in Pakistan. J Pak Med Assoc 2017;67(2):239–46.
Recommended health-based occupational exposure limits for selected vegetable dusts. World Health Organ Tech Rep Ser 1983;684:1–78.
Schilling RSF. Worldwide problems of byssinosis. Chest 1981;79(4 Suppl):S3–5.
Tageldin MA, Gomaa AA, Hegazy EAM. Respiratory symptoms and pulmonary function among cotton textile workers at Misr Company for Spinning and Weaving EL-Mahalla, Egypt. Egypt J Chest Dis Tuberc 2017;66(2):369–76.
Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2016. [Interenet]. [cited 2021 Sep 2]. Available from: http://www.ginasthma.org
Global initiative for chronic obstructive lung diseases (GOLD); 2020 guidelines. [Internet]. [cited 2021 Sep 21]. Available from: https://goldcopd.org
WHO/IASO/IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. [Internet]. Health Communications Australia; Melbourne: 2000. [cited 2021 Sep 21]. Available from: https://apps.who.int/iris/bitstream/handle/10665/206936/0957708211_eng.pdf
Tanzil S, Nafees AA. Low prevalence of asthma among textile workers in Karachi, Pakistan. J Pak Med Assoc 2015;65(8):869–74.
Razzaq S, Nafees AA, Rabbani U, Irfan M, Naeem S, Khan MA, et al. Epidemiology of asthma and associated factors in an urban Pakistani population: adult asthma study-Karachi. BMC Pulm Med 2018;18(1):184.
Jayawardana P, Abeysena C. Prevalence and correlates of asthma among selected garment factory workers at the Free Trade Zone, Ekala. J Coll Community Physicians Sri Lanka 2015;21(1):18–27.
Mishra A, Rotti S, Sahai A, Madanmohan, Narayan KA. Byssinosis among male textile workers in Pondicherry: A case-control study. Natl Med J India 2003;16(2):70–3.
Daba Wami S, Chercos DH, Dessie A, Gizaw Z, Getachew A, Hambisa T, et al. Cotton dust exposure and self-reported respiratory symptoms among textile factory workers in Northwest Ethiopia: a comparative cross-sectional study. J Occup Med Toxicol 2018;13(1):13.
Oo TW, Thandar M, Htun YM, Soe PP, Lwin TZ, Tun KM, et al. Assessment of respiratory dust exposure and lung functions among workers in textile mill (Thamine), Myanmar: a cross-sectional study. BMC Public Health 2021;21(1):673.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.