Occupational risk factors associated with respiratory symptoms among tannery workers in Mojo town, Southeast Ethiopia, 2018: a comparative cross-sectional study

Prevalence of occupational respiratory symptoms and associated factors among industry workers in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Occupational respiratory diseases are major global public health problems, particularly for industry workers. Several studies have investigated occupational respiratory symptoms in various parts of Ethiopia. The findings have been inconsistent and inconclusive, and there is no nationally representative data on the subject. Therefore, this study aimed to estimate the pooled prevalence and factors associated with occupational respiratory symptoms among industry workers in Ethiopia (2010-2022).

METHODS

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis framework Guidelines, search was conducted on several international databases including PubMed, CINAHL, African Journals Online, Hinari, Global Health, and Google scholar. The extracted data was analyzed using STATA 14. Random effect model was used to estimate the effect size. Egger regression test and I2 statistics were used to determine potential publication bias and heterogeneity, respectively among the reviewed articles.

RESULTS

The meta-analysis included a total of 15 studies with 5,135 participants, revealing a pooled prevalence of 51.6% (95% CI: 43.6-59.6) for occupational respiratory symptoms among industry workers in Ethiopia. The absence of personal protective equipment (OR = 1.97, 95% CI: [1.17-3.32]), lack of occupational health and safety training (OR = 3.04, 95% CI: [2.36-3.93]), previous dust exposure (OR = 3.17, 95% CI: [2.3-4.37]), poor working environment (OR = 2.4, 95% CI: [1.7-3.2]), work experience greater than five years (OR = 4.04, 95% CI: [1.61-10.16]), smoking (OR = 6.91, 95% CI: [2.94-16.2]), and previous respiratory illness (OR = 4.25, 95% CI: [2.44-7.42]) were found to associate with the symptoms.

CONCLUSIONS

The high prevalence of occupational respiratory symptoms among industry workers in Ethiopia underscores the urgent need for effective interventions. The provision of personal protective equipment and improvement of working environments by the government, industry owners, and other stakeholders are crucial in reducing occupational respiratory symptoms. Additionally, prioritizing occupational health and safety training for industry workers can help prevent and mitigate the impact of occupational respiratory diseases.

REGISTRATION

This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42022383745.

Occupational respiratory morbidity and associated factors among hairdressers in Ethiopia: a cross-sectional study

OBJECTIVE

This study was designed to determine the prevalence and factors associated with occupational respiratory morbidity among hairdressers in Northwestern Ethiopia.

DESIGN

A cross-sectional study was conducted from 6 July 2022 to 17 August 2022. The data were collected using a standardised American Thoracic Society questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was conducted to identify factors associated with occupational respiratory morbidity. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

SETTING

The study was conducted in Gondar city, Northwestern Ethiopia.

PARTICIPANTS

A total of 403 hairdressers participated in this study.

OUTCOME MEASURES

The primary outcome is the prevalence of occupational respiratory morbidity.

RESULTS

The total response rate was 95.5%. The majority, 250 (62%) of the respondents were women. The mean age (±SD) of the respondents was 27 (±6.0) years. The overall prevalence of occupational respiratory morbidity during the past 12 months was found to be 134 (33.3%) (95% CI (28.7% to 38.1%)). Female hairdressers (18.6%) showed greater respiratory morbidity than male hairdressers (14.7%). Working experience 3-5 years (AOR: 3.05; 95% CI (1.76 to 5.30)) and working experience >5 years (AOR: 6.22; 95% CI (2.73 to 14.16)), overweight (body mass index (BMI)) (AOR: 3.01; 95% CI (1.19 to 7.58)) and working near roadsides (AOR: 2.15; 95% CI (1.33 to 3.37)) were risk factors of occupational respiratory morbidity among hairdressers.

CONCLUSIONS

This study concluded that one-third of hairdressers experienced occupational respiratory morbidity. Longer work experience, higher BMI and working near roadsides were identified as significant risk factors for respiratory morbidity in hairdressers. Dietary calorie restrictions for overweight individuals and the development and implementation of air pollution mitigation measures targeted at roadside workers are advised to curb the problem.

Prevalence of Respiratory Symptoms and Risk Factors Among Street Sweepers in Gondar City Northwest, Ethiopia, 2021: A Cross-Sectional Study

BACKGROUND

Street sweepers are exposed to a variety of risk factors such as dust, bioaerosols, and volatile organic matter, which are responsible for the development of various respiratory symptoms and lung function impairments. However, there is a limited data on the prevalence of respiratory symptoms and associated factors among street sweepers in Ethiopia, especially in the study area.

OBJECTIVE

This study aimed to assess the prevalence of respiratory symptoms and associated factors among street sweepers in Gondar town, northwest Ethiopia, in 2021.

METHODS

Using simple random sampling technique, a total of 391 workers were selected between August 10 and September 15, 2021. The data was entered and analyzed using the Epi Info Version 7 and Statistical Package for Social Science (SPSS) 22 software, respectively. Descriptive statistics, bivariable, and multivariable logistic regression model were used. P ⩽ .05 and adjusted odds ratios (AOR) with 95% confidence interval (CI) were used to declare the statistical significance.

RESULT

A total of 391 respondents, with a response rate of 99.2% participated. The prevalence of respiratory symptoms among street sweepers was 35.3% (95% CI: 30.2, 40.5). History of respiratory illness (AOR = 7.75, (95% CI: 3.45, 17.45), washing personal protective equipments (PPE) after use (AOR = 4.77; 95% CI: 2.02, 11.28), previous work in cement (AOR = 3.10, 95% CI: 1.32, 7.34), and flour factories (AOR = 2.13, 95% CI: 2.02, 4.43), and alcohol drinking (AOR = 3.77, 95% CI: 1.94, 7.29) were associated with respiratory symptom among street sweepers.

CONCLUSION

The overall prevalence of respiratory symptoms among street sweepers was 35.3%. Previous respiratory illness, washing personal protective equipment after use, previous work in a cement and flour factory, and drinking alcohol were independently associated with respiratory symptoms. To reduce the respiratory symptoms among street sweeper, it is advisable implementing safe work practice measures and behavioral changes among workers.

Cr (III) genotoxicity and oxidative stress: An occupational health risk for leather tannery workers of South Asian developing countries

In the leather industry, Cr (III) is used as a basic tanning agent. The wastewater discharged from the tannery industry contains a high concentration of chromium. Recent studies indicate the genotoxic effects especially DNA damage and oxidative stress of Cr (III) in tannery workers. Cr (III) interacts with DNA to form DNA cross-links and DNA strand breaks. It also modifies the oxidative DNA base through the Haber–Weiss reaction. The present study is based on an overview of scientific literature and previous observations regarding the effects of tannery chromium effluents on exposed workers and the population in the vicinity. This study strongly suggests for use of a non-toxic substitute of chromium to be used for the tanning process and placement of tannery industries on the outskirts of the city. In South Asian developing countries like India, Pakistan and Bangladesh where the economy is strongly dependent on leather manufacturing industries, there is a need to spread proper information regarding the harmful effects of chromium toxicity to the workforce employed in the tannery and also to the people living in the surrounding area. Workers should be provided with the required safety protections like gloves, aprons, foot/shoe covers, masks, etc. Last but most important on an immediate basis is the installation of the proper efficient waste treatment plant, so that, waste should be treated before moving out of the industry.

Pulmonary Dysfunction Augmenting Bacterial Aerosols in Leather Tanneries of Punjab, Pakistan

BACKGROUND

Particulate matter-associated microbes in the workplace are a burning issue in occupational toxicology. Studies have reported on respiratory infections among tannery cohorts. This study uniquely presents measurements of airborne bacterial concentrations associated with varied particulate-matter sizes, their exposure, and consequent severity in occupational respiratory problems, all for different microenvironments within leather tanneries.

METHODS

Analyses included molecular identification of isolates, computation of mass median aerodynamic diameter of aerosols, tannery process-exposure dose (TPED) to bacterial aerosols, and spirometry and symptom assessment of impaired pulmonary function.

RESULTS

The highest bacterial concentrations were for rawhide treatment and finishing units, showing 3.6×103 and 3.7×103 CFU/m3, respectively. Identified bacterial species included Ochrobactrum pseudogrignonense, Neisseria bacilliformis, Enterobacter cloacae, Alcaligenes faecalis, Klebsiella pneumoniae, and Corynebacterium spp. Maximum and minimum values of mass median aerodynamic diameter were 8.3 µm and 0.65 µm for buffing and snuffing and production units, respectively. The highest TPED was 1,516.9 CFU/kg for finishing units. Respiratory symptoms in order of incidence were dyspnea > phlegm > cough > wheezing and tachypnea (equivalent). Bronchodilator measurements of FEV1, FVC, and PEF represent decline in lung function. Of 26 patients identified with COPD, most were working in rawhide treatment.

CONCLUSION

We conclude that exposure-infection synergy is also a cause of pulmonary ailments and COPD development, rather than the better-known exposure-smoking synergy.

Respiratory symptoms related to flour dust exposure are significantly high among small and medium scale flour mill workers in Ethiopia: a comparative cross-sectional survey

BACKGROUND

International Labour Organization (ILO) report indicates more than 2.4 million workers die from work-related diseases and accidents each year. Work-related respiratory ailments related to airborne particulate matter such as flour dust are responsible for about 386,000 deaths and 6.6 million illness-adjusted life years. Even though exposure to flour dust together with the extreme expansions of flour mill sectors is a priority health concern, extent of the problem is little investigated in Ethiopia. The aim of this study was to evaluate the magnitude and risk factors of work-related respiratory symptoms among flour mill workers in Bahir Dar City, Ethiopia.

METHODS

This study employed a comparative cross-sectional survey of 560 samples (280 exposed group from flour mill workers and 280 unexposed group from office workers) with a stratified random sampling technique. The study was conducted from March to April 2019 in Bahir Dar City, Northwest Ethiopia. We used the British Medical Research Council (BMRC) questionnaire to assess work-related respiratory symptoms. The questionnaire was pretested and interview administered to collect data. Binary logistic regression analysis was fitted to evaluate significant factors of respiratory symptoms at a < 0.05 p value. Adjusted odds ratio (AOR) with a confidence interval (CI) of 95% was calculated to determine a strength of association.

RESULTS

All the sampled participants had fully responded to the interview. The median age of exposed and unexposed groups was 28.5 interquartile range (IQR, 20) and 31 (IQR, 15) years, respectively. The prevalence of work-related respiratory symptoms among flour mill workers was substantially higher than that of among controls, 63.9% and 20.7%, respectively (Χ2 = 107.11; p < 0.0001). Chest illness among flour mill workers was higher, 43.6% (N = 122) compared to that of among control group, 7.9% (N = 22) followed by dyspnea, 33.6% (N = 94) versus 2.5% (N = 7) among flour mill workers and control group, respectively. Age > 35 years [AOR, 2.03; 95% CI (1.34, 5.48), having no education [AOR, 1.54; 95% CI (1.28, 3.06)], work set up with inadequate ventilation [AOR, 2.05; 95% CI (1.18, 3.56)], work experience > 5 years [AOR, 1.89; 95% CI (1.23, 4.67)] and having no training in safety [AOR, 2.45; 95% CI (1.45, 4.76)] significantly affected the experience of respiratory symptoms among flour mill workers whereas age [AOR, 1.79; 95% CI (1.06, 3.04)], monthly salary [AOR, 1.98; 95% CI (1.04, 3.78)] and exposure status [AOR, 5.18; 95% CI (3.34, 8.04)] were detected to be significant factors of respiratory symptoms in the exposed and the unexposed combined model.

CONCLUSION

Respiratory symptoms emanating from exposure to various flour dusts were significantly higher among flour mill workers than among the control group. Therefore, we recommend the need to effectively implement health and safety programs that account for the reduction of dust at a source, use of engineering controls (e.g., provision of adequate ventilation systems), use of administrative measures (e.g., training program and health surveillance) and provision of a suitable personal protective equipment (PPE). Furthermore, it is vital to integrate workplace health and safety programs to the wider public health policies and strategies to effectively mitigate the burden of work-related respiratory conditions. We also encourage future studies to evaluate concentration of flour dusts combined with physical examinations to establish plausible associations of respiratory symptoms with dusts of flour mill-related origin.

Duration of exposure and educational level as predictors of occupational respiratory symptoms among adults in Ethiopia: A systematic review and meta-analysis

Introduction:

Occupational respiratory symptoms are manifestations of respiratory diseases because of exposure to dust or chemicals such as asbestos, silicon and aluminium in the workplace like cement factory, tannery, textile and/or street sweeping, all of which affect the health condition and productivity. In Ethiopia, several primary studies were conducted regarding the magnitude of occupational respiratory symptoms with the prevalence of 68.89% in street sweepers and associated factors with inconsistent results. This meta-analysis aimed to pool the prevalence of respiratory symptoms and their associated factors among Ethiopian adults working in different workplaces.

Methods:

PubMed, African Journals Online, Google Scholar, Cochrane Library and Direct Google were systematically searched to identify primary studies. Two authors performed data abstraction and quality assessment for each included study independently. Cochran’s Q-statistic and I² (I-squared) statistic were used to check heterogeneity. DerSimonian and Laird random-effects models were used to estimate the pooled prevalence and associated factors of respiratory symptoms. Publication bias was checked by funnel plot and Egger’s test, and also sensitivity analyses were performed.

Results:

Ten primary studies with 3441 study participants were included for the narrative synthesis and meta-analysis of the pooled prevalence of occupational respiratory symptoms. The pooled prevalence of overall occupational respiratory symptom was 54.58% (95% CI: 45.37–63.79). Dry cough was the most encountered respiratory symptom [34.93, 95% CI: 29.52–40.35], followed by breathlessness [28.67%, 95% CI: 20.13–37.22]. Work experience of over 5 years [OR = 2.24, 95% CI: 1.21–4.16] and educational level of Grade 8 and lower [OR = 1.28, 95% CI: 1.06–1.55] were significantly associated with occupational respiratory symptoms.

Conclusion:

In this review, the pooled prevalence of occupational respiratory symptoms was high. The findings of this study dictate the need for the implementation of workplace safety measures. Special attention is required to employees with lower educational level and longer duration of work experience.

Prospero registration:

CRD42020176826

Factors Associated With Health Complaints Among Leather Tannery Workers in Bangladesh

Background: Few studies have reported associations between occupational exposure to tannery chemicals with breathing difficulty and skin diseases and none have been conducted in Bangladesh. The aim of this study was to investigate the associations of health complaints with types of work and length of employment among tannery workers in Bangladesh, where occupational health and safety regulations are less restricted compared with the developed world. Methods: One hundred sixty-seven (n = 167) workers from 10 tanneries were interviewed using a questionnaire adapted from the European Community Respiratory Health Survey (ECRHS) and the Tasmanian Longitudinal Health Study (TAHS) to collect information on occupational exposures and health outcomes. Workers' length of employment was examined, as well as their areas of work including beamhouse, wet finishing, dry finishing, and miscellaneous. Univariate and multivariate logistic regressions were performed to investigate potential associations while controlling for confounders. Results: Length of employment was positively associated with breathing difficulty (odds ratio [OR]: 1.32, 95% confidence interval [CI]:1.07-1.64). Workers involved in the wet finishing (OR: 11.75, 95% CI: 2.12-65.10) and dry finishing (OR: 13.38, 95% CI: 1.00-181.70) had higher odds of breathing difficulty; while, working in the beamhouse was associated with an increased risk of developing skin diseases (OR: 4.36, 95% CI: 1.10-17.32). Conclusion/Application to Practice: Length of employment and types of work were associated with increased risk of health complaints, including breathing difficulty and skin disease among tannery workers. Stronger regulations with regular enforcement, regular health surveillance, and worker and employer education are necessary for reducing these exposures and improving the health outcomes of the tannery workers.