Occupational Musculoskeletal and Respiratory Illness among Brick Kiln Industry Workers in Bangladesh

Brick kiln pollution and its impact on health: A systematic review and meta-analysis

Brick kiln emissions adversely affect air pollution and the health of workers and individuals living near the kilns; however, evidence of their impacts remains limited. We conducted a systematic review of brick kiln pollution (emissions, source contributions and personal exposures) and its effects on health. We extracted articles from electronic databases and through manual citation searching. We estimated pooled, sample-size-weighted means and standard deviations for personal exposures by job type; computed mean emission factors and pollutant concentrations by brick kiln design; and meta-analyzed differences in means or proportions for health outcomes between brick kiln workers and controls or for participants living near or far away from kilns. We identified 104 studies; 74 were conducted in South Asia. The most evaluated pollutants were particulate matter (PM; n = 48), sulfur dioxide (SO2; n = 24) and carbon monoxide (CO; n = 22), and the most evaluated health outcomes were respiratory health (n = 34) and musculoskeletal disorders (n = 9). PM and CO emissions were higher among traditional than improved brick kilns. Mean respirable silica exposures were only measured in 4 (4%) studies and were as high as 620 μg/m3, exceeding the NIOSH recommended exposure limit by a factor of over 12. Brick kiln workers had consistently worse lung function, more respiratory symptoms, more musculoskeletal complaints, and more inflammation when compared to unexposed participants across studies; however, most studies had a small sample size and did not fully describe methods used for sampling or data collection. On average, brick kiln workers had worse health outcomes when compared to unexposed controls but study quality supporting the evidence was low. Few studies reported silica concentrations or personal exposures, but the few that did suggest that exposures are high. Further research is needed to better understand the relationship between brick kiln pollution and health among workers, and to evaluate exposure mitigation strategies.

Assessment of obstructive and restrictive patterns of lung function among the workers of brick kilns

This article aims to measure the obstructive and restrictive patterns of lung function of 506 consented workers aged between 18 and 60 years and having at least 1 year of work experience in brick kilns. A questionnaire was completed by workers and also lung functions were measured using a spirometer. It was observed that 81% of workers had abnormal lung function, with 33% obstructive and 67% restrictive impairments. Further severe obstructive impairment was seen in 56% of workers, 41% having moderate obstructive impairment and only 3% with mild obstructive impairment. Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were significantly reduced (p < 0.05) for both restrictive and obstructive impairments while the FEV1/FVC ratio was non-significant for unhealthy workers with restrictive impairments as compared to obstructive impairments. The pulmonary abnormalities of workers were linked to increased occupational exposure to dust and smoke of brick kilns.