Health status of cement workers in the United Arab Emirates

Irritant-Induced Chronic Cough Triggers: A Scoping Review and Clinical Checklist

Purpose The primary aim of this review was to identify environmental irritants known to trigger chronic cough through the life span and develop a comprehensive clinically useful irritant checklist. Method A scoping review was conducted using the Preferred Reporting Items for Systematic Review and Meta-Analysis Extension for Scoping Reviews, checklist, and explanation. English-language, full-text resources were identified through Medline, PsycINFO, SPORTDiscus, Web of Science, and ProQuest Dissertations and Theses Global. Results A total of 1,072 sources were retrieved; of these, 109 were duplicates. Titles of abstracts of 963 articles were screened, with 295 selected for full-text review. Using the exclusion and inclusion criteria listed, 236 articles were considered eligible and 214 different triggers were identified. Triggers were identified from North America, Europe, Africa, Asia, and Australia. Occupational exposures were also delineated. Conclusions A clinically useful checklist of both frequently encountered triggers and idiosyncratic or rare triggers was developed. The clinical checklist provides a unique contribution to streamline and standardize clinical assessment of irritant-induced chronic cough. The international scope of this review extends the usefulness of the clinical checklist to clinicians on most continents.

Association Between Occupational Physicochemical Exposures and Headache/Eyestrain Symptoms Among Korean Indoor/Outdoor Construction Workers

Background

Headache/eyestrain symptoms are common health problems that people experience in daily life. Various studies have examined risk factors contributing to headache/eyestrains, and physicochemical exposure was found to be a leading risk factor in causing such symptoms. The purpose of this study was to examine the relationship of headache/eyestrain symptoms with physicochemical exposure among Korean construction workers depended on worksite.

Methods

This study used data from the 4th Korean Workers Conditions Survey and selected 1,945 Korean construction workers as participants. Multivariable logistic regression analysis was used to determine the relationship.

Results

Exposure to vibrations among all construction workers affected the moderate exposure group [odds ratio (OR) 1.53, 95% confidence interval (CI) 1.01–2.32], the high exposure group (OR 1.77 95%CI 1.17–2.67), and the indoor high exposure group (OR 1.61, 95%CI 1.02-2.55) and among outdoor construction workers, the moderate group (OR 6.61, 95%CI 15.4–28.48) and the high group (OR 6.61, 95%CI 1.56–27.98). When exposed to mist, dust, and fumes, the indoor high exposure group was significantly affected (OR 1.63, 95%CI 1.07–2.47). All construction workers exposed to organic solvents were affected, high exposure group (OR 1.69, 95%CI 1.15–2.49) and indoor high exposure group (OR 1.77, 95%CI 1.08–2.89). The high exposure group in all construction worker (OR 1.70, 95%CI 1.20–2.42) and the indoor high exposure group (OR 1.83, 95%CI 1.17–2.89) also were affected by secondhand smoking exposure.

Conclusion

Many physicochemical exposure factors affect headache/eyestrain symptoms among construction workers, especially indoor construction workers, suggesting a deficiency in occupational hygiene and health environments at indoor construction worksites.

Dust exposure and respiratory symptoms among cement factory workers in the United Arab Emirates

This study was conducted in a cement factory in the United Arab Emirates to assess cement dust exposure and its relationship to respiratory symptoms among workers. A total of 149 exposed and 78 unexposed workers participated in this cross-sectional study. Information on demographic and respiratory symptoms was collected by questionnaire. Personal total dust levels were determined by the gravimetric method. Concentration of the total dust ranged between 4.20 mg/m(3) in the crushers and 15.20 mg/m(3) in the packaging areas, and exceeded the exposure limit in the packaging and raw mill areas. The prevalence of respiratory symptoms was higher among the exposed workers, but the difference from that of unexposed workers was statistically significant only for cough (19.5%; OR=4.5; 95%CI=1.5-13.2), and phlegm (14.8%; OR=13.3; 95%CI=1.8-100.9). Cough and phlegm were found to be related to exposure to dust, cumulative dust and smoking habit, while chronic bronchitis was related to smoking habit. The few factory workers (19.5%) who used masks all the time had a lower prevalence rate of respiratory symptoms than those not using them. High dust level was the only variable that influenced the workers to use the mask all the time. It is recommended that control measures be adopted to reduce the dust and workers should be encouraged to use respiratory protection devices during their working time.

Effect of cement dust exposure on phagocytic function of polymorphonuclear neutrophils in cement mill workers

OBJECTIVES

Exposure to cement dust can cause various occupational health problems due to its increasing incidence and long-term complications. However, the influence of cement dust on phagocytic function of polymorphonuclear neutrophils (PMNs), has not as yet been investigated. Therefore, the aim of the study was to measure the phagocytic activity of PMNs by assessing chemilumiscence (CL) response in cement mill workers and controls.

MATERIAL AND METHODS

In this study, 50 volunteer males, aged 25-60 years, apparently healthy and nonsmoking, were randomly selected from among cement mill workers. These workers were further classified into subgroups based on exposure duration of less than 10, 10-20, and more than 20 years. The controls were 50 healthy, nonsmoking, males who matched the study group with respect to age, height, weight, and socioeconomic status. The phagocytic function of PMNs, stimulated with opsonized zymosan, was determined by measuring CL response.

RESULTS

The findings show a significant decrease in phagocytic activity of PMNs [PMNs OPZ p < 0.005] in cement mill workers compared to controls.

CONCLUSION

It is concluded that exposure to cement dust can impair the phagocytic function of PMNs which is reflected in decreased chemiluminescence response.

Dose response effect of cement dust on respiratory muscles competence in cement mill workers

Electromyography (EMG) of respiratory muscles is a reliable method of assessing the ventilatory muscle function, but still its use has not been fully utilized to determine the occupational and environmental hazards on respiratory muscles. Therefore, EMG of intercostal muscles was performed to determine the dose response effect of cement dust on respiratory muscles competence. Matched cross-sectional study of EMG in 50 non-smoking cement mill workers with an age range of 20 - 60 years, who worked without the benefit of cement dust control ventilation or respiratory protective devices. EMG was performed by using surface electrodes and chart recorder. Significant reduction was observed in number of peaks (p < 0.0005), maximum peak amplitude (p < 0.0005), peak-to-peak amplitude (p < 0.0005) and duration of response (p < 0.0005) in cement mill workers compared to their matched control. Cement dust impairs the intercostal muscle competence and stratification of results shows a dose-effect of years of exposure in cement mill.

Chronic cough due to occupational factors

Within the large variety of subtypes of chronic cough, either defined by their clinical or pathogenetic causes, occupational chronic cough may be regarded as one of the most preventable forms of the disease. Next to obstructive airway diseases such as asthma or chronic obstructive pulmonary disease, which are sometimes concomitant with chronic cough, this chronic airway disease gains importance in the field of occupational medicine since classic fiber-related occupational airway diseases will decrease in the future.

Apart from acute accidents and incidental exposures which may lead to an acute form of cough, there are numerous sources for the development of chronic cough within the workplace. Over the last years, a large number of studies has focused on occupational causes of respiratory diseases and it has emerged that chronic cough is one of the most prevalent work-related airway diseases. Best-known examples of occupations related to the development of cough are coal miners, hard-rock miners, tunnel workers, or concrete manufacturing workers.

As chronic cough is often based on a variety of non-occupational factors such as tobacco smoke, a distinct separation into either occupational or personally -evoked can be difficult. However, revealing the occupational contribution to chronic cough and to the symptom cough in general, which is the commonest cause for the consultation of a physician, can significantly lead to a reduction of the socioeconomic burden of the disease.

Acute respiratory health effects among cement factory workers in Tanzania: an evaluation of a simple health surveillance tool

OBJECTIVES

The effects of cement dust exposure on acute respiratory health were assessed among 51 high exposed and 33 low exposed male cement workers. The ability of the questionnaire to diagnose acute decrease in ventilatory function was also assessed.

METHODS

Acute respiratory symptoms were recorded by interview using a structured optimal symptom score questionnaire. Peak expiratory flow (PEF) was measured preshift and postshift for each worker with a Mini-Wright PEF meter. Personal respirable dust (n=30) and total dust (n=15) were measured with 37-mm Cyclone and 37-mm closed-faced Millipore cassette. Twenty-nine workers had concurrent respirable dust, PEF and questionnaire on the same day.

RESULTS

The geometric means of personal respirable dust and total dust among high exposed were 4.0 and 13.2 mg/m(3), respectively, and 0.7 and 1.0 mg/m(3) among low exposed. High exposed workers had more acute cough, shortness of breath and stuffy nose than the low exposed. Mean percentage cross-shift decrease in PEF was significantly more pronounced among high exposed workers than low exposed (95% CI 1.1, 6.1%). For workers with concurrent respirable dust, PEF and questionnaire assessment, an exposure-response relationship was found between log-transformed respirable dust and percentage cross-shift decrease in PEF (4.5% per unit of log-respirable dust in mg/m(3) ; 95% CI 3.3, 5.6%). Respirable dust exposure >/=2.0 mg/m(3) versus <2.0 mg/m(3) was associated with increased prevalence ratio for cough (7.9) and shortness of breath (4.2). Shortness of breath was associated with the highest sensitivity (0.87) and specificity (0.83) for diagnosing a percentage cross-shift decrease in PEF of >/=10%.

CONCLUSION

The observed acute respiratory health effects among the workers are most likely due to exposure to high concentrations of irritant cement dust. The results also highlight the usefulness of the questionnaire for health surveillance of the acute respiratory health effect.

Respiratory symptoms and ventilatory function in workers exposed to portland cement dust

The healthy worker effect and incomplete exposure information have been problems in former studies regarding the association between exposure to Portland cement dust and respiratory effects. We included former workers and made an individual estimation of particle exposure to reduce the selection bias in this controlled cross-sectional study on the effects of cement dust exposure on respiratory symptoms and ventilatory function in long-term exposed Norwegian cement plant workers. A total of 119 workers from the largest cement plant in Norway and 50 workers from a nearby control plant, born 1918 to 1938, performed spirometry and gave information on respiratory symptoms in 1998 and 1999. The prevalence of symptoms and mean pulmonary function indices were similar for exposed workers and controls. There was no dose-response-related increase in symptoms or decrease in lung function indices. The estimated power to detect a true difference between forced expiratory volume in one second (FEV1) in the two groups of 0.3l was 0.90, assuming 95% significance level. The prevalence of chronic obstructive pulmonary disease was 14.3% in the exposed group and 14.0% among the controls. These findings do not support the hypothesis that cement dust exposure has a negative impact on lung function or gives an increase in respiratory symptoms.