Respiratory symptoms and illnesses among brick kiln workers: a cross sectional study from rural districts of Pakistan

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.

Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal

OBJECTIVES

Brick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE and identify factors associated with respiratory PPE use.

METHODS

We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use.

RESULTS

We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users.

CONCLUSIONS

Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.

Comparative analysis of enriched flyash based cement-sand compressed bricks under various curing regimes

This study investigates the substitution of traditional burnt clay bricks (BCB), used since 7000 BCE, with environmentally friendly Fly Ash-Cement and Sand Composite Bricks (FCBs), utilizing industrial waste like Coal Fly Ash (CFA) from thermal power plants. The research encompasses two phases: the first involves experimental production of FCBs, while the second focuses on optimizing FCBs by varying CFA (50%, 60%, 70%), Ordinary Portland Cement (OPC) content (9%-21%), and incorporating stone dust (SD) and fine sand. Comprehensive tests under normal and steam curing conditions, adhering to ASTM C 67-05 standards, include X-Ray Diffraction (XRD), Energy Dispersive X-Ray (EDX), and Scanning Electron Microscopy (SEM) analyses. Results indicate that steam curing enhances early strength, with an optimized mix (MD: 5S) achieving a compressive strength of 15.57 MPa, flexural strength of 0.67 MPa, water absorption rate of 20.08%, and initial rate of water absorption of 4.64 g/min per 30 in2, devoid of efflorescence. Notably, a 9% OPC and 50% CFA mix (MD: 1S) shows improved early strength of 4.95 MPa at 28 days. However, excessive CFA replacement (70%) with lesser cement content negatively impacts physio-mechanical properties. This research underscores the potential of FCBs as a sustainable and economically viable alternative to BCBs in the construction industry.

Respirable dust and crystalline silica concentrations among workers at a brick kiln in Bhaktapur, Nepal

Exposure to respirable dust and crystalline silica (SiO2) has been linked to chronic obstructive pulmonary disease, silicosis, cancer, heart disease, and other respiratory diseases. Relatively few studies have measured respirable dust and SiO2 concentrations among workers at brick kilns in low- and middle-income countries. The purpose of this study was to measure personal breathing zone (PBZ) respirable dust and SiO2 concentrations among workers at one brick kiln in Bhaktapur, Nepal. A cross-sectional study was conducted among 49 workers in five job categories: administration, fire master, green (unfired) brick hand molder, green brick machine molder, and top loader. PBZ air samples were collected from each worker following Methods 0600 (respirable dust) and 7500 (respirable crystalline SiO2: cristobalite, quartz, tridymite) of the U.S. National Institute for Occupational Safety and Health. Eight-hour time-weighted average (TWA) respirable dust and quartz concentrations were also calculated. SiO2 percentage was measured in one bulk sample each of wet clay, the release agent used by green brick hand molders, and top coat soil at the brick kiln. The geometric mean (GM) sample and TWA respirable dust concentrations were 0.20 (95% confidence interval [CI]: 0.16, 0.27) and 0.12 (95% CI: 0.09, 0.16) mg/m3, respectively. GM sample and TWA quartz concentrations were 15.28 (95% CI: 11.11, 21.02) and 8.60 (95% CI: 5.99, 12.34) µg/m3, respectively. Job category was significantly associated with GM sample and TWA respirable dust and quartz concentrations (all p < 0.0001). Top loaders had the highest GM sample and TWA respirable dust concentrations of 1.49 and 0.99 mg/m3, respectively. Top loaders also had the highest GM sample and TWA quartz concentrations of 173.08 and 114.39 µg/m3, respectively. Quartz percentages in bulk samples were 16%-27%. Interventions including using wet methods to reduce dust generation, administrative controls, personal protective equipment, and education and training should be implemented to reduce brick kiln worker exposures to respirable dust and SiO2.

Assessment of inflammatory cytokines in exhaled breath condensate and exposure to mixtures of organic pollutants in brick workers

Brick production causes a lot of pollution in the form of dust, fumes, and toxic substances. Therefore, brick workers are highly exposed to pollutants and present a high risk of developing respiratory diseases. The objective of this research was to determine the exposure to polycyclic aromatic hydrocarbons (PAHs) and toluene in urine and evaluate the effects on health using markers of oxidative stress in exhaled breath condensate (EBC) as well as the exposure to pollutants in suspended particles of the studied area. Exposure to PAHs and toluene was evaluated using hydroxylated markers (OH) of PAHs and hippuric acid in urine, respectively. Cytokines like TNF-α, INF-y, IL-2, IL-4, IL-6, IL-8, IL-10 y GMCSF in EBC were also evaluated. PM_2.5 particles were measured during an 8-h work shift. The results in brick workers presented a total OH-PAHs concentration of 97.3 µg/L and hippuric acid concentration of 0.2 g/L. The environmental concentrations of suspended particles were found within a range of 41.67-3541.6 μg/m³. The median of cytokines oscillated between 11.8 pg/mL to 1041 pg/mL. In conclusion, these results are similar to those of occupations in which there is high exposure to pollutants and populations with lung diseases. For that reason, the brick production sector requires prevention and control strategies against the pollutants emitted.

Studying the Association Between Occupational Stress and Urinary Levels of Oxidative Stress Biomarkers (8-OHdG and Biopyrrins) in Brickfield Workers

OBJECTIVES

The aims of the study are to measure the prevalence and level of occupational stress (OS) and to explore its association with oxidative stress among some brickfield workers.

METHODS

Eighty-six brickfield workers and 90 administrative controls were assessed using the Arabic validated version of the Occupational Stress Index. The urinary levels of oxidative biomarkers; 8-hydroxy-2'-deoxyguanosine and biopyrrins were also measured.

RESULTS

The prevalence of moderate and severe OS in addition to the urinary levels of both oxidative biomarkers was significantly higher among the brickfield workers compared with their controls. Both biomarkers levels were significantly and positively correlated with scores of Occupational Stress Index, duration of employment, and with each other. The receiver operating characteristic analysis showed significant specificity and sensitivity of both biomarkers for determining the level of OS.

CONCLUSIONS

A significant association between occupational and oxidative stresses was detected in brickfield workers.

Assessment and mapping of total suspended particulate and soil quality around brick kilns and occupational health issues among brick kilns workers in Pakistan

Brick kilns constitute one of the major sources of environmental degradation in Pakistan. The present study was conducted to determine the soil quality and total suspended particulates (TSPs) around the brick kilns and assess the health effects on brick kiln workers. Four brick kilns were selected, two each at Sheikhupura and Pattoki city. The soil quality was assessed by analyzing pH, electrical conductivity, moisture content, nitrogen, phosphorus, potassium content, and heavy metal concentration while TSPs were measured by hand-held Microdust Pro Real time monitor. Average TSP concentration around brick kilns at Sheikhupura and Pattoki ranged between 1100 and 1200 µg/m³ and between 550 and 600 µg/m³ respectively which exceeded the Punjab Ambient Air Standards. The soil was slightly acidic (Sheikhupura: average pH = 6.41; Pattoki: average pH = 6.6) while all other analyzed parameters, except heavy metals, were lower than the required FAO Standards for good quality agriculture soil. Heavy metal accumulation in soil samples followed the general order zinc (Zn) > chromium (Cr) > nickel (Ni) > manganese (Mn) > cadmium (Cd) > copper (Cu). For assessment of occupational health and safety issues, all 440 brick kiln workers from the study areas were interviewed. Mostly, brick kiln workers suffered from chronic back pain (84%), skin issues (80.5%), dry cough (72.9%), common cold (46.1%), and shortness of breath (17.1%). The vulnerability risk varied with the nature of the work as workers engaged in brick baking were more vulnerable to respiratory issues than were those in molding task. The study concludes that brick kilns are a source of increased TSP, deteriorated surrounding soil quality, and impaired worker health. It is necessary to regulate these activities and implement requisite health and safety measures.

Otorhinolaryngologic Evaluation of Brick Kiln Workers: ENT Findings of Brick Kiln Workers

Brick kiln workers were evaluated in the field using otorhinolaryngologic and head and neck surgery (ENT) assessments. One-hundred and twenty laborers were assessed. The subjects were divided into three categories according to the work area: before the brick kiln, in the brick kiln, and after the brick kiln. Two evaluations were made, a questionnaire and an ENT examination. If structural changes were observed during the examination, the complication was deemed structural. Seventeen laborers who completed the questionnaire did not participate in the examination. A total of 103 laborers participated in the study: 29 before the brick kiln, 63 in the brick kiln, and 11 after the brick kiln. While general otologic complications were observed in 26 (25.2%) laborers, structural otologic complications were observed in 2 (1.9%). While general nasal complications were observed in 70 (68.0%) laborers, structural nasal complications were observed in 27 (26.2%). Although the general otologic and structural nasal complication rates were higher in the brick kiln group, the general, structural otologic, and nasal complication rates did not reach statistical significance among groups (p > 0.05). Both the general and structural nasal complication rates were significantly higher in laborers who had worked for more than 10 years and did not wear a mask (p < 0.01). We detected prominent nasal pathologies in brick kiln workers in our ENT-based study. These pathologies were much more common in laborers who had worked for over 10 years and did not wear a mask.

Biochemical and reproductive biomarker analysis to study the consequences of heavy metal burden on health profile of male brick kiln workers

The present study aims to assess the effect of a heavy metal burden on general health, biochemical parameters, an antioxidant enzyme, and reproductive hormone parameters in adult male brick kiln workers from Pakistan. The study participants (n = 546) provided demographic data including general health as well as body mass index. Blood was collected to quantitatively assess hematological, biochemical, and reproductive hormone parameters as well as heavy metal concentrations using both atomic absorption spectroscopy (AAS) and particle-induced X-ray emission (PIXE). The data showed that 10% of the brick kiln workers were underweight and 10% obese (P = 0.059), with workers also reporting multiple health issues. Heavy metal concentrations utilizing AAS revealed significantly (p = 0.000) higher levels of cadmium, chromium, and nickel, while PIXE detected more than permissible levels of Si, P, S, Cl, K, Ca, Zn, Ti (p = 0.052), Mn (p = 0.017), Fe (p = 0.055), Co (p = 0.011), Ni (p = 0.045), and Cu (p = 0.003), in the blood of kiln workers. Moreover, a significant increase in platelet count (P = 0.010), a decrease in sodium dismutase levels (p = 0.006), a major increase in reactive oxygen species (p = 0.001), and a reduction in protein content (p = 0.013) were evident. A significant increase in cortisol levels (p = 0.000) among the workers group was also observed. The concentration of LH and FSH increased significantly (p = 0.000), while that of testosterone decreased (p = 0.000) in the worker group compared with controls. A significant inverse relationship was found between cortisol, LH (r =  - 0.380), and FSH (r =  - 0.946), while a positive correlation between cortisol and testosterone was also evident (r = 0.164). The study concludes that increased heavy metal burden in the blood of brick kiln workers exposes them to the development of general and reproductive health problems due to compromised antioxidant enzyme levels, increased oxidative stress conditions, and a disturbing reproductive axis.

Evaluation of respiratory function and biomarkers of exposure to mixtures of pollutants in brick-kilns workers from a marginalized urban area in Mexico

Brick-kilns are polluted environments due to the use of low-quality technologies and fuels, which generates black fumes with a large number of pollutants. The objective of this research was to analyze environmental exposure and biomarkers of exposure to polycyclic aromatic hydrocarbons, metals, and respiratory health in brickmakers to assess the baseline state of contamination in a brick-kiln area of San Luis Potosi, Mexico. Lead was quantified in soil and particulate matter of 2.5 μm (PM_2.5) and 10 μm (PM₁₀) in brick-kiln areas. In brickmakers, lead was evaluated in whole blood and 10 hydroxylated metabolites of polycyclic aromatic hydrocarbons were determined in urine. Respiratory health was assessed by spirometry, exhaled breath condensate, and a COPD-PS questionnaire. Data association was performed by Spearman correlation. Environmental concentrations and biomarkers of exposure are presented as medians, for lead, it was 60.4 mg/kg, for PM10, it was 2663.1 μg/m³, and for PM2.5, it was 166.6 μg/m³. For blood lead, it was 1.06 μg/dL, and the summed concentration of OH-PAHs in urine was 16.1 μg/L. Spirometry values were 2.8 ± 0.6 L and 2.9 ± 1.3 L/s FEV1 and FEV 25-75 respectively. The correlation results indicate that the older the age of the workers is and the extensive period they have been working, their lung function is affected the most. The health vulnerability present in these occupational activities is high, so it is necessary to make visible, address these economic activities in Mexico, and apply surveillance systems based on the health of the worker.

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.

Impact of Air Pollution Generated by Brick Kilns on the Pulmonary Health of Workers

BACKGROUND

Brick kiln workers are often not aware of the health effects of their working environment and health-related respiratory problems. There have been few studies on the relationship between brick kiln pollution and its health impact on brick kiln workers.

OBJECTIVES

The present study measured the association of brick kiln contamination with severe respiratory problems and lung function among brick kiln workers in the Kasur district, Pakistan.

METHODS

Air quality variables (PM_2.5, PM₁₀, sulfur dioxide (SO₂), nitrogen dioxide (NO₂) and volatile organic compounds (VOCs)) were monitored during operations in brick kiln modulation and kiln areas. Workers (n=60) were selected for participation if they were between the ages of 18 and 60 and had been working in brick kilns for at least one year and gave consent to participate. Their lung function was measured.

RESULTS

The average concentrations of measured air quality variables for all working sites were found to exceed the World Health Organization (WHO) and National Ambient Air Quality Standard (NAAQS) guidelines. These high values of brick kiln pollutants were associated with a significant decrease in spirometric values (forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), and average flow between 25% and 75% of the FVC (FEF2575)) among workers and revealed that 78.33% of workers had abnormal lung function with 5% obstructive and 95% restrictive impairments. Occurrences of pulmonary problems like frequent cough (50%), chronic cough (11.67%), frequent phlegm (21.67%), chronic phlegm (11.67%), frequent wheezing (20%), chronic wheezing (15%), shortness of breath grade-I & grade-II (38.33%) and self-reported asthma (3.33%) were also found among the workers.

CONCLUSIONS

Pollution from brick kiln operations was significantly high and associated with respiratory problems as well as a decrease in lung function. There was a clear correlation between pulmonary function in workers with brick kiln contamination.

PARTICIPANT CONSENT

Obtained.

ETHICS APPROVAL

This study was approved by the Bioethics Committee of the Department of Zoology, University of the Punjab, Lahore, Pakistan (Ref.1443-UZ).

COMPETING INTERESTS

The authors declare no competing financial interests.

Emerging challenges of air pollution and particulate matter in China, India, and Pakistan and mitigating solutions

This study examines point and non-point sources of air pollution and particulate matter and their associated socioeconomic and health impacts in South Asian countries, primarily India, China, and Pakistan. The legislative frameworks, policy gaps, and targeted solutions are also scrutinized. The major cities in these countries have surpassed the permissible limits defined by WHO for sulfur dioxide, carbon monoxide, particulate matter, and nitrogen dioxide. As a result, they are facing widespread health problems, disabilities, and causalities at extreme events. Populations in these countries are comparatively more prone to air pollution effects because they spend more time in the open air, increasing their likelihood of exposure to air pollutants. The elevated level of air pollutants and their long-term exposure increases the susceptibility to several chronic/acute diseases, i.e., obstructive pulmonary diseases, acute respiratory distress, chronic bronchitis, and emphysema. More in-depth spatial-temporal air pollution monitoring studies in China, India, and Pakistan are recommended. The study findings suggest that policymakers at the local, national, and regional levels should devise targeted policies by considering all the relevant parameters, including the country's economic status, local meteorological conditions, industrial interests, public lifestyle, and national literacy rate. This approach will also help design and implement more efficient policies which are less likely to fail when brought into practice.

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.

Study of occupational exposure to brick kiln emissions on heavy metal burden, biochemical profile, cortisol level and reproductive health risks among female workers at Rawat, Pakistan

The present study was planned to understand the heavy metal burden and its possible actions in blood of occupational females working at brick kilns at Rawat, Pakistan. A total of 232 women were included in the study, of which 114 presented control subjects. Apart from collection of demographic data, fertility indicators and body mass index (BMI), blood was collected from subjects that was later used for the determination of heavy metal concentrations using atomic absorption spectroscopy and haematological profile. Blood was centrifuged and plasma was obtained and stored at - 20° to study biochemical variables (sodium dismutase, peroxidase, reactive oxygen species, thiobarbituric acid reactive species, protein estimation), lipid profile and cortisol concentrations among the two groups. Analysis of heavy metal in blood showed elevated levels of cadmium (3.09 ± 0.01 μg/dl), chromium (4.20 ± 0.02 μg/dl) and nickel (5.59 ± 0.03 μg/dl) in worker's group as compared with control. Increased platelet count; decreased antioxidant enzyme and increased oxidants level; increased total cholesterol, low-density lipoprotein (LDL) and triglyceride (TG); decreased total protein and high-density lipoprotein (HDL); and increased cortisol levels were evident among workers as compared with the control group. The study concluded that occupational workers experience increased heavy metals burden in blood and, therefore, pose a risk to human health by causing reduction in antioxidant enzymes concentration and increase in stress conditions.

Air Quality in the Working Environment and Respiratory Health of Female Congolese Stone Quarry Workers

Background and Aim. Environmental and occupational exposure to high dust levels are known to be associated with lung function impairment. We assessed the ambient air quality in the working environment and the respiratory health of female stone quarry workers in Lubumbashi, Democratic Republic of Congo (DRC) in a context of severe economic, security, and health crises. Methods. This was a case-control study conducted in three stone quarry sites. Participants were 256 dust-exposed female stone quarry workers matched to 256 unexposed female office workers and market tax collectors (N = 512). They each answered a structured respiratory health questionnaire and underwent physical examination and a lung function test with the use of a spirometer and peak flow meter. Quality of ambient air in the working environment was assessed by means of a BRAMC air quality monitor (BR-AIR-329). Results. Results showed that exposed women did not use any personal protective equipment (PPE); in quarry sites, abnormally high levels of PM_2.5 (205 ± 13.2 μg/m³ vs. 31.3 ± 10.3 μg/m³ in control sites; p < 0.001) and volatile organic compounds (VOC, 2.2 ± 0.2 μg/m³ vs. 0.5 ± 0.3 μg/m³, respectively; p < 0.01) were found. Furthermore, respiratory complaints were more common among exposed women (32.4% vs. 3.5% in controls; p < 0.01), who had abnormal chest auscultation and reduced lung capacity than controls (mean PEFR: 344.8 ± 2.26 and 405 ± 67.7 L/s, respectively; p < 0.001 Conclusion. Findings from this study show that in the midst of severe crises in the DRC, women stone quarry workers are exposed to abnormally high levels of respiratory hazards, which contribute to impaired lung function. There is a need to regulate quarry work and improve the working conditions in quarry sites in the DRC.

Chronic Cough Due to Stable Chronic Bronchitis: CHEST Expert Panel Report

BACKGROUND

Chronic cough due to chronic bronchitis (CB) causes significant impairment in quality of life, and effective treatment strategies are needed. We conducted a systematic review on the management of chronic cough due to CB to update the recommendations and suggestions of the American College of Chest Physicians (CHEST) 2006 guideline on this topic.

METHODS

This systematic review asked three questions: (1) What are the clinical features of the history that suggest a patient's cough-phlegm syndrome is due to CB? (2) Can treatment of stable CB improve or eliminate chronic cough? (3) Can therapy that targets chronic cough due to CB prevent or reduce the occurrence of acute CB exacerbations? Studies of adult patients with CB were included and assessed for relevance and quality. Based on the systematic review, guideline suggestions were developed and voted on by using the CHEST organization methodology.

RESULTS

The search strategy used an assortment of descriptors and assessments to identify studies of chronic cough due to CB.

CONCLUSIONS

The evidence supporting the management of chronic cough due to CB is limited overall and of low quality. This article provides guidance on treatment by presenting suggestions based on the best currently available evidence and identifies gaps in our knowledge and areas for future research.

Mapping Time-Space Brickfield Development Dynamics in Peri-Urban Area of Dhaka, Bangladesh

Due to the high demand for cheap construction materials, clay-made brick manufacturing has become a thriving industry in Bangladesh, with manufacturing kilns heavily concentrated in the peripheries of larger cities and towns. These manufacturing sites, known as brickfields, operate using centuries-old technologies which expel dust, ash, black smoke and other pollutants into the atmosphere. This in turn impacts the air quality of cities and their surroundings and may also have broader impacts on health, the environment, and potentially contribute to global climate change. Using remotely sensed Landsat imagery, this study identifies brickfield locations and areal expansion between 1990 and 2015 in Dhaka, and employs spatial statistics methods including quadrat analysis and Ripley’s K-function to analyze the spatial variation of brickfield locations. Finally, using nearest neighbor distance as density functions, the distance between brickfield locations and six major geographical features (i.e., urban, rural settlement, wetland, river, highway, and local road) were estimated to investigate the threat posed by the presence of such polluting brickfields nearby urban, infrastructures and other natural areas. Results show significant expansion of brickfields both in number and clusters between 1990 and 2015 with brickfields increasing in number from 247 to 917 (total growth rate 271%) across the Dhaka urban center. The results also reveal that brickfield locations are spatially clustered: 78% of brickfields are located on major riverbanks and 40% of the total are located in ecologically sensitive wetlands surrounding Dhaka. Additionally, the average distance from the brick manufacturing plant to the nearest urban area decreased from 1500 m to 500 m over the study period. This research highlights the increasing threats to the environment, human health, and the sustainability of the megacity Dhaka from brickfield expansion in the immediate peripheral areas of its urban center. Findings and methods presented in this study can facilitate data-driven decision making by government officials and city planners to formulate strategies for improved brick production technologies and decreased environmental impacts for this urban region in Bangladesh.

Gender differences in prevalence of musculoskeletal disorders and physiological stress among the brick field workers of West Bengal, India

BACKGROUND

The manual brick field industry is one of the most important and oldest industries in India, where millions of male and female workers make their livelihood.

OBJECTIVE

To estimate the different ergonomic risk factors associated with brick making, identify potential gender differences and the prevalence of Work-related musculoskeletal disorders (WMSDs), physiological and psychological stress among the brickfield workers.

METHODS

Brickfield workers - 152 male and 148 female were randomly selected from the 12 brickfields. The Modified Nordic Questionnaire was applied to assess the discomfort reported among both groups of brickfield workers. Objective measurement of physiological parameters and lung function values were also recorded.

RESULTS

From this study, it was revealed that there is significantly higher discomfort reported in hands, lower back and knees among female brick molders than male brick molders. The physiological parameters did not show any significant change between male brickfield workers and female brickfield workers. The mean values of FVC, FEV1 and PEFR for females were lower than those for male brickfield workers.

CONCLUSION

This study concludes that female brickfield workers reported more discomfort than male brickfield workers; perhaps in part due to their additional domestic work responsibilities.

Impact of brick kilns industry on environment and human health in Pakistan

The increase in population has led to the rise in the construction and manufacturing of bricks. Bricks are manufactured in brick kilns that emit very harmful gases which in turn affect the human health, environment and economy. In Pakistan, the diseases related to skin, and respiratory system have created a lot of problems for the humans and animals. According to experts and professionals, one of the main causes of the environment and health related problems is brick kiln. It is very important to identify the brick kilns and emissions that are extremely harmful for the environment and human health. Therefore, the objective of this research paper is threefold. Firstly, to identify and rank the emissions from brick kilns based on their harmful impact on human health and environment. Secondly, to rank the three types of brick kilns i.e. Traditional Brick Kilns (TBK) with coal as a fuel, Traditional Brick Kilns (TBK) with rubber as a fuel and Contemporary Brick Kilns (CBK) (technologically advanced brick kilns) based on their impact on human health and environment. Thirdly, to identify the relation of three alternative brick kilns with health and environmental problems, respectively. DEMATEL and Fuzzy-TOPSIS have used for achieving the objectives. The results show that CO₂, CO and SO₂ have the most harmful effects on the environment. Similarly, carcinogenic dioxin, SO₂ and PM have the adverse effects on the human health. TBK in which rubber is used as a fuel is the most harmful and CBK is the safest types of brick kilns, respectively. In the light of the results, it is recommended to the government of Pakistan to formulate and implement the rules and regulations for minimizing the negative impacts of brick kilns on human health and environment. Moreover, new technologies should be used in order to reduce the harmful impacts.

Exposure to bioaerosols at open dumpsites: A case study of bioaerosols exposure from activities at Olusosun open dumpsite, Lagos Nigeria

Activities associated with the open dumping of municipal solid waste has the potential for greater impact on the environment and public health compared to other forms of waste-to-land treatment of such wastes. However, there is a lack of quantitative data on the exposure to bioaerosols from open dumpsites, hence impeding the development of effective interventions that would reduce the risk of respiratory symptoms among scavengers and waste workers at such dumpsites. This study investigated exposure to bioaerosols at Olusosun open dumpsite, Lagos Nigeria using three methodologies; (1) Conducting a cross-sectional survey on the respiratory health of the population on the dumpsite, (2) Measuring bioaerosol concentrations in the ambient air by measuring four bioaerosols indicator groups (total bacteria, gram-negative bacteria, Aspergillus fumigatus and total fungi) using a Anderson six stage impactor sampler, (3) Measuring activity related exposures to bioaerosols using an SKC button personal sampler. After a cross sectional health survey of 149 participants (waste workers, scavengers, middlemen, food vendors and business owners), smokers reported higher symptoms of chronic cough (21%) and chronic phlegm (15%) compared to non-smokers (chronic cough 15%, chronic phlegm 13%). Years of work > 5 years showed no statistically significant association with chronic phlegm (OR 1.2, 95% CI 0.4-3.4; p > 0.05) or asthma (OR 1.8, 95% CI 0.6-5.2; p > 0.05). At the 95th percentile, the concentration of total bacteria was the highest (2189 CFU/m³), then gram negative bacteria (2188 CFU/m³), total fungi (843 CFU/m³) and Aspergillus fumigatus (441 CFU/m³) after ambient air sampling. A comparison of the data showed that the activity-based sampling (undertaken using body worn personal sampler) had higher bioaerosols concentrations (10⁴ -10⁶ CFU/m³), i.e. 2-3 logs higher than those recorded from static ambient air sampling. Bioaerosol exposure was highest during scavenging activities compared to waste sorting and site supervision. Particle size distributions showed that 41%, 46%, 76% and 63% of total bacteria, gram-negative bacteria, Aspergillus fumigatus and total fungi respectively were of respirable sizes and would therefore be capable of penetrating deep into the respiratory system, posing a greater human health risk. This study has shown that exposure to bioaerosols can be associated with activities undertaken at open dumpsites and may contribute to the high prevalence of the chronic respiratory symptoms among the workers in such environments.

A Comparative Study of Stack Emissions from Straight-Line and Zigzag Brick Kilns in Nepal

Nepal has approximately 1000 operational brick kilns, which contribute significantly to ambient air pollution. They also account for 1.81% of the total bricks produced in the South Asian region. Little is known about their emissions, which are consequently not represented in regional/global emission inventories. This study compared emissions from seven brick kilns. Four were Fixed Chimney Bull’s Trench Kilns (FCBTKs) and three were Induced-Draught Zigzag Kilns (IDZKs). The concentrations of carbon dioxide (CO2), sulfur dioxide (SO2), black carbon (BC), and particulate matter (PM) with a diameter less than 2.5 µm (PM2.5) were measured. The respective emission factors (EFs) were estimated using the carbon mass balance method. The average fuel-based EF for CO2, SO2, PM2.5, and BC were estimated as 1633 ± 134, 22 ± 22, 3.8 ± 2.6 and 0.6 ± 0.2 g per kg, respectively, for all FCBTKs. Those for IDZKs were 1981 ± 232, 24 ± 22, 3.1 ± 1, and 0.4 ± 0.2 g per kg, respectively. Overall, the study found that converting the technology from straight-line kilns to zigzag kilns can reduce PM2.5 emissions by ~20% and BC emissions by ~30%, based on emission factor estimates of per kilogram of fuel. While considering per kilogram of fired brick, emission reductions were approximately 40% for PM2.5 and 55% for BC, but this definitely depends on proper stacking and firing procedures.

A cross-sectional analysis of respiratory ill-health among charcoal workers and its implications for strengthening occupational health services in southern Nigeria

OBJECTIVES

This study was conducted to assess the concentration of air pollutants at charcoal sites, the dose-response relationship between site-based exposure levels to air pollutants and prevalence of respiratory symptoms among charcoal workers, and the measures these workers employ to safeguard their health.

DESIGN

Cross-sectional but comparative design SETTING: Charcoal production kiln sites in Sapele, Delta State, Nigeria.

PARTICIPANTS

Overall 296 charcoal workers and age-matched, sex-matched and height-matched non-exposed traders (comparison group).

PRIMARY AND SECONDARY OUTCOME MEASURES

The primary outcome measure was the prevalence of respiratory symptoms among charcoal workers while secondary outcomes included lung function indices as well as hazard control practices among charcoal workers.

RESULTS

Majority (83.3%) of the sites had PM10 and PM2.5 values five times higher than the WHO standard. Charcoal workers were more likely to have respiratory symptoms; wheeze was statistically significant after adjusting for confounders, (OR 4.22; CI 1.37 to 12.99). The dose-response relationship between site-based exposure levels to air pollutants and the prevalence of respiratory symptoms among charcoal workers was statistically significant for all symptoms except chest tightness (p=0.167). Mean forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) were considerably lower among workers with differences of -0.22 (-0.42 to -0.05) L and -0.52 (-0.76 to -0.29) L, respectively, whereas FEV1/FVC ratio and peak expiratory flow rate were higher among workers with mean differences of 5.68 (3.59-8.82)% and 0.31 (-23.70 to 24.43) L/min, respectively; but the mean difference was significant only for the FEV1/FVC ratio. Charcoal workers had poor hazard control practices; only 3.4% reportedly used personal protective equipment.

CONCLUSION

Air pollutants at kiln sites were higher than WHO standards. Despite the significantly higher prevalence of wheeze, chest tightness and chronic cough among charcoal workers, their hazard control practices were inadequate. Charcoal workers should adopt appropriate hazard control practices, and use improved devices which emit minimal pollutants.

Prevalence and Predictors of Respiratory Diseases Among Coal-Based Sponge Iron Plant Workers: A Cross-Sectional Study in Barjora, India

BACKGROUND

During the last decade, coal-based sponge iron plants, a highly polluted industry, have grown rapidly in Barjora, India. The toxic effects of particulate matters and gaseous pollutants are often rapid and include respiratory diseases (such as asthma and rhinoconjunctivitis).

OBJECTIVES AND METHODS

A cross-sectional study was conducted among 258 coal-based sponge iron plant workers in Barjora to assess the prevalence of respiratory diseases (self-reported) and to determine the associated factors.

FINDINGS

The percentage of participants with any chronic respiratory disease, asthma and rhinoconjuctivitis were 25.5%, 8.9%, and 17.1%, respectively. The odds of any chronic respiratory disease were lower in participants with family history of any chronic respiratory disease (odds ratio [OR] 0.47, 95% confidence interval [CI] 0.24-0.91, P = 0.024). The odds of asthma were lower in participants living in a room with less than 3 people (OR 2.86, 95% CI 1.16-7.07, P = 0.023) and with family history (OR 0.20, 95% CI 0.08-0.53, P = 0.001). The odds of rhinoconjuctivitis were lower in illiterate participants (OR 0.34, 95% CI 0.12-0.94, P = 0.038) and those with pucca/semipucca house type (OR 2.44, 95% CI 1.11-5.39, P = 0.027).

CONCLUSION

Many coal-based sponge iron plant workers in Barjora report the presence of respiratory diseases, and the predictors such as overcrowding and poor quality housing were identified.

Health hazards and risks for musculoskeletal problems among child labourers in the brickfield sector of West Bengal, India

Aims

The purpose of this study was to describe the health hazards among child labourers in brickfields, and to assess occupational health problems, together with physiological and respiratory stress, compared with child control subjects.

Methods

A cross-sectional study was conducted on 112 child brickfield workers and 120 control subjects, and a modified Nordic Questionnaire was applied to assess the discomfort felt among both groups of workers. Physiological assessment of the workload was carried out by the measurement of heart rate, blood pressure and spirometry of the workers.

Results

Child brickfield workers suffer from pain, especially in the lower back (97%), shoulder (88%), hands (82%), wrist (76%), neck (73%) and ankle (71%). The post-activity heart rate of the child brickfield workers was 166.5 beats/min, whereas the systolic and diastolic blood pressures were 132.2 and 67.2 mm/Hg, respectively. The forced vital capacity value of child brickfield workers was 2.04, and in the case of the controls it was 2.18, which was significantly different. The forced expiratory volumes in 1 s of experimental and control subjects were 1.82 and 1.92, respectively. The peak expiratory flow rate was significantly different between the two groups.

Conclusions

Most of the brick-making activities were strenuous ones that affected the children. The cardiovascular and respiratory health of the child brickfield workers has changed markedly due to strenuous activity. The child brickfield workers also experienced other occupational health problems and severe musculoskeletal pain.

Respiratory Abnormalities among Occupationally Exposed, Non-Smoking Brick Kiln Workers from Punjab, India

BACKGROUND

Brick manufacturing industry is one of the oldest and fast-growing industries in India that employs a large section of people. Brick kiln workers are occupationally exposed to air pollutants. Nonetheless, only a few studies have so far been conducted on their respiratory health.

OBJECTIVE

To investigate the extent of respiratory impairment in brick kiln workers and to correlate it with the duration of exposure.

METHODS

A cross-sectional study was conducted. Spirometric parameters of 110 non-smoking male brick kiln workers aged 18-35 years in Patiala district, Punjab, India, were compared with an age-matched comparison group of 90 unexposed individuals.

RESULTS

Brick kiln workers showed a significant (p<0.05) decline in forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), forced mid-expiratory flow rate (FEF_25-75%) and peak expiratory flow rate (PEFR) compared with those of the comparison group. The extent of deterioration in lung function of brick kiln workers was associated with the duration of exposure. In workers with >8 years of exposure, the mean values of FEV₁ (1.92 L), FVC (2.01 L), FEF_25-75% (2.19 L/s) and PEFR (4.81 L/s) were significantly (p<0.05) lower than those recorded in workers with <8 years of exposure in whom the values were 2.01 L, 2.68 L, 2.71 L/s, and 5.76 L/s, respectively.

CONCLUSION

There is a significant association between exposure to workplace pollutants and lung function deterioration among brick kiln workers.

Occupational Tasks Influencing Lung Function and Respiratory Symptoms Among Charcoal-Production Workers: A Time-Series Study

Background

Tasks involved in traditional charcoal production expose workers to various levels of charcoal dust and wood smoke. This study aimed to identify specific tasks influencing lung function and respiratory symptoms.

Methods

Interviews, direct observation, and task/symptom checklists were used to collect data from 50 charcoal-production workers on 3 nonwork days followed by 11 workdays. The peak expiratory flow rate (PEFR) was measured four times per day.

Results

The PEFR was reduced and the prevalence of respiratory symptoms increased over the first 6–7 workdays. The PEFR increased until evening on nonwork days but not on workdays. Loading the kiln and collecting charcoal from within the kiln markedly reduced the PEFR and increased the odds of respiratory symptoms.

Conclusion

Tasks involving entry into the kiln were strongly associated with a short-term drop in the PEFR and the occurrence of respiratory symptoms, suggesting a need for the use of protective equipment and/or the operation of an effective kiln ventilation system.

Respiratory symptoms and illnesses related to the concentration of airborne particulate matter among brick kiln workers in Kathmandu valley, Nepal

BACKGROUND

Bricks have been manufactured in Nepal for hundreds of years and are seen as a component of Nepalese sculpture and architecture. Large quantities of hazardous materials including high concentrations of particulate matter are emitted on a daily basis from brick kilns. Exposure to these hazardous materials can lead to adverse consequences on the environment and human health. This study was conducted to  estimate the prevalence of respiratory symptoms/illnesses and the magnitude of respirable and total dust exposures among Nepalese brick kiln workers.

METHODS

Respiratory symptoms/illnesses were evaluated by questionnaire among brickfield workers (n = 400) and a referent group of grocery workers (n = 400) in Kathmandu valley. Work zones (WZs): green brick molding (GBM), green brick stacking/carrying (GBS/C), red brick loading/carrying (RBL/C), coal preparation (CP) and firemen (FM) were the similar exposure groups (SEGs) from where personal air samples and interviews were taken. Among brickfield workers, personal monitoring was conducted across SEGs for total (n = 89) and respirable (n = 72) dust during February-March 2015 and March-April 2016. Applying multi-stage probability proportionate to size sampling technique, 16 kilns and 400 brick workers for interview were selected. Proportions, means, medians and ranges were calculated for the demographics, samples and respiratory symptoms/illnesses. One-way ANOVA was applied to compare the significance differences of the level of particulate matter among SEGs. Bivariate and multivariate logistic regression analysis were performed to evaluate association between respiratory symptoms/illnesses and participants groups, and SEGs among brick kiln workers at 0.05 level. Statistical analyses were performed using IBM SPSS Statistics 21.

RESULTS

Chronic cough (14.3%), phlegm (16.6%) and bronchitis (19.0%) were higher (P < 0.05) among brickfield compared with grocery workers (6.8, 5.8 and 10.8%). Mean respirable (5.888 mg/m3) and total (20.657 mg/m3) dust exposures were highest for red brick loading tasks. The prevalence of chronic cough, chronic phlegm, chronic bronchitis, wheezing and asthma were significantly higher for other WZs workers (p < 0.05) compared with CP; for GBM: 22.9, 34.6, 15.0 and 7.5%; for GBS/C: 13.5, 15.8, 10.0, 8.8 and 7.5%; for RBL/C: 11.1, 17.1, 27.4, 19.0 and 11.9%; for FM: 18.4, 12.5, 28.4, 4.9 and 0.0%; and for CP: 4.9, 6.3, 13.3, 9.3 and 4.0% respectively.

CONCLUSION

High dust exposures identified in this study may explain the increased prevalence of respiratory symptoms/illnesses among Nepalese brickfield workers, warranting action to reduce exposures.

Occupational and Environmental Contributions to Chronic Cough in Adults: Chest Expert Panel Report

BACKGROUND

In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected.

METHODS

MEDLINE and TOXLINE literature searches were supplemented by articles identified by the cough panel occupational and environmental subgroup members, to identify occupational and environmental aspects of chronic cough not previously covered in the 2006 ACCP Cough Guideline. Based on the literature reviews and the Delphi methodology, the cough panel occupational and environmental subgroup developed guideline suggestions that were approved after review and voting by the full cough panel.

RESULTS

The literature review identified relevant articles regarding: mechanisms; allergic environmental causes; chronic cough and the recreational and involuntary inhalation of tobacco and marijuana smoke; nonallergic environmental triggers; laryngeal syndromes; and occupational diseases and exposures. Consensus-based statements were developed for the approach to diagnosis due to a lack of strong evidence from published literature.

CONCLUSIONS

Despite increased understanding of cough related to occupational and environmental triggers, there remains a gap between the recommended assessment of occupational and environmental causes of cough and the reported systematic assessment of these factors. There is a need for further documentation of occupational and environmental causes of cough in the future.

Assessment of respiratory symptoms and lung function values among the brick field workers of West Bengal, India

Brick manufacturing process releases large amounts of silica dust into the work environment due to the use of silica-containing materials. The main aim of the study was to investigate the impairment of lung function and prevalence of respiratory symptoms among the different groups of brick field workers in comparison with control subjects. A total of 250 brick field workers and 130 unexposed control subjects were randomly selected in which demographic characteristics, respiratory symptoms, and lung function values were recorded. The result showed significantly lower p value (<.001) in lung function and respiratory symptoms among brick field workers when compared with control group. The prevalence of respiratory symptoms was dyspnea (46.8%), phlegm (39.2%), and chest tightness (27.6%). Dust exposure in working environment affected the lung function values and increased the respiratory symptoms among the brick field workers.

Pollutional haze and COPD: etiology, epidemiology, pathogenesis, pathology, biological markers and therapy

In recent years, serious pollutional haze occurs in the mainland of China thanks to the development of urbanization and industrialization. There is a close relationship between air pollution and the occurrence and development of chronic obstructive pulmonary disease (COPD), but there are some new characteristics in some aspects of COPD associated with pollutional haze compared with COPD induced by traditional physical and chemical factors. This article attempts to summarize the new progress from these new features of COPD related to pollutional haze, focus on etiology, epidemiology, pathogenesis, pathology, biological markers and therapy.

Cement Dust Exposure and Perturbations in Some Elements and Lung and Liver Functions of Cement Factory Workers

Background. Cement dust inhalation is associated with deleterious health effects. The impact of cement dust exposure on the peak expiratory flow rate (PEFR), liver function, and some serum elements in workers and residents near cement factory were assessed. Methods. Two hundred and ten subjects (50 workers, 60 residents, and 100 controls) aged 18–60 years were studied. PEFR, liver function {aspartate and alanine transaminases (AST and ALT) and total and conjugated bilirubin (TB and CB)}, and serum elements {lead (Pb), copper (Cu), manganese (Mn), iron (Fe), cadmium (Cd), selenium (Se), chromium (Cr), zinc (Zn), and arsenic (As)} were determined using peak flow meter, colorimetry, and atomic absorption spectrometry, respectively. Data were analysed using ANOVA and correlation at p = 0.05. Results. The ALT, TB, CB, Pb, As, Cd, Cr, Se, Mn, and Cu were significantly higher and PEFR, Fe, and Zn lower in workers and residents compared to controls (p < 0.05). Higher levels of ALT, AST, and Fe and lower levels of Pb, Cd, Cr, Se, Mn, and Cu were seen in cement workers compared to residents (p < 0.05). Negative correlation was observed between duration of exposure and PEFR (r = −0.416, p = 0.016) in cement workers. Conclusions. Cement dust inhalation may be associated with alterations in serum elements levels and lung and liver functions while long term exposure lowers peak expiratory flow rate.

Chronic cough: an Asian perspective. Part 1: Epidemiology

Asia is one of the most diverse and dynamic continents. Due to recent rapid industrialisation and urbanisation, morbidity patterns are likely to be diverse in Asian populations. Chronic cough is a disease condition resulting from host-environmental interactions, and is associated with a high global epidemiological burden. However, the underlying epidemiology remains unclear, particularly in Asia. We performed a literature search to identify peer-reviewed articles on chronic cough in community-based adult Asian populations that have been published between January 2000 and June 2015. In this review, we aim to examine the epidemiological characteristics and determinants of chronic cough in several geographical areas of Asia.

Prevalence of chest symptoms amongst brick kiln migrant workers and care seeking behaviour: a study from South India

BACKGROUND

Early detection and treatment of tuberculosis (TB) have been key principles of TB control. However, this can be a challenge with 'hard to reach' populations such as migrants. Brick kiln workers are one such group of migrants who are exposed to smoke, heat and dust from brick kilns which are one of the major causes of respiratory illnesses.

METHODOLOGY

A cross-sectional community based study was carried out in Thiruvallur, Tamil Nadu, South India, from August 2011 to June 2012. A total of 4002 individuals from 55 brick kiln chambers were interviewed to determine the prevalence of chest symptoms and care seeking behaviour patterns.

RESULTS

Three hundred and seventy-seven (9.4%) chest symptomatics were identified. The most significant variables associated with chest symptoms were illiteracy, alcohol abuse and heavy smoking. Of the chest symptomatics identified, 50.4% took action to get relief from their symptoms. The duration of over 6-month stay in the chamber was significantly associated with taking action (OR, 5.5, 95% CI: 2.3, 13.3).

CONCLUSIONS

The TB control programme needs to further explore how to extend its services to such 'hard to reach' groups. Active case finding to ensure early diagnosis and treatment initiation amongst such groups needs consideration.

Cancer risk evaluation of brick kiln workers exposed to dust bound PAHs in Punjab province (Pakistan)

Principal objective of this study was to evaluate the health risks of brick kiln workers to dust bound PAHs exposure in Punjab province (Pakistan). To this aim, surface dust samples were collected from brick kiln units located in Chung Khurd (Lahore city), Gujranwala city and Sohra village (in the vicinity of Gujranwala). The highest ΣPAH levels were measured in the dust samples collected in Sohdra village (mean 2578 ng g(-1) d.w., range 302-6757 ng g(-1) d.w.) followed by Gujranwala city (mean 957, range 16.1-1963 ng g(-1) d.w.) and Chung Khurd (mean 882, range 692-1007 ng g(-1) d.w.). Source identification using diagnostic ratios and principal component analysis identified coal and wood combustion as the major PAHs sources. The cancer risk model (CR-Model 1) and the Incremental Lifetime Cancer Risk model (ILCR-Model 2) were used to evaluate the cancer risk assessment via ingestion, inhalation and dermal contact pathways. Both models suggested that brick kiln workers (including adults and children) were exposed to high-potential carcinogenic risk via both ingestion and dermal contact pathways during the brick making process. This study also emphasizes the need for pollution control in the brick kiln industry of Pakistan.

PAH exposure biomarkers are associated with clinico-chemical changes in the brick kiln workers in Pakistan

In this study we investigated the clinico-chemical parameters and the level of exposure of brick kiln workers to polycyclic aromatic hydrocarbons (PAHs) in Punjab (Pakistan). The brick kiln workers and a non-occupationally exposed group were recruited for comparative analysis of urinary biomarkers of PAH exposure (i.e. 1-hydroxypyrene (1-OHPyr), α-naphthol and β-naphthol) and blood level of superoxide dismutase (SOD), as a biomarker of oxidative stress and other hematologic parameters. Questionnaires were used to document information on socio-demographic characteristics of all the subjects. The analysis of urinary biomarkers showed higher median concentrations of 1-OHPyr, and α- and β-naphthols in brick kiln workers (1.53, 3.65 and 1.53 μmol/mol-Cr, respectively) than non-occupationally exposed group (0.62, 0.64 and 0.66 μmol/mol-Cr, respectively). The 1-OHPyr in brick kiln workers was above the occupational exposure level. Among the clinical parameters of brick kiln workers, hemoglobin (Hb) and red blood cells (RBCs) were very low and closely associate with 1-OHPyr and β-naphthol. Additionally, the white blood cells (WBCs) and superoxide dismutase (SOD) were also elevated in brick kiln workers, which suggested inflammatory symptoms and high oxidative stress. The results show that regardless of possibly being affected by the poor nutrition, the anemic state and hematological changes observed in brick kiln workers may be associated with their exposure to smoke present in the environment of brick kilns.

Assessment of occupational health problems and physiological stress among the brick field workers of West Bengal, India

OBJECTIVES

The brick field industry is one of the oldest industries in India, which employs a large number of workers of poor socioeconomic status. The main aim of the present investigation is i) to determine the prevalence of musculoskeletal disorders among brick field workers, ii) to determine the prevalence of respiratory disorders and physiological stress among brick field workers compared to control workers.

MATERIAL AND METHODS

For this study, a total of 220 brick field workers and 130 control subjects were selected randomly. The control subjects were mainly involved in hand-intensive jobs. The Modified Nordic Questionnaire was applied to assess the discomfort felt among both groups of workers. Thermal stress was also assessed by measuring the WBGT index. The pulmonary functions were checked using the spirometry. Physiological assessment of the workload was carried out by recording the heart rate and blood pressure of the workers prior to work and just after work in the field.

RESULTS

Brick field workers suffered from pain especially in the lower back (98%), hands (93%), knees (86%), wrists (85%), shoulders (76%) and neck (65%). Among the brick-making activities, brick field workers felt discomfort during spading for mud collection (98%), carrying bricks (95%) and molding (87%). The results showed a significantly lower p value < 0.001 in FVC, FEV1, FEV1/FVC ratio and PEFR in brick field workers compared to the control group. The post-activity heart rate of the brick field workers was 148.6 beats/min, whereas the systolic and diastolic blood pressure results were 152.8 and 78.5 mm/Hg, respectively.

CONCLUSIONS

This study concludes that health of the brick field workers was highly affected due to working in unhealthy working conditions for a long period of time.

Liver functions in silica-exposed workers in Egypt: possible role of matrix remodeling and immunological factors

BACKGROUND

Brick manufacturing constitutes an important industrial sector in Egypt with considerable exposure to silica.

OBJECTIVES

We aimed for evaluating hepatic functions in silica-exposed workers in the clay brick industry, and the possible role of matrix remodeling and immunological factors.

METHODS

A case-control study, 87 workers as exposed and 45 as control subjects. Questionnaire, clinical examination, and laboratory investigations: liver functions, matrix metalloproteinase-9, immunoglobulins G and E, and anti-liver kidney microsomal antibody.

RESULTS

In the exposed workers, mean levels of liver functions, matrix metalloproteinase-9 (MMP-9), and IgG and IgE were significantly higher. In the silicotic subgroup the mean level of GGT was almost twice the level in the non-silicotic subjects. Logistic regression showed that abnormal GGT and ALT were associated with production workers.

CONCLUSION

Workers in the clay brick industry showed evidence of liver disease that could be related to matrix remodeling.

Air quality and climate--synergies and trade-offs

Air quality and climate are often treated as separate science and policy areas. Air quality encompasses the here-and-now of pollutant emissions, atmospheric transformations and their direct effect on human and ecosystem health. Climate change deals with the drivers leading to a warmer world and the consequences of that. These two science and policy issues are inexorably linked via common pollutants, such as ozone (methane) and black carbon. This short review looks at the new scientific evidence around so-called "short-lived climate forcers" and the growing realisation that a way to meet short-term climate change targets may be through the control of "air quality" pollutants. None of the options discussed here can replace reduction of long-lived greenhouse gases, such as CO2, which is required for any long-term climate change mitigation strategy. An overview is given of the underlying science, remaining uncertainties, and some of the synergies and trade-offs for addressing air quality and climate in the science and policy context.