Prevalence of lung function impairment among Greek cement production workers: a cross-sectional study

Prevalence of chronic respiratory symptoms among cement factory workers in Gauteng Province, South Africa

Cement workers are exposed to various kinds of occupational hazards, dust being the most hazardous. Despite certain exposure limits on the emission of air pollutants in place, several people die each year due to complications from respiratory disease. This study aimed to assess the prevalence of chronic respiratory symptoms among workers exposed to cement dust. A quantitative, descriptive cross-sectional design was employed among 81 workers from two cement production companies in Gauteng, South Africa in 2018. A self-administered questionnaire, anthropometric measurements, and a spirometry test were used as data collection tools. Data were analyzed using Wilcoxon rank sum, binary logistic regression, Pearson's chi-squared, and Fischer's exact tests. Respiratory symptoms such as wheezing, recurring blocked nose, sneezing/stuffy nose, fatigue/tiredness, rapid breathing, soreness/watery eyes, and breathlessness were significantly prevalent among participants from both facilities. Engineering and housekeeping control measures such as the use of High-Efficiency Particulate Air (HEPA) vacuums to clean up dust and proper use of Personal Protective Equipment (PPE) where workers are exposed to dust particles should be implemented.

Lung Function and Respiratory Morbidity Among Informal Workers Exposed to Cement Dust: A Comparative Cross-Sectional Study

Background

Cement dust is a significant source of occupational exposure affecting lung function and respiratory health. A higher burden of respiratory morbidity is known among factory workers involved in cement production. Globally or from India, there are no estimates of this burden from informal workers exposed to cement dust.

Objective

To assess difference in lung function and respiratory symptoms among informal workers exposed to cement and those unexposed, using a comparative community based cross-sectional study from purposively selected areas in Delhi, India.

Methods

Using a portable spirometer we measured lung function and collected respiratory symptoms from conveniently sampled informal workers (n = 100) exposed to cement dust, 50 indoor informal workers (tailors), and 50 outdoor (vegetable) vendors. Regression analyses were performed to compare respiratory symptom score and lung function parameters, adjusted for age, body mass index, smoking, socioeconomic status, and years of occupational exposure.

Findings

Exposed workers had significantly lower lung function (PEF = -750 ml/s and -810 ml/s and FEV1/FVC (%) = -3.87 and -2.11) compared to indoor and outdoor groups, with three times higher chronic respiratory symptoms when compared to the unexposed groups. The cement dust exposure was observed to be associated with PEF (mean difference (MD) = -0.75L, 95%CI = -1.36 to -0.15, p = 0.01), %FEV1/FVC (MD = -3.87, 95%CI = -6.77 to -0.96, p = 0.03) and respiratory symptoms (p < 0.001).

Conclusion

This study generates evidence regarding the respiratory burden of occupational exposure among vulnerable informal workers. There is an urgent need for policy reforms to safeguard health from occupational exposures, especially among informal workers.

Consequences of cement dust exposure on pulmonary function in cement factory workers

BACKGROUND

Several health conditions are associated with cement dust exposure; obstructive and restrictive lung disorders are the most common consequences. The aims of this study were to assess the pulmonary function of cement factory workers and to determine the distribution of respiratory consequences resulting from dust inhalation.

METHODS

A cross-sectional study with convenience sampling was undertaken from December 2019 to March 2020. A total of 97 (response rate, 92.4%) nonsmoking male cement workers were recruited and compared with 97 apparently healthy volunteers. A spirometer was used to measure forced vital capacity (FVC), forced expiratory volume in one second (FEV₁ ), and their ratio (FEV₁ /FVC). The measured parameters were interpreted according to American Thoracic Society/European Respiratory Society guidelines.

RESULTS

Significant reductions were observed in pulmonary function parameters of cement factory workers compared to controls (FVC 4.03 vs. 4.65 L in controls; FEV₁ 3.06 vs. 3.95 L in controls; p < 0.001 for both comparisons). A significant variation was observed in the prevalence of spirometric patterns between the two participating groups. Ninety (92.8%) controls had normal respiratory function with no defects, compared with only 25 (25.8%) of the cement workers. Restriction was the most common respiratory problem, with a greater prevalence in the cement workers (44 [45.4%]) compared to six (6.2%) controls.

CONCLUSIONS

Cement factory workers showed decreased lung function and abnormal spirometric patterns which we attribute to dust inhalation. These workers should have periodic medical examinations and regular rotations through different factory departments to minimize the pulmonary hazards of cement dust.