Respiratory Morbidity among Rice Mill Workers in an Urban Area of Burdwan District, West Bengal: A Cross-sectional Study

Effect on pulmonary functions of dust exposed rice mill workers in comparison to an unexposed population

BACKGROUND

Paddy milling is the oldest and largest agro-processing industry in India. A large number of workers are employed in the rice mills where they are potentially exposed to dust. It has been shown that exposure to dust results in a high prevalence of respiratory diseases, such as asthma, chronic bronchitis, extrinsic allergic alveoli ties, toxic syndrome, and interstitial lung disease.

OBJECTIVE

The aim of this study was to investigate the effect of dust on rice mill workers' health using lung function tests with comparison to an unexposed population.

PARTICIPANTS

Two hundred eighteen rice mill workers (exposed volunteers) were randomly selected from 25 rice mills in Assam, India. Participants were 18-60 years with at least one year of work experience. Further, 377 volunteers who were not exposed to dust and having similar demographic characteristics also participated as a control group.

METHOD

Pulmonary function tests were conducted for all participants by spirometry. The tests included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC (%), peak expiratory flow (PEF) and forced expiratory flow during the middle half of a forced vital capacity (FEF25-75%). Values from exposed workers were compared with the unexposed volunteers.

RESULTS

It was observed that the lung function parameters FVC, FEV1, PEF and FEF25-75% in exposed workers were significantly decreased compared with unexposed volunteers. There were also significantly decreased FVC, FEV1, FEV1/FVC%, PEF and FEF25-75% with increase in age and duration of dust exposure. It was further observed that 48% and 32% of the total male and female volunteers, respectively, had evidence of lung disease. Irrespective of gender, approximately 45% of mill workers had evidence of lung disease, of which 21% was restrictive and 24% was obstructive.

CONCLUSION

Compared with unexposed controls, rice mill workers have a greater prevalence of respiratory disease based on pulmonary function tests.

Prevalence of COPD among population above 30 years in India: A systematic review and meta-analysis

Background

By 2030, Sustainable Development Goal 3.4 aims to reduce the premature mortality caused by non-communicable diseases through prevention and treatment. Chronic obstructive pulmonary disease is the second leading cause of mortality and disability-adjusted life years in India. This review was conducted to estimate the prevalence of COPD using systematic review and meta-analysis technique.

Method

Search was conducted using six databases for studies on COPD among population above 30 years in India between years 2000 to 2020. Cross-sectional and cohort studies reporting prevalence of COPD and associated risk factors were included in the present review. Screening and data extraction was done by two authors independently. Studies were appraised for quality using the modified New Castle Ottawa scale and reporting quality was assessed using STROBE guidelines.

Result

Our search returned 8973 records, from which 23 records fulfilled the eligibility criteria. Overall, the prevalence of COPD among population aged 30 years and above in India was 7%. Risk factors like active and passive smoking, biomass fuel exposure, environmental tobacco smoke, occupational exposure to dust, indoor and outdoor pollution, and increasing age were reported to have a significant association with COPD among Indian population.

Conclusion

Our findings suggest the need for a multicentric national-level research study to understand COPD burden and its contributing risk factors. The findings also suggest the need for COPD sensitive health literacy program focused on early screening and primary prevention of risk factors for COPD, which may help early initiation of self-management practices, that are crucial for better quality of life.