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Nicolaou L, Sylvies F, Veloso I, Lord K, Chandyo RK, Sharma AK, Shrestha LP, Parker DL, Thygerson SM, DeCarlo PF, Ramachandran G, Checkley W. Brick kiln pollution and its impact on health: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2024; 257:119220. [PMID: 38797466 DOI: 10.1016/j.envres.2024.119220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 05/20/2024] [Accepted: 05/21/2024] [Indexed: 05/29/2024]
Abstract
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.
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Affiliation(s)
- Laura Nicolaou
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - Fiona Sylvies
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Isabel Veloso
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Katherine Lord
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Ram K Chandyo
- Kathmandu Medical College, Sinamangal, Kathmandu, Nepal
| | - Arun K Sharma
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - Laxman P Shrestha
- Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal
| | - David L Parker
- University of Minnesota School of Public Health, Minneapolis, USA
| | | | - Peter F DeCarlo
- Department of Environmental Health and Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, MD, USA; Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, USA.
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Gaviola C, Nicolaou L, Sharma AK, Chandyo R, Parker D, Shrestha L, Das SK, Ramachandran G, Thygerson SM, Beres L, Checkley W. Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal. Occup Environ Med 2024; 81:287-295. [PMID: 38955484 DOI: 10.1136/oemed-2024-109516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/17/2024] [Indexed: 07/04/2024]
Abstract
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.
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Affiliation(s)
- Chelsea Gaviola
- Department of Medicine, Duke University, Durham, North Carolina, USA
- Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Laura Nicolaou
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
| | - Arun K Sharma
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | | | - David Parker
- University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Laxman Shrestha
- Department of Pediatrics, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Santa K Das
- Department of Pulmonology and Critical Care, Institute of Medicine, Tribhuvan University, Kathmandu, Nepal
| | - Gurumurthy Ramachandran
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | | | - Laura Beres
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - William Checkley
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Center for Global Non-Communicable Disease Research and Training, School of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
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Curtis KL, Chang A, Johnston JD, Beard JD, Collingwood SC, LeCheminant JD, Peterson NE, South AJ, Farnsworth CB, Sanjel S, Bikman BT, Arroyo JA, Reynolds PR. Differential Inflammatory Cytokine Elaboration in Serum from Brick Kiln Workers in Bhaktapur, Nepal. Diseases 2024; 12:129. [PMID: 38920561 PMCID: PMC11203241 DOI: 10.3390/diseases12060129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Revised: 06/13/2024] [Accepted: 06/13/2024] [Indexed: 06/27/2024] Open
Abstract
Previous studies involving workers at brick kilns in the Kathmandu Valley of Nepal have investigated chronic exposure to hazardous levels of fine particulate matter (PM2.5) common in ambient and occupational environments. Such exposures are known to cause and/or exacerbate chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma. However, there is a paucity of data regarding the status of systemic inflammation observed in exposed workers at brick manufacturing facilities within the country. In the current study, we sought to elucidate systemic inflammatory responses by quantifying the molecular cytokine/chemokine profiles in serum from the study participants. A sample of participants were screened from a kiln in Bhaktapur, Nepal (n = 32; 53% female; mean ± standard deviation: 28.42 ± 11.47 years old) and grouped according to job category. Blood was procured from participants on-site, allowed to clot at room temperature, and centrifuged to obtain total serum. A human cytokine antibody array was used to screen the inflammatory mediators in serum samples from each of the participants. For the current study, four job categories were evaluated with n = 8 for each. Comparisons were generated between a control group of administration workers vs. fire master workers, administration workers vs. green brick hand molders, and administration workers vs. top loaders. We discovered significantly increased concentrations of eotaxin-1, eotaxin-2, GCSF, GM-CSF, IFN-γ, IL-1α, IL-1β, IL-6, IL-8, TGF-β1, TNF-α, and TIMP-2 in serum samples from fire master workers vs. administration workers (p < 0.05). Each of these molecules was also significantly elevated in serum from green brick hand molders compared to administration workers (p < 0.05). Further, each molecule in the inflammatory screening with the exception of TIMP-2 was significantly elevated in serum from top loaders compared to administration workers (p < 0.05). With few exceptions, the fire master workers expressed significantly more systemic inflammatory molecular abundance when compared to all other job categories. These results reveal an association between pulmonary exposure to PM2.5 and systemic inflammatory responses likely mediated by cytokine/chemokine elaboration. The additional characterization of a broader array of inflammatory molecules may provide valuable insight into the susceptibility to lung diseases among this population.
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Affiliation(s)
- Katrina L. Curtis
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
| | - Ashley Chang
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
| | - James D. Johnston
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - John D. Beard
- Department of Public Health, Brigham Young University, Provo, UT 84602, USA
| | - Scott C. Collingwood
- Department of Pediatrics, University of Utah, Salt Lake City, UT 84112, USA
- Rocky Mountain Center for Occupational and Environmental Health, University of Utah, Salt Lake City, UT 84112, USA
| | - James D. LeCheminant
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, UT 84602, USA
| | - Neil E. Peterson
- College of Nursing, Brigham Young University, Provo, UT 84602, USA
| | - Andrew J. South
- Department of Civil and Construction Engineering, Brigham Young University, Provo, UT 84602, USA
| | - Clifton B. Farnsworth
- Department of Civil and Construction Engineering, Brigham Young University, Provo, UT 84602, USA
| | - Seshananda Sanjel
- Department of Community Medicine and Public Health, Karnali Academy of Health Sciences, Jumla 21200, Nepal
| | - Benjamin T. Bikman
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
| | - Juan A. Arroyo
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
| | - Paul R. Reynolds
- Department of Cell Biology and Physiology, Brigham Young University, Provo, UT 84602, USA
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Aniyikaiye TE, Piketh SJ, Edokpayi JN. Quantification of ambient PM 2.5 concentrations adjacent to informal brick kilns in the Vhembe District using low-cost sensors. Sci Rep 2023; 13:22453. [PMID: 38105285 PMCID: PMC10725883 DOI: 10.1038/s41598-023-49884-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 12/13/2023] [Indexed: 12/19/2023] Open
Abstract
The widespread exposure to ambient PM2.5 poses a substantial health risk globally, with a more pronounced impact on low- to medium-income nations. This study investigates the spatiotemporal distribution of PM2.5 in the communities hosting informal brickmaking industries in Vhembe District. Utilizing Dylos DC1700, continuous monitoring of PM2.5 was conducted at nine stations adjacent to informal brick kilns from March 2021 to February 2022. The study determined the correction factor for PM2.5 measurements obtained from the Dylos DC1700 when it was collocated with the GRIMM Environmental Dust Monitor 180. Additionally, the diurnal and seasonal variations across monitoring stations were assessed, and potential PM2.5 sources were identified. The study also evaluated the compliance of ambient PM2.5 concentrations across the stations with the South African National Ambient Air Quality Standard (NAAQS) limits. Annual PM2.5 concentrations for the stations ranged from 22.6 to 36.2 μgm-3. Diurnal patterns exhibited peak concentrations in the morning and evening, while seasonal variations showed higher concentrations in winter and lower concentrations in summer and spring. All monitoring stations reported the highest daily exceedance with respect to the daily NAAQS limit in the winter. Major PM2.5 sources included domestic biomass combustion, vehicular emissions, industrial emissions, and construction sites. Well-calibrated low-cost sensors could be employed in suburb regions with scarce air quality data. Findings from the study could be used for developing mitigation strategies to reduce health risks associated with PM2.5 exposure in the area.
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Affiliation(s)
- Tolulope Elizabeth Aniyikaiye
- Department of Geography and Environmental Science, University of Venda, Private Bag X5050, Thohoyandou, 0950, South Africa.
| | - Stuart J Piketh
- Unit for Environmental Sciences and Management, Climatology Research Group, North-West University, Potchefstroom, 2531, South Africa
| | - Joshua Nosa Edokpayi
- Water and Environmental Management Research Group, Department of Geography and Environmental Science, University of Venda, Private Bag X5050, Thohoyandou, 0950, South Africa
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Berumen-Rodríguez AA, Alcántara-Quintana LE, Pérez-Vázquez FJ, Zamora-Mendoza BN, Díaz de León-Martínez L, Díaz Barriga F, Flores-Ramírez R. Assessment of inflammatory cytokines in exhaled breath condensate and exposure to mixtures of organic pollutants in brick workers. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:13270-13282. [PMID: 36129651 DOI: 10.1007/s11356-022-23071-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/13/2022] [Indexed: 06/15/2023]
Abstract
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. PM2.5 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.
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Affiliation(s)
- Alejandra Abigail Berumen-Rodríguez
- Centro de Investigación Aplicada en Ambiente Y Salud (CIAAS), Colonia Lomas Segunda Sección, Avenida Sierra Leona No. 550, CP, 78210, San Luis Potosí, SLP, México
| | - Luz Eugenia Alcántara-Quintana
- Unidad de Innovación en Diagnóstico Celular Y Molecular. Coordinación Para La Innovación Y La Aplicación de La Ciencia Y Tecnología, Universidad Autónoma de San Luis Potosí Av, Sierra Leona 550, Lomas 2a sección, 78120, San Luis Potosí, SLP, México
| | - Francisco Javier Pérez-Vázquez
- CONACYT Research Fellow, Coordinación Para La Innovación Y Aplicación de La Ciencia Y La Tecnología (CIACYT), Colonia Lomas Segunda Sección, Avenida Sierra Leona No. 550, CP, 78210, San Luis Potosí, SLP, México
| | - Blanca Nohemí Zamora-Mendoza
- Centro de Investigación Aplicada en Ambiente Y Salud (CIAAS), Colonia Lomas Segunda Sección, Avenida Sierra Leona No. 550, CP, 78210, San Luis Potosí, SLP, México
| | - Lorena Díaz de León-Martínez
- Centro de Investigación Aplicada en Ambiente Y Salud (CIAAS), Colonia Lomas Segunda Sección, Avenida Sierra Leona No. 550, CP, 78210, San Luis Potosí, SLP, México
| | - Fernando Díaz Barriga
- Centro de Investigación Aplicada en Ambiente Y Salud (CIAAS), Colonia Lomas Segunda Sección, Avenida Sierra Leona No. 550, CP, 78210, San Luis Potosí, SLP, México
| | - Rogelio Flores-Ramírez
- CONACYT Research Fellow, Coordinación Para La Innovación Y Aplicación de La Ciencia Y La Tecnología (CIACYT), Colonia Lomas Segunda Sección, Avenida Sierra Leona No. 550, CP, 78210, San Luis Potosí, SLP, México.
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Beard JD, Thygerson SM, Olivares A, Tadje JE, Willis S, Johnston JD. Gaseous Air Pollutants and Respirable Crystalline Silica Inside and Outside Homes at Brick Kilns in Bhaktapur, Kathmandu Valley, Nepal. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12431. [PMID: 36231729 PMCID: PMC9566599 DOI: 10.3390/ijerph191912431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/07/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
Household and ambient air pollution remain public health problems in much of the world. Brick kiln employees in Nepal may be particularly at risk of high air pollution exposures and resulting health effects due to high levels of outdoor air pollution, substandard housing, and indoor biomass cooking. We conducted a cross-sectional study of indoor and outdoor air pollution concentrations at workers' homes at four fixed chimney Bull's trench brick kilns in Bhaktapur, Kathmandu Valley, Nepal. We measured air concentrations of carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), and respirable crystalline silica (SiO2; cristobalite, quartz, tridymite) using established methods and conducted a survey about characteristics of homes or samples that may be associated with air pollution concentrations. Geometric mean concentrations of CO, CO2, and SiO2 (quartz) were 0.84 ppm, 1447.34 ppm, and 6.22 µg/m3, respectively, whereas concentrations of all other air pollutants measured below lower detection limits. Most characteristics of homes or samples were not associated with air pollution concentrations. We found a positive association between the variable how long lived in house and SiO2 (quartz) concentrations, which may reflect sustained take-home exposure to SiO2 (quartz) over time. Interventions should focus on administrative controls to reduce take-home exposure to SiO2 (quartz) in this population.
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