Respiratory symptoms related to flour dust exposure are significantly high among small and medium scale flour mill workers in Ethiopia: a comparative cross-sectional survey

BACKGROUND@#International Labour Organization (ILO) report indicates more than 2.4 million workers die from work-related diseases and accidents each year. Work-related respiratory ailments related to airborne particulate matter such as flour dust are responsible for about 386,000 deaths and 6.6 million illness-adjusted life years. Even though exposure to flour dust together with the extreme expansions of flour mill sectors is a priority health concern, extent of the problem is little investigated in Ethiopia. The aim of this study was to evaluate the magnitude and risk factors of work-related respiratory symptoms among flour mill workers in Bahir Dar City, Ethiopia.@*METHODS@#This study employed a comparative cross-sectional survey of 560 samples (280 exposed group from flour mill workers and 280 unexposed group from office workers) with a stratified random sampling technique. The study was conducted from March to April 2019 in Bahir Dar City, Northwest Ethiopia. We used the British Medical Research Council (BMRC) questionnaire to assess work-related respiratory symptoms. The questionnaire was pretested and interview administered to collect data. Binary logistic regression analysis was fitted to evaluate significant factors of respiratory symptoms at a < 0.05 p value. Adjusted odds ratio (AOR) with a confidence interval (CI) of 95% was calculated to determine a strength of association.@*RESULTS@#All the sampled participants had fully responded to the interview. The median age of exposed and unexposed groups was 28.5 interquartile range (IQR, 20) and 31 (IQR, 15) years, respectively. The prevalence of work-related respiratory symptoms among flour mill workers was substantially higher than that of among controls, 63.9% and 20.7%, respectively (Χ@*CONCLUSION@#Respiratory symptoms emanating from exposure to various flour dusts were significantly higher among flour mill workers than among the control group. Therefore, we recommend the need to effectively implement health and safety programs that account for the reduction of dust at a source, use of engineering controls (e.g., provision of adequate ventilation systems), use of administrative measures (e.g., training program and health surveillance) and provision of a suitable personal protective equipment (PPE). Furthermore, it is vital to integrate workplace health and safety programs to the wider public health policies and strategies to effectively mitigate the burden of work-related respiratory conditions. We also encourage future studies to evaluate concentration of flour dusts combined with physical examinations to establish plausible associations of respiratory symptoms with dusts of flour mill-related origin.

Exposición a polvo de harina de trigo en panaderías de la Región Metropolitana / Bakers' exposure to wheat flour dust in Santiago, Chile

Wheat flour is a known sensitizer for humans. Bakers exposed to flour dust may develop occupational rhinitis and asthma. In Chile there is no current permissible limit for occupational exposure to wheat flour. To propose such a limit, 9 bakeries located in 6 districts of Santiago de Chile were evaluated, 6 bakeries were semi-industrial and 3 were small business. Twenty-eight environmental personal samples were obtained by standard sampling methods and they were analyzed at the Institute of Public Health of Chile. No significant differences were found (p = 0,2915, Kruskall-Wallis' test) between air concentrations of flour particles in the working environment of semi-industrial (geometric mean: MG = 0.88 mg/m³,geometric deviation: DEG = 2,68) and small business (MG = 1.39 mg/m³, DEG = 2,31). A permissible limit of wheat flour dust exposure is recommended.

Se conoce que la harina de trigo es un sensibilizador en seres humanos. Los panaderos expuestos a polvo de harina pueden desarrollar rinitis y asma ocupacional. En Chile actualmente no existe un límite permisible para la exposición ocupacional a polvo de harina. Con el objetivo de proponer un límite, fueron evaluadas 9 panaderías de 6 comunas de Santiago de Chile, de las cuales 6 fueron semi-industriales y 3 pequeñas. Un total de veintiocho muestras personales de aire fueron obtenidas según método estándar de muestreo y analizadas en el Instituto de Salud Pública de Chile. No se encontraron diferencias significativas (p = 0,2915, prueba de Kruskall-Wallis) en la concentración de partículas de harina en el ambiente de trabajo semi-industrial (media geométrica: MG = 0,88 mg/m³, desviación geométrica: DEG = 2,68) y en el de panaderías pequeñas (MG = 1,39 mg/m³, DEG = 2,31). En base a las observaciones realizadas se recomienda establecer un límite permisible de exposición para polvo de harina de trigo.