RESUMO
Objective: To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan
Study Design: Cross-sectional survey
Place and Duration of Study: Karachi, Pakistan, from October to December 2009
Methodology: Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire [ATS-DLD-78-a] and spirometry
Results: Out of 372 participants, 29 [7.8%] workers had chronic bronchitis [4, 9.1% aged >/= 40 years] and 25 [6.7%] had COPD [12, 27.2% aged >/= 40 years]. Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe self-perceived dust exposure at work, >/= 10 pack years of smoking, uneducated, longer duration of work [>/= 11 years], and ever smokers were more likely to have chronic bronchitis or COPD. In the multivariate analyses, severe self-perceived dust exposure at work [AOR = 7.4; 95% CI: 1.9, 28.0], family history of respiratory illness/symptoms [AOR = 4.8; 95% CI: 1.1, 20.9] and lack of education [AOR = 4.2; 95% CI: 1.1, 16.9] were significant predictors of chronic bronchitis. Duration of work >/= 11 years [AOR = 5.5; 95% CI: 1.5, 19.7] and pack years of smoking >/= 10 years [AOR = 3.5; 95% CI: 1.1, 11.7] were strong predictors for COPD
Conclusion: There is a high frequency of chronic bronchitis and COPD among textile workers. Multiple important predictors for prevention are identified
RESUMO
The authors reviewed literature on interventions for cotton dust-associated lung diseases among textile workers. Internet sources [PubMed, Cochrane Library, Google and Google Scholar] were accessed and interventions were categorized into: Engineering or administrative controls, or personal protective equipment [PPE]. Ten relevant articles were shortlisted, five related to engineering controls [pre-processing, bactericidal treatment of cotton, improved workplace design, machinery and dust control measures]. Administrative controls may involve setting standards, environmental surveillance, periodic medical examinations, and workers training. Although specific guidelines are available regarding the use of PPEs, but there was little literature on their effectiveness. It was concluded that there is a dearth of literature regarding field-based assessment of interventions for control of cotton dust associated respiratory diseases and the available studies primarily focus on pre-processing of cotton. This review highlights the uncertainties that remain; and recommends several areas for future research on respiratory health of textile workers
RESUMO
To determine the prevalence and predictors of good knowledge, appropriate attitude and appropriate protective practices regarding respiratory symptoms among textile workers, and to determine the association of knowledge, attitude and practices with respiratory symptoms. The cross-sectional study was conducted in 2009 and comprised male workers from 15 textile mills in and around Karachi. A structured and pre-tested questionnaire was used which included questions to explore the knowledge, attitude and practices regarding respiratory symptoms. SPSS 19 was used for statistical analysis. The study had a sample size of 372 and found prevalence of good knowledge to be in 182 [48.9%] workers and appropriate attitude in 302 [81%], while only 80 [21%] were practising these measures appropriately. Being educated and older than 38 years of age, belonging to Sindhi ethnicity, and working in the weaving section were significant [p<0.05] predictors of knowledge, attitude and practices. Generally, there was no significant association of knowledge, attitude and practices with respiratory symptoms [p>0.05]. There was low prevalence of appropriate practices, high prevalence of good knowledge and attitude, indicating an interplay of several other social and environmental factors which need to be explored