Assessment of paper dust exposure and chronic respiratory symptoms among paper factory workers in, Ethiopia; a comparative cross-sectional study.

BACKGROUND: Workers in pulp and paper factories are continuously exposed to paper dust. Excessive exposure to paper dust can cause respiratory disease. Information about the prevalence of chronic respiratory symptoms and dust exposure levels among workers in pulp and paper factories is not available in Ethiopia. The aim of this study was, therefore, to assess personal total dust exposure levels, the prevalence of chronic respiratory symptoms and their associated risk factors among workers in Ethiopian pulp and paper factories. METHODS: A comparative cross-sectional study was conducted. A total of 40 dust measurements were carried out on 20 randomly selected workers. To assess chronic respiratory symptoms and associated factors, 434 workers from two paper factories and controls were interviewed using a standard questionnaire adapted from the American Thoracic Society (ATS). Gravimetric analyses of the filters were undertaken using a standard microbalance. Poisson regression was performed for comparing the prevalence of symptoms and risk factors for the two groups. Multivariable analyses were conducted to identify factors associated with chronic respiratory symptoms. RESULT: The arithmetic mean (AM) and geometric mean (GM) of dust exposure levels among the paper factories workers were 11.3 (± 7.7) and 10.2 (± 1.4) mg/m3 respectively. This exposure level exceeded the threshold limit value recommended for total dust (10 mg/m3). The prevalence of having at least one chronic respiratory symptom was about 51% among the workers in paper factories. The prevalence ratio of having chronic respiratory symptoms among paper factory workers was 5.6 times higher (PR = 6, 95% CI 3.5-10.3) than in the controls. Chronic respiratory symptoms were significantly associated with factors such as an educational status of less than grade 9, being employed in the work sections of the factories, having work experience of 5 years and above, working more than 8 h per day and having a past history of occupation and respiratory illnesses. CONCLUSION: The dust concentration in the paper factories exceeded the acceptable recommended limit value of 10 mg/m3. The prevalence of chronic respiratory symptoms among paper factory workers was higher than among controls. The main determining factors for chronic respiratory symptoms among the workers were the specific work section such as production section, low income, having past history of respiratory illnesses, the number of years of working and low educational status. This finding indicated the need for improving the working conditions in paper factories in Ethiopia.

Assessment of dust exposure and chronic respiratory symptoms among workers in medium scale woodwork factories in Ethiopia; a cross sectional study.

BACKGROUND: Wood dust in a form of inhalable particulates can penetrate the lung tissues and affect respiratory health. Woodwork factory workers are at a greater risk of developing respiratory health problems because of exposure in their working environment, but existing data were few. The aim of this study was to assess the prevalence of chronic respiratory symptoms, associated factors, and concentration of personal total wood dust level among medium-scale woodwork factory workers. METHODS: An institutional based cross-sectional study was conducted among 506 woodwork factory workers. We selected study participants using a simple random sampling technique. We assessed chronic respiratory symptoms using the British Medical Research Council respiratory symptoms questionnaire with a few modifications. A multivariate logistic regression model was used to identify the factors. Forty dust measurements were collected from 20 randomly selected workers using a closed-face cassette (CFC) personal sampler. We analyzed the dust samples gravimetrically using a standard microbalance scale. RESULTS: We recruited a random sample of 506 workers in the study with a response rate of 98%. The prevalence of chronic respiratory health symptoms among woodworkers was 69.8% with a prevalence of cough (54.6%), phlegm (52.2%), wheezing (44.6%), breathlessness (42.1%), and chest pain (42.9%). Past occupational dust exposure history (AOR = 2.09, 95% CI; 1.09-4.01), work experience > 5 years (AOR = 9.18, 95% CI; 5.27-16.00), using bio-fuel as energy for cooking (AOR = 2.42, 95% CI; 1.44-4.07), and having no occupational safety and health training (AOR = 3.38, 95% CI; 1.20-9.49) were factors that significantly associated with chronic respiratory symptoms among woodwork workers. The geometric mean (GM) of dust exposure level among woodworkers was 10.27 mg/m3, which exceeded the limit of 10 mg/m3 set by the ACGIH. CONCLUSIONS: High prevalence of chronic respiratory symptoms was reported from woodwork factory workers. Increased work- experience, using bio-fuel as an energy source for cooking, past occupational dust exposure history, and having no occupational safety and health training were identified risk factors. The measured average personal wood dust exposure level was above the recommended occupational threshold limit value. Therefore, workers' wood dust exposure reduction and control methods and respiratory health awareness programs should be implemented.

Chronic respiratory symptoms, lung function and associated factors among flour mill factory workers in Hawassa city, southern Ethiopia: "comparative cross-sectional study".

BACKGROUND: Occupational related respiratory diseases arise as a result of the deposition of dust particles in the lungs. Flour milling industries; generate organic dust during industrial processes, such as cleaning, milling, packaging, and loading which release dust into the air and later inhaled by workers. Flour mill workers are at risk of developing respiratory health problems because of exposure in their working environment, but existing data were few. The aim of this study was to assess the prevalence of chronic respiratory symptoms, lung function and associated factors among flour mill factory workers. METHODS: A comparative cross-sectional study was conducted among 196 flour mill factory workers and 210 soft drinks factory workers. We selected study participants using a systematic sampling technique. We assessed the chronic respiratory symptoms using the questionnaire adopted from the British Medical Research Council. Binary logistic regression analysis with 95% CI and p < 0.05 was used to identify the factors. Lung function parameters; Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and ratio FEV1/FVC was measured by using spirometer and analyzed by using an independent t-test. RESULTS: We included 406 (96.7%) workers in this study. The prevalence of chronic respiratory symptoms was higher among flour mill workers as compared to soft-drinks factory workers (56.6% vs.12.9%). Primary education (AOR = 5.8, 95% CI, 1.3-23.2), mixing department (AOR = 5.3, 95% CI = 1.68-16.56), work experience 6-9 years (AOR = 5.1, 95% CI = 2.05-12.48), work experience ≥10 years (AOR = 2.5, 95% CI = 1.01-6.11) and working over eight hours (AOR = 2.4, 95% CI, 1.16-5.10) were factors that significantly associated with chronic respiratory symptoms among flour mill workers. FVC (p < 0.002), FEV1 (p < 0.001) and FEV1/FVC (p < 0.012) were significantly reduced among flour mill workers. CONCLUSIONS: We found chronic respiratory symptoms to be high among flour mill workers. Lower education level, mixing department, increased work experience, and longer working hours were identified factors. The flour mill dust exposed worker's lung function parameters were highly reduced. This study suggested that workers' dust exposure reduction and control methods in flour mill factories need to be implemented.

Assessment of Diarrhea and Its Associated Factors in Under-Five Children among Open Defecation and Open Defecation-Free Rural Settings of Dangla District, Northwest Ethiopia.

Background: Open defecation (OD) is a widespread problem in the developing world. This practice facilitates the transmission of diarrheal diseases. In Ethiopia, still the national open defecation rate in 2014 was 34.1% (37.9% in rural and 8.7% in urban). Objective: To assess diarrheal morbidity in under-five children and its associated factors in Dangla district, Northwest Ethiopia, 2016. Methods: A community-based comparative cross-sectional study design with a multistage random sampling technique was applied. The total sample size was 550 (275 ODF and 275 OD). Descriptive and inferential statistics were done. Results: A total of 525 participants were interviewed making the response rate 95.45%. The prevalence of diarrhea was 9.9% in ODF and 36.1% in OD kebeles. In ODF kebeles, child immunization (AOR = 0.037; 95% CI: 0.006-0.243), latrine presence (AOR = 0.036; 0.006-0.233), water shortage (AOR = 8.756; 95% CI: 1.130-67.831), and solid waste disposal (AOR = 0.143; 95% CI: 0.020-0.998) have statistically significant association with diarrhea occurrence. While in OD kebeles child immunization (AOR = 0.032; 95 CI: 0.008-0.123), water access of 7.5-15 liters/day (AOR = 0.029; 95% CI: 0.006-0.152), water shortage (AOR = 18.478; 95% CI: 4.692-72.760), and proper solid waste disposal (AOR = 0.023; 95% CI: 0.005-0.117) have significant association with diarrhea occurrence. Conclusions: The overall prevalence of under-five diarrhea was low in ODF kebeles as compared with OD kebeles. The study showed that child immunization, latrine presence, water shortage in household, and solid waste disposal practices had statistically significant association with diarrhea occurrence in ODF kebeles, while water access at the individual level, water shortage in household, child immunization, and solid waste disposal have statistically significant association with diarrhea occurrence in OD kebeles. Integrated efforts are needed from the Ministry of Health together with line ministries and developmental partners in improving latrine utilization at household level, water shortage in households, and solid waste disposal practices.

Outcome of external dacryocystorhinostomy in Ethiopian patients.

BACKGROUND: An imbalance between tear production and drainage results in epiphora, which is an annoying symptom embarrassing the patient socially and functionally. The two widely accepted modalities of treatment for nasolacrimal duct obstruction (NLDO) are external dacryocystorhinostomy (EDCR) and endoscopic dacryocystorhinostomy. EDCR is the mainstay of treatment of NLDO and it remains to be the gold standard with which all other methods must be compared. OBJECTIVE: To determine the outcome of EDCR in Menelik II hospital, Addis Ababa, Ethiopia. The study was also intended to give a baseline data at a tertiary eye care center. METHODS: A prospective study was done in Menelik II Hospital. All patients scheduled for EDCR between June 2005 and May 2006 were included in the study. EDCR was done for all our cases. Success was defined by patient satisfaction (no complaint of tearing) supported by examination for regurgitation of fluid on pressing the lacrimal sac; and slit lamp assessment for increased tear meniscus. RESULTS: One hundred and twenty eight eyes of 106 patients were included in the study, 36 (34%) were males and 70 (66%) were females. The male to female ratio was approximately 1:2. The commonest indication for dacryocystorhinostomy was chronic dacryocystitis 93 (72.7%). Patients were followed postoperatively for a mean follow up period of 9.3 months (6-12 months). Success was recorded in 119 (93%) of operated eyes. Patients graded incision scar as excellent in 107 (83.6%) eyes, good in 9 (14.8%) and bad in 2 (1.6%) eyes. All patients respond that they would recommend operation for others. CONCLUSION: The success rate of EDCR in our set up is comparable to studies done in other parts of the world and EDCR is a very effective surgical procedure for our patients with NLDO.