Reduced lung function among sisal processors.

OBJECTIVES: The objective of this study was to examine lung function and chronic respiratory symptoms among sisal workers in Tanzania and compare the results with a control group. METHODS: A cross-sectional study on chronic respiratory symptoms and lung function was conducted in 2006 among male Tanzanian sisal processing workers from six sisal estates. Participants included 86 workers in decortication departments, 68 workers in brushing departments and 30 low exposed security guards. The response rate was 97%. Chronic respiratory symptoms and background information were obtained by structured interview. Forced ventilatory capacity (FVC) and forced expiratory volume in 1 s (FEV(1)) were estimated before and after a work shift, and FEV(1)/FVC ratio calculated. RESULTS: Workers were aged 19-85, with the oldest in the brushing and security departments. Chronic cough and chest tightness were experienced by 38% and 68% of workers in brushing departments, 20% and 6% of workers in decortication and 7% and 0% of security workers, respectively. A reduced FEV(1)/FVC ratio related to years of work was found among workers in brushing departments when adjusting for age, smoking, previous respiratory illnesses and body mass index, using regression analyses. Work in decortication departments was not related to reduced lung function parameters. The prevalence of FEV(1)/FVC<70 was above 50 for all three groups. Lung function parameters were similar before and after work shifts, except that peak expiratory flow increased among workers in brushing departments after work shifts. CONCLUSIONS: The results indicate a relationship between work in sisal brushing departments and the development of obstructive lung disorders.

Working conditions and exposure to dust and bioaerosols in sisal processing factories in Tanzania.

Information was collected on working conditions and personal exposures to dust, bacteria, and fungi in sisal fiber processing factories in Tanzania to identify health hazards and possible needs for preventive measures. Walkthrough surveys were performed in the brushing and decorticating departments of six sisal factories. The number of departments showing adequate scores for ergonomics and work organization, physical working environment, and occupational health items were determined. Personal thoracic dust samples were collected during sisal processing and analyzed for concentration of dust (n = 24) and for fungi and bacteria (n = 32). In both departments, most items considered to be a prerequisite for a good working environment were either missing or inadequate. Ergonomic and physical hazards were observed. Repetitive strenuous tasks, awkward work postures, and high noise levels were found. Visible dust and inadequate ventilation were seen in the brushing departments, and wet floors were observed in the decortication departments. Personal protective equipment was hardly used. The arithmetic mean exposure of sisal processors was 1.2 mg thoracic dust/m(3), 43 x 10(6) bacteria/ m(3), and 2.35 x 10(6) fungal spores/m(3). The highest exposure levels were measured in the decortication departments when machines were cleaned of waste. Significant differences were found for mean thoracic dust exposure and bacteria counts between the brushing and decortication departments and the security guards. Within individual departments, there were no significant differences in exposures between the different work tasks. A linear mixed effect model of thoracic dust including department as fixed effect explained 65% of the between-worker variability for thoracic dust exposure. The study shows that workers in sisal processing in Tanzania are exposed to bioaerosols, and suitable control measures should be implemented. More exposure studies are needed in this type of industry.

High prevalence of immunoglobulin E (IgE) sensitization among sisal (Agave sisalana) processing workers in Tanzania.

PURPOSE: Allergic sensitization among workers exposed to sisal is scarcely documented. We examined whether sisal processing is associated with IgE sensitization and its relationship to the prevalence of respiratory symptoms among Tanzanian processors. METHODS: 138 sisal exposed workers and 78 non-exposed controls were skin prick tested (SPT) using dry sisal extract and fresh sisal sap. Sera from a subset of 43 participants were analyzed for total and sisal specific IgE. SPT wheal size, prevalence of positive SPTs and adjusted relative risk (RR) for sisal sensitization were determined and compared between exposed and controls. Prevalences for respiratory symptoms were compared between sensitized and non-sensitized sisal workers. RESULTS: Significantly higher prevalence of positive SPTs to sisal was found among 74 % of sisal workers compared to 17 % among controls. Compared to controls, the RR of sensitization to sisal was 4 times higher (95 % CI; 2.4-6.7) among exposed workers. All exposed workers had elevated IgE levels (>100 kU/l) and 27 % of tested sera had elevated sisal specific IgE. A high prevalence of respiratory symptoms was found in both sensitized and non-sensitized sisal workers. CONCLUSION: Sisal processing is associated with increased risk of IgE sensitization, but its clinical implication is not obvious.

Variability and Determinants of Occupational Noise Exposure Among Iron and Steel Factory Workers in Tanzania.

Background: Machines, processes, and tasks in the iron and steel factories may produce noise levels that are harmful to hearing if not properly controlled. Studies documenting noise exposure levels and related determinants in sub-Saharan Africa, including Tanzania are lacking. The aim of this study was to document noise exposure and to identify determinants of noise exposure with a view to establishing an effective hearing conservation programme. Methods: A walk-through survey was conducted to describe the working environment in terms of noise sources in four metal factories (A-D) in Tanzania. Noise measurements were conducted by both personal, full-shift noise measurements (8 h) using dosimeters and area measurements (10-s measurements) using a sound level meter. A total of 163 participants had repeated personal noise measurements (Factory A: 46 participants, B: 43, C: 34, and D: 40). Workers were randomly selected and categorized into 13 exposure groups according to their job. Linear mixed effects models were used to identify significant determinants of noise exposure in the furnace section and the rolling mill section. Results: The average personal noise exposure in the four factories was 92.0 dB(A) (range of job group means; 85.4-96.2 dB(A)) (n = 326). Personal exposure was significantly higher in the rolling mill section (93.0 dB(A)) than in the furnace section (89.6 dB(A)). Among the job groups, the cutters located in the rolling mill section had the highest noise exposure (96.2 dB(A)). In the furnace section, furnace installation (below the ground floor), manual handling of raw materials/billets/crowbars, and billet weighing/transfer were significant determinants explaining 40% of the total variance in personal noise exposure. In the rolling mill section, the size of the cutting machine, steel billet weight and feeding re-heating furnace explained 46% of the total variance in personal noise exposure. The mean noise level of the area measurements was 90.5 dB(A) (n = 376). Conclusion: Workers in the four iron and steel factories in Tanzania were exposed to average noise of 92.0 dB(A), without using hearing protection, implying a high risk of developing hearing loss. Task and factory level determinants were identified in the furnace and the rolling mill sections of the plant, which can inform noise control in factories with similar characteristics.

Endotoxin, dust and exhaled nitrogen oxide among hand pickers of coffee; a cross-sectional study.

BACKGROUND: Primary coffee processing takes place in countries where coffee is grown, and may include hand picking of coffee to remove low quality beans. Hand picking is mostly performed by women. No previous studies on dust and respiratory health have been performed in this occupational group, although studies indicate respiratory problems among other coffee production workers. FINDINGS: Our aim was to assess dust and endotoxin exposure among hand pickers in a coffee factory and compare the levels with limit values. In addition we wanted to examine the fraction of exhaled nitric oxide (FeNO) as a possible inflammatory marker in the airways among the hand pickers and evaluate the association between FeNO and years of hand picking. All hand pickers in a factory were examined during 1 week. The response was 100 %; 69 participated. FeNO was measured using an electrochemistry-based NIOX MINO device. Nine out of 69 workers (13 %) had levels of FeNO above 25 ppb, indicating presence of respiratory inflammation. A significant positive association was found between increasing FeNO and years of hand picking. Nine personal samples of total dust and endotoxin were taken. None of the dust samples exceeded the occupational limit value for total organic dust of 5 mg/m(3). Three samples of endotoxin (33 %) were above the recommended value of 90 EU/m(3). CONCLUSIONS: Levels of endotoxin were higher than recommended standards among hand pickers, and there was a positive association between the level of exhaled nitrogen oxide and years of work with hand picking coffee.

Respiratory inflammation among workers exposed to airborne dust with endotoxins in a coffee curing factory.

OBJECTIVE: To study dust exposure and inflammatory reactions in the respiratory tract among coffee curing workers in Tanzania. METHODS: A cross-sectional study was conducted in a Tanzanian coffee curing factory. Coffee workers (n = 15) were compared with unexposed controls (n = 18); all workers were nonsmokers. Exhaled nitric oxide was examined using an electrochemistry-based NIOX MINO device. Personal air samples were analyzed for total dust and endotoxins, using gravimetric analysis and the chromogenic Limulus amebocyte lysate endpoint assay, respectively. RESULTS: Total dust levels ranged from 0.2 to 27.9 mg/m, and endotoxin levels ranged from 42 to 75,083 endotoxin units/m. Concentrations of exhaled nitric oxide, analyzed by linear regression and adjusted for age (ß = 0.57; 95% confidence interval, 0.08 to 1.06; P = 0.02), was higher among coffee workers than among the control group. CONCLUSION: The results indicate a relationship between the coffee dust and signs of respiratory inflammation.

Prevalence of respiratory symptoms among sisal processors in Tanzania.

Respiratory health among sisal workers has been an unresolved issue of concern for many years. The authors performed a 1-week follow-up questionnaire study on acute respiratory symptoms and cross-shift peak expiratory flows among 163 sisal brushing and decortication workers (exposed participants) and 31 security workers (control participants) from 6 sisal estates in Tanzania. The authors used the Optimal Symptom Score Questionnaire on Acute Respiratory Symptoms and the standardized American Thoracic Society and British Medical Research Council respiratory questionnaires. Decortication and brushing workers had a higher prevalence and higher severity scores of acute symptoms throughout the week than did control participants. Shortness of breath among brushing workers decreased (p < .01) from 39% on Monday to 20% on Friday. Brushing workers also had significantly higher prevalence of chronic sputum (30%) and chest tightness (48%) and the lowest preshift and postshift PEF values. The authors recommend preventive measures and further research.

Acute respiratory symptoms among sisal workers in Tanzania.

BACKGROUND: Few studies have focused on respiratory health effects among sisal workers. AIM: To report on the prevalence of acute respiratory symptoms among sisal processors. METHODS: We interviewed 163 dust-exposed brushing and decortication workers and 31 low-exposed security workers from six sisal estates in Tanzania using a modified symptom score questionnaire to determine the prevalence of acute respiratory symptoms during work. Groups were compared using chi-square tests, Fisher's exact tests, t-tests and logistic regression, adjusting for confounding factors. RESULTS: After the first working day of the week, 73% of the brushing workers reported dry cough, 66% sneezing, 65% productive cough, 63% running nose and 34% stuffy nose. Brushing workers had a significantly higher prevalence of these symptoms than decortication workers. Brushing and decortication workers had significantly more dry cough and sneezing than the control group of security workers, when adjusting for age, smoking, past respiratory diseases and residence. CONCLUSION: Processors of sisal fibre have a high prevalence of acute respiratory symptoms. More detailed studies on work and health in sisal estates are needed, including exposure studies.