Rizwana Shahid^1*, Sana Bilal¹, Syed Arshad Sabir², Mahjabeen Qureshi³, Umaira Ali⁴

¹Assistant Professor Community Medicine, Rawalpindi Medical University

²Dean of Community Medicine & Public Health, Rawalpindi Medical University

³Senior Demonstrator Community Medicine, Rawalpindi Medical University

⁴Postgraduate Trainee Community Medicine, Rawalpindi Medical University

*Corresponding Author: Rizwana Shahid, Assistant Professor Community Medicine, Rawalpindi Medical University, Rawalpindi

Abstract

Objective: To determine the frequency of respiratory disorders among daily life occupational workers of Rawalpindi city

Subjects & Methods: A cross-sectional descriptive study was carried out among 100 daily life occupational workers at Rawalpindi city during March 2019 through convenience sampling. The garment shop workers, carpenters, furniture polishers, barbers, hotel cooks, street food sellers, poultry workers, karyana, and tandoor workers were also interviewed to ascertain their job-related respiratory problems, family history, and duty hours per day through consecutive sampling. Data were analyzed by using SPSS version 25.0 and Microsoft Excel 2010. The mean difference in working hours of garment shop workers and barbers was verified by an independent sample t-test. P < 0.05 was considered significant.

Results: Of the total 100 daily life occupational workers, the majority (20%) was constituted by garment shop workers and barbers (16 %). The median age of workers was 30 ± 6.9 years. Their mean working hours per day were 12.34 ± 2.72 hours. About 2 garments, 1 poultry, and 1 tandoor worker were known as asthmatic. Family history of asthma was positive among 4 garments, 4 barbers, 3 carpenters, 2 karyana store, 2 furniture polishers, 1 poultry, and 1 tandoor worker. About 17 % of workers had to wheeze for the last 12 months. Approximately 13 % of workers used to wake up with chest tightness while 24 % with an attack of cough during the last 12 months. 90 % of barbers and 50 % of garment workers had a history of cough at the workplace. However, the mean difference in their duty hours was determined to be statistically significant (P = 0.002)

Conclusion: Various occupational workers are susceptible to respiratory problems due to exposure to toxic agents at their workplace.

Keywords: respiratory disorders, wheeze, cough, occupational workers, working hours.

Healthcare workers are also likely to develop work-related asthma due to the use of disinfectants, sterilizing agents, antibiotics, and aerosolized drugs[3]. Our Physicians, respiratory therapists [4], endoscopists, radiologists, and nurses are at high risk of developing occupational asthma in healthcare settings [5]. Smoking also contributes towards the development of occupational asthma apart from genetics. An international study revealed 12.54 % positive cases of occupational asthma among employees of food, cement, and ceramic industries [6].  The poultry workers are highly susceptible to respiratory disorders particularly obstructive lung diseases due to exposure to bioaerosols at workplace [7].  Carpenters are also at risk of developing mesothelioma due to inhalation of toxic asbestos fibers even during wall insulation. In addition to allergic symptoms, these occupational workers are highly vulnerable to significantly deranged pulmonary function tests [8].

Chronic obstructive lung diseases among 24-45 % non-smokers are attributed to various hazardous inhalational agents at their workplace [9]. Textile workers are known as highly vulnerable to obstructive pulmonary maladies[10]. A study by Bakirci N et al revealed that about 20 % of the newly hired cotton mill workers left their job in the first month of their employment and about half of the employees got termination from their contract due to the development of vocational lower respiratory tract infections [11].

Research by Khan M et al among female workers employed in Faisalabad and Lahore spinning mills concluded that long working duration was considerably linked to the breathing difficulties [12]. Although numerous researches are carried out to explore the adverse health effects among various industrial workers but the discovery of inhalational diseases among other occupational workers like barbers, furniture polishers and hotel chefs are insubstantial. The present study is therefore intended to determine the frequency of respiratory ailments prevailing among daily life occupational workers of Rawalpindi city. The findings of this study would really enable our policymakers to devise appropriate strategies for lessening the inhalation of menacing agents at the workplace and educating the susceptible population about compliance with precautionary measures.

Subjects & Methods
A cross-sectional descriptive study was carried out among 100 daily life occupational workers 20-40 years old belonging to diverse occupations at Rawalpindi city during March 2019 through convenience sampling. These included garment shop workers, carpenters, furniture polishers, barbers, hotel cooks, street food sellers. In addition, workers of poultry form, karyana stores, and tandoors were also interviewed to ascertain their job-related respiratory problems. Data was collected by using a self-structured questionnaire. The data was collected from study subjects regarding their age, duty hours per day, complaint of cough and wheeze at the workplace, history of waking up with cough or chest tightness during last 12 months, family history of asthma, the reason for breathlessness, and medication for respiratory symptoms. Informed consent was taken from all the workers before the face-to-face interview. Data were analyzed by using SPSS version 25.0 and Microsoft Excel 2010. The mean difference in working hours of garment shop workers and barbers was compared by an independent sample t-test. P < 0.05 was taken as significant.

Results
The median age of respondents was 30 ± 6.9 years. Mean working hours per day were 12.34 ± 2.72 hours. Workers enrolled in this research were indulged in diverse occupations as depicted below in Figure 1. 

Figure 1: Occupations of different daily life workers

2 garment shop workers, 1 poultry worker, and 1 tandoor worker were determined to be known asthmatic and on anti-asthmatic medication. However, 4 garment shop workers, 4 barbers, 3 carpenters, 2 karyana store workers, 2 furniture polishers, 1 poultry worker and 1 tandoor worker had a family history of asthma. Only 4 workers were found to have episodes of breathlessness for no apparent reason. 17 % of workers had wheezing since last 12 months as illustrated below in Table 1 out of which only 3 % were seeking treatment for wheezing. 

Table 1: Wheezing since last 12 months among daily life occupational workers (n = 17)

Only 7 % workers complained of having breathlessness associated with wheezing and 8 % observed to have wheezing even in the absence of cold. 13 % and 24 % workers used to wake up with chest tightness / SOB and attack of cough respectively during the last 12 months as shown below in Figure 2