Sam Chidi Ibeneme1,2,3,4,5, Rita Nkechi Ativie6, Georgian Chiaka Ibeneme7, Hellen Myezwa8, Amarachi Destiny Ezuma9,10, Amaka Nnamani9,11, Salome Ezeofor9,11, Maduabuchukwu Joseph Nwankwo12, Theresa Ucheoma Ettu13, Akachukwu Omumuagwula Nwosu6, Ifeoma Joy Okoye9,11, Gerhard Fortwengel14,15. 1. Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria. sam.ibeneme@unn.edu.ng. 2. Department of Nursing Sciences, Faculty of Health Sciences & Technology, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria. sam.ibeneme@unn.edu.ng. 3. Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, Gauteng, 2193, South Africa. sam.ibeneme@unn.edu.ng. 4. Department of Physiotherapy, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Enugu State, Nigeria. sam.ibeneme@unn.edu.ng. 5. Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu, 400001, Nigeria. sam.ibeneme@unn.edu.ng. 6. Department of Medical Rehabilitation, Faculty of Health Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria. 7. Department of Medical Rehabilitation, Faculty of Health Sciences, College of Health Sciences, Nnamdi Azikiwe University, nnewi Campus, Nnewi, Anambra State, Nigeria. 8. Department of Nursing Sciences, Faculty of Health Sciences & Technology, College of Health Sciences, Ebonyi State University, Abakaliki, Ebonyi State, Nigeria. 9. Department of Physiotherapy, Faculty of Health Sciences, School of Therapeutic Studies, University of the Witwatersrand, 7 York Road, Parktown, Johannesburg, Gauteng, 2193, South Africa. 10. Owerri Study Centre, National Open University of Nigeria, Owerri, Imo State, Nigeria. 11. Faculty III, Hochschule Hannover University of Applied Sciences & Arts, Hannover, Lower Saxony, Germany. 12. Clinical Trial Consortium Research Group, University of Nigeria, Enugu Campus, Enugu, Enugu State, Nigeria. 13. Department of Physiotherapy, Faculty of Health Sciences, David Umahi federal University of Health Sciences, Uburu, Ebonyi State, Nigeria. 14. Department of Radiation Medicine, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Enugu Campus, Enugu, Enugu, 400001, Nigeria. 15. UNIRED Research Group, Faculty III, Hochschule Hannover University of Applied Sciences & Arts, Lower Saxony, 30159, Hannover, Germany.
Abstract
BACKGROUND: Upsurge in cardiopulmonary dysfunctions in Enugu, Nigeria, involved mainly cement workers, automobile spray painters, woodworkers, and Cleaners and was worsened in the dry season, suggesting the need for an occupation-specific characterization of the disease features and seasonal evaluation of air quality for prevention and management. METHODS: We conducted a randomized cross-sectional study of eighty consenting participants (in Achara Layout, Enugu), comprising 20 cement workers (39.50 ± 14.95 years), 20 automobile spray painters (40.75 ± 9.85 years), 20 woodworkers (52.20 ± 9.77 years), and 20 cleaners (42.30 ± 9.06 years). The air quality, some haematological (fibrinogen-Fc, and C-reactive protein-CRP), and cardiopulmonary parameters were measured and analyzed using ANCOVA, at p < 0.05. RESULTS: The dry season particulate matter (PM) in ambient air exceeded the WHO standards in the New layout [PM10 = 541.17 ± 258.72 µg/m3; PM2.5 = 72.92 ± 25.81 µg/m3] and the University campus [PM10 = 244 ± 74.79 µg/m3; PM2.5 = 30.33 ± 16.10 µg/m3], but the former was twice higher. The PM differed significantly (p < 0.05) across the sites. Forced expiratory volume at the first second (FEV1) (F = 6.128; p = 0.001), and Peak expiratory flow rate (PEFR) (F = 5.523; p = 0.002), differed significantly across the groups. FEV1/FVC% was < 70% in cement workers (55.33%) and woodworkers (61.79%), unlike, automobile spray painters (72.22%) and cleaners (70.66%). FEV1 and work duration were significantly and negatively related in cement workers (r = -0.46; r2 = 0.2116; p = 0.041 one-tailed). CRP (normal range ≤ 3.0 mg/L) and Fc (normal range-1.5-3.0 g/L) varied in cement workers (3.32 ± 0.93 mg/L versus 3.01 ± 0.85 g/L), automobile spray painters (2.90 ± 1.19 mg/L versus 2.54 ± 0.99 mg/L), woodworkers (2.79 ± 1.10 mg/L versus 2.37 ± 0.92 g/L) and cleaners (3.06 ± 0.82 mg/L versus 2.54 ± 0.70 g/L). CONCLUSION(S): Poor air quality was evident at the study sites, especially in the dry season. Cement workers and automobile spray painters showed significant risks of obstructive pulmonary diseases while woodworkers had restrictive lung diseases. Cement workers and cleaners recorded the highest risk of coronary heart disease (CRP ≥ 3.0 mg/L). The similarity in Fc and CRP trends suggests a role for the inflammation-sensitive proteins in the determination of cardiovascular risk in cement workers and cleaners. Therefore, there are occupation-specific disease endpoints of public health concern that likewise warrant specific preventive and management approaches among the workers.
BACKGROUND: Upsurge in cardiopulmonary dysfunctions in Enugu, Nigeria, involved mainly cement workers, automobile spray painters, woodworkers, and Cleaners and was worsened in the dry season, suggesting the need for an occupation-specific characterization of the disease features and seasonal evaluation of air quality for prevention and management. METHODS: We conducted a randomized cross-sectional study of eighty consenting participants (in Achara Layout, Enugu), comprising 20 cement workers (39.50 ± 14.95 years), 20 automobile spray painters (40.75 ± 9.85 years), 20 woodworkers (52.20 ± 9.77 years), and 20 cleaners (42.30 ± 9.06 years). The air quality, some haematological (fibrinogen-Fc, and C-reactive protein-CRP), and cardiopulmonary parameters were measured and analyzed using ANCOVA, at p < 0.05. RESULTS: The dry season particulate matter (PM) in ambient air exceeded the WHO standards in the New layout [PM10 = 541.17 ± 258.72 µg/m3; PM2.5 = 72.92 ± 25.81 µg/m3] and the University campus [PM10 = 244 ± 74.79 µg/m3; PM2.5 = 30.33 ± 16.10 µg/m3], but the former was twice higher. The PM differed significantly (p < 0.05) across the sites. Forced expiratory volume at the first second (FEV1) (F = 6.128; p = 0.001), and Peak expiratory flow rate (PEFR) (F = 5.523; p = 0.002), differed significantly across the groups. FEV1/FVC% was < 70% in cement workers (55.33%) and woodworkers (61.79%), unlike, automobile spray painters (72.22%) and cleaners (70.66%). FEV1 and work duration were significantly and negatively related in cement workers (r = -0.46; r2 = 0.2116; p = 0.041 one-tailed). CRP (normal range ≤ 3.0 mg/L) and Fc (normal range-1.5-3.0 g/L) varied in cement workers (3.32 ± 0.93 mg/L versus 3.01 ± 0.85 g/L), automobile spray painters (2.90 ± 1.19 mg/L versus 2.54 ± 0.99 mg/L), woodworkers (2.79 ± 1.10 mg/L versus 2.37 ± 0.92 g/L) and cleaners (3.06 ± 0.82 mg/L versus 2.54 ± 0.70 g/L). CONCLUSION(S): Poor air quality was evident at the study sites, especially in the dry season. Cement workers and automobile spray painters showed significant risks of obstructive pulmonary diseases while woodworkers had restrictive lung diseases. Cement workers and cleaners recorded the highest risk of coronary heart disease (CRP ≥ 3.0 mg/L). The similarity in Fc and CRP trends suggests a role for the inflammation-sensitive proteins in the determination of cardiovascular risk in cement workers and cleaners. Therefore, there are occupation-specific disease endpoints of public health concern that likewise warrant specific preventive and management approaches among the workers.
Authors: Robert D Brook; Barry Franklin; Wayne Cascio; Yuling Hong; George Howard; Michael Lipsett; Russell Luepker; Murray Mittleman; Jonathan Samet; Sidney C Smith; Ira Tager Journal: Circulation Date: 2004-06-01 Impact factor: 29.690
Authors: Adan Z Becerra; Steve Georas; J Thomas Brenna; Philip K Hopke; Cathleen Kane; David Chalupa; Mark W Frampton; Robert Block; David Q Rich Journal: J Toxicol Environ Health A Date: 2016-03-30