Pooled Prevalence of Byssinosis in India: A Systematic Review and Meta-analysis

Abstract

Byssinosis is an occupational lung disease affecting textile workers exposed to cotton, jute and hemp dust. It causes symptoms like cough, breathlessness, and wheezing which is more during Mondays. Diagnosis is mainly clinical. The true burden of byssinosis in India remains unknown, and this systematic review and meta-analysis (SR-MA) aims to estimate its prevalence among textile industry workers in India. This study was registered in PROSPERO. The search spanned from January 2000 to September 2023, focusing on observational studies that met specific criteria. Two independent reviewers screened the literature, extracted relevant data, and assessed the risk of bias. Statistical analysis included a random effects model, assessment of heterogeneity and publication bias. Eighteen studies (5678 individuals) were included in the analysis. Byssinosis diagnosis was based on Schilling’s criteria in the majority of studies. Seven studies had low risk of bias, three had high risk, and the rest were moderate. There was no significant publication bias. The pooled prevalence of byssinosis was 24% (95% CI = 13%-36%) with high heterogeneity (I 2 = 99.02%). Sub-group analysis of studies with low risk of bias showed a prevalence of 20% (95% CI = 11% - 29%). Extrapolation of these findings to India suggests that about 10 million people are affected by byssinosis. The authors recommend development and practice of tailored health surveillance guidelines and the promotion of respiratory protective equipment (RPE) among those employed in textile industries.