Sweeper’s lung disease: a cross-sectional study of an overlooked illness among sweepers of Pakistan

Abstract

BackgroundSweepers are prone to develop chronic obstructive pulmonary disease even without tobacco smoking.PurposeTo investigate roadside dust as a cause of air flow obstruction among sweepers, and the role of spirometry in its preclinical diagnosis.Material and methodsOne-hundred nonsmoking sweepers (aged 30–60 years) of both sexes sweeping on roads for 8–12 hours a day for the Capital Development Authority of Islamabad, Pakistan were used as study participants (Group A). One-hundred healthy nonsmokers (aged 30–60 years) in the same socioeconomic group and living in the same environment represented the nonsweeper group (Group B). After proper clinical evaluation and chest X-rays, spirometric evaluation was carried out in both groups. Comparisons were drawn between various spirometric parameters.ResultsPulmonary function tests showed that the mean forced vital capacity was 78 ± 1.40 in the sweeper group (Group A) and 83 ± 0.86 in the nonsweeper group (Group B). Mean forced expiratory volume in 1 second was 66 ± 1.67 in Group A and 85 ± 0.85 in Group B (P < 0.05), a difference of 19%. The forced midexpiratory flow was 41% lower in Group A than in Group B (P < 0.0001). The pattern of pulmonary function obstruction was shown to be proportional to the duration of exposure to dust caused by sweeping.ConclusionOccupational exposure to dust leads to an obstructive pattern among sweepers. Spirometry is the simplest, noninvasive technique to detect preclinical disease.

Effects of Dust Exposure on the Respiratory Health Symptoms and Pulmonary Functions of Street Sweepers

“…In the present study, there was no correlation between the work experience and pulmonary functions of the exposed group, which is consistent with the findings of the study by Neghab et al ( 35 ). Conversely, Mariammal et al ( 36 ) and Anwar et al ( 12 ) suggested that the number of years of employment affected the pulmonary parameters. Perhaps the lack of significance observed in the current study may be due to the differences in the factors, including the exposure duration, dust concentration and particle size, previous occupations, and the absence of accurate work experience documentation of Zahedan street cleaners.…”

“…The incidence and COPD-related mortality has been higher in women than men in recent years ( 11 ). The long and continuous inhalation of non-industrial dust in Pakistani street sweepers has been reported to be one of the critical factors in the development of COPD, resulting in obstructive ventilatory patterns ( 12 ). When compared with other health hazards, respiratory problems are more prevalent among Indian cleaners ( 13 ).…”

Pulmonary Function Impairment in Female Workers Exposed to Environments with Varied Ambient Air Pollution in the Central Business Area of Lusaka-Zambia

“…The study further revealed that use of personal protective equipment (PPE) was essential in preventing this. Other studies have equally revealed that street sweepers by virtue of their exposure to dust were more likely to have a FEV 1 /FVC ratio less than 60% [16,29]. Office cleaners are also at risk of developing lung function impairment due to exposure to indoor sources of PM 2.5 like chemical detergents and fungal spores from furniture [30].…”

“…This shows that street sweepers are more likely to have impaired pulmonary function than office cleaners. Indeed other associated street sweeping and exposures to large amounts of dust with respiratory conditions [22,29].…”

“…This could be a possible explanation for the observed lung function impairment in the two groups. Studies show that street sweeping without precautionary measures such as proper use of personal protective equipment in the form of facemasks and respirators may predispose t conditions [29,34]. This is based on the observation that the use of precautionary measures such as PPE tend to reduce the levels of inhaled particulates and subs pathological effects [35].…”