RESPIRATORY HEALTH EFFECTS OF COTTON INHALABLE DUST ON WORKERS IN THE GARMENT PROCESSING UNIT

Abstract

A cross-sectional study was conducted among 150 garment factory workers selected with stratified random sampling technique to examine their lung impairment with respect to cotton dust. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced vital capacity ratio (FEV1/FVC) and forced expiratory flow (FEF (25%-75%)) were obtained according to American Thoracic Society criteria. Exposure to cotton inhalable dust concentration was measured in accordance with National Institute of Occupational Safety and Health criteria. Mann Whitney U test was used for comparison among target groups and statistical significance of the study was set at p<0.05. Cough, phlegm and dyspnea was observed in 78%, 51% and 44% patients (workers) respectively. Personal exposure of the subjects to cotton inhalable dust was measured in stitching, button hall and special effect sections of the garment processing unit at mean dust levels of .603±.436 mg/m3, .446±.257 mg/m3 and .382±.174 mg/m3 respectively. The exposed group was categorized into three groups having normal, obstructive and restrictive pattern of disease. This study provided evidence for relationship between exposure to cotton dust and other respiratory impairments without any association to smoking.

Full text

Pakistan Journal of Science (Vol. 69 No. 3 September, 2017)
260
RESPIRATORY HEALTH EFFECTS OF COTTON INHALABLE DUST ON WORKERS
IN THE GARMENT PROCESSING UNIT
A. Mahmood, H. Ilyas*, M. N. Chaudhry* and A. Ali
Center for the Improvement of Working Conditions and Environment (CIWCE), Labour and Human Resource
Department, Government of Punjab, Lahore.
*College of Earth and Environmental Sciences, University of Punjab, Lahore, Punjab, Pakistan.
Corresponding author’s email: arshadhset@gmail.com
ABSTRACT: A cross-sectional study was conducted among 150 garment factory workers selected
with stratified random sampling technique to examine their lung impairment with respect to cotton
dust. Vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1),
forced vital capacity ratio (FEV1/FVC) and forced expiratory flow (FEF (25%-75%)) were obtained
according to American Thoracic Society criteria. Exposure to cotton inhalable dust concentration was
measured in accordance with National Institute of Occupational Safety and Health criteria. Mann
Whitney U test was used for comparison among target groups and statistical significance of the study
was set at p<0.05. Cough, phlegm and dyspnea was observed in 78%, 51% and 44% patients (workers)
respectively. Personal exposure of the subjects to cotton inhalable dust was measured in stitching,
button hall and special effect sections of the garment processing unit at mean dust levels of .603±.436
mg/m3, .446±.257 mg/m3 and .382±.174 mg/m3 respectively. The exposed group was categorized into
three groups having normal, obstructive and restrictive pattern of disease. This study provided
evidence for relationship between exposure to cotton dust and other respiratory impairments without
any association to smoking.
Key words: Prevalence, Byssinosis, Chronic Obstructive Pulmonary Diseases, Inhalable Dust, Spirometry and
Workplace pollution.
(Received 26-05-2017 Accepted 18-09-2017).
INTRODUCTION
Workplace pollution is an important
occupational problem in numerous industries causing
occupational lung diseases which are documented on
accounts of previous history (Monson, 1986). Industries,
associated with the processing and handling of cotton
specifically thread, yarn and fabric, are seen to be most
associated with workers exposure to cotton dust
(Kahraman et al., 2013). The primary steps of textile
processing release a greater amount of dust in the air and
its long-term exposure can cause respiratory disorders
among workers (Stellman, 1998). Through inhalation,
small invisible cotton dust particles enter into the alveoli
of lungs, which get accumulated in the lymph leading to
reduction in the capacity to retain oxygen and ultimately
causing damage to them (Pearce et al., 2007). As a result
of cotton dust accumulation, the workers get brown lungs
and suffer from illness known as byssinosis (Baillargeon
et al., 1998). Industrial workplaces contaminated with
cotton dust result in prolonged exposure along with
substantial smoking habits have been proved to be
significant risk factors to health of workers (Würtz et al.,
2014). Byssinosis is breathing disorder which occurs in
individuals who are exposed to cotton, jute, flax and
hemp. It is characterized by shortness of breath or chest
tightness when a worker returns in a cotton processing
enterprise for a day or so with cough of work week
(Arrighi and Hertz-Picciotto, 1993).
Globally more than 62 million people are
associated with textile sector (Sardanelli and Di Leo,
2009). The textile workers, who account for 38% of
workforce of Pakistan, suffer from different workplace
hazards causing pulmonary symptoms at manufacturing
sites along with high cotton dust levels. None the less, not
much is identified about the harmful effects caused due to
cotton dust and endotoxins at cellular level (Boubopoulos
et al., 2010). Workers employed in the textile industry are
exposed to various airborne particles, dusts having
allergic, toxic, and infectious properties (Tadesse et al.,
2016). Occupational exposure to organic dusts such as
cotton, flax, hemp, jute and various grains are held
responsible for reversible pattern of asthma and chronic
obstructive pulmonary disease (COPD) (Berry et al.,
1973).Technological maneuvers have changed work
environment in the developed countries. Never the less,
preventive measures in developing countries are far from
being adequate (Malik et al., 2010). Unfortunately, in
Pakistan, there is no reliable data available about health
hazards in textile sector. Therefore, the aim of this study
was to measure the prevalence of respiratory symptoms
and pulmonary function among workers of a garment

Pakistan Journal of Science (Vol. 69 No. 3 September, 2017)
261
manufacturing unit in Lahore and to study their
association with demographic and environmental factors.
MATERIALS AND METHODS
There are different processes in the plant which
produce a variety of cotton inhalable dust and fine
suspended particles into workplace (Evans et al., 2012).
The study was approved by the code of ethics by
University of the Punjab and a written consent of subjects
was taken before trial in the month of February and
March 2016. A modified version of questionnaire of the
National Institute of Occupational Safety and Health
(NIOSH) was used to elicit information on socio-
demographic factors (Badesch et al., 2010 and Nafees et
al., 2013) like gender, race, education, religion, ethnicity,
marital status, income, residential status, job status, social
security, smoking, job history, history of family
respiratory ailment and cooking styles which were
available in English, translated into national language
(Urdu) and back translated into English to fetch healthy
data.
Personal cotton dust sampling: Breathing zone cotton
inhalable dust concentration was measured using a batch
of twelve Apex Casella personal sampling pumps fitted
with three piece assembly on 37mm polyvinyl filters
containing SKC Aluminum cyclone, for about 7-8 hours
in general shift in accordance with NIOSH recommended
method No. 0600 (Hoek and Brunekreef, 1993). The
filters were equilibrated for at least 2 hours in a non-
vacuumed desiccator to remove moisture to maintain
weight of samples. Mettler Toledo AS60/220.R2
analytical balance for weighing pre and post sampling
filters was used (Lahiri et al., 2005). The weight
difference of post and pre sampling filters were corrected
using variations in the field blanks. The personal
sampling pumps were calibrated at an air flow rate of 2.5
L/min.
Sampling technique: According to the objectives, the
researchers were unable to understand the behavior of the
cotton dust exposure concentration. The concentration of
the dust varied from section to section, firstly the
concentration of the respirable dust was collected and the
total sample for evaluation of the vulnerability was
collected according to concentration of the said effect.
Stratified random sampling technique was used to draw
sample from the population when the problem of
heterogeneous population was observed and strata were
constructed on the basis of similarity. According to the
situation stratified random sampling technique was
applied to collect information from the textile unit due to
heterogeneous population with regard to dust
concentrations and population was divided into different
strata. The textile unit comprised of 2045 subjects
working in different sections. Each section was
considered as a separate stratum with regard to dust
concentration. Sample (respondents) were selected from
each stratum (working sections) using simple random
sampling within the strata with regard to size of working
department ascertained from rosters.
A total of 200 textile workers were enrolled in
the study. Eleven of them did not join during trial due to
private engagement and were on leave while 30 declined
to show their consent. Out of 159, nine subjects could not
perform the pulmonary function test and were excluded
resulting into the trial of 150 subjects (75% participation
rate). For control group, a total of 75 eligible identified
individuals were contacted for interview, pulmonary
function test and other socio-demographic characteristics
of same age group of which 50 were successfully taken
and interviewed, yielding an overall control response rate
of 66.6%. Twenty five controls were excluded from the
study because they could not join the study. Control
group subjects were selected from the working offices
and students from a university and did not have cotton
dust or other workplace chemical exposure in routine life.
Pulmonary function measurements: Pulmonary
function tests were performed according to American
Thoracic Society (ATS) criteria whilst the workers in
standing and upright position using a portable
Vitalograph 2120 with Spirotrac V software (Spirometry,
2003). The height (cm) without shoes and weight (kg) of
the subjects wearing light cotton safety dress were
measured using medical weighing balance. The
instrument was calibrated using standard Vitalograph 1
Liter precision syringe. A minimum of three satisfactory
forced expiratory manoeuvers were required of each
subject. Workers were asked to refrain from smoking for
at least 1 hour before performing the test and directed to a
test room isolated from the work area. For each of the
participant, vital capacity (VC), forced vital capacity
(FVC), forced expiratory volume in 1 second (FEV1),
forced vital capacity ratio (FEV1/FVC) and forced
expiratory flow FEF (25%-75%) were measured. Analysis of
the lung function variables were carried out on best of
three values taken as percentage of predicted values. The
workers were classified as smoker, non-smokers and ex-
smokers. The criterion for smoking was defined as pack
year which was determined as twenty tobacco sticks per
day for a year (Lee and Schwartz, 1999). Do you now
smoke daily, some days or not at all, were defined as
current smokers. Ex-smoker were defined as those who
had quit smoking ≥ 5 years (Liu et al., 2015). Cough and
phlegm were defined as cough or phlegm for 3
consecutive months for at least two years. Whistling
sounds from chest with or without cold for at least two
years was characterized as wheezing were incorporated in
the questionnaire. Asthma was discussed as self-reported
or physician diagnosed. Byssinosis was defined
according to criteria set by (Schilling et al., 1955) while

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262
breathlessness as walking sluggishly in comparison to co-
workers or shortness of breath whilst using stairs. The
following criteria was used for interpretation of lung
function based on percentage predicted pulmonary
volume.
 In the first category, individuals with measured
FEV1/FVC ratio greater than 0.7, FVC and
FEV1 values greater than 80% predicted, were
considered normal.
 In second category, the individuals with
measured FEV1/FVC below 0.7 and FEV1 less
than 80% predicted were considered having
obstructive pattern.
 Third category consist of subjects with
measured FEV1/FVC values greater than 0.7 and
FEV1, FVC less than 80% predicted were
considered restrictive pattern.
 Fourth category comprised of the combination
of last two categories.
In data analysis, considering the assumption of
normality suitable test for analysis from parametric and
non-parametric was adopted. Shapiro-wilk test for
conformity of normality and Mann Whitney test for
comparison among the groups in case of non-normality
were used. Prevalence of respiratory ailment, lung
function symptoms and association among personal
exposure were analyzed using Pearson’s correlation. The
statistical analysis was performed using the statistical
package program IBM SPSS software Statistics version
22.0.
RESULTS AND DISCUSSION
Section-wide distribution of cotton inhalable dust:
Personal sampling was done to measure time-weighted
average of exposure to cotton dust in different sections of
the unit. The highest cotton dust concentration was
recorded in stitching (0.603±0.436 mg/m3) and lowest in
finishing sections (0.0003±0.0001 mg/m3). Likewise the
cotton inhalable dust concentration in cutting, button hall,
special effect, embroidery & screen printing, trimming,
over-lock, washing, product development and
administration sections were (0.281±0.145 mg/m3),
(0.446±0.257mg/m3), (0.382±0.174 mg/m3), (0.355±0.97
mg/m3), (0.308±0.002 mg/m3), (0.0003±0.001 mg/m3),
(0.325±0.066 mg/m3), (0.348±0.102 mg/m3) and
(0.191±0.053 mg/m3) respectively, as mentioned in table-
1 with total number of subjects whose personal exposure
to cotton dust were noted. Almost half of the sample i.e.
73(49%) of the workers were from stitching and
trimming sections.
One hundred and fifty garment textile workers
with at least one year work experience were selected for
trial. Among them 128(85.3%) were males and
22(14.7%) were females having mean age of 33.23±9.08
years with employment duration of 7.31±5.83 years,
while the control group comprised of males (100%) with
a mean age of 30.18±10.54 years. The demographics,
smoking habits and respiratory symptoms among the two
groups are presented in table-2. Among the exposed
groups 34% were reported were having phlegm and other
respiratory symptoms like cough, wheezing and dyspnea
(shortness of breath) which were 52%, 18% and 29%
respectively. Six (4%) individuals were self-reported to
have asthma from their childhood. Major (71.34%) part
of the workforce under study was non-smoker while 43
(28.66%) were current smoker. In the control group, 10%
of the subjects were having phlegm while prevalence of
other respiratory symptoms such as wheezing, cough and
dyspnea was 4%, 18% and 18% respectively. The overall,
participants in the control group were young and non-
smokers (74.4%), showing less respiratory illnesses in
comparison to the exposed group. None of the subjects
were ex-smokers. The subjects in the study were
categorized into two groups i.e. those with employment
duration of more than five years and the others less than
five years.
Individuals with employment duration greater
than 5 years were 94(62%) among them 48(51%) had
normal lung function values, 7(7.5%) showed
obstructive, 20(21.3%) restrictive while 19 (20.2%)
showed mixed pattern. On the other hand, individuals
with employment duration less than 5 years were
56(38%) among them 31(55%) were normal, 5(9%) were
obstructive, 9(16%) showed restrictive lung diseases and
11(20%) has mixed pattern as shown in table-3.
In the study, both absolute and percentage
values of the lungs function indicating the same results
were analyzed and for the sake of scarce volume only the
absolute values analysis was presented. After analyzing
the results of lung functions of workers it was noted that
younger the worker higher the lung capacity when
compared with older.
The boxplot of the MFVC, MFEV1,
MFEV1/MFVC ratio and MFEF(25-75)% in accordance with
average concentration of cotton dust presented in figure-1
showed that the said factor resulted in lung impairment. It
is evident that distribution of lung function was different
from each other indicating the different aspects of
vulnerability dispersion pattern among the subjects.
Employees working in the industry for more than 5 years
showed reduction in the pulmonary function values.
Negative correlation was observed between change in
FVC, FEV1, FEV1/FVC ratio, FEF(25-75)% and cotton dust
as (r= -0.138), (r= -0.10), (r= -0.036), and (r= -0.057)
respectively showing reduction in pulmonary function
indices with an increase in cotton dust concentration
(Aminian et al., 2013) as depicted in Table-4.

Pakistan Journal of Science (Vol. 69 No. 3 September, 2017)
263
Table 1: Descriptive statistics (including Mean ±SD)
of cotton dust concentration in different
sections of a garment processing unit.
Table 2: Descriptive statistics (Mean ±SD, frequency
& percentage) and respiratory symptoms
among the exposed and unexposed groups.
Variables
Exposed
group
Unexposed
group
N
150
50
Mean age (±SD)
33.23±9.08
30.18±10.54
No. of male
128(85.33%)
50(100%)
No. of female
22(14.66%)
----
Smoker
43(28.66%)
13(25.6%)
Non-smoker
107(71.33%)
37(74.4%)
Cigarette (per-day)*
7.66±6.37
4.9±5.99
Employment duration
(years)
7.31±5.83
---
Cough
78 (52%)
9(18%)
Wheezing
27 (18%)
2(4%)
Dyspnea (shortness of
breath)
44 (29%)
9(18%)
Phlegm
51 (34%)
5(10%)
Asthma
6(4%)
0
*significant at   
Table 3: Descriptive statistics (including Mean ±SD) and significance level of PFT of the exposed and control
groups showing decline in pulmonary function indices.
Categories
Variables
Exposed Group
Control Group
P- value
Normal
FVC (L)
4.09 ±0.96
4.69 ±0.90
0.001
FEV1 (L/sec)
3.21 ± 0.81
3.91 ±0.78
0.002
FEV1/FVC (%)
79.02 ± 12.95
83.34 ±0.06
0.015
FEF(25-75%) (L/sec)
3.11 ± 1.74
4.32±1.70
0.001
Obstructive
FVC (L)
3.84 ±0.99
4.09 ± 0.96
0.424*
FEV1 (L/sec)
2.28 ±0.45
3.21 ± 0.81
0.001
FEV1/FVC (%)
60.42 ±0.06
79.02 ± 12.95
0.001
FEF(25-75%) (L/sec)
0.94 ±0.72
3.11 ± 1.74
0.001
Restrictive
FVC (L)
2.78±0.55
4.09 ± 0.96
0.001
FEV1 (L/sec)
2.38 ±0.44
3.21 ± 0.81
0.001
FEV1/FVC (%)
86.28 ±0.07
79.02 ± 12.95
0.009
FEF(25-75%) (L/sec)
2.84 ±0.97
3.11 ± 1.74
0.468*
*P-values indicates insignificance at   .
Table-3 indicated the comparison of vulnerability among both exposed and control groups. It could be observed
from the comparison that exposed group was facing higher vulnerability in comparison to control group.
a: Boxplot between MFVC and Average Cotton Dust
b: Boxplot between MFEV1 and Average Cotton Dust
0.19 0.26 0.28 0.31 0.33 0.35 0.38 0.45 0.6
2 4 6 8
Average Cotton Dust
MFVC
0.19 0.26 0.28 0.31 0.33 0.35 0.38 0.45 0.6
2 3 4 5 6
Average Cotton Dust
MFEV1
Sr.
No.
Section
Cotton Dust
Concentration
(mg/m3)
No. of
samples of
personal
exposure
1
Cutting
0.281±0.145
11(7.33%)
2
Stitching
0.603±0.436
39(26%)
3
Button Hall
0.446±0.257
7(4.66%)
4
Special Effect
0.382±0.174
20(13.33%)
5
Embroidery &
Screen Printing
0.355±0.97
3(2%)
6
Trimming
0.308±0.002
34(22.66%)
7
Over-lock
0.0003±0.001
5(3.33%)
8
Washing
0.325±0.066
11(7.33%)
9
Finishing
0.0003±0.0001
4(2.67%)
10
Product
Development
0.348±0.102
10(7%)
11
Administration
0.191±0.053
6(4%)

Pakistan Journal of Science (Vol. 69 No. 3 September, 2017)
264
c: Boxplot between MFEV1/MFVC and Average Cotton
Dust
d: Boxplot between FEF25-75 and Average Cotton Dust
Figure 1: Boxplot of the lung function with regard to inhalable average cotton inhalable dust
Table 4: Correlation Structure among Pulmonary Function Test (PFT) values and Multiple Variables.
Correlations Structure
Year
Worked
Age
Height
Weight
cotton
dust
FVC
Measured
FEV1
Measured
FEV1/
FVC
Measured
FEF25-75
Measured
Year
Worked
Pearson
Correlation
1
.458*
*
0.153
0.192
0.018
0.111
0.047
-0.097
-0.093
P-value
0
0.175
0.087
0.874
0.326
0.676
0.393
0.411
Age
Pearson
Correlation
.458**
1
-0.138
0.206
-0.067
0.138
0.138
0.051
0.081
P-value
0
0.221
0.067
0.555
0.221
0.223
0.654
0.476
Height
Pearson
Correlation
0.153
-
0.138
1
.356**
.317**
-0.089
-0.003
0.129
-0.046
P-value
0.175
0.221
0.001
0.004
0.433
0.982
0.254
0.686
Weight
Pearson
Correlation
0.192
0.206
.356**
1
0.205
-0.041
-0.014
0.01
-0.059
P-value
0.087
0.067
0.001
0.069
0.721
0.903
0.932
0.605
Cotton
Dust
Pearson
Correlation
0.018
-
0.067
.317**
0.205
1
-0.138
-0.1
-0.036
-0.057
P-value
0.874
0.555
0.004
0.069
0.221
0.377
0.752
0.613
FVC
Measured
Pearson
Correlation
0.111
0.138
-0.089
-0.041
-0.138
1
.840**
-0.201
.296**
P-value
0.326
0.221
0.433
0.721
0.221
0
0.074
0.008
FEV1
Measured
Pearson
Correlation
0.047
0.138
-0.003
-0.014
-0.1
.840**
1
.344**
.729**
P-value
0.676
0.223
0.982
0.903
0.377
0
0.002
0
FEV1/FV
C
Measured
Pearson
Correlation
-0.097
0.051
0.129
0.01
-0.036
-0.201
.344**
1
.778**
P-value
0.393
0.654
0.254
0.932
0.752
0.074
0.002
0
FEF25-75
Measured
Pearson
Correlation
-0.093
0.081
-0.046
-0.059
-0.057
.296**
.729**
.778**
1
P-value
0.411
0.476
0.686
0.605
0.613
0.008
0
0
**Correlation is significant at the 0.01 level (2-tailed).
*Correlation is significant at the 0.05 level (2-tailed).
DISCUSSION
In this study, respiratory symptoms of workers
of textile processing unit located in the center of the city
were explored. It was generally recognized that exposure
to cotton dust in textiles was associated with byssinosis
and other respiratory ailments and workers were more
prone to them (Cui et al., 2011). These symptoms are
important causes of morbidity among them. The
enterprise was not good enough to illustrate the picture of
situation of occupational health and safety at workplace
and there were no signs of good housekeeping as noted
by the authors (Nafees et al., 2013). The workers in this
textile facility were reasonably of same composition with
regard to education, race, religion, marital status, housing
facilities and other socio-demographic characteristics.
Most of the workers were Punjabi and had experience of
only one job throughout their professional career.
0.19 0.26 0.28 0.31 0.33 0.35 0.38 0.45 0.6
0.5 0.7 0.9
Average Cotton Dust
MFEV1/MFVC
0.19 0.26 0.28 0.31 0.33 0.35 0.38 0.45 0.6
0 2 4 6 8
Average Cotton Dust
FEF25_75

Pakistan Journal of Science (Vol. 69 No. 3 September, 2017)
265
A number of research studies proved that cotton
textile workers had more chronic cough, chronic
bronchitis and decrement in FVC and FEV1 than controls.
In a research study, the prevalence of respiratory
characteristics among exposed workers were higher in
comparison to control while the studies carried out by
Nafees et al. (2013) and (Mitchell et al., 2015 and
Astrakianakis et al., 2007) showed opposite results. In
present study, there was a clear indication that exposed
groups had higher chronic respiratory symptoms as
compared to control group. The occupational asthma was
commonly found among textile workers with the
prevalence of 14.5 % in case studies by (Zock et al.,
1998). None of the subjects complained about workplace
asthma in this study. Anyhow, 4 percent of the subjects
complained about asthma in their childhood present study
which was reported in Pakistan by (Nafees et al., 2013
and Farooque et al., 2008).
Duration of work exposure ≥5 years was
associated with shortness of breath as well as drop in lung
function seen after adjusting for age, height and other
covariates reported by (Tanzil and Nafees, 2015). It was
also found during data analysis that trimming and sewing
sections of the textile unit were deeply associated with
respiratory symptoms, showing wheeze, chronic wheeze
and chest tightness which was comparable with studies
carried out by (Tanzil and Nafees, 2015; Nafees et al.,
2013 and Farooque et al., 2008). In these sections
obstructive pattern of lung function was observed and the
concentration of cotton dust was also high. Anyhow,
preventive measures were warranted in order to develop
safety and health culture at workplace to reduce high
prevalence of respiratory disorders in garment industry.
COPD was the main cause of morbidity and mortality
around the globe and its prevalence was linked to
workplace exposures and cigarette smoking. The COPD
pattern was also found higher in exposed worker in
comparison to control group. The detrimental effects of
cotton dust exposure were less in non-smokers than
smokers. The above mentioned studies proved that
occupational exposures like organic dust were the causes
of irreversible obstruction of airflow. In this study impact
of cotton dust on textile workers, office staff, university
department staff and students as control was observed. It
was also recognized that exposure to organic dust was a
reason for respiratory inflammation which lead to
development of chronic respiratory symptoms and loss to
lung function. The prevalence of COPD in significant
manner among the exposed group and this was in
agreement with the studies narrating deep link between
cotton dust exposure and COPD progression.
Many studies have proved harmful effects of
smoking among workers of textile and other occupations.
Anyhow, this study did not show any deleterious effects
on lung function indices among smokers due to which it
cannot infer about additive association by smoking. One
of the possibilities of having no relation of smoking for
adverse effect might be that smoking was very common
among healthier and younger individuals and they kept it
continued as long as they were alive. The other
possibility of not showing any adverse effect was due to
young population with mean age of 33.23±9.03 years,
often termed as healthy smoker selection. The
strengthening factors for the study were using
standardized procedures developed by NIOSH, ATS
guidelines reducing any chance of error in the procedure
reported by (Centurion et al., 2012). According to the
criteria at least three acceptable attempts were made for
each worker in the study to escape poor technique factor
(Zwar et al., 2011).
In textile sector a number of chemicals were
used in processes like dyeing and washing and even dyed
stuff contained dyes, residues of pesticides, endotoxin
level and other toxic compounds which were highly
hazardous which caused respiratory problems leading to
increased risk of COPD among cotton textile workers
(Singh and Chadha, 2013). The concentrations of
endotoxins were higher in the textile processing units,
therefore, workers employed in this sector of economy
were more likely to suffer from byssinosis (Centurion et
al., 2012) and other sectors like agriculture (Reynolds et
al., 2012; Cui et al., 2011) and wood trimmers (Jacobsen
et al., 2010). Prevalence of COPD increased with age and
smoking history, but other factors like history of lung
tuberculosis, some socio-demographics like in-house
biomass smoke exposure, exposure to fumes, air
pollution and chronic asthma were also thought to be
important factors in explaining the variations. There is a
dire need to work on this direction to study the effects of
aforementioned factors on health of textile worker.
Conclusion: In this cross-sectional study, lungs
impairment with regard to cotton dust was observed
which was independent of smoking among subjects and
control group. Prevalence of COPD among them was also
observed.
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