Shaheen MZ, Sardar K, Ayyaz S, Mudaza HG, Nadeem M, Iftikhar U


INTRODUCTION: Approximately 10% of all adult onset asthma cases are related to occupation. It is estimated that 5% of subjects exposed to high molecular weight agents and up to 10% of subjects exposed to low molecular weight agents develop asthma. In addition, repeated exposure is found to be associated with the development of persistent asthma. A fertilizer factory is a major chemical unit known to emit various gases which have the potential to cause occupational asthma. While preventive measures are not so optimum in most of the units in Pakistan, it was suggested that exposed workforce of a fertilizer factory could have higher asthma prevalence. AIM: To find out whether there is a higher prevalence of respiratory symptoms in the working and/or nearby residential population exposed to various gases and chemicals of the fertilizer factory which is located at the northern edge of Multan city. STUDY DESIGN: This is a cross sectional questionnaire based survey carried out in the employees and residents of the fertilizer factory located at the northern edge of Multan city. Questionnaire contained various asthma symptoms and was derived from ISAAC study questionnaire. RESULTS: Questionnaire on respiratory symptoms was circulated among 550 persons working and/or living in the factory. Four hundred and eighty nine (88.9%) people returned the questionnaire. Sixty six percent were males. Mean age was 38.02+12.33 years. Mean duration of job/residence in the fertilizer company was 17.25+10.97 years. The most prevalent symptom was allergic rhinitis/sneezing, in 54.80% (268/489) followed by breathlessness experienced by 51.73% (253/489). Other common symptoms included frequent dry cough in 33.53%, wheezing 17.79% and nocturnal shortness of breath/cough in 16.35% of the study population. Around 38.24% (187/489) cases were already known to have allergy/asthma, while 37.01% (181/489) cases had a doctor's advice or prescription for allergy/asthma. All these symptoms had significantly higher prevalence among those workers who lived within the residential compound of the factory as compared to those living outside the factory. In former, the most prevalent symptom was shortness of breath experienced by 162/261 (62.06%) persons as compared to 91/228 (39.91%) in those living outside the factory. CONCLUSION: This study has provided evidence of significantly higher prevalence of asthma/rhinitis related symptoms among workers as well as non workers living in the residential compound of the fertilizer factory. It indicates that measures should be taken to identify the causative agents, reduce the exposure and to relocate people who have developed asthma. Stringent health safety measures should be adopted at the work site and appropriate measures taken to control the emission and environmental pollutants emitted by the fertilizer plants.


Respiratory Diseases; Fertilizers: Respiratory Symptoms.

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