title: Pattern and predictors for respiratory illnesses and symptoms and lung function among textile workers in Karachi, Pakistan.
abstract: OBJECTIVE
  To determine pattern and predictors for respiratory illnesses and symptoms and lung function among textile workers in Karachi, Pakistan.
  
  
  METHODS
  This was a cross-sectional survey of 372 adult male textile workers from the spinning and weaving sections of 15 textile mills from Karachi. Data were collected from November to December 2009 through a structured, pretested questionnaire and spirometry.
  
  
  RESULTS
  Prevalence of byssinosis was 10.5%, chronic cough 7.5%, chronic phlegm 12.9%, wheeze with shortness of breath 22.3%, shortness of breath (grade 2) 21%, chest tightness ever 33.3%; whereas, a low prevalence of asthma (4%) was identified in this population. Eight per cent had obstructive, 8% restrictive and 2% mixed pattern of lung function abnormality. After controlling for potential confounders, work in the spinning section predicts frequent wheeze (AOR=2.0; 95% CI 1.1 to 3.5), wheeze with shortness of breath (AOR=1.8; 95% CI 1.0 to 3.4), and obstructive pattern on spirometry (AOR=2.5; 95% CI 1.0 to 6.2). Prolonged duration of work predicts breathlessness grade 1 (AOR=1.8; 95% CI 1.0 to 3.1) and grade 2 (AOR=2.7; 95% CI 1.3 to 5.4), as well as decrements in Forced Expiratory Volume in the first second (FEV(1)) and FEV(1)/Forced Vital Capacity ratio. Lack of education predicts frequent wheeze (AOR=2.0; 95% CI 1.2 to 3.3), and Sindhi ethnicity predicts chest tightness apart from during cold (AOR=2.7; 95% CI 1.1 to 6.6).
  
  
  CONCLUSIONS
  This study highlights the burden of respiratory illnesses and symptoms, and a low prevalence of asthma among textile workers in Karachi. Work in the spinning section, lack of education, prolonged duration of work and Sindhi ethnicity, were identified as important risk factors.
authors.affiliation: Division of Environmental Health Sciences, Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan. asaad.nafees@aku.edu
authors.forename: Asaad Ahmed
authors.initials: AA
authors.lastname: Nafees
authors.forename: Zafar
authors.initials: Z
authors.lastname: Fatmi
authors.forename: Muhammad Masood
authors.initials: MM
authors.lastname: Kadir
authors.forename: Nalini
authors.initials: N
authors.lastname: Sathiakumar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D032561:Cotton Fiber; D003430:Cross-Sectional Studies; D004391:Dust / Q000032:analysis; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008171:Lung Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000453:epidemiology* / Q000503:physiopathology; D010154:Pakistan / Q000453:epidemiology; D012120:Respiration Disorders / Q000453:epidemiology* / Q000503:physiopathology; D012135:Respiratory Sounds / Q000503:physiopathology; D013783:Textile Industry / Q000706:statistics & numerical data*; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
chemical_list: D004391:Dust