title: Industrial hygiene, occupational safety and respiratory symptoms in the Pakistani cotton industry.
abstract: OBJECTIVE
  In the cotton industry of Pakistan, 15 million people are employed and exposed to cotton dust, toxic chemicals, noise and physical hazards. The aim of this study was to determine the prevalence of health symptoms, particularly respiratory symptoms, and to measure cotton dust and endotoxin levels in different textile factories of Faisalabad, Pakistan.
  
  
  METHODS
  A cross-sectional investigation was performed in a representative sample of 47 cotton factories in the Faisalabad region in Punjab, Pakistan. Respiratory symptoms of 800 workers were documented by questionnaire. Occupational safety in the factories was assessed by a trained expert following a checklist, and dust and endotoxin levels in different work areas were measured.
  
  
  RESULTS
  Prevalence of respiratory disease symptoms (fever, shortness of breath, chest tightness and cough) was generally high and highest in the weaving section of the cotton industry (20-40% depending on symptoms). This section also displayed the poorest occupational safety ratings and the highest levels of inhalable cotton dust (mean±SD 4.6±2.5 vs 0.95±0.65 mg/m(3) in compact units). In contrast, endotoxin levels were highest in the spinning section (median 1521 EU/m(3)), where high humidity is maintained.
  
  
  CONCLUSIONS
  There are still poor working conditions in the cotton industry in Pakistan where workers are exposed to different occupational hazards. More health symptoms were reported from small weaving factories (power looms). There is a dire need for improvements in occupational health and safety in this industrial sector with particular focus on power looms.
authors.affiliation: Institute of Environmental Health, Medical University of Vienna, Vienna, Austria Federal Government Polyclinic (Post-graduate Medical Institute), Islamabad, Pakistan.
authors.forename: Abdul Wali
authors.initials: AW
authors.lastname: Khan
authors.affiliation: Institute of Environmental Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Hanns Michael
authors.initials: HM
authors.lastname: Moshammer
authors.affiliation: Institute of Environmental Health, Medical University of Vienna, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Kundi
mesh_terms: D000395:Air Pollutants, Occupational / Q000009:adverse effects* / Q000032:analysis; D032561:Cotton Fiber; D003430:Cross-Sectional Studies; D004391:Dust / Q000032:analysis*; D004731:Endotoxins / Q000032:analysis; D004784:Environmental Monitoring / Q000331:legislation & jurisprudence / Q000379:methods*; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000517:prevention & control; D016273:Occupational Exposure / Q000009:adverse effects* / Q000331:legislation & jurisprudence / Q000517:prevention & control; D016272:Occupational Health; D010154:Pakistan / Q000453:epidemiology; D011050:Policy Making; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000517:prevention & control; D011795:Surveys and Questionnaires; D013783:Textile Industry / Q000331:legislation & jurisprudence
chemical_list: D000395:Air Pollutants, Occupational; D004391:Dust; D004731:Endotoxins
keywords: Byssinosis; Endotoxin; OCCUPATIONAL & INDUSTRIAL MEDICINE
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