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      Dust Exposure and Respiratory Health Among Workers in Primary Coffee Processing Factories in Tanzania and Ethiopia

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          Abstract

          Introduction: In primary coffee factories the coffee beans are cleaned and sorted. Studies from the 80- and 90-ties indicated respiratory health effects among the workers, but these results may not represent the present status. Our aim was to review recent studies on dust exposure and respiratory health among coffee factory workers in Tanzania and Ethiopia, two major coffee producing countries in Africa.

          Methods: This study merged data from cross-sectional studies from 2010 to 2019 in 4 and 12 factories in Tanzania and Ethiopia, respectively. Personal samples of “total” dust and endotoxin were taken in the breathing zone. Chronic respiratory symptoms were assessed using the American Thoracic Society (ATS) questionnaire. Lung function was measured by a spirometer in accordance with ATS guidelines.

          Results: Dust exposure among male production workers was higher in Ethiopia (GM 12 mg/m 3; range 1.1–81) than in Tanzania (2.5; 0.24–36). Exposure to endotoxins was high (3,500; 42–75,083) compared to the Dutch OEL of 90 EU/m 3. The male workers had higher prevalence of respiratory symptoms than controls. The highest symptom prevalence and odds ratio were found for cough (48.4%; OR = 11.3), while for breathlessness and wheezing the odds ratios were 3.2 and 2.4, respectively. There was a significant difference between the male coffee workers and controls in the adjusted FEV1 (0.26 l/s) and FVC (0.21 l) and in the prevalence of airflow limitation (FEV1/FVC < 0.7) (6.3 vs. 0.9%). Among the male coffee workers, there was a significant association between cumulative dust exposure and the lung function variables FEV1 and FVC, respectively.

          Conclusions: The results suggest that coffee production workers are at risk of developing chronic respiratory symptoms and reduced lung function, and that the findings are related to high dust levels. Measures to reduce dust exposure should be targeted to factors identified as significant determinants of exposure.

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          Most cited references21

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          Optimal assessment and management of chronic obstructive pulmonary disease (COPD)

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            Health risks due to coffee dust.

            This study assessed current health risks due to occupational exposure to coffee dust. We performed a cross-sectional study in a coffee haulage company (n = 24), a coffee silo (n = 19), and a decaffeinating company (n = 17). Cross-shift and cross-week case histories of these employees as well as lung function values were recorded. During the handling of green coffee, measurements of airborne dust were conducted. The employees in these workplaces were mainly affected by erythematous and rhinoconjunctival symptoms. They occurred especially in subjects exposed to a high dust load (> 10 mg of inhalable dust per cubic meter of air; n = 28) [Pearson chi(2) test, p = 0.020 and p = 0.023]. IgE antibodies to green coffee and castor beans were detected in 3 workers and 10 workers, respectively. The majority of them (two employees and six employees, respectively) had shown respiratory symptoms during the past 12 months. The preshift lung function values were below average but were not dependent on the level of the inhalable coffee dust exposure. Employees with a coffee dust load > 10 mg/m(3) of air showed higher unspecific bronchial responsiveness more frequently than those with lower exposures. During the transshipment (especially during unloading) of green coffee, a high and clinically relevant exposure to irritative and sensitizing dust occurs. Therefore, efforts to reduce these dust exposures are generally recommended.
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              Respiratory function in coffee workers.

              Respiratory function was studied in three groups of workers employed in processing coffee. The prevalence of almost all chronic respiratory symptoms was significantly higher in coffee processors than in control workers. In each group during the Monday work shift there was a significant mean acute decrease in the maximum expiratory flow rate at 50% vital capacity (VC), ranging from 4.0% to 8.7%, and at 25% VC, ranging from 6.0% to 18.5%. Acute reductions in FEV1.0 were considerably lower, ranging from 1.3% to 2.8%. On Thursdays the acute ventilatory function changes were somewhat lower than on Mondays. Acute decreases in flow rates at low lung volumes suggest that the bronchoconstrictor effect of the dust acts mostly on smaller airways. Administration of Intal (disodium cromoglycate) before the shift considerably diminished acute reductions in flow rates. A comparison of Monday pre-shift values of ventilatory capacity in coffee workers with those in controls indicates that exposure to dust in green or roasted coffee processing may lead to persistent loss of pulmonary function.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                20 September 2021
                2021
                : 9
                : 730201
                Affiliations
                [1] 1Department of Global Public Health and Primary Care, University of Bergen , Bergen, Norway
                [2] 2Department of Preventive Medicine, School of Public Health, Addis Ababa University , Addis Ababa, Ethiopia
                [3] 3School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences , Dar es Salaam, Tanzania
                [4] 4Department of Global Public Health and Primary Care, Centre for International Health, University of Bergen , Bergen, Norway
                Author notes

                Edited by: Kristin J. Cummings, California Department of Public Health, United States

                Reviewed by: Victor C. W. Hoe, University of Malaya, Malaysia; Sadeel Shanshal, University of Mosul, Iraq; Francesca Larese Filon, University of Trieste, Italy

                *Correspondence: Magne Bråtveit magne.bratveit@ 123456uib.no

                This article was submitted to Occupational Health and Safety, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2021.730201
                8488214
                1021f293-a8aa-4bfe-9eec-b5b719230b8c
                Copyright © 2021 Bråtveit, Abaya, Sakwari and Moen.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 24 June 2021
                : 23 August 2021
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 27, Pages: 8, Words: 6114
                Funding
                Funded by: Direktoratet for Utviklingssamarbeid, doi 10.13039/100007843;
                Award ID: 13000646
                Funded by: Universitetet i Bergen, doi 10.13039/501100005036;
                Categories
                Public Health
                Review

                coffee workers,dust exposure,respiratory symptoms and lung function,endotoxin,exposure assessment

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