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Introduction: The use of hearing protection devices (HPDs) has been an intervention of choice in many workplaces such as in the construction industry for quite some time due to impractical effects of engineering and administrative interventions. Questionnaires for assessment for HPDs use among construction workers have been developed and validated in developed countries. However, there is limited knowledge of the same, among manufacturing workers in developing countries that are assumed to have a different culture, work organizations and production processes. Methods: We conducted a stepwise methodological study to develop a questionnaire to predict the use of HPDs among noise exposed workers in manufacturing factories in Tanzania. The questionnaire included 24 items and was developed through rigorous and systematic procedures involving three steps; (i) item formulation that involved two experts, (ii) expert content review and item rating that involving eight experts with vast experience in the field, and (iii) a field pre-test that involved 30 randomly selected workers from a factory with similar characteristics as a planned study site. A modified Pender's Health Promotion Model was adopted in the questionnaire development. We analyzed the questionnaire in terms of content validity and item reliability. Results: The 24 items were categorized into seven domains i.e., perceived self-efficacy, perceived susceptibility, perceived benefits, perceived barriers, interpersonal influences, situational influences and safety climate. The score for content validity for each item was satisfactory as the content validity index ranged between 0.75 to 1.00 for clarity, relevance, and essentiality criteria. Similarly, the scores for the content validity ratio (for all items) were 0.93, 0.88 and 0.93 for clarity, relevance, and essentiality, respectively. In addition, the overall value for Cronbach's alpha was 0.92 with domain coefficients: perceived self-efficacy 0.75; perceived susceptibility 0.74; perceived benefits 0.86; perceived barriers 0.82; interpersonal influences 0.79; situational influences; 0.70; and safety climate 0.79. The mean inter-item correlation was 0.49 suggesting good internal consistency. Discussion and conclusion: The developed and preliminary validated questionnaire can be used to predict the HPDs use among noise exposed manufacturing factory workers. Future surveys using this questionnaires warranted for further validation of the scale developed.
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Pérdida Auditiva Provocada por Ruido , Ruido en el Ambiente de Trabajo , Humanos , Pérdida Auditiva Provocada por Ruido/prevención & control , Tanzanía , Reproducibilidad de los Resultados , Ruido en el Ambiente de Trabajo/prevención & control , Dispositivos de Protección de los Oídos , Encuestas y Cuestionarios , AudiciónRESUMEN
BACKGROUND: Spirometry is a commonly used lung function test. It assesses respiratory functions by measuring the air volume and the rate at which a person can exhale from lungs filled to their total capacity. The most helpful spirometry parameters are: forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow (PEF). Pregnancy derives an altered physiological state due to hormonal and anatomical changes that affect the respiratory system. Despite that, spirometry is less commonly done during pregnancy, and if done, test results are evaluated against non-pregnancy references. OBJECTIVE: This study aimed to explore spirometry profiles in pregnant and non-pregnant women and describe their differences. METHODOLOGY: This cross-sectional study involved age-matched pregnant and non-pregnant participants recruited from Mnazi Moja ANC and Muhimbili University (MUHAS). A digital spirometer was used to assess respiratory function. Data were entered and analyzed using SPSS version 23. The mean spirometry values of pregnant participants were compared to those of non-pregnant participants using an independent sample t-test. A p-value of < 0.05 was considered statistically significant. RESULTS: The study included 92 pregnant and 98 non-pregnant participants subjected to spirometry. Both FVC and FEV1 values were significantly lower in pregnant than in non-pregnant participants (2.7 ± 0.5 L vs. 2.9 ± 0.5 L; p < 0.01 and 2.2 ± 0.4 L vs. 2.5 ± 0.4 L; p < 0.01 respectively). In addition, pregnant participants had significantly lower mean PEF values than their non-pregnant counterparts (303 ± 84 L/min versus 353 ± 64 L/min; p < 0.01). CONCLUSION: Spirometry test values are lower in pregnancy than in non-pregnant participants. RECOMMENDATIONS: Interpreting the spirometry test values of pregnant women using references obtained from non-pregnant women may be inappropriate. Future studies should evaluate the appropriateness of predicting spirometry values of pregnant women using reference equations derived from non-pregnant women.
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Población Negra , Femenino , Humanos , Estudios Transversales , Espirometría , UniversidadesRESUMEN
Background: Workers in iron and steel factories in Tanzania are exposed to noise levels above recommended limit values, without using hearing protection devices. Exposure to noise levels above 85 dB(A) is associated with temporary threshold shifts (TTS) of human hearing. Nevertheless, there are few studies of noise and hearing from African countries. Objective: To determine whether the normal hearing workers in Tanzania experiences TTS after full-shift occupational noise exposure of 85 dB(A) and above. Methods: A total of 55 workers were included. Full-shift personal noise measurements were conducted. Pre- and post-shifts pure-tone audiometry were conducted for each worker. TTS was defined as a 10 dB or greater change at 1000, 2000, 3000 or 4000 Hz in either ear. Results: We found that 85.5% of the workers developed TTS across the work shift. There was significant increase in mean hearing thresholds across shift at 1000, 2000, 3000 and 4000 Hz among the workers exposed to an average personal noise exposure (LAeq,8h) of 90.4 dB(A) (SD = 2.7). The difference in mean hearing thresholds was higher at 4000 Hz [Arithmetic Mean (AM) = 10 dB SD = 4 dB] compared to that of 1000 Hz (AM = 4 dB SD = 3 dB), 2000 Hz (AM = 4 dB SD = 4 dB), and 3000 Hz (AM = 9 dB SD = 6 dB), respectively. Conclusions: Interventions to reduce occupational personal noise exposure are warranted to reduce the high risk of developing a permanent threshold shift with persistent high noise exposure. An intervention study is planned for this group of workers.
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Pérdida Auditiva Provocada por Ruido , Ruido en el Ambiente de Trabajo , Pérdida Auditiva Provocada por Ruido/epidemiología , Pérdida Auditiva Provocada por Ruido/etiología , Pérdida Auditiva Provocada por Ruido/prevención & control , Humanos , Hierro , Ruido en el Ambiente de Trabajo/efectos adversos , Acero , Tanzanía/epidemiologíaRESUMEN
OBJECTIVES: To compare total dust exposure, prevalence of chronic respiratory symptoms, lung function, and chronic obstructive pulmonary disease (COPD) among Tanzanian cement workers before (2002) and after (2010-2011) establishment of dust-control measures. METHODS: Personal total dust-exposure measurements, questionnaire assessment for chronic respiratory symptoms, and spirometry were conducted in both examination periods. RESULTS: Total dust exposure was lower in 2010-2011 than in 2002. The prevalence of most chronic respiratory symptoms and COPD was lower in 2010 than in 2002. Forced expiratory volume in 1 second (FEV1), percentage predicted FEV1, and percentage predicted forced vital capacity were higher among cement workers in 2010 than in 2002. CONCLUSIONS: There was reduced total dust exposure level, lower prevalence of chronic respiratory symptoms and COPD, and higher lung function among cement workers in 2010 than in 2002.
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Materiales de Construcción , Polvo/prevención & control , Enfermedades Profesionales/epidemiología , Exposición Profesional/prevención & control , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Adulto , Bronquitis Crónica/epidemiología , Enfermedad Crónica , Tos/epidemiología , Volumen Espiratorio Forzado , Humanos , Masculino , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Prevalencia , Espirometría , Esputo , Encuestas y Cuestionarios , Tanzanía , Capacidad Vital , Adulto JovenRESUMEN
BACKGROUND: It has been suggested that dust exposure causes airway inflammation among cement factory workers. However, there is limited information on the mechanisms of this effect. We explored any associations between total dust exposure and fractional exhaled nitric oxide (FENO) as a marker of airway eosinophilic inflammation among cement production workers in Tanzania. We also examined possible differences in FENO concentration between workers in different parts of the production line. METHODOLOGY: We examined 127 cement workers and 28 controls from a mineral water factory. An electrochemistry-based NIOX MINO device was used to examine FENO concentration. Personal total dust was collected from the breathing zone of the study participants using 37 mm cellulose acetate filters placed in three-piece plastic cassettes. Interviews on workers' background information were conducted in the Swahili language. RESULTS: We found equal concentrations of FENO among exposed workers and controls (geometric mean (GM)=16 ppb). The GM for total dust among the exposed workers and controls was 5.0 and 0.6 mg/m(3), respectively. The FENO concentrations did not differ between the exposed workers with high (GM≥5 mg/m(3)) and low (GM<5 mg/m(3)) total dust exposure. There was no significant difference in FENO concentration between workers in the two main stages of the cement production process. CONCLUSIONS: We did not find any difference in FENO concentration between dust-exposed cement workers and controls, and there were similar FENO concentrations among workers in the two main stages of cement production.