Coffee Dust Exposure And Respiratory Health Among Workers In Primary Coffee Processing Factories In Ethiopia

Background: Dust exposure is one of the major risk factors for health in many work placesrnincluding coffee processing factories. Dust generates at different stages of coffee handlingrnand processing. Excessive exposure to coffee dust can cause respiratory health problems.rnCoffee workers in Ethiopia are exposed to coffee dust, but the level of exposure and thernmagnitude of its health effect have not been widely investigated. rnObjectives: The aims of this study were to assess the level of personal total dust exposure,rnfactors affecting dust exposure, the prevalence of respiratory symptoms and lung functionrnreduction among coffee workers. In addition, assessing microbial contamination of coffee atrndifferent stages of both wet and dry method on farm coffee processing was a part of thisrndissertation. rnMethods: Comparative cross-sectional studies were conducted in primary coffee processingrnfactories involving 3 regions: Oromia Regional State; Addis Ababa City Administration; andrnSouthern Nations, Nationalities and Peoples’ Region. The study also included a comparativernpopulation in 3 water bottling factories, one from each region mentioned above. A total ofrn360 dust samples were collected from 12 primary coffee processing factories for dustrnexposure assessment. In addition, 60 total dust samples were collected from the 3 waterrnbottling factories. Dust samplings were collected from breathing zone of workers using 25mmrnthreernpiece,rnclosed-facedrnconductiverncassettesrnrnwithrnarncellulosernacetaternfilterrnrnattachedrntornrnSidernrnKick Casella pumps with a flow rate of 2 liter/ minute. Observational checklist wasrnused to identify possible determinants for dust exposure. rnLung function tests were performed for a total of 420 participants ( 120 male coffee workers,rn120 male controls, 60 hand pickers with tables, 60 hand pickers without tables and 60 femalerncontrols) using a portable spirometer (SPIRARE 3 sensor model SPS 320). Lung functionrnparameters such as Forced Vital Capacity (FVC), Forced Expiratory Volume in one secondrn(FEVrn1rn), the mean forced expiratory flow between 25% and 75% of the FVC (FEFrn) andrnratio FEVrn FVC were measured. Prevalence of chronic respiratory symptoms were assessedrnwith an interview, using a standardized questionnaire adopted from the American ThoracicrnSociety. rn1/rnCoffee cherries each weighing about 25 grams were sampled from each stage of the wet andrndry processes for microbial contamination assessment. Standard Plate Count agar was used rn25-75% rnto grow total bacteria and gram stain technique were used to identify gram negative and gramrnpositive bacteria. rnData were entered into an electronic database using EpiData version 3.1 and exported tornSPSS version 22 for analysis. Missing values and outliers were checked using frequencyrntabulation, and then were managed accordingly. The results were described as arithmeticrnmean, standard deviation, geometric mean (GM), and geometric standard deviation (GSD).rnrnA one-way analysis of variance was performed to compare the GM of personal total dustrnexposure level between different job groups and between tasks. Linear mixed effectrnregression models were developed to identify significant determinants for personal total dustrnexposure. Independent t-tests were used to compare the mean values for the continuousrnvariables. The Pearson Chi-square test or Fisher’s exact test, if the expected value was lessrnthan 5, were used to test the difference between the groups regarding the categoricalrnvariables. Poisson regression analysis with a robust variance was used to determine thernprevalence ratio of the different respiratory symptoms between the coffee workers andrncontrols. Analysis of covariance and linear regression were used to compare the mean lungrnfunction parameters between the coffee workers and controls while adjusting forrnconfounders.rnrnResults: The GM dust exposure among machine room workers ranged from 4.09 to 34.40rnmg/mrn rn3rn, among transport workers from 3.51 to 24.19 mg/mrn3rn, and among hand pickers fromrn0.26 to 5.87 mg/mrn3rn. Overall the GM personal dust exposure was significantly higher (P =rn0.001) for the machine room (12.54 mg/mrn3rn) and transport workers (12.30 mg/mrn) than for thernhand pickers (1.08 mg/mrn3rn). In these three groups, 84.6%, 84.1%, and 2.6% of the samplesrnexceeded the occupational exposure limit of 5 mg/mrn3 rnrespectively. The result also indicatedrnthat pouring coffee vigorously from a dropping height was the determinant with the highestrnimpact on personal total dust exposure with 3.2-fold increase compared to gradually pouringrncoffee from a very short height.rnrnCoffee workers had significantly higher prevalence of most of the chronic respiratoryrnsymptoms compared with the controls. For most of the chronic respiratory symptoms, handrnpickers without tables displayed a significantly higher prevalence ratio than in hand pickersrnwith tables. rn3rnMale coffee workers in the age groups 28–39 years and ≥40 years, had a significantly lowerrnFVC and FEVrn compared to the controls in the similar age groups. There were statisticalrndifferences in FEFrn1rn25-75% rn between hand pickers and controls. In addition, FVC and FEVrnwerernsignificantly lower among hand pickers without tables than among hand pickers with tables. rnThe results also indicated the presence of gram negative bacteria in dried and stored beansrnfrom both the wet and dry process. rnConclusion: About 84% of the dust samples among machine room and transport workers inrnprimary coffee processing factories were above the occupational exposure limit value forrnorganic dust. Machine and transport workers in primary coffee processing factories had arnhigher prevalence of chronic respiratory symptoms and lower FVC and FEVrn than therncontrols. Pouring coffee beans vigorously from a dropping height, mixing coffee and feedingrnhopper were the main determinants for increased personal dust exposure level. The dustrnexposure was related to reduced lung function and higher prevalence of chronic respiratoryrnsymptoms among coffee workers. Gram negative bacteria found in dried and stored coffeernbeans, might release endotoxin which may cause respiratory health problems among coffeernproduction workers. rnRecommendations: Coffee workers should be provided with efficient respiratory protectiverndevice and training on its importance prior to employment and regularly afterwards asrnnecessary. Changing process of pouring coffee beans from vigorously to gradual couldrnreduce personal dust exposure level in the coffee factories. rn1rn1

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