O-213 Obstructive lung disease associated with occupational and environmental exposures among small-scale tobacco farmers in Malawi. (14th March 2023)

• Record Type: Journal Article
• Authors: Moyo, Yotam Mgonjetsi; Jeebhay, Mohamed F; Baatjies, Roslynn; Dadabhai, Sufia; Adams, Shahieda
• Is Part Of: Occupational and environmental medicine. Volume 80(2023)Supplement 1
• Page Start: A21
• Page End: A21
• Publication Date: 2023-03-14
• Subjects: Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; 616.980305
• DOI: 10.1136/OEM-2023-EPICOH.50
• Languages: English
• ISSNs: 1351-0711

Abstract

Abstract : Introduction: Nicotine and pesticide exposure in agricultural settings have been linked to the development of chronic respiratory disease in workers. The aim of this study was to determine the prevalence of obstructive lung disease and its relationship to concurrent nicotine and pesticide exposure among small-scale tobacco farmers in Malawi. Material and Methods: A cross-sectional study was conducted enrolling 279 workers in flue-cured tobacco farms in Zomba, Malawi. Health outcomes were assessed using a standardised European Community Respiratory Health Survey II questionnaire. Spirometry testing was conducted during the working day. Results: The average age of participants was 37.7 years with a greater proportion (68%) being male. The prevalence of work-related ocular nasal symptoms, chronic bronchitis, and work- related chest symptoms was 20%, 17%, and 29%, respectively. Airflow limitation measured as FEV1/FVC <70% was found in 8% of workers. Self-reported exposure to pesticide was between 72% (spraying) and 83% (field re-entry after spraying). The prevalence of recent green tobacco sickness (proxy for nicotine exposure) was 26%. Tasks linked to nicotine exposure, such as harvesting and curing, were significantly associated with respiratory symptoms. Work involving pesticide application was associated with an increased risk of respiratory symptoms. Duration of pesticide exposure was also associated with obstructive impairment FEV1/FVC<LLN and FEV1/FVC<70%. Conclusions: This study demonstrated that tobacco farmers in Malawi have a higher prevalence of respiratory symptoms and airflow limitation due to obstructive lung disease when compared to the general population. This could be attributable to to nicotine or pesticide exposure in small scale tobacco farming. The implementation of occupational health and safety measures to mitigate these exposures may play an important role in modifying the risk of obstructive lung disease in this population.