EFFECTS ON RESPIRATORY SYSTEM DUE TO EXPOSURE TOWHEAT FLOUR

Abstract

SUMMARY M any studieshaveshownthatflour dust exposure causes respiratory symptoms and is associated with impairment of lung function; the respiratory effects of exposure to flour dust are influenced by the dose and duration of exposure. The aim of this study is to assess the effects of exposure to flour dust on respiratory symptoms and lung function of bakery workers at a number of bakeries in Cairo. The present study was conducted on 30 bakery workers working at bakeries in Cairo state, All bakery workers participated in this study were subjected to following: Full medical history taking, Thorough clinical examination, Routine laboratory investigation, BMI was calculated, Chest x ray, Spirometric lung function test, Diffusion capacity for carbon monoxide (DLCO), Further proper radiological assessment for cases that shows abnormalities in their chest X-ray or DLCOSB . Bakery workers with skeletal abnormalities, neuromuscular diseases, Known cases of bronchiectasis or asthma, Subjects with morbid obesity and Subjects with abnormalities of RBCs were excluded from the study. A total of 30 workers were included in this study, exposed to flour dust in the work place without any protective equipment. All workers included in the study were males. The age of the flour milling workers ranged between14-56 years with a mean of (29.5±9.98) years. They work at least for 10 hours per day for 6 days per week for total working years ranged between 2-30 years with a mean of (12.97±7.65). This study reported that there increase in respiratory symptoms (upper respiratory symptoms, lower respiratory symptoms, work related symptoms) among bakery workers due to exposure to wheat flour, also reported that 16.6% of study population groups have abnormal pulmonary function as regard spirometry compared to the reference value, 30% of study population groups have abnormal pulmonary function as regard diffusion capacity of lung to carbon mono-oxide compared to reference value. Nine participants underwent HRCT chest as their DLCOSB has shown diffusion defect, five (55.6%) of them have normal HRCT chest and four (44.4%) of them have interstitial changes. Furthermore the study reported the effect of age as regard spirometric lung functions and lower respiratory symptoms being higher in age more than 40 years. In addition this study confirmed the effect of smoking on exposed worker to wheat flour leading to increase lower respiratory symptoms and decrease pulmonary function. Also, smoking augment effect of heavy exposure to wheat flour on DLCO, and affect findings ofHRCT chest, this means increase possibility of the interstitial lung disease induced by exposure to wheat flour in smokers. As previous studies, there is direct effect of duration of exposure to wheat flour on pulmonary function leading to obstructive airway disease even in non-smoker groups; likewise there is effect of duration of exposure to wheat flour on DLCO in a group heavy exposed to wheat flour. Furthermore this study has shown relation between amount of exposure to wheat flour and increase upper respiratory symptoms, work related symptoms, and decrease DLCOSB. This draws attention to the effect of exposure to wheat flour on lung interstitium which determine by amount and duration of exposure and could be detected early by DLCO.