Translating Evidence Based Exposure Assessment into Occupational Health Promotion in Resource Limited Settings

摘要

Chemical exposure assessment in occupational environment and related health disorders in poor urban settings is extremely neglected in Pakistan. A human biomonitoring study of 120 petrol pump workers using serum naphthalene, pyrene and urinary 1-hydroxyprene was conducted to quantify occupational exposure. The health risks based on self-reported health status was also noted using a questionnaire. We categorized health disorders into physical (e.g. skin lesions, eye redness, dryness of tongue/lips, appetite loss, acidity after meals at workplace) and neurasthenic symptoms (e.g. energy loss, fatigue, fainting, twitching, sleeplessness, irritability, body aches). Results of HPLC based serum analysis showed that mean concentration of blood naphthalene was 106 μg L-1 which had significant correlation with cigarette smoking by (r=0.49; p＜0.01). However, pyrene body burden (mean 19.18 μg L-1) appeared to be a significant predictor of urinary 1-hydroxyprene pyrene (69.9 μmol mol-1 creatinine). There was fairly high significant effect of daily work-hours and job duration on serum pyrene levels. Workers exposed to 6 hour per day or more had significantly high prevalence of physical disorders (OR=2.79, 95% CI=1.28-6.09). Neurasthenic symptoms were found in 65% of the subjects and were associated with years of involvement in job. Ten years or more occupational work at petrol pumps attributed substantial development of neurasthenic effects (OR=2.80, 95% CI=1.23-6.34). We conclude that subjects associating disturbances in physical and neurological behavior with petrol related occupation rated their overall health and functional capacity significantly poorer than that of urban area general population. To promote health of petrol pump workers, reduction in work hours and provision of masks and gloves could be introduced as occupational health interventions.