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ObjectivesTo assess the association of exposure in cotton mills in Karachi with different definitions of byssinosis and lung health.MethodsThis cross-sectional survey took place between June 2019 and October 2020 among 2031 workers across 38 spinning and weaving mills in Karachi. Data collection involved questionnaire-based interviews, spirometry and measurements of personal exposure to inhalable dust. Byssinosis was defined using both WHO symptoms-based (work-related chest tightness), and Schilling’s criteria (symptoms with decreased forced expiratory volume in 1 s (FEV1). Values of FEV1/forced vital capacity ratio below the lower limit of normality on postbronchodilator test were considered as ‘chronic airflow obstruction’ (CAO).Results56% of participants had at least one respiratory symptom, while 43% had shortness of breath (grade 1). Prevalence of byssinosis according to WHO criteria was 3%, it was 4% according to Schilling’s criteria, and likewise for CAO. We found low inhalable dust exposures (geometric mean: 610 µg/m3). Cigarette smoking (≥3.5 pack-years), increasing duration of employment in the textile industry and work in the spinning section were important factors found to be associated with several respiratory outcomes.ConclusionWe found a high prevalence of respiratory symptoms but a low prevalence of byssinosis. Most respiratory outcomes were associated with duration of employment in textile industry. We have discussed the challenges faced in using current, standard guidelines for identifying byssinosis.

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license., Background: Small airways obstruction is a common feature of obstructive lung diseases. Research is scarce on small airways obstruction, its global prevalence, and risk factors. We aimed to estimate the prevalence of small airways obstruction, examine the associated risk factors, and compare the findings for two different spirometry parameters. Methods: The Burden of Obstructive Lung Disease study is a multinational cross-sectional study of 41 municipalities in 34 countries across all WHO regions. Adults aged 40 years or older who were not living in an institution were eligible to participate. To ensure a representative sample, participants were selected from a random sample of the population according to a predefined site-specific sampling strategy. We included participants' data in this study if they completed the core study questionnaire and had acceptable spirometry according to predefined quality criteria. We excluded participants with a contraindication for lung function testing. We defined small airways obstruction as either mean forced expiratory flow rate between 25% and 75% of the forced vital capacity (FEF25-75) less than the lower limit of normal or forced expiratory volume in 3 s to forced vital capacity ratio (FEV3/FVC ratio) less than the lower limit of normal. We estimated the prevalence of pre-bronchodilator (ie, before administration of 200 μg salbutamol) and post-bronchodilator (ie, after administration of 200 μg salbutamol) small airways obstruction for each site. To identify risk factors for small airways obstruction, we performed multivariable regression analyses within each site and pooled estimates using random-effects meta-analysis. Findings: 36 618 participants were recruited between Jan 2, 2003, and Dec 26, 2016. Data were collected from participants at recruitment. Of the recruited participants, 28 604 participants had acceptable spirometry and completed the core study questionnaire. Data were available for 26 443 participants for FEV3/FVC ratio and 25 961 participants for FEF25-75. Of the 26 443 participants included, 12 490 were men and 13 953 were women. Prevalence of pre-bronchodilator small airways obstruction ranged from 5% (34 of 624 participants) in Tartu, Estonia, to 34% (189 of 555 participants) in Mysore, India, for FEF25-75, and for FEV3/FVC ratio it ranged from 5% (31 of 684) in Riyadh, Saudi Arabia, to 31% (287 of 924) in Salzburg, Austria. Prevalence of post-bronchodilator small airways obstruction was universally lower. Risk factors significantly associated with FEV3/FVC ratio less than the lower limit of normal included increasing age, low BMI, active and passive smoking, low level of education, working in a dusty job for more than 10 years, previous tuberculosis, and family history of chronic obstructive pulmonary disease. Results were similar for FEF25-75, except for increasing age, which was associated with reduced odds of small airways obstruction. Interpretation: Despite the wide geographical variation, small airways obstruction is common and more prevalent than chronic airflow obstruction worldwide. Small airways obstruction shows the same risk factors as chronic airflow obstruction. However, further research is required to investigate whether small airways obstruction is also associated with respiratory symptoms and lung function decline., National Heart and Lung Institute and Wellcome Trust. Supported by Wellcome Trust grant 085790/Z/08/Z for the BOLD study

Vegetable spoilage produces various microbes of different origins like parasites, fungi, viruses, and bacteria. This causes infections and diseases in vegetables, and later on, when humans eat these vegetables; diseases induce in humans. So, to prevent human diseases, the symptoms of various infections in vegetables must be known. Moreover, the conditions supporting the infections in vegetables must be understood. So that spoiled vegetable consumption can be prevented. Sometimes spoiled vegetables are regarded as disease free and suitable for consumption. These misconceptions sometimes lead to lethal human diseases, which in history led to major outbreaks. The antimicrobial resistance is faced by microbes which deteriorate the situation and make the cure of diseases.

We assessed the association of formaldehyde, carbon monoxide (CO), and particulate matter (PM 2.5 ) with respiratory symptoms, asthma, and post-bronchodilator reversibility.We included 1629 adults in a community-based cross-sectional study in Karachi in 2015. Data were collected using the American Thoracic Society respiratory questionnaire and spirometry (available for 930 participants). YesAir eight-channel monitor was used for measuring concentrations of formaldehyde and CO, whereas PM 2.5 was measured using UCB PATS.Higher levels of formaldehyde and CO were associated with cough, phlegm, and wheeze, whereas those of PM 2.5 were associated with shortness of breath and presence of any of the respiratory symptoms (combined), as well as a "lower" risk of cough, phlegm, and bronchitis.Poorer household air quality was associated with poorer respiratory health in this population; however, further studies with a robust exposure assessment are required.

This study analyzed physicochemical and bacteriological parameters of packaged water sold in Gilgit city and its vicinity. Samples from source, market, and after the process were collected randomly from three different companies and analyzed from April 2017 to May 2017. Bacteriological parameters include Escherichia coli and Enterococci; it was further examined with conformity tests. The investigated physical parameters included (pH, Turbidity, Conductivity, Total Dissolved Solids). Some important chemical parameters like Total phosphorous and Total Nitrogen were assessed through a spectrophotometer. The results revealed that the Physicochemical parameters fell within WHO tolerable limits, pH ranged from 7.0 to 8.4, TDS were observed from 260 ppm to 40 ppm, Electrical conductivity was found between 91 μs-510 μs, Turbidity varied from 0.03 NTU to 0.52 NTU. The Total Nitrogen and Total Phosphorus range from 0.09 mg/L to 2.09 mg/L and 95 mg/L to 540 mg/L. The bacteriological parameters were unsatisfactory as some of the samples were contaminated with the E. coli and Enterococci. The maximum value for E. coli was 288 CFU/100 ml, and that of the Enterococci was 267 CFU/100 ml, which strongly violates the WHO specifications for bottled drinking water quality. Based on our findings, the Bacteriological examination of some samples is classified under the high-risk category since they are found to be unsafe for drinking. It is recommended there should be strict monitoring and surveillance of bottled water quality; sources should be protected, and awareness should be given to the public regarding its quality.

Milk contains all the essential nutrients like fats, proteins, and minerals. The utilization of contaminated food can induce a proportion of pesticides in the body. The main purpose of the study was to determine the pesticide residues and current status of breast milk in primiparous and multiparous mothers. In a current study, a total of 50 samples were collected from different areas of District Gilgit and Astore. The pesticides cypermethrin, deltamethrin, and chlorpyrifos were analyzed using gas chromatography. The presence of cypermethrin in 10 samples was in a range 0.00 – 0.012 mg/kg, while the detection of Deltamethrin in 07 with variation from 0.000.12mg/kg. Whereas chlorpyrifos was found in 05 samples with the ranges of 0.00-0.0062 mg/kg. Residue level was quite higher in urban areas than rural areas. The multiparous women had prominent residues level than primiparas and the concentration of Deltamethrin was higher than other pesticides. All the pesticides residues levels in the breast milk of primiparous and multiparous mothers were within the permissible limits of WHO. Yet the women of these areas are not vulnerable but prolong exposure may pose a serious threat to neonatal and maternal health and other relevant reproductive issues. To manage the risk of milk contamination in the future, the demand for public awareness campaigns and the adoption of alternative clean approaches to control pests and other disease-spreading vectors in the best interests of public health seems reasonable.

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/., Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita and the local annual mean level of ambient particulate matter (PM2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improved understanding of the link between CAO and poverty should be prioritised., Supported by Wellcome Trust grant 085790/Z/08/Z for the BOLD (Burden of Obstructive Lung Disease) Study. The initial BOLD programprogramme was funded in part by unrestricted educational grants to the Operations CenterCentre in Portland, Oregon from Altana, Aventis, AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Merck, Novartis, Pfizer, Schering-Plough, Sepracor, and the University of Kentucky (Lexington, KY). A full list of local funders can be found at https://www.boldstudy.org.

Background: Cotton dust is generated during various textile manufacturing processes. Only a few studies from Pakistan assessed cotton dust exposure and explored the relationship of duration of work in the textile industry with respiratory health outcomes. We aimed to assess cotton dust exposure and its association with lung function and respiratory symptoms among textile workers in Pakistan. Methods: We report findings from the baseline cross- sectional survey of the larger study, MultiTex, among 498 adult male textile workers from six mills conducted between Oct 2015-March 2016 in Karachi, Pakistan. Data collection included the use of standardized questionnaires; spirometry, and area dust measurements through UCB-PATS. Multivariable logistic and linear regression models were developed to assess the association of risk factors with respiratory symptoms and illnesses. Results: We found the mean age of workers to be 32.5 (±10) years; around 25% were illiterate. The prevalence of COPD, asthma, and byssinosis in our study was 10%, 17%, and 2%, respectively. The median cotton dust exposure was 0.33 mg/m3 (IQR;0.12-0.76). Increased duration of work among non-smokers was associated with a decline in lung function, FVC (-245 ml; 95% CI -385.71, -104.89) and FEV1 (-200 ml; 95 % CI -328.71, -84.11). Workers with certain job titles (machine operators, helpers, and jobbers), those with greater duration of work, and higher dust exposure, were more likely to report respiratory symptoms and illnesses. Conclusion: We report a high prevalence of asthma and COPD and a low prevalence of byssinosis. Cotton dust exposure and duration of employment were associated with respiratory health outcomes. Our findings highlight the need for preventive interventions in the textile industry in Pakistan.

The present study was aimed to evaluate the antioxidant potential and inhibitory effect ofCannabis sativa and Morus nigra against lipid peroxidation in goat brain and liver homogenates. The formation of free radicals, highly reactive oxygen species (ROS) and reactive nitrogen species (RNS) is a normal metabolic process for cellular signaling and countering the antigens. However, they may cause serious damage if they produced at amplified tolls. In addition, metabolic disorders also serve as sources of these reactive species. Although the issue can be addressed through supplements and other phytochemicals. In this study, two plant species were evaluated for their biological potential by employing a spectrum of antioxidant assays. The antioxidant activity was performed by lipid peroxidation assay. The water extract prepared from leaves of Cannabis sativa and Morus nigra showed significant (P

The adverse environmental and human health impact of chemical use against micro-organism is profoundly increased. For this motive, substitute methods to minimize chemicals are being developed. One of the effective methods is use plant extracts which having natural antimicrobial properties. The aim of this study was to evaluate ethanolic extract of Datura stramonium L. (leaves) and Hippophae rhamnoides (fruits) against the selected micro-organisms. Results revealed that mean zone of inhibition for bacterial species ranged from 23±0.72 to 27±1.24 mm in case of Hippophae rhamnoides and from 21±0.79 to 30±1.06 mm in case of D. stramonium leaves respectively. For antifungal activity, the inhibition zone ranges from 39.42±1.07 to 47.22±2.11 mm in case of D. stramonium and from 38.42±1.19 to 48.46±2.32 mm in case of H. rhamnoides. However, sensitivity reaction of bacterial and fungal species against each plant extract was also differential. D. stramonium showed highest toxic effect against E. coli (30±1.06 mm)) and Aspergillus flavus (47.22±2.11mm). Whereas, H. rahmnoides showed highest zone of inhibition against bacterial species (B. subtilis 27±1.24 mm) and fungal species (R. stolonifer 48.46±2.32 mm). Both plant extract exhibited antimicrobial properties, which could be used against micro-organisms.

ObjectiveByssinosis remains a significant problem among textile workers in low/middle-income countries. Here we share our experience of using different prediction equations for assessing ‘chronic’ byssinosis according to the standard WHO classification using measurements of forced expiratory volume in 1 s (FEV1).MethodsWe enrolled 1910 workers in a randomised controlled trial of an intervention to improve the health of textile workers in Pakistan. We included in analyses the 1724 (90%) men who performed pre-bronchodilator spirometry tests of acceptable quality. We compared four different equations for deriving lung function percentage predicted values among those with symptoms-based byssinosis: the third US National Health and Nutrition Examination Survey (NHANES-III, with ‘North Indian and Pakistani’ conversion factor); the Global Lung Function Initiative (GLI, ‘other or mixed ethnicities’); a recent equation derived from survey of a western Indian population; and one based on an older and smaller survey of Karachi residents.Results58 men (3.4%) had symptoms-based byssinosis according to WHO criteria. Of these, the proportions with a reduced FEV1 (1/forced vital capacity (FVC) ratio (ConclusionAccurate measures of occupational disease frequency and distribution require approaches that are both standardised and meaningful. We should reconsider the WHO definition of ‘chronic’ byssinosis based on changes in FEV1, and instead use the FEV1/FVC.

OBJECTIVE: To determine prevalence of and risk factors for respiratory symptoms in an adult urban Pakistani population.METHODS: We conducted a multi-stage, community-based, cross-sectional survey from May 2014 to August 2015, comprising 1629 adults from 75 random clusters in Karachi using questionnaire-based interviews.RESULTS: Around 60% of participants were females and 43% belonged to the >37 years age group. At least one respiratory symptom was reported by 37.5% of participants. Breathlessness was the most common symptom (25.2%, 95%CI 23.1–27.3), followed by acute wheeze (10.1%, 95%CI 8.7–11.7). Multivariable models revealed that males and those aged >37 years were more likely to report acute and chronic phlegm and bronchitis, and breathlessness. Participants with a higher level of education were less likely to report acute and chronic cough. Participants with >5 years pack-years of smoking were more likely to report acute and chronic cough and breathlessness. Other risk factors included passive smoking, regular use of air conditioning and mosquito coils, wet spots and mould in the house, and exposure to dusty jobs.CONCLUSION: We found breathlessness to be the most prevalent respiratory symptom and identified various risk factors for respiratory symptoms.

Child labour is common in low- and middle-income countries. Although child labour is widespread in Pakistan, no data are available on the health of child labourers.This study aimed to assess the food security, food intake and nutritional status of child labourers aged 5-14 years working in lower Sindh, Pakistan.Child labourers aged 5-14 years working in agriculture, manufacturing industry, hotels and restaurants, domestic work and migrant child labourers working in vegetable markets were recruited using a respondent-driven sampling technique. Sociodemographic and nutrition information was obtained by an interviewer questionnaire. The children's height and weight were measured to assess stunting (height-for-age z scores less than -2) and wasting (weightfor- height z scores less than -2).A total of 634 child labourers were included: 184 worked in agriculture, 120 in industry, 67 in hotels and restaurants, 63 in domestic work and 200 were migrant child labourers. Overall, 15.5% of the children were stunted and 30.0% were wasted. The prevalence of stunting was highest in children working in agriculture (27.2%) and the prevalence of wasting was highest in migrant child workers (35.0%). About half the children (51.1%) were suffering from food insecurity. Food inadequacy was mainly in consumption of vegetables/potatoes (98% of the children had inadequate intake), legumes (97%), fruits (96%), meat/ poultry (95%) and milk/dairy products (82%).The nutritional status and food insecurity of the child labourers of Pakistan are comparable with the general population, highlighting the grave situation of the country with regard to food security.سوء التغذية و انعدام الأمن الغذائي في العمال الأطفال في السند، باكستان: دراسة مقطعية.ميشا إقبال، ظفار فاطمي، كوثر خان، يسرا جوماني، نيلما أمجد، أسعد نفيس.يشيع عمل الأطفال في البلدان المنخفضة والمتوسطة الدخل. وعلى الرغم من انتشار عمل الأطفال في باكستان على نطاق واسع، إلا أنه لا توجد بيانات بشأن صحة العمال الأطفال.هدفت هذه الدراسة إلى تقييم الأمن الغذائي، والمدخول الغذائي، والوضع التغذوي للعمال الأطفال الذين تتراوح أعمارهم بين 14-5 عاماً ويعملون في السند السفلي، باكستان.شملت الدراسة العمال الأطفال الذين تتراوح أعمارهم بين 14-5 عاماً الذين يعملون في الزراعة، والصناعات، والفنادق والمطاعم، والعمل المنزلي، والعمال الأطفال المهاجرين الذين يعملون في أسواق الخضروات، وذلك باستخدام أسلوب أخذ العينات من المستجيبين. وقد حُصل على البيانات الاجتماعية-السكانية والتغذوية باستخدام استبيان للأشخاص الذين جرت معهم المقابلة، وقيس طول الأطفال ووزنهم لتقييم التقزم (الطول-مقابل-الوزن-2 نقطة من الانحراف المعياري) والهزال (الوزن-مقابل-الطول-2 نقطة من الانحراف المعياري).بلغ مجموع العمال الأطفال 634 طفلاً، توزيعهم كالتالي: 184 في الزراعة، و 120 في الصناعة، و 67 في الفنادق والمطاعم، و 63 في العمل المنزلي، و 200 كانوا من العمال الأطفال المهاجرين. وبشكل عام، يعاني الأطفال من التقزم والهزال بنسبة 15.5٪ و 30.0٪ على التوالي. وقد تركَّز أعلى معدل لانتشار التقزم في الأطفال الذين يعملون في الزراعة (27.2 ٪)، بينما تركّز أعلى معدل لانتشار الهزال في العمال الأطفال المهاجرين (35.0 ٪). وكان نصف الأطفال تقريباً (51.1 ٪) يعاني من انعدام الأمن الغذائ ي. وتركز نقص التغذية أساساً في عدم استهلاك مدخولٍ كافٍ من الفواكه (96 ٪)، والخضروات/ البطاطس (98٪)، والحليب/ منتجات الألبان (82 ٪)، والبقوليات (97 ٪)، واللحوم/ الدواجن (95 ٪).يتقارب الوضع التغذوي و انعدام الأمن الغذائي للعمال الأطفال في باكستان مع السكان عموماً، مما يلقي الضوء على خطورة الوضع في البلد في ما يتعلق بالأمن الغذائي.Étude transversale de la malnutrition et de l’insécurité alimentaire chez les enfants travailleurs du Sindh (Pakistan).Le travail des enfants est courant dans les pays à revenu faible et intermédiaire. Bien que le travail des enfants soit répandu au Pakistan, aucune donnée n’est disponible sur la santé des enfants travailleurs.La présente étude avait pour objectif d’évaluer la sécurité alimentaire, les apports alimentaires et l’état nutritionnel d’enfants âgés de 5 à 14 ans et travaillant dans le bas Sindh (Pakistan).Des enfants âgés de 5 à 14 ans travaillant dans les secteurs de l’agriculture, de l’industrie de transformation, des hôtels et restaurants et du travail domestique, ainsi que des enfants de migrants travaillant sur les marchés de légumes, ont été recrutés au moyen de la méthode d'échantillonnage déterminé selon les répondants. Des informations sociodémographiques et nutritionnelles ont été recueillies à l’aide d’un questionnaire d’entretien. La taille et le poids des enfants ont été mesurés enfin d’évaluer le retard de croissance (score z de la taille-pour-l’âge inférieur à –2) et l’émaciation (score z du poids-pour-l’âge inférieur à –2).Au total, 634 enfants travailleurs ont été inclus dans l’étude : 184 travaillaient dans l’agriculture, 120 dans l’industrie, 67 dans des hôtels et restaurants et 63 dans le travail domestique ; 200 étaient des enfants de migrants. Dans l’ensemble, un retard de croissance a été observé chez 15,5 % des enfants et une émaciation chez 30,0 % d’entre eux. La prévalence du retard de croissance était plus élevée chez les enfants travaillant dans l’agriculture (27,2 %), tandis que la prévalence de l’émaciation était plus élev ée chez les enfants de migrants (35,0 %). Près de la moitié des enfants (51,1 %) souffraient d’insécurité alimentaire. Les insuffisances alimentaires constatées concernaient principalement la consommation de légumes et de pommes de terre (98 % des enfants avaient des apports insuffisants), de légumineuses (97 %), de fruits (96 %), de viande et de volaille (95 %) et de lait et de produits laitiers (82 %).L’état nutritionnel et l’insécurité alimentaire chez les enfants travailleurs au Pakistan sont comparables avec ceux de la population générale, ce qui souligne la gravité de la situation de ce pays en matière de sécurité alimentaire.

We aimed to identify the contemporary prevalence of byssinosis through a systematic review. Medline, Web of Science, Embase, and Global Health databases were used to identify studies published in any language between 2000 and 2019, reporting primary data on byssinosis among adults. We used the Joanna Briggs Institute checklist to estimate the risk of bias in studies and undertook a qualitative, narrative data analysis. The review considered the prevalence of byssinosis, chest tightness, and airflow obstruction in textile workers in low- and middle-income countries (LMICs). We found 26 relevant studies that included 6930 workers across 12 countries. Most of the studies (n = 19) were from Asia, and seven from African countries. Twenty-five studies were cross-sectional surveys while one was a cohort study. The prevalence of byssinosis was reported by 18 studies, and ranged from 8% to 38%, without any clear associations, at the group level, between the prevalence of byssinosis and durations of workers’ exposures. Prevalence of chest tightness ranged between 4% and 58% and that of airflow obstruction between 10% and 30%. A strong correlation ( r = 0.72) was found between prevalence of byssinosis and cotton dust levels. Our findings indicate that byssinosis remains a significant, contemporary problem in some parts of the textile sector in LMICs.