Chronic bronchitis and COPD among textile workers in Pakistan: Findings from a cross-sectional survey

Background: There is scarce data regarding burden of chronic bronchitis and COPD assessed through spirometry among textile workers globally, especially in developing countries. Aims: To determine the prevalence and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan. Methods: This cross-sectional survey involved 372 male textile workers from 15 mills of Karachi. Data were collected through American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry. Results: The overall prevalence of chronic bronchitis was 7.8% (9.1% for ≥40 years) and COPD 6.7% (27.2% for ≥40 years). Workers categorized as having chronic bronchitis were found to have significantly decreased lung function compared to the healthy workers. Those reporting severe self-perceived dust exposure at work, ≥10 pack years of smoking, uneducated, increased duration of work ≥11 years, and ever smokers were more likely to have chronic bronchitis or COPD. In the multivariate analyses, severe self-perceived dust exposure at work (AOR = 7.4; 95% CI: 1.9, 28.0), family history of respiratory illness/symptoms (AOR = 4.8; 95% CI: 1.1, 20.9) and lack of education (AOR = 4.2; 95% CI: 1.1, 16.9) were significant predictors of chronic bronchitis. While duration of work ≥11 years (AOR = 5.5; 95% CI: 1.5, 19.7) and pack years of smoking ≥10 years (AOR = 3.5; 95% CI: 1.1, 11.7) were found to be strong predictors for COPD. Conclusion: This study found high prevalence of chronic bronchitis and COPD among textile workers and identifies important predictors for prevention.