Assessment of Occupational Health Hazards among Leather Tannery Workers at Minia and Assuit city

Introduction

Occupational health is an area concerned with protecting the safety, health and welfare of people engaged in work. It plays a vital role in helping employers care and understand the need of their employees to create enabling businesses with reduced sickness, absence level and optimized staff performance and productivity. Occupational health remains neglected in developing countries because of competing social, economic, and political challenges (Tawhidur Rahman, 2012).

 Occupational health is a multidisciplinary activity aimed at protection and promotion of the health of workers by preventing and controlling occupational disease and accidents and by eliminating occupational factors and conditions hazards to health and safety at work (Geneva international, 2010). Developing countries generally have fewer adequately effective occupational health programs and fewer adequately developed and enforced laws and regulations than those in the developed countries (Azom et al., 2012).

A healthy, productive and well-motivated workforce is the key agent for overall socioeconomic development. Moreover, high-quality and productive work can ensure healthy production of materials, goods and services, and the consideration and practical implementation of the principles of sustainable development (WHO,2000).

Occupational diseases are adverse health conditions in the human being. The occurrence or severity of which is related to exposure to factors in the work environment .These factors may be: physical (e.g. heat, noise, radiation ), chemical ( e.g. solvents, pesticides, heavy metals, dust),biologic (e.g. HIV, tuberculosis, hepatitis), Ergonomic  (e.g. improperly designed tool or work areas), mechanicals ( e.g. these mainly cause work accidents and injuries rather than occupational disease). (WHO, 2000).  Hazards is defined as the presence of a material or condition that has the potential for causing loss or harm .work related hazards are brought about by unsafe work conditions and unsafe work behaviors.(Salauddin and Rahman , 2014) .

The workplace should be periodically reassessed for any changes in conditions, equipment or operating procedures that could affect occupational hazards. This periodic reassessment should also include a review of injury and illness records to spot any trends or areas of concern and taking appropriate corrective action. The suitability of existing Personal protective equipment, including an evaluation of its condition and age, should be included in the reassessment (charles, 2009).

  Leather is exclusively vast, multi-dimensional and mutually dependent material all over the world. Currently more than 5000,000 people are working in this sector and the number of workers is increasing from day to day all over the world, The growth rate of tanning materials is increasing in developing countries 

(Tawhidur Rahman,  2012) Working in the leather industry is fraught with potential risks and hazards which are categorized into occupational, environmental and public hazard,(Salauddin and Rahman , 2014) .

Tanning processes involve several chemicals and some of them are known to be potentially carcinogenic as well as having other adverse health effects, ( Apte at el., 2005).Tannery workers are mainly exposed to Cr in the inorganic or protein-bound form leather dust Occupational exposure to Cr is generally through inhalation, as well as dermal absorption, although ingestions also possible (Febriana et al., 2012).

Chromium exists in two oxidation states, namely the trivalent (III) and hexavalent (VI) forms. Hexavalent Cr is more toxic than trivalent Cr and the toxicological impact is due to its oxidizing ability and high solubility. Chromium (VI) is capable of damaging the skin due to its high penetration power and ability to form free radicals (Khan etal.,2013) (Stern,2010) .

 The chemical used in the leather industry can be divided in to three broad categories:  pre-tanning chemicals, tanning chemicals, and finishing chemicals. Pre-tanning chemicals are used to clean and prepare skin for tanning process and they are mostly washed away with waste water. Chrome Sulphate is the basic tanning chemical which is expensive and also series pollutant. Finishing chemicals are used to impart certain properties of leather like softness, color, appearance etc. like tanning chemicals finishing chemicals also get discharged in wastewater (Zewdie et al., 2011)

Aim of the study

The aim of the present study is to assess occupational health hazards among leather tannery workers at Minia and Assuit city.

Specific objective:

• Assessing knowledge of leather tannery workers about occupational health hazards.
• Assessing leather tannery workers practice towards safety measures of protection from occupational health hazards related to leather tannery.

Research Questions:

• What is the occupational health hazards related to leather tannery and its prevention?

Significance of the study:

More than 5,000,000 people are working in tanneries around the world Work related accidents and diseases continue to have series consequences, with an estimated 2.3 million fatalities per year and economic losses of 4% of global gross domestic product, In the Egyptian economy leather tanning representing about 5% of the total industrial production of the country. The labor force is made up of about 250,000 workers and has 300 leather tanners. The 300 leather tanners and much of the industry are located in the old Cairo. There is a paucity of local data regarding leather tanneries in Egypt and no study has been done in Upper Egypt. So study of occupational health effect among workers in tanneries is useful in the development of occupational epidemiology (Marina et al., 2012 ).

Subjects and Methods Research Design:

A cross-sectional descriptive study was used in this study.

Setting:

The current study was carried out at Minia Governorate (Malawi district ) beside Mobark zoo and Assuit Governorate in Arab Elmadabegh . Every leather tannery consists of one floor; each one contains 4-5 Ponds for salting.

Sample

Recruitment sample included 50 workers in two leather tannery, Data was collected over a period of 5 months from October 2017 to February2018 (2-3 days per week).

Inclusion Criteria:

All workers present in two leather tanneries in Minia and Assuit city.

Tools and technique of data collection:

Two tools were utilized to collect data pertinent for this current study. These tools are

standard, and then reviewed by a panel of five experts, these tools are:

Tool I: Structured Interview questionnaire It was developed by the researcher in Arabic language after reviewing the literature it covered the following three parts:

Part I: demographic Characteristics: which included age, educational level, marital status, work hours, living conditions, work experience. etc….

Part II: Medical history regarding to Past history and current history which include previous and current disease, complication and follow up.

Part III: Health habits and life style which include smoking, exercise, nutrition, rest ,sleep and personal hygiene.

Tool 2: Occupational health hazards questionnaire.

Part I: It included chemical hazards such as (dermatitis, ulcer, stones formation), physical such as (fatigue, increase rate of accident, irritation of eye, skin cancer, lung cancer), respiratory health problems (cough, shortness of breath, wheezes), mental hazards such as (inability to take decisions, inability to solve problem, insomnia, feeling of depression, loss of self-steam, loss of concentration), biological hazards as (nephritis, T.B, hepatitis)   etc …….

Part II: Work environment including health and safety information, health and safety training, workplace supervision, work section, PPE, utilization, ventilation, illumination.

Validity of tools:

Validity is the accuracy and meaningfulness of inferences, which are based on the research results. The tool was tested for content validity by a Jury of five experts (Minia University, Assiut University,Community health Nursing Department) All jury members  (100%) agree that current study tools were valid and relavant with the aim of the study. A pilot study was carried out on 10 workers (5%) of the total sample to test Feasibility, objectivity, and applicability of the tools. Results of the pilot study illustrated that no any refinements and modifications needed so the subjects were included to the actual sample.

Also, the tool was tested for internal reliability (reliability referred to the consistency of measurement and was frequently assessed using the test-retest reliability method). To achieve reliability of the questionnaire, the instrument was designed with great care matching questions with objectives for the study.

Ethical Consideration:

• Approval was sought from the Provincial and District ethical committee before undertaking the research.
• The purpose of the study was explained to all participants.
• The participant had ethical rights to agree or refuse to participate in the study.
• Oral consent was obtained from every participant.
• Every participant was informed that the information and data obtained was confidential and used only for the purpose of the study through coding of all data and protecting the obtained data.

Study Procedure:

An official permission was granted from the manager of leather tannery, in addition obtaining formal agreement which obtained one month before conducting the study. Data was collected over a period of  5 months (2-3 days per week).,Selected sample was admitted to the manager of leather tannery, then the nature and purpose of the study were explained. Written informed consent was obtained from those who accepted to participate in this study.

The researcher has started collection of data from all workers by using the questionnaire and some workers were illiterate, .so the questionnaire was filled by the  researcher .Health education message about how and when to use PPE was given.

Limitation of the study:

• The number of workers was limited per day.
• Interruption during interview was occurred from other workers so researcher made an effort and spent a lot of useless time to complete the questionnaire.
• Place of tannery was far away and beside Cemeteries in Assuit city.
• The leather tanneries in this area (Cemeteries) were limited

Statistical analysis of data

Statistical Package for the Social Sciences Version 21 was used for data entry and analysis, and Microsoft Excel (Microsoft Corp., Redmond, WA, USA) was used for graphics. Quantitative data were presented as mean and standard deviation, and qualitative data were presented as a frequency distribution. Chi-squared test and Student's t test were used. P < 0.05 was considered to indicate significance.

Result:

Table 1: Demographic characteristics of studied workers N= (50).

Table (1): it was shows that the studied workers were 50 males. The age of study subjects ranged from 17 to 58 years old with a mean age and SD of 34.6±12.5. Majority of the worker were single (48%) followed by married (44%). More than half of them were from rural areas. More than one third of them were illiterate.

Table 2: work characteristics of studied workersN= (50).

Table (2): it was found that 72% of the participants were workers. Workers working in tanning represent 44% followed by 30% working in salting. The average weekly working hours in the tannery was 47.4±1.5. Forty percent of the workers had experience from 0 to 5 years and 38% of the workers had more than 10 years’ experience.

Table 3:  Medical history of studied workers N= (50).

Table (3): it was shows that 12% of workers suffered from hypertension and 24% had a history of injuries resulting in wounds and scratches. 44% and 28% of them had been subjected to routine investigation by CBC and chest x ray respectively.

Table 4: Frequency distribution of tannery workers according to using of personal protective equipment (PPE) of studied workers N= (50).

Table (4): shows that 70% of tannery workers always wear gloves and 80% of them put on boot shoes. More than half of the workers did wear neither mask nor apron. 80% of workers did not wear goggles during work.

Table 5: Occupational risks and hazards of leather tanning of studied workers N= (50).

Table (5): shows that 32% and about one quarter of workers had knowledge about physical and respiratory hazards respectively. 24% of them knew that increased fatigue is one of indirect risks of extreme heat exposure. More than half of the workers had a knowledge that lack of concentration is one of the side effects of noise. 80% of tannery workers knew different methods of personal protection during their work.

Table 6: Relation between knowledge score and demographic characteristics of studied workers N= (50).

Table (6): it was shows that there is a significant difference was observed in the level of knowledge of occupational health and safety practice among workers of different educational level (p=0.002). About 52% of knowledgeable workers had attended institute or with diplom (51.6%) compared to (42.1%) of not knowledgeable workers who could not read and write.

Table 7 Relation between respiratory complications and using of mask of studied workers N= (50).

Table (7): shows that there is a significant difference between those who used to wear mask and those who did not as regards respiratory complications. 80% of workers who used to wear mask did not complain from any respiratory complications versus 20% of them.  

Table 8: Relation between skin complications and using of gloves, apron and boot of studied workers N= (50).

Table (8): shows that that there is a significant difference between those who used to wear gloves or put on apron and those who did not as regards skin complications. About 81% of those who put on apron did not complain from skin problems versus 18.8% of them.