Abstract：
OBJECTIVE: Brick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE and identify factors associated with respiratory PPE use.
METHODS: We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use.
RESULTS: We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users.
CONCLUSIONS: Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.
METHODS: We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use.
RESULTS: We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users.
CONCLUSIONS: Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.
摘要：
目标：尼泊尔的砖窑工人是一个被忽视的人群，他们暴露于高可吸入二氧化硅浓度，很少使用干预措施来减少暴露。我们旨在描述呼吸系统个人防护设备(PPE)使用的普遍性，了解对窑尘和呼吸PPE的知识和态度，并确定与呼吸PPE使用相关的因素。
方法：我们在巴克塔普尔进行了一项横断面研究，尼泊尔。我们使用简单的随机选择来确定64个窑炉中的10个，并对30个家庭进行分层随机抽样，以在选定的窑炉中招募年龄≥14岁的工人。现场工作人员使用结构化问卷对参与者进行了调查。我们的主要结果是表征当前呼吸性PPE使用的患病率，次要结果是知识摘要。PPE使用的态度和实践。
结果：我们调查了83名工人（平均年龄30.8岁，77.1%男性）。其中,28.9%报告目前在工作中使用呼吸性个人防护装备，在调查之前，有3.6％的人听说过矽肺病，而24.1％的人正确地确定了最佳的呼吸性PPE（与外科口罩和屏障面罩相比，N95）以减少粉尘暴露。与非使用者相比，呼吸性PPE使用者的收入更高（平均每月家庭收入206美元对145美元；p=0.04）和教育水平（25％对5.1％的完成率高于小学；p=0.02）。
结论：呼吸性PPE使用率较低。工人对窑尘的健康影响和适当的呼吸PPE了解不足。我们强调PPE使用的重要障碍，特别是知识差距，这可以指导今后的调查，以减轻砖窑工人的矽肺负担。
方法：我们在巴克塔普尔进行了一项横断面研究，尼泊尔。我们使用简单的随机选择来确定64个窑炉中的10个，并对30个家庭进行分层随机抽样，以在选定的窑炉中招募年龄≥14岁的工人。现场工作人员使用结构化问卷对参与者进行了调查。我们的主要结果是表征当前呼吸性PPE使用的患病率，次要结果是知识摘要。PPE使用的态度和实践。
结果：我们调查了83名工人（平均年龄30.8岁，77.1%男性）。其中,28.9%报告目前在工作中使用呼吸性个人防护装备，在调查之前，有3.6％的人听说过矽肺病，而24.1％的人正确地确定了最佳的呼吸性PPE（与外科口罩和屏障面罩相比，N95）以减少粉尘暴露。与非使用者相比，呼吸性PPE使用者的收入更高（平均每月家庭收入206美元对145美元；p=0.04）和教育水平（25％对5.1％的完成率高于小学；p=0.02）。
结论：呼吸性PPE使用率较低。工人对窑尘的健康影响和适当的呼吸PPE了解不足。我们强调PPE使用的重要障碍，特别是知识差距，这可以指导今后的调查，以减轻砖窑工人的矽肺负担。
