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Embay Amare Alemseged,1 Abera Kumie Takele,2,* Yifokire Zele,2,* Samson Wakuma Abaya,2,* Kbrom Gmechu Kiros,3,* Medhin Mehari,1,* Yonas Angaw Bezabh,1,* Abadi Hailay Atsbaha,1,* Tegegnework Yitayew Awoke,4,* Mekonnen Haftom Goyteom3 ** 1Department of Public Health, School of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 2Department of Preventive Medicine, School of Public Health, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Nursing, School of Medicine and Health Sciences, Adigrat University, Adigrat, Ethiopia; 4Food, Medicine, and Health Care Authority, Addis Ababa City Administration, Addis Ababa, Ethiopia*These authors contributed equally to this workCorrespondence: Embay Amare Alemseged Email embayamare2@gmail.comBackground: Flour mill workers are at high risk of developing respiratory symptoms due to exposure to flour dust in their working environment. Exposure to flour dust linked with the development of chronic respiratory disorders. However, very little evidence has been available on the respiratory symptoms of exposed workers in large-scale flour mill factories. Therefore, the aim of this study was to assess chronic respiratory health symptoms and associated factors among flour mill workers in Addis Ababa, Ethiopia.Methods: Cross-sectional study was conducted among a sample of 424 randomly selected workers from Addis Ababa flour mill factories. Respiratory health symptoms were assessed using an American Thoracic Society standard questionnaire customized with local context. Data were checked for completeness and Epi-Info V. 7.2 and SPSS V.21 statistical software were used for data entry and analysis, respectively. Multivariable logistic regression model was used to identify variables associated with chronic respiratory health symptoms. Variables that had significant association were identified based on adjusted odds ratio (AOR) with 95% confidence interval (CI) and p < 0.05. Data were presented using tables, texts and figures.Results: The prevalence of chronic respiratory health symptoms among flour mill factory workers was 58.3% (95% CI: 53.7– 63.4). Chronic respiratory health symptoms were significantly associated with age group (AOR=1.95, 95% CI; 1.17– 2.79 and AOR=12.3, 95% CI; 4.39– 34.6), monthly income (AOR=1.68, 95% CI; 1– 2.79), work experience (AOR=2.58, 95% CI; 1– 6.62), past dust exposure (AOR=1.86, 95% CI; 1.08– 3.2) and utilization of respiratory protective equipment (AOR=2.29, 95% CI; 1.27– 4.13).Conclusion and Recommendation: Chronic respiratory health symptoms were highly prevalent among flour mill factory workers. Supportive supervision and cooperation between Ministry of Labour and Social Affairs, flour mill managers and workers are needed to reduce exposure and improve working environment.Keywords: flour dust, flour mill worker, prevalence, Addis Ababa, Ethiopia

Background: The Coronavirus disease (COVID-19) pandemic caused significant morbidity and mortality in Africa, in addition to other socio-economic consequences. Across the continent, Schools of Public Health (SPHs) played several roles in supporting national, regional, and global response to the pandemic. Following a published and grey literature search, this paper reviews and analyses the contribution of SPHs in Africa during the COVID-19 pandemic., Contribution of the Schools of Public Health: SPH faculty in most countries contributed their expertise through COVID-19 task forces and advisory committees where they guided and supported decision-making. Faculty also supported the identification, review, and synthesis of rapidly evolving global and local evidence, adapting it to the local context to guide policy decisions. Through research, SPHs contributed to a better understanding of the disease epidemiology, response interventions, as well as prevention and control measures. SPHs engaged in training field epidemiologists, frontline health workers, and district response teams. SPH staff, students and field epidemiology trainees also supported field activities including surveillance, contact tracing, as well as managing quarantine facilities and points of entry. SPHs engaged in public education and awareness-raising initiatives to share information and dispel misinformation. In partnership with other stakeholders, SPHs also developed important innovations and technologies., Conclusion: SPHs are a critical pillar for pandemic prevention, preparedness, and response, that support health systems with important functions. To further enhance their capacity, efforts to improve coordination of SPHs, strengthen collaboration among schools, harmonize training and curricula, and enhance capacity for advanced research are needed. There is also a need to bridge the inequities in capacity and resources that exist among SPHs across regions and countries., Competing Interests: Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests., (© 2024. The Author(s).)

Introduction: Inadequate ventilation and improper use of personal protective equipment are often observed in many occupational settings with a high risk of dust and other fine particle exposure. Workers who are exposed to dust at work may suffer from respiratory difficulties. Previous systematic reviews on organic dust exposure and its association with respiratory health outcomes did not provide a comprehensive assessment. Therefore, the objective of this systematic review and meta-analysis was to summarize the reported effects of organic dust exposure on lung function parameters among African industrial workers., Methods: A compressive literature search was conducted in PubMed, MEDLINE, Google Scholar, Embase, the Web of Science, African Journals Online, and ScienceDirect databases to identify relevant studies for the review. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. The lung function indices including forced vital capacity (FVC), forced expiratory volume in the first second (FEV 1 ), the FEV 1 /FVC ratio, and peak expiratory flow rate (PEFR) were obtained from primary studies and analyzed using STATA version 17. The I 2 test was used to assess the heterogeneity of studies. We used a random-effects model to estimate the pooled standard mean difference in lung function indices between organic dust-exposed and non-exposed industrial workers. To analyze publication bias, funnel plots and Egger's test were applied., Results: In this systematic review and meta-analysis, 32 studies involving 7,085 participants were included from 13,529 identified studies. The estimated mean differences with 95% confidence intervals were as follows: -0.53 [-0.83 to -0.36] L for FVC, -0.60 [-0.77 to -0.43] L for FEV 1 , -0.43 [-0.57, -0.29] L for FEV 1 /FVC, and -0.69 [-0.88 to -0.50] L/min for PEFR., Conclusion: This systematic review and meta-analysis revealed that the lung function indices, such as FVC, FEV 1 , FEV 1 /FVC, and PEFR, were statistically significantly lower among organic dust-exposed industrial workers compared to non-exposed industrial workers. Therefore, effective dust control measures should be implemented to protect workers from exposure to organic dust., Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display&#95;record.php?ID=CRD42024527139., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Ashuro, Debela, Daba, Hareru, Abaya and Byrne.)

Purpose: Excessive paper dust during paper production may harm the workers' respiratory health. We wanted to assess the inhalable paper dust levels and its determinants among paper industry workers., Methods: A study was conducted in Ethiopia to assess the level of personal inhalable paper dust exposure among four paper mills. A total of 150 samples were collected using the IOM sampler attached to Side Kick Casella pumps at a flow rate of 2 L/min. The samples were analyzed in Nemko Norlab, Norway. Linear mixed-effect models were applied to identify determinants of inhalable paper dust., Results: The geometric mean of personal inhalable paper dust was 3.3 mg/m 3 with 80% of the measurements exceeding the Swedish occupational exposure limit (OEL) of 2 mg/m 3 . The linear mixed-effects model showed that the level of dust was 28% higher when using high-speed than when using low-speed rewinding machines, while paper mills with an average of more than four machines per job group had 22% higher exposure than paper mills with a lower number of machines. Furthermore, working in packing and preparation was associated with higher dust exposure than in other areas., Conclusions: The dust exposure levels were above the Swedish OEL for 80% of the samples. This indicates that preventive measures should be established in the industry. The exposure model identified high-speed rewinding machines, a high number of machines, and work in preparation and packing as associated with high levels of paper dust exposure., Competing Interests: Declarations Ethical approval Ethical clearance was obtained from the Institutional Review Board of the College of Health Science Addis Ababa University number 079/22/SPH and from the Regional Committee for Research Ethics South East Norway, number 2022/521268. After the purpose and the importance of their participation were explained informed consent was taken from each study participant. Privacy and confidentiality of information given by each participant were kept properly and personal identifiers were removed. Conflict of interest The authors declare that they have no competing interests., (© 2024. The Author(s).)

Chronic respiratory symptoms are a health concern in the paper industry. This study evaluates the association between personal inhalable paper dust exposure and chronic respiratory symptoms among workers in this industry. In total, 270 workers from the paper industry and 267 from a water bottling factory participated. Chronic respiratory symptoms were assessed using a standardized questionnaire, modified from the American Thoracic Society. A job exposure matrix, based on cross-sectional personal measurements of inhalable paper dust, was used to estimate the exposure-response relationship between cumulative dust exposure and chronic respiratory symptoms. There was a higher prevalence of chronic coughs (27.4% vs. 7.5%), breathlessness (25.6% vs. 11%), coughs with sputum (21.1% vs. 1.1%), and wheezing (25.6% vs. 5%) among paper workers compared to those in the water bottling industry. A Poisson regression analysis revealed that the prevalence ratios for chronic coughs (APR = 3.3 and 95% CI: 2.0-5.4), breathlessness (APR = 2.2 and 95% CI: 1.4-3.4), and wheezing (APR = 4.3 and 95% CI: 2.3-7.7) were significantly higher in paper workers than in water bottling workers. Among paper workers, a significant exposure-response relationship was observed between cumulative dust exposure and chronic coughs after adjusting for age, sex, history of respiratory illnesses, work in other dusty industries, and use of biofuels. As there were only four ever-smokers, smoking was not included in the regression analysis. The results show a significant association between dust exposure and coughing, highlighting the need for control measures to prevent the development of respiratory symptoms among workers.

Excessive occupational exposure to noise results in a well-recognized occupational hearing loss which is prevalent in many workplaces and now it is taken as a global problem. Therefore, this study aims to assess the prevalence of noise-induced hearing loss and associated factors among workers in the Bishoftu Central Air Base in Ethiopia. An institutional-based cross-sectional study was conducted among 260 central air base workers through face-to-face interviews, an environment noise survey, and an audiometric test for data collection. Data were entered by Epi-data version 3.1 and SPSS was used to analyze the data. Finally, a statistical analysis such as descriptive and binary logistic regression analysis was applied. A P-value < 0.05 at 95% CI was considered statistically significant. The overall prevalence of noise-induced hearing loss and hearing impairments was 24.6 and 30.9%, respectively. The highest prevalence of noise-induced hearing loss was recorded for workers who were exposed to noise levels greater than 90 dBA. Out of 132 workers exposed to the average noise level of 75 dB A, only 5% of workers were affected with noise-induced hearing loss, while 128 workers exposed to an average noise level equal to or greater than 90 dB A, 19.6% of workers were identified with noise-induced hearing loss. Regarding sex, around 21.9% of male workers were identified with noise-induced hearing loss. Workers who were exposed to a high noise level workplace previously or before the Central Air Base workplace were five times (AOR = 5.0, 95% CI 1.74-14.36) more likely affected by noise-induced hearing loss than those workers not previously exposed. Those workers who were exposed to greater or equal to 90dBA noise level were 4.98 times (AOR = 4.98, 95% CI 2.59-9.58) more likely to be exposed to noise-induced levels than those who were exposed to less than 90dBA noise level. Moreover, male air base workers were 3.5 times more likely exposed to hearing impairment than female workers (AOR = 3.5, 95% CI 1.01-12.0). This study identified that the prevalence of noise-induced hearing loss and hearing impairments was significantly high. So implementation of a hearing conservation program, giving noise education, and supplying adequate hearing protective devices (HPDs) are essentials., (© 2024. The Author(s).)

Background: Exposure to welding fumes can lead to different respiratory health disorders, including lung cancer, due to long-term exposures. In Ethiopia, large numbers of people are engaged in the welding sector. Often, these workers are exposed to welding fumes at their workplaces, however, the level of exposure and its health effects have never been studied., Objective: To measure the level of personal welding fume exposure and assess chronic respiratory symptoms and associated factors, among micro and small-scale enterprise metal workshop workers, in Akaki Kality Sub city, Ethiopia., Methods: A comparative cross-sectional study involving 226 welders and 217 controls. Chronic respiratory symptoms were assessed using a standardized questionnaire adopted from the American Thoracic Society (ATS). Welding fumes were collected from the welder's breathing zone using 37 mm close-faced plastic cassettes fitted with Polyvinyl Chloride (PVC) filters connected to Casella pumps at an airflow rate of 2 L/min., Result: The overall prevalence of chronic respiratory symptoms among welders and controls were 54 (23.9%) and 20 (9.2%) respectively. The geometric mean and geometric standard deviation (GSD) of personal welding fume exposure, among welders was 5.98 mg/m 3 (± GSD = 1.54). In this study, 53.3% of the samples exceeded the Occupational Exposure Limit defined by the American Conference of Governmental Industrial Hygiene. Chronic respiratory symptoms were significantly associated with educational status (Adjusted Odds Ratio (AOR): 5.11, 95% CI: 1.35, 19.33), respiratory protective equipment use (AOR: 3.33, 95% CI: 1.52, 7.31), safety training (AOR: 2.41, 95% CI: 1.10, 5.28), smoking (AOR:3.57, 95% CI: 1.54, 8.23), welding machine maintenance (AOR: 1.87, 95% CI: 1.01, 3.59) and welding site (i.e. indoors vs. outdoor) (AOR: 6.85. 95% CI: 2.36, 19.89)., Conclusions: The prevalence of chronic respiratory symptoms among welding workers was significantly higher than controls. More than half of the samples exceeded the Occupational Exposure Limit. Educational status, implementation of safety training, and welding sites were significantly associated with chronic respiratory symptoms. The results suggested a need to reduce welding fume exposure to improve the respiratory health of the workers., (© 2024. The Author(s).)

Introduction and Objective: Endotoxins from gram-negative bacteria might be released when the coffee cherries are processed and may cause respiratory health problems among workers in the coffee industry. The relationship between bacterial contamination and occupational exposure to endotoxin levels has not been thoroughly explored previously in primary coffee processing factories in Ethiopia, or elsewhere. The aim of this study was to characterize the level of personal endotoxin exposure and its relations with bacterial contamination of coffee cherries in such factories in Ethiopia., Material and Methods: A cross-sectional study was conducted from March 2020 - February 2021 in 9 primary coffee processing factories in 3 regions in Ethiopia. A total of 180 personal air samples were collected to analyze workers' exposure to inhalable dust and endotoxin. Correlation tests were performed to assess the relationship between total bacteria and endotoxin levels and between inhalable dust and endotoxin levels., Results: The geometric mean (GM) of personal inhalable dust exposure among machine room workers and hand pickers were 9.58 mg/m 3 and 2.56 mg/m 3 , respectively. The overall GM of endotoxin exposure among machine room workers and hand pickers were 10,198 EU/m 3 and 780 EU/m 3 , respectively. Gram-negative bacteria were found in all 54 coffee samples. The correlation between inhalable dust and endotoxin exposure was significant (r=0.80; P <0.01)., Conclusions: About 92% of the samples from hand pickers and all samples from machine room workers exceeded the occupational exposure limit of 90 EU/m 3 recommended by the Dutch Expert Committee on Occupational Standards. Prevention and control of bacterial contamination of the coffee in primary coffee processing are suggested to reduce endotoxin exposure that might cause respiratory health problems among coffee workers.

Even though the COVID-19 vaccine has been available and free of charge to the targeted population in Ethiopia, the vaccination rate was lower than needed to achieve herd immunity at community level. This study aimed to explore community perceptions of COVID-19 and vaccine hesitancy in selected cities of Ethiopia involving 70 in-depth interviews and 28 focused group discussions. The audio-taped data were transcribed verbatim, translated into English, and analyzed using a qualitative content analysis approach using the ATLAS.ti software version 8. The findings revealed that COVID-19 was perceived as evil and caused fear and frustration upon its emergence. The community initially used traditional remedies for its prevention but later transitioned to employing non-pharmaceutical interventions. The primary reasons for vaccine hesitancy were misinformation and misconceptions, such as connecting the vaccine with the mark of the beast, a lack of trust due to the multiple vaccine types, a shorter production timeline resulting in distrust of its effectiveness, and a fear of pain and side effects. Based on our findings, we recommend monitoring the use of social media and countering misinformation with the correct information and continuous public health campaigns. Further studies should be conducted to assess the types and magnitude of impacts from the myths and misconceptions on vaccination uptake.

Background: Occupational respiratory disorders are a major global public health concern among workers exposed to dust particles in dust-generating workplaces. Despite fragmented research findings on the magnitude of respiratory problems and the lack of a national occupational respiratory disease recording and reporting system at the Ethiopian factory, the prevalence of respiratory symptoms among factory workers were unknown. Therefore, the aim of this meta-analysis was to summarize and pool estimates from studies that reported the prevalence of respiratory symptoms and predictors among Ethiopian factory workers who worked in dusty environments., Methods: A systematic literature searches were conducted using electronic databases (PubMed, Science Direct, African Journals Online, and Web of Science). The primary and secondary outcomes were prevalence of respiratory symptoms and predictors, respectively. The STATA version 17 was used to analyze the data. A random effect meta-analysis model was used. Eggers test with p-value less than 5%, as well as the funnel plot, were used to assess publication bias., Results: The searches yielded 1596 articles, 15 of which were included in the systematic review and meta-analysis. The pooled prevalence of respiratory symptoms among Ethiopian factory workers was 54.96% [95% confidence interval (CI):49.33-60.59%]. Lack of occupational health and safety (OSH) training [Odds Ratio (OR) = 2.34, 95%CI:1.56-3.52], work experience of over 5 years [OR = 3.19, 95%CI: 1.33-7.65], not using personal protective equipment (PPE) [OR = 1.76, 95%CI:1.30-2.39], and working more than eight hours per day [OR = 1.89, 95%CI:1.16-3.05] were all significant predictors of respiratory symptoms., Conclusion: The prevalence of respiratory symptom was found to be high in Ethiopian factory workers. To prevent workers from being exposed to dust, regular provision and monitoring of PPE use, workers OSH training, and adequate ventilation in the workplace should be implemented., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Ashuro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Fasciolosis is regarded as a major challenge to livestock productivity worldwide, but the burden of disease in humans has only started to receive some attention in the past three decades. The aim of this study was to determine the prevalence of human and animal fasciolosis and its determinant factors in the Gilgel Gibe and Butajira Health and Demographic Surveillance System (HDSS) sites in Ethiopia. A study was undertaken among 389 households across the two sites. Face-to-face interviews were conducted to investigate the knowledge, attitudes and practices of households with regard to fasciolosis. Stools from 377 children aged 7-15 years, and 775 animals (cattle, goats and sheep) were analyzed using a proprietary Fasciola hepatica ( F. hepatica ) coproantigen ELISA kit. The prevalence of fasciolosis in children was 0.5% and 1% in Butajira and Gilgel Gibe HDSS sites, respectively. The overall prevalence of animal fasciolosis was 29%, 29.2%, and 6% among cattle, sheep, and goats, respectively. More than half of the respondents from Gilgel Gibe (59%, n = 115) did not know that humans can be infected with F. hepatica . The majority of respondents in Gilgel Gibe (n = 124, 64%) and Butajira (n = 95, 50%) did not know the transmission route for fasciolosis. Grazing animals were 7 times more likely to be infected with fasciolosis than animals in cut-and-carry production systems (adjusted odds ratio [AOR] = 7.2; 95% confidence interval [CI]: 3.91-13.17). The findings indicated a lack of knowledge amongst local populations about fasciolosis. Thus, there is a need for public health awareness campaigns about fasciolosis in the study areas.

Freshwater snails are intermediate hosts for several snail-borne diseases affecting humans and animals. Understanding the distribution of snail intermediate hosts and their infection status is very important to plan and implement effective disease prevention and control interventions. In this study, we determined the abundance, distribution, and trematode infection status of freshwater snails in two agro-ecological zones of Ethiopia. We sampled snails from 13 observation sites and examined them for trematode infections using a natural cercarial shedding method. A redundancy analysis (RDA) was used to examine the relationship between snail abundance and environmental variables. Overall, a total of 615 snails belonging to three species were identified. Lymnea natalensis and Bulinus globosus were the dominant snail species, representing 41% and 40% of the total collection, respectively. About one-third of the total snail population (33%) shed cercariae. The cercariae species recorded were Xiphidiocercaria , Brevifurcate apharyngeate distome ( BAD ), Echinostome, and Fasciola . Snail species were found in high abundance in aquatic habitats located in the agricultural landscape. Therefore, land-use planning and protection of aquatic habitats from uncontrolled human activities and pollution can be considered as important strategies to prevent and control the spread of snail-borne diseases in the region.

Background: Workers in pulp and paper factories are continuously exposed to paper dust. Excessive exposure to paper dust can cause respiratory disease. Information about the prevalence of chronic respiratory symptoms and dust exposure levels among workers in pulp and paper factories is not available in Ethiopia. The aim of this study was, therefore, to assess personal total dust exposure levels, the prevalence of chronic respiratory symptoms and their associated risk factors among workers in Ethiopian pulp and paper factories., Methods: A comparative cross-sectional study was conducted. A total of 40 dust measurements were carried out on 20 randomly selected workers. To assess chronic respiratory symptoms and associated factors, 434 workers from two paper factories and controls were interviewed using a standard questionnaire adapted from the American Thoracic Society (ATS). Gravimetric analyses of the filters were undertaken using a standard microbalance. Poisson regression was performed for comparing the prevalence of symptoms and risk factors for the two groups. Multivariable analyses were conducted to identify factors associated with chronic respiratory symptoms., Result: The arithmetic mean (AM) and geometric mean (GM) of dust exposure levels among the paper factories workers were 11.3 (± 7.7) and 10.2 (± 1.4) mg/m 3 respectively. This exposure level exceeded the threshold limit value recommended for total dust (10 mg/m 3 ). The prevalence of having at least one chronic respiratory symptom was about 51% among the workers in paper factories. The prevalence ratio of having chronic respiratory symptoms among paper factory workers was 5.6 times higher (PR = 6, 95% CI 3.5-10.3) than in the controls. Chronic respiratory symptoms were significantly associated with factors such as an educational status of less than grade 9, being employed in the work sections of the factories, having work experience of 5 years and above, working more than 8 h per day and having a past history of occupation and respiratory illnesses., Conclusion: The dust concentration in the paper factories exceeded the acceptable recommended limit value of 10 mg/m3. The prevalence of chronic respiratory symptoms among paper factory workers was higher than among controls. The main determining factors for chronic respiratory symptoms among the workers were the specific work section such as production section, low income, having past history of respiratory illnesses, the number of years of working and low educational status. This finding indicated the need for improving the working conditions in paper factories in Ethiopia., (© 2023. The Author(s).)

Background: Occupational wood dust causes chronic respiratory health problems as well as a decline in lung function. However, data on the prevalence of chronic respiratory symptoms and lung function parameters among large-scale wood factories workers in Ethiopia producing furniture are limited. The objective of this study was to determine the prevalence of chronic respiratory symptoms, lung function measures, and associated factors among large-scale wood industry workers in Addis Ababa, Ethiopia., Methods: An institution-based cross-sectional study was conducted among 232 wood workers and 232 controls. Participants for the study were selected using stratified and systematic sampling from soft drink and wood factories. The chronic respiratory symptoms were assessed using a modified American Thoracic Society (ATS) questionnaire, and lung function tests were performed using an Easy on PC spirometer in accordance with the ATS standards for spirometry. The data were imported into Epi-data version 4.4.2 and analyzed with SPSS version 23. Poisson regression, Multivariate linear regression and multivariable logistic regression analysis were used., Results: The prevalence ratio of overall chronic respiratory symptoms was significantly higher among woodworkers (65.7%) compared to controls (23.3%) in this study (PR = 2.17, 95% CI: 1.51-3.12). Current chronic respiratory symptoms were associated with gender, and previous chronic respiratory disease. Woodworkers had significantly lower Forced vital capacity (FVC) and Forced expiratory volume in the first second (FEV1) when compared to controls., Conclusion: Woodworkers had a higher prevalence of chronic respiratory symptoms and lower lung function measures, which lowered lung capacity when compared to controls. To reduce workers' exposure to wood dust, engineering control methods should be implemented., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Introduction: In primary coffee factories the coffee beans are cleaned and sorted. Studies from the 80- and 90-ties indicated respiratory health effects among the workers, but these results may not represent the present status. Our aim was to review recent studies on dust exposure and respiratory health among coffee factory workers in Tanzania and Ethiopia, two major coffee producing countries in Africa. Methods: This study merged data from cross-sectional studies from 2010 to 2019 in 4 and 12 factories in Tanzania and Ethiopia, respectively. Personal samples of "total" dust and endotoxin were taken in the breathing zone. Chronic respiratory symptoms were assessed using the American Thoracic Society (ATS) questionnaire. Lung function was measured by a spirometer in accordance with ATS guidelines. Results: Dust exposure among male production workers was higher in Ethiopia (GM 12 mg/m 3 ; range 1.1-81) than in Tanzania (2.5; 0.24-36). Exposure to endotoxins was high (3,500; 42-75,083) compared to the Dutch OEL of 90 EU/m 3 . The male workers had higher prevalence of respiratory symptoms than controls. The highest symptom prevalence and odds ratio were found for cough (48.4%; OR = 11.3), while for breathlessness and wheezing the odds ratios were 3.2 and 2.4, respectively. There was a significant difference between the male coffee workers and controls in the adjusted FEV1 (0.26 l/s) and FVC (0.21 l) and in the prevalence of airflow limitation (FEV1/FVC < 0.7) (6.3 vs. 0.9%). Among the male coffee workers, there was a significant association between cumulative dust exposure and the lung function variables FEV1 and FVC, respectively. Conclusions: The results suggest that coffee production workers are at risk of developing chronic respiratory symptoms and reduced lung function, and that the findings are related to high dust levels. Measures to reduce dust exposure should be targeted to factors identified as significant determinants of exposure., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Bråtveit, Abaya, Sakwari and Moen.)

Background: Wood dust in a form of inhalable particulates can penetrate the lung tissues and affect respiratory health. Woodwork factory workers are at a greater risk of developing respiratory health problems because of exposure in their working environment, but existing data were few. The aim of this study was to assess the prevalence of chronic respiratory symptoms, associated factors, and concentration of personal total wood dust level among medium-scale woodwork factory workers., Methods: An institutional based cross-sectional study was conducted among 506 woodwork factory workers. We selected study participants using a simple random sampling technique. We assessed chronic respiratory symptoms using the British Medical Research Council respiratory symptoms questionnaire with a few modifications. A multivariate logistic regression model was used to identify the factors. Forty dust measurements were collected from 20 randomly selected workers using a closed-face cassette (CFC) personal sampler. We analyzed the dust samples gravimetrically using a standard microbalance scale., Results: We recruited a random sample of 506 workers in the study with a response rate of 98%. The prevalence of chronic respiratory health symptoms among woodworkers was 69.8% with a prevalence of cough (54.6%), phlegm (52.2%), wheezing (44.6%), breathlessness (42.1%), and chest pain (42.9%). Past occupational dust exposure history (AOR = 2.09, 95% CI; 1.09-4.01), work experience > 5 years (AOR = 9.18, 95% CI; 5.27-16.00), using bio-fuel as energy for cooking (AOR = 2.42, 95% CI; 1.44-4.07), and having no occupational safety and health training (AOR = 3.38, 95% CI; 1.20-9.49) were factors that significantly associated with chronic respiratory symptoms among woodwork workers. The geometric mean (GM) of dust exposure level among woodworkers was 10.27 mg/m 3 , which exceeded the limit of 10 mg/m 3 set by the ACGIH., Conclusions: High prevalence of chronic respiratory symptoms was reported from woodwork factory workers. Increased work- experience, using bio-fuel as an energy source for cooking, past occupational dust exposure history, and having no occupational safety and health training were identified risk factors. The measured average personal wood dust exposure level was above the recommended occupational threshold limit value. Therefore, workers' wood dust exposure reduction and control methods and respiratory health awareness programs should be implemented.

The aim of this study was to assess the magnitude, socio-demographic, and clinical characteristics of oesophageal cancer patients in selected referral hospitals of Ethiopia. A retrospective document review was employed in ten referral hospitals in different regions of Ethiopia. A structured data extraction tool was used to extract data from clinical care records of all clinically and pathologically confirmed oesophageal cancer patients who were diagnosed and treated in those hospitals from 2012 to 2017. During the study period, a total of 777 oesophageal cancer cases were identified, and the median age of these patients was 55 years, with an interquartile range of 19. More than half (55.1%, n = 428) of the cases were males, and the majority of them were reported from Oromia (49.9%, n = 388) and Somali (25.9%, n = 202) regional states. The highest numbers of oesophageal cancer cases were recorded in 2016 (23.8%, n = 185), while the lowest were in 2012 (12.6%, n = 98). Eighty per cent of oesophageal cancer cases were diagnosed in later stages of the disease. More than one-fourth (27.0%, n = 210) of patients had surgical procedures where the majority (74.3%, n = 156) required insertion of a feeding tube followed by transhiatal oesophagectomy (10.9%, n = 23). Of the 118 patients for which there was histology data, squamous cell carcinoma (56.7%, n = 67) and adenocarcinoma (36.4%, n = 43) were the predominant histologic type. One-fourth (25.0%, n = 194) of the patients were alive, and more than two-thirds (71.7%, n = 557) of the patients' current status was unknown at the time of the review. In these referral hospitals of Ethiopia, many oesophageal cancer patients presented during later stages of the disease and needed palliative care measures. The number of patients seen in Oromia and Somali hospitals by far exceeded hospitals of the other regions, thus postulating possibly unique risk factors in those geographic areas., Competing Interests: The authors declare that no competing interests exist.

Background: Occupational related respiratory diseases arise as a result of the deposition of dust particles in the lungs. Flour milling industries; generate organic dust during industrial processes, such as cleaning, milling, packaging, and loading which release dust into the air and later inhaled by workers. Flour mill workers are at risk of developing respiratory health problems because of exposure in their working environment, but existing data were few. The aim of this study was to assess the prevalence of chronic respiratory symptoms, lung function and associated factors among flour mill factory workers., Methods: A comparative cross-sectional study was conducted among 196 flour mill factory workers and 210 soft drinks factory workers. We selected study participants using a systematic sampling technique. We assessed the chronic respiratory symptoms using the questionnaire adopted from the British Medical Research Council. Binary logistic regression analysis with 95% CI and p < 0.05 was used to identify the factors. Lung function parameters; Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and ratio FEV1/FVC was measured by using spirometer and analyzed by using an independent t-test., Results: We included 406 (96.7%) workers in this study. The prevalence of chronic respiratory symptoms was higher among flour mill workers as compared to soft-drinks factory workers (56.6% vs.12.9%). Primary education (AOR = 5.8, 95% CI, 1.3-23.2), mixing department (AOR = 5.3, 95% CI = 1.68-16.56), work experience 6-9 years (AOR = 5.1, 95% CI = 2.05-12.48), work experience ≥10 years (AOR = 2.5, 95% CI = 1.01-6.11) and working over eight hours (AOR = 2.4, 95% CI, 1.16-5.10) were factors that significantly associated with chronic respiratory symptoms among flour mill workers. FVC (p < 0.002), FEV1 (p < 0.001) and FEV1/FVC (p < 0.012) were significantly reduced among flour mill workers., Conclusions: We found chronic respiratory symptoms to be high among flour mill workers. Lower education level, mixing department, increased work experience, and longer working hours were identified factors. The flour mill dust exposed worker's lung function parameters were highly reduced. This study suggested that workers' dust exposure reduction and control methods in flour mill factories need to be implemented.

Coffee workers respiratory health problems, found to be associated with dust exposure in the coffee factories, but the content of the dust is not well known. A cross-sectional survey was conducted to assess the microbial contamination of coffee in dry and wet coffee process, from four farms in two regions of Ethiopia. A total of 36 samples of coffee were collected for laboratory investigation. The microbial load in the dry process ranged from 6.9 × 10 2 to 7.2 × 10 5 colony forming units (CFU)/mL while the microbial load in wet process ranged from 2.5 × 10 2 to 4.6 × 10 5  CFU/mL. The results indicate the presence of gram negative bacteria in dried and stored beans from both the wet and dry process. During further coffee processing possible release of endotoxin from coffee contaminated by gram negative bacteria might affect coffee workers respiratory health. Further studies are required to assess the relation between bacterial contamination of coffee and endotoxin level in coffee factories.

Objective: The aim of this study was to assess chronic respiratory symptoms and lung function among female hand pickers., Methods: A total of 374 hand pickers exposed to coffee dust and 175 female controls from water bottling factories were included. The symptoms were assessed using a standardized questionnaire. Personal total dust exposure and lung function tests were performed., Results: Hand pickers experienced a higher dust exposure, displayed a higher prevalence ratio for cough [prevalence ratio (PR) = 3.0, 95% confidence interval (95% CI): 1.4 to 6.2] and work-related shortness of breath (PR = 2.5, 95% CI: 1.1 to 5.6), and had a lower FEF25-75 than controls. Hand pickers without tables had a significantly higher prevalence ratio of cough with sputum (PR = 3.9, 95% CI: 1.6 to 9.5) and lower forced vital capacity, forced expiratory volume in 1 second, and mean forced expiratory flow between 25% and 75% of the FVC than hand pickers with tables., Conclusion: Hand pickers show a range of adverse symptoms and lung function impairments that warrant efforts to improve working conditions.

Background: Coffee processing has been shown to cause high dust exposure among the workers, but there are few studies from primary processing of coffee, and none of them is from Ethiopia. The aim of this study was to assess dust exposure and its determinants among workers in primary coffee processing factories of Ethiopia., Methods: A total of 360 personal 'total' dust samples were collected from the breathing zone of workers in 12 primary coffee processing factories in Ethiopia. Dust sampling was performed with 25-mm three piece conductive cassettes with cellulose acetate filters attached to pumps with flow rate of 2 l min-1 for an average sampling duration of 410 min. The dust samples were analysed gravimetrically using a standard microbalance scale. An observational checklist was used to collect information about possible determinants of dust exposure in the work environment. Linear mixed effect regression models were used to identify significant determinants of total dust exposure., Results: Personal total dust exposure levels varied between the three main job groups with a geometric mean (GM) of 12.54 mg m-3 for the machine room workers, 12.30 mg m-3 for the transport workers, and 1.08 mg m-3 for hand pickers. In these three groups, 84.6%, 84.1% and 2.6% of the samples exceeded the occupational exposure limit for organic total dust of 5 mg m-3, respectively. The mixed-effects model for the machine room workers explained 21% of the total variance in total dust exposure, and showed that vigorously pouring coffee from a dropping height was associated with an about two times increase in exposure. For the transport workers, the mixed-effects model that included pouring method of coffee beans, number of huller machine in the room, mixing coffee, and feeding hopper explained 32% of total variance in personal total dust exposure., Conclusion: About 84% of the dust samples among machine room and transport workers in primary coffee processing factories were above the occupational exposure limit value for organic dust. Proper control measures are necessary to reduce the exposure.

Dust exposure is one of the major risk factors for respiratory health in many workplaces, including coffee factories. The aim of this study was to assess the prevalence of respiratory symptoms and lung function reduction among workers in Ethiopian primary coffee processing factories, compared to a control group of workers. A total of 115 coffee workers and 110 water bottling workers were involved in this study, from 12 coffee and 3 water bottling factories in Ethiopia, respectively. The chronic respiratory symptoms were assessed using a structured interview, using a standardized questionnaire adopted from the American Thoracic Society (ATS). The lung function tests were performed according to the ATS recommendation for spirometry. The coffee workers had a significantly higher prevalence of coughing, coughing with sputum, breathlessness, work-related shortness of breath, and wheezing compared with the controls. The prevalence ratio of work-related shortness of breath (PR = 3.7, 95% CI: 1.6⁻8.7) and wheezing (PR = 3.3, 95% CI: 1.3⁻8.4) was significantly higher for the coffee workers compared to the controls. The coffee workers in the age groups 28⁻39 years and ≥40 years, had a significantly lower forced vital capacity and forced expiratory volume in 1 s compared to the controls in the similar age groups. The findings indicated the need for longitudinal studies on the possible effect of coffee dust on respiratory health of coffee production workers.

Background: Open defecation (OD) is a widespread problem in the developing world. This practice facilitates the transmission of diarrheal diseases. In Ethiopia, still the national open defecation rate in 2014 was 34.1% (37.9% in rural and 8.7% in urban)., Objective: To assess diarrheal morbidity in under-five children and its associated factors in Dangla district, Northwest Ethiopia, 2016., Methods: A community-based comparative cross-sectional study design with a multistage random sampling technique was applied. The total sample size was 550 (275 ODF and 275 OD). Descriptive and inferential statistics were done., Results: A total of 525 participants were interviewed making the response rate 95.45%. The prevalence of diarrhea was 9.9% in ODF and 36.1% in OD kebeles. In ODF kebeles, child immunization (AOR = 0.037; 95% CI: 0.006-0.243), latrine presence (AOR = 0.036; 0.006-0.233), water shortage (AOR = 8.756; 95% CI: 1.130-67.831), and solid waste disposal (AOR = 0.143; 95% CI: 0.020-0.998) have statistically significant association with diarrhea occurrence. While in OD kebeles child immunization (AOR = 0.032; 95 CI: 0.008-0.123), water access of 7.5-15 liters/day (AOR = 0.029; 95% CI: 0.006-0.152), water shortage (AOR = 18.478; 95% CI: 4.692-72.760), and proper solid waste disposal (AOR = 0.023; 95% CI: 0.005-0.117) have significant association with diarrhea occurrence., Conclusions: The overall prevalence of under-five diarrhea was low in ODF kebeles as compared with OD kebeles. The study showed that child immunization, latrine presence, water shortage in household, and solid waste disposal practices had statistically significant association with diarrhea occurrence in ODF kebeles, while water access at the individual level, water shortage in household, child immunization, and solid waste disposal have statistically significant association with diarrhea occurrence in OD kebeles. Integrated efforts are needed from the Ministry of Health together with line ministries and developmental partners in improving latrine utilization at household level, water shortage in households, and solid waste disposal practices.