Shakri, Siti Farhanah Md
(2020)
Effects of endotoxin exposure on respiratory health among rice mill workers : from workplaces to homes.
Masters thesis, Universiti Sains Malaysia.
Abstract
The study of occupational exposure to endotoxin has been broad and high
concentration of endotoxins detected across various sectors and industries. These
exposure leads to the health effects which include respiratory disorder, asthma,
chronic bronchitis and chronic obstructive pulmonary disease. The major route of
exposure is through inhalation. In fact, the contamination might be transferred to the
family members of the exposed workers. Thus, this comparative cross-sectional
study aims to study the workplace to home transmission of endotoxin among rice
millers in Malaysia and administrative staffs of USM Health Campus and their
respiratory effects. Endotoxin level in inhalable dust for both area and personal
samplings were collected using 25 mm Glass Fiber (A) filter loaded in IOM sampler
connected to a pump which was clipped at the collar of the rice millers for eight
hours. Take-home exposure route was studied by taking the post-shift hands wipes
and vacuum home dust from both groups. The questionnaires were circulated among
the participants where it consists of six parts; personal details, occupational details,
PPE, safety practices at work, respiratory symptoms and take-home exposure. The
samples were stored at -20ºC and analysed using Limulus Amoebocyte Lysate (LAL)
Chromogenic Endpoint assay at 405 nm. The lung function tests (LFT) were carried
out using Spirometer. The results were statistically analysed using SPSS Version 24.
Findings for the median concentration of endotoxin for areas and personal inhalable
were 0.32 EU/m3 with Interquartile Range (IQR) 0.13 to 0.37 EU/m3 and 0.33EU/m3
with IQR (0.14-0.34) EU/m3 respectively. There was no significant decline in postshifts
hand wipes between rice millers and administrative staffs each with the median
(IQR); 0.06 (0.00-0.11) EU/ml and 0.04 (0.02-8.37) EU/ml. The administrative staffs
have higher detectable of endotoxin in the vacuum home dusts, compared to rice
millers with median (IQR); 4.76 (0.16-6.35) EU/ml and 0.21 (0.07-0.21) EU/ml
respectively. Most of the rice millers complained having cough (32.4%, n=24),
phlegm (27%, n=20) and dyspnoea (16.2%, n=12). Post-shift LFT for FEV1/FVC
measured was lower among the rice millers (58.36 ± 21.41) % compared to the
administrative staffs (63.65 ± 19.26) %, but was not statistically significant (p =
0.158). However, there were significant correlations between endotoxin
concentration and post-shift LFT parameters of measured FVC, FEV1, FEV1/FVC
and PEFR (p< 0.05). There was significant difference in home dust endotoxin level
between these two groups, but higher detectable endotoxin level found among
administrative staffs compared to the rice millers with median (IQR): 4.76 (0.1-6.35)
EU/ml and 0.21 (0.07-0.21) EU/ml respectively. This current study has established
that the endotoxin level detectable among rice millers in Malaysia was very low
which indicating safe level. Despite low level of endotoxin exposure, yet proper
protective measure should be applied among the rice millers for long term protection.
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