Sweeper's lung disease: A cross-sectional study of an overlooked illness among sweepers of Pakistan

Abstract

Background: Sweepers are prone to develop chronic obstructive pulmonary disease even without tobacco smoking. Purpose: To investigate roadside dust as a cause of air flow obstruction among sweepers, and the role of spirometry in its preclinical diagnosis. Material and methods: One-hundred nonsmoking sweepers (aged 30-60 years) of both sexes sweeping on roads for 8-12hours a day for the Capital Development Authority of Islamabad, Pakistan were used as study participants (Group A). One-hundred healthy nonsmokers (aged 30-60 years) in the same socioeconomic group and living in the same environment represented the nonsweeper group (Group B). After proper clinical evaluation and chest X-rays, spirometric evaluation was carried out in both groups. Comparisons were drawn between various spirometric parameters. Results: Pulmonary function tests showed that the mean forced vital capacity was 78±1.40 in the sweeper group (Group A) and 83±0.86 in the nonsweeper group (Group B). Mean forced expiratory volume in 1 second was 66±1.67 in Group A and 85±0.85 in Group B (P<0.05), a difference of 19%. The forced midexpiratory flow was 41% lower in Group A than in Group B (P<0.0001). The pattern of pulmonary function obstruction was shown to be proportional to the duration of exposure to dust caused by sweeping. Conclusion: Occupational exposure to dust leads to an obstructive pattern among sweepers. Spirometry is the simplest, noninvasive technique to detect preclinical disease. © 2013 Anwar et al, publisher and licensee Dove Medical Press Ltd.