الفهرس 
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Abstract
Brick manufacturing involves three main steps: clay shaping with water (molding), drying with solar energy and firing with fuel (baking). Workers at brick kiln may be involved in carrying the clay dust and bricks, molding or baking. Although all the workers are exposed to dust and smoke, molders are more likely to be directly exposed to dust and bakers have more proximal exposure to smoke. Smoke and dust from brick kilns are important causes of respiratory health problems.
Aim of work:
To through more light on the respiratory health among brick kilns workers in Egypt through these objectives:
1. To identify some of respiratory health problems among brick kilns workers in Mit Ghamr District, Dakhlia Governorate.
2. To asses some of the occupational and personal risk factors that may be associated with these respiratory problems.
3. To recommend prevention and control measures in brick kilns industries.
Subjects and methods:
A cross sectional descriptive study was conducted among 173 male brick kilns workers, exposed to dust and smoke within their current work in Mit Ghamr District, Dakhlia Governorate. Another group of 170 seller men in Mit Ghamr District not exposed to dust nor smoke even had past history of exposure to dust nor smoke.
All subjects were interviewed personally using apre-constructed questionnaire which included:
1. Socio-demographic data as age, marital status income and education.
2. Occupational history as type of work and exposure, number of worked hours /day, duration of work in this job /year and usage of personal protective equipments.
3. Present history of chronic respiratory symptoms as chronic cough, chronic phlegm, Dspnea and chest wheeze.
4. Acute symptoms as headache, chest burn, throat irritation and chest tightness.
5. Past history of bronchitis, pulmonary TB, bronchial asthma and pneumonia before joining the currant job.
6. Smoking history of cigarettes and gozza.
Computerized pulmonary function tests were done to the workers.
Results:
This study showed that brick kilns workers and their control groups were matched regarding some socio-demographic characteristics (age, marital status, income and level of education). Most of the workers of both groups were ≥ 30 years and married, while more than 50% of them were school educated and had not enough income. Also brick kilns workers and their control group were matched regarding smoking habits, about half of both groups were smokers (48.6% and 49.4% respectively), where most of them smoke <10 cigarettes per day, and for <15 years. More than 30% of both groups smoke goza.
More than half of both groups were working in their current job for ≥ 15 years (57.8% and 55.3 % respectively), and for ≥10 hours per day (56.6% and 66.5% respectively), but with out any significant difference between them, about 58.4% of the studied brick kilns workers were molders and 41.6% were bakers. On the other hand, workers in both groups didn’t use any personal protective equipment at all.
This study showed that brick kilns workers had a significant higher prevalence of chronic respiratory problems compared with their control group, where the most common chronic respiratory symptoms among them were chronic cough (34.7% and 10.0% respectively) followed by dyspnea (21.4% and 5.3% respectively), chest wheeze (20.2% and 8.8% respectively), chronic bronchitis (19.7% and 6.5% respectively), and asthma (15.6% and 7.4% respectively). Moreover, 39.9% of brick kilns workers were complaining from one symptom or more compared to 11.7% among their control group.
This study showed a high significant difference between brick kilns bakers and molders regarding some chronic respiratory problems, as chronic cough (61.1% and 15.8% respectively), chronic phlegm and chronic bronchitis (30.6% and 11.9% respectively), and one symptom or more (58.3% and 26.7% respectively).
This study showed that brick kilns workers had a significant higher frequency of acute respiratory problems than their control group, as the most common acute respiratory problems among them were chest tightness (56.1% and 9.4% respectively), headache and throat irritation (31.2% and 17.5% respectively), and chest burn (28.3% and 14.7% respectively).
The study shows that there is a high significant increase of chronic respiratory problems in brick kilns workers aged ≥30 years compared to the workers aged˂30 years.
Regarding the smoking habits, this study showed that there was a significant higher prevalence of chronic respiratory problems among smokers (60.9%), who smoke for <15 years, and for <10 cigarettes per day, also the prevalence of chronic respiratory problems increase significantly among brick kilns bakers, who work in brick kilns for ≥ 15 years and for ≥ 10 hours per day.
This study showed that, all ventilatory lung function measurements of brick kilns workers were significantly lower than that of their control group, and there was no statistical difference between brick kilns bakers and molders regarding ventilatory lung function measurements.
In this study, the percentage of the brick kilns bakers with abnormal lung function was 51.5%, while the percentage of brick kilns molders with abnormal lung function was 43.1% with no significant difference between them.
About the relation between smoking status and ventilatory lung measurements, there was no significant difference between smokers and non smokers regarding their ventilatory lung measurements.
This study showed that FEV1/FVC decreases significantly when the duration of work increased.
This study showed that most significant predictors of chronic respiratory problems among the studied brick kilns workers were the type of work followed by smoking status, where the brick kilns bakers and smokers were predicted to have chronic respiratory problems more than molders and non smokers. But the most significant predictor of ventilatory impairment was working in brick kilns for≥ 15 years.
Conclusion:
It can be concluded from this study that brick kilns workers in Mit Ghamr district are at risk of respiratory problems and the brick kilns bakers and smokers are predicted to develop these respiratory problems more than molders and non-smokers.
Also it can be concluded that these respiratory problems among brick kilns workers are leading to abnormal lung functions especially in workers whose duration of work is ≥ 15 years.
Recommendations:
a. Pre-placement medical examination: to exclude those susceptible to any respiratory health problems.
b. Periodic medical examination: for early detection and management of cases with any respiratory health problems.
C. Health education: about respiratory health problems causes and effects, how the brick kilns worker can protect himself from these problems and encourage to stop smoking.
d. use of personal protective equipment, and training how to use it.
e. Use of cleaner fuel as natural gas.