Table 1

Characteristics and main results of included cross-sectional studies assessing non-malignant respiratory disease and exposure to cement production dust

CountryExposure metric (number), personal dust levels mg/m3 (SD)Number of exposed workers (response rate, %)Source of controlsAdjustment for age and smokingMain effects respiratory symptoms and other findings: OR (95% CI) or percentage (SD) exposed vs non-exposed, p valueMain effects lung function tests: OR (95% CI) or percentage (SD) exposed vs non-exposed, p valueReference
USATotal dust (211): 2.9, range: 0.01–79, respirable dust (1011): 0.6 range: 0.01–46.22736 (87)Blue-collar workersYesOR for dyspnoea: 1.6 (p=0.05)NS differences in lung function indices5
YugoslaviaTotal (NR): range: 6.5–230, respirable (NR): 2.2–4648 (100)NoneYesNot reported (NR)FVC and FEV1 levels negatively related to duration of exposure6
MalaysiaTotal (NR): exposed (exp): 10, control (ctr): 0.232 (NR)OfficeNoNRNon-smoking exposed vs non-smoking ctr: FEV1/FVC ratio: 92 (0.7) vs 84 (2.1)7
TaiwanRespirable: exp (147): 3.6 (4.9), ctr (51): 0.41 (0.98)147 (100)OfficeYesOR for cough: 1.6 (1.3 to 1.8), phlegm: 1.3 (1.1 to 1.5), wheezing: 1.2 (1.0; 1.4), dyspnoea: 1.2 (1.1 to 1.4)FEV1: 2.7 L vs 3.0, p<0.05, FVC: 3.5 L vs 3.8 (p<0.05)8
JordanRespirable (65): low: 0.5 (2.1), medium: 1.6 (2.6) high: 3.9 (4.0)348 (58)Low-exposedYesIncreased prevalence of symptoms,NS differences in lung function in the three groups9
Saudi ArabiaRespirable (97): 2.1–6072 (48)OfficeYesOR for wheezing: 1.2 (1.0 to 1.4), dyspnoea: 2.9 (1.0 to 7.0), asthma: 1.2 (1.1 to 1.4)NR10
TanzaniaTotal (120): mg/mg3× year: exp: 69 (3.9), ctr: 11 (2.8)126 (100)Blue-collar, officeYesNR>300 mg/m3 vs <100 associated with FEV1/FVC <0.7: OR 9.9 (3.5 to 28)11
TanzaniaTotal (120): exp: 13 (10), ctr: 1.5 (2.1)120 (95)Blue-collar, low-exposed, officeYesOR for chronic cough: 4.5 (1.9 to 10), chronic sputum: 4.8 (1.6 to 14), chronic bronchitis: 5.5 (2.0 to 15), chronic obstructive respiratory disease: 19 (10)% vs 1.5 (2.1)%NR12
TanzaniaHigh exposed: respirable (30): 4 (3.3), low: 0.7 (0.6)84 (97)Blue-collar low-exposed, officeYesExposure ≥2 mg/m3 associated with cough: OR 7.9 (1.8 to 35), dyspnoea: 4.2 (1.1 to 15)Peak expiratory flow: 4.5% decrease per unit log-transformed dust13
TanzaniaTotal (137): exp: 5.0 (3.2), ctr: 0.6 (1.3)102 (82)Blue-collarSmokers excluded, no adj. for ageFraction of exhaled nitric oxide: NS differences exp vs ctrNR14
IranInhalable dust (NR): 53 (43), respirable (NR): 26 (14)88 (100)OfficeNoPrevalence exposed vs ctr: cough: 32% vs 20% (p=0.04), phlegm: 26% vs 15% (p=0.03), dyspnoea: 17% vs 5% (p=0.006), wheeze: 28% vs 5% (p<0.0001)FEV1/FVC: 104 (9.2) vs 105 (11)
FVC% predicted: 88 (25) vs 109 (27)
15
IranRespirable (139): exp: 5.4–30 ctr: 0.994 (100)OfficeNoNSFEV1/FVC: 0.79 vs 0.82 (p=0.006), FVC: 3.9 vs 4.2 (p=0.006)16
UAE**Total (NR): 4.5–15149 (100)OfficeYesOR for cough: 12 (1.5; 13), phlegm: 15 (1.8; 101)NR17
EuropeThoracic aerosol: group median (2670): 0.85 (4.6), lowest quartile: <0.49, highest: >1.734265 (NR)Office. low-exposedYesOR for symptoms range: 1.2–2.6 in highest quartile vs lowest quartile of exposureReduced FEV1: 0.27 (0.19 to 0.30) in highest vs lowest level of exposure18
Tanzania*2002 (79): Total: 1.4–56
2010 (179): Total: 1.1–20
2002: 120
2010: 171 (82)
Blue-collar low-exposed, officeYesOR for chronic bronchitis in 2002 vs 2010: 5.5 (2.0 to 15) vs 0.5 (0.2 to 2.0), p=0.02FEV1/FVC: 0.77 (0.6) vs 0.83 (0.1), p<0.001, FVC: 95 (13) vs 111 (17), p<0.00119
  • *†Comparison of two cross-sectional studies.

  • †Study supplemented by the authors.

  • FEV1, Forced expiratory volume in 1 s; FVC, Forced vital capacity; NR, not reported; NS, non-significant; UAE, United Arab Emirates.