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Table of Contents
ORIGINAL ARTICLE
Year : 2019  |  Volume : 6  |  Issue : 2  |  Page : 65-67

Assessment of vital respiratory indices of petrol pump workers of Kathmandu


Department of Physiology, Nepal Medical College, Kathmandu, Nepal

Date of Web Publication18-Nov-2019

Correspondence Address:
Mr. Rajan Pandit
Department of Physiology, Nepal Medical College, Jorpati, Kathmandu
Nepal
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ami.ami_21_19

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  Abstract 

Introduction: Petrol pump is a place where workers are exposed to both fuel vapor and the vehicular exhaust fumes. Automobile exhaust, a complex mixture of different gasses such as sulfur dioxide, carbon dioxide, carbon monoxide, nitrogen dioxide, and particulate matter, has an adverse impact on the respiratory system. The present cross-sectional study, therefore, has been designed to determine the few vital respiratory indices of petrol pump workers. Methods: Forty nonsmoker petrol pump workers and other forty participants, as a control group from the same locality, were considered in this study. All inclusion and exclusion criteria were followed. After participants were familiarized with spiro-excel (PC bases) spirometer, they were asked to perform maneuver – a forced expiratory following full inspiration – until they could duplicate the maneuvers successfully on three consecutive attempts. Parameters such as forced vital capacity (FVC), forced expiratory volume in the 1st s (FEV1), FEV1/FVC (%), peak expiratory flow rate (PEFR), and forced expiratory flow at 25%–75% (FEF25%–75%) were recorded in sitting position preceded by 5-min rest, and the best values of three attempts were considered for data analysis using SPSS 16.0 version, and t-test (P < 0.05) was used for statistical analysis. Results: The mean ± standard deviation values of FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR for petrol pump workers versus control groups were 3.44 ± 0.23 versus 3.94 ± 0.25 L, 2.64 ± 0.20 versus 3.24 ± 0.29 L, 77.11% ± 0.08% versus 82.61% ± 0.09%, 4.36 ± 0.37 versus 5.58 ± 0.36 L/s, and 6.35 ± 0.27 versus 7.62 ± 0.45 L/s, respectively. Conclusion: The significant decrease in FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR in this study showed that long-term exposure to gasoline fumes/products leads to inflicted changes in lungs functions and could result to obstructive lung disease.

Keywords: Lung function test, Nepalese, petrol pump workers, spirometer


How to cite this article:
Pandit R. Assessment of vital respiratory indices of petrol pump workers of Kathmandu. Acta Med Int 2019;6:65-7

How to cite this URL:
Pandit R. Assessment of vital respiratory indices of petrol pump workers of Kathmandu. Acta Med Int [serial online] 2019 [cited 2019 Dec 6];6:65-7. Available from: http://www.actamedicainternational.com/text.asp?2019/6/2/65/264365


  Introduction Top


The rising number of vehicles, especially in Kathmandu, not only increases the demand of petrol and diesel but also simultaneously increases the level of air pollution. Along with hydrocarbons, gasoline/petrol and diesel also contain benzene, toluene, ethylbenzene, and xylene, of which particularly benzene has been classified as carcinogens.[1],[2] These gasolines undergo combustion in automobile engines and give rise to combustion-derived nanoparticles, which remain airborne for longer time periods and are highly respirable.[3] Automobile exhaust is a complex mixture of different gasses such as sulfur dioxide, carbon dioxide, carbon monoxide, nitrogen dioxide (NO2), and particulate matter.

Animal study has demonstrated that exposure to particulate matter combined with exposure to an irritant gas such as NO2 results in greater damage to the lung. The gaseous pollutants may also alter the properties and concentration of surfactant and contribute to early closure of small airways.[4],[5] Long-term exposure to petrol vapor has shown to affect the different physiological systems in the body, with the highest impact on the respiratory system.[6]

Petrol pump is a place where workers are exposed to both fuel vapor and the vehicular exhaust fumes. Apart from refueling vehicles, workers also do all sorts of works such as unloading of fuel and daily checking of fuel levels in the storage tanks.[7],[8]

Although substantial number of international studies reported the deleterious effects of automobiles fuels in health, hardly any similar type of study has been carried out in Kathmandu, Nepal. The present cross-sectional study, therefore, has been designed to determine the few vital respiratory indices of petrol pump workers.


  Methods Top


After obtaining approval from the Nepal Health Research Council and informed consent from the participants, the present study was carried out during the morning hours between 7 and 8 am in Kathmandu, Nepal, in the month of August–November 2017.

Forty nonsmoker petrol pump male workers, who worked for more than 5 years of the age group of 20–50 years, were requested to participate for the study and age-matched forty nonsmoker males from the same locality but from other occupational background served as a control group. Participants with a history of major cardiopulmonary diseases, diabetes mellitus, abdominal and chest surgery, and body mass index (BMI ≥30) and those unwilling to give consent for participation were excluded from the study. Furthermore, participants with chest wall deformities, neuromuscular disease, obesity and any history of smoking, addiction of tobacco, and alcohol intake were excluded from the study. After the participants answered the open-angle questionnaire, the basic anthropometric measurements such as age, height, weight, and BMI were recorded. Then, participants were familiarized with spiro-excel (PC bases) spirometer. They were asked to perform maneuver, a forced expiratory following full inspiration, until they could duplicate the maneuvers successfully on three consecutive attempts. Parameters such as forced vital capacity (FVC), forced expiratory volume in the 1st s (FEV1), FEV1/FVC (%), peak expiratory flow rate (PEFR), and forced expiratory flow at 25%–75% (FEF25%–75%) were recorded, and the best values of three attempts were considered for data analysis using SPSS 16.0 version (SPSS Inc., Chicago, US). Prior to performing the maneuver, they were requested to take rest for 5 min comfortably in a chair.


  Results Top


[Table 1], using t-test (P < 0.05), depicts no statistical difference in mean values of age, height, weight, and BMI in between petrol pump workers and control group. The mean ± standard deviation (SD) values of age, height, weight, and BMI in petrol pump workers versus control were 30.23 ± 2.13 versus 30.1 ± 1.94 years, 1.58 ± 0.02 versus 1.56 ± 0.05 m, 63.8 ± 4.61 versus 60.0 ± 4.86 kg, and 21.60 ± 1.95 versus 21.59 ± 2.31 kg/m2, respectively. The mean exposed years of automobile exhaust/gasoline of petrol pump workers were 7.34 ± 2.23.
Table 1: Characteristic of participants

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[Table 2], using t-test (P < 0.05), shows that all the studied parameters of pulmonary function tests were significantly decreased in the petrol pump workers than in the control group. The mean ± SD values of FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR for petrol pump workers versus control groups were 3.44 ± 0.23 versus 3.94 ± 0.25 L, 2.64 ± 0.20 versus 3.24 ± 0.29 L, 77.11% ± 0.08% versus 82.61% ± 0.09%, 4.36 ± 0.37 versus 5.58 ± 0.36 L/s, and 6.35 ± 0.27 versus 7.62 ± 0.45 L/s, respectively.
Table 2: Pulmonary function test parameter values of study and control groups

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  Discussion Top


Comparison of vital respiratory indices such as FVC, FEV1, FEV1/FVC, FEF25%–75%, and PEFR were done in the present study in between petrol pump workers and control group, who have no statistical difference in mean values of age, height, weight, and BMI.

In this study, the mean FVC value in petrol pump workers (3.44 L) was significantly decreased in comparison to control group (3.94 L). Batta and Dhir also depicted a significant decrease in FVC in petrol pump workers in comparison to age- and sex-matched healthy controls.[9] Dube et al. found statistically significant lower values of FEV1 in petrol pump workers than control group,[10] which also bolster this study – the mean FEV1 value in petrol pump workers and control group was, respectively, 2.64 L and 3.24 L. Similarly, Begum and Rathna also showed a statistically significant decrease in FVC, and FEV1 in petrol pump workers when compared to their control counterpartners.[11]

Meo et al. depicted that there was a significant decrease in FEV1/FVC (%) in petrol refinery workers in comparison to age- and sex-matched healthy controls,[12] whereas Sharma and Agarwal reported a nonsignificant decrease in FEV1/FVC (%) in petrol pump workers in comparison to age- and sex-matched healthy controls.[13] However, this study showed a significant decrease in FEV1/FVC (%) in petrol pump workers (77.11%) than the control group (82.61%).

Chakraborty et al.[14] found a significantly lower mean value of FEF25%–75% in petrol pump worker as compared to control group, which is in consonance with the present study – the value is 4.36 L/s for petrol pump workers and 5.58 L/s for the control group. In petrol pump workers and healthy controls, Singhal et al. found a PEFR value of 5.41 and 7.25 L/s, respectively, and the difference was statistically significant.[15] A decrease in PEFR was also noted in this study, having mean value of 6.35 L/s for petrol pump workers and 7.62 L/s for the control group.

The significant decrease in the vital respiratory indices in petrol pump workers in comparison to control groups could be attributed to established facts that gaseous pollutants alter the properties and concentration of surfactant leading to early closure of small airways.[4],[5] In addition, chronic inflammation of respiratory tract and lung parenchyma developed due to prolonged exposure to petroleum products.[5] Furthermore, it is also reported that exposure to high ambient concentrations of gasoline vapors can cause welldefined and marked systemic pulmonary inflammatory response.[16],[17]

The significant decrease in FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR in the present study revealed that long-term exposure to gasoline fumes/products leads to inflicted changes in lungs functions and could result to obstructive lung disease. In obstructive lung disease, the above all recorded parameters are decreased.[18]


  Conclusion Top


Overall, the study depicted that long-term exposure to gasoline fumes/products leads to significant decrease in FVC, FEV1, FEV1/FVC (%), FEF25%–75%, and PEFR in petrol pump workers as compared to their control counterpartners, and in near future, they will vehemently suffer from obstructive lung disease, if they don't take proper precaution in the work sites and follow medical check-ups regularly.

Limitations and recommendations

The sample size was small and only represents petrol pump workers from Kathmandu; hence, a similar type of study is suggested to carry out in other cities of Nepal. Furthermore, it is also recommended to record the level of the ambient air quality data near the petrol pump, which is lacking in this study. Petrol pump workers must be cognizant to minimize the health-related issues arise from working places and are advised to wear safety oronasal masks and follow periodic medical checkup.

Acknowledgement

The author would like to express the sincerest gratitude to the Principal Prof. Dr. Pramod Kumar Chettri and Prof. Dr. Tapas Pramanik, Department of Physiology, Nepal Medical College, for their support. Furthermore, the author is thankful to Prem Prasad Panta, Lecturer, Department of Community Medicine for Statistical Analysis, and Balaram Dhungana, office Secretary; Gokul KC, Maiya Kandel, Department of Physiology for their help.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Kesavachandran C, Rastogi SK, Anand M, Mathur N, Dhawan A. Lung function abnormalities among petrol-pump workers of Lucknow, North India. Curr Sci 2006;90:1177-8.  Back to cited text no. 1
    
2.
Edokpolo B, Yu QJ, Connell D. Health risk assessment of ambient air concentrations of benzene, toluene and xylene (BTX) in service station environments. Int J Environ Res Public Health 2014;11:6354-74.  Back to cited text no. 2
    
3.
Wichmann HE. Diesel exhaust particles. Inhal Toxicol 2007;19 Suppl 1:241-4.  Back to cited text no. 3
    
4.
Boren HG. Pathobiology of air pollutants. Environ Res 1967;1:178-97.  Back to cited text no. 4
    
5.
Cotes JE. Lung Function Assessment and Application in Medicine. 5th ed. Boston: Oxford Blackwell Scientific Publications; 1993. p. 122.  Back to cited text no. 5
    
6.
Anuja AV, Veeraiah V, Johnson P, Subashini AS. Evaluation and comparison of pulmonary function tests in petrol pump workers vs. individuals unexposed to petrol fumes. J Clin Biomed Sci 2014;4:276-81.  Back to cited text no. 6
    
7.
Periago JF, Prado C. Evolution of occupational exposure to environmental levels of aromatic hydrocarbons in service stations. Ann Occup Hyg 2005;49:233-40.  Back to cited text no. 7
    
8.
Uzma N, Salar BM, Kumar BS, Aziz N, David MA, Reddy VD, et al. Impact of organic solvents and environmental pollutants on the physiological function in petrol filling workers. Int J Environ Res Public Health 2008;5:139-46.  Back to cited text no. 8
    
9.
Batta M, Dhir KS. Effect of automobile exhaust on pulmonary function tests in petrol pump workers. Int J Community Health Med Res 2015;1:22-5.  Back to cited text no. 9
    
10.
Dube S, Mungal SU, Kulkarni M. Evaluation of respiratory functions in petrol pump workers at Nanded. Int J Recent Trends Sci Technol 2013;8:149-52.  Back to cited text no. 10
    
11.
Begum S, Rathna MB. Pulmonary function tests in petrol filling workers in Mysore city. Pak J Physiol 2012;8:12-4.  Back to cited text no. 11
    
12.
Meo SA, Alrashed AH, Almana AA, Altheiban YI, Aldosari MS, Almudarra NF. Lung function and fractional exhaled nitric oxide among petroleum refinery workers. J Occup Med Toxicol 2015;10:37.  Back to cited text no. 12
    
13.
Sharma H, Agarwal S. Forced vital capacity, forced expiratory volume in 1st second (FEV1) and forced expiratory ratio (FEV1/FVC) in petrol pump-workers at Jhalawar and Jhalarapatan (Rajasthan). Indian J Clin Anat Physiol 2015;2:177-80.  Back to cited text no. 13
    
14.
Chakraborty D, Aggarwal M, Paul D. A comparative evaluation of respiratory indices in petrol station workers of Agartala. Int J Basic Appl Physiol 2016;5:173-7.  Back to cited text no. 14
    
15.
Singhal M, Khaliq F, Singhal S, Tandon OP. Pulmonary functions in petrol pump workers: A preliminary study. Indian J Physiol Pharmacol 2007;51:244-8.  Back to cited text no. 15
    
16.
Salvi S, Blomberg A, Rudell B, Kelly F, Sandström T, Holgate ST. Acute inflammatory responses in the airways and peripheral blood after short-term exposure to diesel exhaust in healthy human volunteers. Am J Respir Crit Care Med 1999;159:702-9.  Back to cited text no. 16
    
17.
Chawla A, Lavania AK. Air pollution and fuel Vapour induced changes in lung functions: Are fuel handlers safe? Indian J Physiol Pharmacol 2008;52:255-61.  Back to cited text no. 17
    
18.
Koeppen BM, Stanton BA. Berne and Levy Physiology. 7th ed. New Delhi: Elsevier Publications; 2017. p. 459.  Back to cited text no. 18
    



 
 
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  [Table 1], [Table 2]



 

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