Research by AKU highlights the effectiveness of interventions to improve the health of textile workers in Pakistan

Karachi (Muhammad Yasir)

A multi-faceted study conducted by Dr Asaad Nafees, Assistant Professor, Department of Community Health Sciences at the Aga Khan University (AKU) is the largest of its kind to determine the effectiveness of a simple intervention in reducing cotton dust-related respiratory health effects on textile workers in Pakistan. The study titled MultiTex RCT, in collaboration with the National Heart and Lung Institute (NHLI) and Imperial College London, marked a crucial step towards revolutionizing occupational health interventions for textile workers in Pakistan and other Low- and Middle-Income Countries (LMICs).

Persistent cotton dust exposure leads to the development of a disease called byssinosis, a disease prevalent among textile workers in LMICs due to limited access to occupational health and safety measures. With an initial cohort of 2031 workers from 38 textile mills in Karachi, the study tested a low-cost intervention package to ascertain if it would mitigate the adverse respiratory effects experienced by these workers. The interventions comprised training in occupational health for all workers and managers, regular refresher sessions, formation of workplace committees to enforce a health and safety plan including wet mopping and safe disposal of cotton dust, and provision of face masks. The results showed clear improvements in respiratory symptoms and lung function of the textile workers.

Funded by the Wellcome Trust for a period of three years, the findings of this important research can be applied to the larger textile landscape helping workers in Pakistan and elsewhere stay safe and minimize their disease burden. Discussing the study outcomes, Prof Paul Cullinan, formerly of Imperial College London, involved in the study said, “Studies of this caliber on occupational health interventions are extremely rare and this work has promise for large-scale uptake since the multifaceted intervention was designed to fit the local context in Pakistan.  There is no obvious reason why it could not be rolled out more widely, nationally, and internationally.  In the 200 years we have been faced with byssinosis, this work represents a landmark in its control”. He underlined the importance of these simple yet transformative interventions, advocating for their widespread adoption for the benefit the workers.

Dr Asaad Nafees, the Principal Investigator, explained that “this trial was a parallel, cluster-randomized controlled study with textile mills as the unit of randomization. It can be replicated across the region to potentially impact respiratory health of all relevant workers, and potentially result in a healthier, more productive workforce.”

Key findings were recently presented at a seminar, where Engineer Sibtain Mughal, Joint Director Labour (OSH), Government of Sindh, committed the government’s support to the implementation of the health measures recommended by the study. “Workers deserve a high level of care and attention since their health holds significant importance for the industrial productivity and economy of the country.”

Several manuscripts have been published in high-impact occupational health journals. The study was also recently accepted for publication in the European Respiratory Journal.

Indus Hospital & Health Network commemorates World Lung Day with Karachi United & Kiran Foundation in friendly football match

Karachi (Muhammad Yasir)

Voices Against Tobacco (VAT), an initiative of Indus Hospital & Health Network (IHHN), commemorated World Lung Day this week by hosting a friendly football match with partners Karachi United and Kiran Foundation. World Lung Day is commemorated each year to bring attention to the several factors that affect lung health and how to address them. On this day, VAT brings together partners and stakeholders from different industries and communities to showcase how lung health impacts everyone.

The event kicked off with lung health patient, Gulshan, initiating the match with the first kick. When Gulshan first visited Indus Hospital and Health Network, she used a wheelchair and oxygen support on a daily basis. Yet today, she was able to walk onto the field and start the match. Later in the event, she bravely shared her personal journey, illustrating the significant impact that the pulmonary rehabilitation program at Indus had on her life. “Being here today means the world to me. Living with a lung condition has been a journey of challenges, but thanks to the incredible care and support I received from Indus Hospital and Health Network, I am here, standing strong,” Gulshan emotionally shared. Gulshan’s moving testimony underscored the importance of access to prevention and treatment, which is the theme for this year’s World Lung Day.

Especially in low- and middle-income countries such as Pakistan, where mortality from non-communicable disease is highest, early access to diagnostics and holistic care is imperative for individuals facing lung health challenges. Also in attendance were representatives of IHHN, including Dr. Abdul Bari Khan, President IHHN, and Dr. Saima Saeed, Director of the IHHN Lung Health Program, as well as Karachi United founder Taha Alizai and members of Kiran Foundation. “The collaboration between VAT, Karachi United, and Kiran Foundation exemplifies the collective commitment to foster a healthier community,” said Dr. Abdul Bari Khan. “Through events and activities like this, the partners aim to inspire individuals to take proactive steps towards maintaining optimal lung health and to support those affected by lung conditions.” VAT has also partnered with Kiran Foundation, signing the MoU this year.

Kiran Foundation is a non-profit organization, initiated in 2006 and provides transformational education and holistic support in marginalized communities. VAT conducted several student sensitization sessions with youth from a wide array of backgrounds, allowing for a greater reach of the anti-tobacco cause. “Efforts to improve lung health must include the medical and public health community, civil society organizations, youth groups, academic institutions and policy makers,” said Dr. Saima Saeed. “By working with partners such as Karachi United and Kiran Foundation, we can empower communities to prioritize improved air quality, reduce tobacco use and increase exercise to promote better lung health.” “Strong lung health is essential for all individual, and is especially important for young athletes, as their health directly affects their ability to perform,” said Taha Alizai. “For this reason, we are proud to partner with VAT and IHHN to bring awareness to this cause.”

The Lung Health program at IHHN used VAT to emphasize the importance of tobacco control policies, most recently through a petition too ban sale of all novel tobacco and nicotine products. They have garnered over 8500 signatures. Lung Health has also integrated spirometry diagnostics in primary care and had more than 9,300 referrals across the network. Over 200 breathless patients with lung disease such as Gulshan have benefited from the multidisciplinary pulmonary rehabilitation program at the hospital.