Advances in Environmental Biology Workers

Advances in Environmental Biology, 8(15) Special 2014, Pages: 238-242
AENSI Journals
Advances in Environmental Biology
ISSN-1995-0756
EISSN-1998-1066
Journal home page: http://www.aensiweb.com/AEB/
The Prevalence of Lung Function and Respiratory Symptoms Among Palm Oil Mill
Workers
Putri Anis Syahira M.J., Shamsul Bahri M.T. and Karmegam K.
Department of Environmental and Occupational Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM
Serdang, Selangor, Malaysia
ARTICLE INFO
Article history:
Received 25 July2014
Received in revised form 8 August
2014
Accepted 12 September 2014
Available online 25 October 2014
Keywords:
Spirometer, Lung Function, Palm Oil
Mill, Respiratory Disease
ABSTRACT
Background: Palm oil mill is one of the important industries for Malaysian economy.
Among the major contributor to the physical hazards in the palm oil mill is dust which
comes from the fibers of the palm oil fruits and are scattered all around the working
area. This can result in occupational lung diseases. Objective: The primary aim of this
study is to identify the status of lung function among the palm oil workers and
respiratory symptoms by using lung function test. Results: The spirometry results show
a significant presence and severity of restrictive lung defect among workers in palm oil
mill. The pulmonary function test study identified that the workers experience signs or
symptoms of respiratory disease. Conclusion: Therefore, the most appropriate control
measure for this problem should be applied, where in this case is by using personal
protective equipment (PPE) such as N95 mask.
© 2014 AENSI Publisher All rights reserved.
To Cite This Article: Putri Anis Syahira Mohamad Jamil, Shamsul Bahri Mohd Tamrin, and Karmegam Karuppiah.. The Prevalence Of
Lung Function And Respiratory Symptoms Among Palm Oil Mill Workers Adv. Environ. Biol., 8(15), 238-242, 2014
INTRODUCTION
Malaysia is the second highest producer of palm oil after Indonesia. According to Malaysian Palm Oil
Board (MPOB), the totals of palm oil mills in Malaysia are 426 in 2012 with 5 000 109 hectares of land were
explored for palm oil plantation. Malaysia is currently the second highest net exporter of oil and fats according
to Malaysian Palm Oil Council (MPOC). Generally, the process of palm oil mill can be divided into several
stages or sections.
By referring to Figure 1, the general process starts with bunch reception. The overall processes of palm oil
extraction differ according to small-scale or large scale plants. At bunch reception, fresh fruit bunch will be sent
by the harvester and soon will be graded into specific grades. Next is the sterilization or cooking means the use
of high-temperature wet-heat treatment of loose fruit. Cooking normally uses hot water; sterilization uses
pressurized steam. The cooking action serves several purposes.
Digestion is the process of releasing the palm oil in the fruit through the rupture or breaking down of the
oil-bearing cells. There are two distinct methods of extracting oil from the digested material. One system uses
mechanical presses and is called the ‘dry’ method. The other called the ‘wet’ method uses hot water to leach out
the oil.
In the ‘dry’ method the objective of the extraction stage is to squeeze the oil out of a mixture of oil,
moisture, fibre and nuts by applying mechanical pressure on the digested mash. There are a large number of
different types of presses but the principle of operation is similar for each. The presses may be designed for
batch (small amounts of material operated upon for a time period) or continuous operations.
The residue from the press consists of a mixture of fibre and palm nuts. The nuts are separated from the
fibre by hand in the small-scale operations. The sorted fibre is covered and allowed to heat, using its own
internal exothermic reactions, for about two or three days.
Similar to other industries, palm oil moll workers are subjected to the occupational hazards. Among the
hazards in the palm oil mill are physical, chemical, biological, psychosocial and ergonomic. The workers of
agricultural industry are highly exposed to harmful factors in their work environment, such as dust, unfavorable
microclimatic condition, excessive noise and insufficient light [2]. Among the major contributor to the physical
hazards in the palm oil mill is dust which came from the fibers of the palm oil fruits and are scattered all around
Corresponding Author: Karmegam Karuppiah, Department of Environmental and Occupational Health, Faculty of
Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor,
Malaysia.
Tel: +60389472513,
E-mail: [email protected]
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the working area. This can results in occupational lung diseases. The occupationally related lung diseases are
most likely due to the deposition of dust in the lungs and are influenced by the sort of dusts, the period of
exposure, the concentration and size of airborne dust in the breathing zone [3].
Fig. 1: Palm oil extraction process.
Occupational pulmonary diseases are more widespread and more disabling than any other group of
occupational disease. The lung with its extensive surface area, high blood flow and thin alveolar epithelium is an
important site of contact with substance in environment. The inhalation of dust over periods of time leads to
proliferation and fibrotic changes in lungs.
The pulmonary function tests have opened a new era towards scientific approach in diagnosis, prognosis
and management of pulmonary disorders by the early recognition of their alteration in industry workers who are
constantly exposed to various dust pollutants and to institute protective and preventive measures to minimize the
hazards of exposure to polluted environment [4]. However, the there is no specific study have been conducted
on the hazard of dust among the workers in palm oil mill. Hence this study is carried out to measures the status
of individual lung function among workers in palm oil mill according to their work sections. The results from
this study will serve as a reference to help employer to improve the working environment in palm oil mill so that
it will be convenient for their health and productivity.
Research Objectives:
 To determine respiratory status of palm oil mill workers using lung function test as overall
 To determine the occurrence of respiratory symptoms of palm oil mill workers
Methodology:
This is a cross sectional study which is designed to measures the status of lung function among palm oil
mill workers and their respiratory symptoms. This study was conducted in three palm oil mill in Peninsular
Malaysia. A total of 95 workers from the production section were selected as the respondents for both mills. The
selected workers are those without history of smoking, cardiovascular and acute or chronic respiratory disease.
Instrumentation.
SpirolabII was used to measure the lung function status of the palm oil mill workers. The procedures are as
follows:
a) Procedure:
After taking a detailed history and anthropometric data, the workers were informed about the whole
maneuver. The workers were encouraged to practice this maneuver before performing the pulmonary function
test. The test was performed with the subject in standing position without using a nose clip. The test was
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repeated three times after adequate rest and results were obtained in the spirometer. The measured parameters
were:
i) forced vital capacity (FVC),
ii) forced expiratory volume in one second (FEV1),
forced expiratory ratio (FEV1/FVC %)
Fig. 2: Spirometer.
Fig. 3: Spirometry test among workers.
b) Questionnaire:
A self-administered questionnaire was used for the respiratory symptoms. Emphasis was laid on enquiry
regarding occurrence of chest tightness, chest compression, wheezing, cough and phlegm appearing in them and
the frequency of occurrence, day of occurrence, duration and relationship with work were recorded.
RESULTS AND DISCUSSION
Fig. 4: Spirometry Result.
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Based on Figure 4, 64.21% of the workers shows normal spirometry result whereas 31.58% of the workers
show restrictive lung function and 4.21% for mixed obstructive/restriction. Although the lung function test
results show that most workers are normal, there are some of them who possess respiratory symptoms. As
compared to previous studies [6,7,8], the abnormal pulmonary function tests we observed were mainly
restrictive changes, However, there are few cases had combined obstructive and restrictive impairment.
Therefore, further studies should be conducted to evaluate if long-term dust exposure can lead to restrictive
changes.
A worker with obstructive pattern of impairment occurs as a result of damage to the small airways or
bronchioles, resulting in a decreased ability to exhale air. A worker with restrictive pattern of impairment
describes a condition in which there is a reduction in the volume of air that can be taken in and then pushed out
of the lungs (a breath). It is possible for both patterns of impairment to occur at the same time. Pre-existing
conditions, such as asthma, chronic bronchitis and allergies can aggravate the situation.
Fig. 5: Respiratory symptoms among palm oil mill workers.
As we can see in Figure 5, workers with coughing symptoms is only 27.9% whereas the rest of the workers
having no problem with coughing. For phlegmy problems, 32% of the workers showing they have problems and
68% have no phlegmy problems. Next, there is 13.5% of the workers showing wheezing problems while the rest
are not having the problem. As for breathlessness, there are 28.8% of the workers having the occurrence and
71.2 % have no symptoms of breathlessness. This might be due to their nature of work which some of the
workers in varies work section do not exposed directly to the source of hazard that is palm oil fruit fibers.
As overall, majority of the workers has no respiratory symptoms. However, more in-depth studies should be
done to understand more on the respiratory status of palm oil mill workers. Also, since this studies did not
account for smoking habit, further studies with larger numbers of participants that allow stratification of
smoking habit in greater details are warranted to better evaluate the effect of smoking [9].
In our study, smoking did not appear to be one of the risk factor for respiratory symptoms and pulmonary
function, but its effects to lung and enhancement of toxicities of other occupational hazards are documented in
numbers of studies. Therefore, anti-smoking campaigns are one of the ways that is desirable in palm oil
industry.
Conclusion:
In summary, the workers in palm oil mill were exposed to various hazards but mostly contribute by physical
hazards. As overall, to ensure there are no problems with lung function, the management of the mill has to take
appropriate action to control their exposure to hazards.
Recommendations:
The current system practice use was engineering control, administrative control, and personal protective
equipment’s which need further review. The current control system is not adequate since some of the workers
still have respiratory symptoms. As a suggestion, by changing the old ventilation system with a new one and
also by maintaining them would be a good help. Appropriate personal protection equipment should be used by
the workers. Other than that, to prevent the development of respiratory diseases, by providing a proper
respiratory questionnaire and performing pulmonary function tests in periodic examination and screening
programs for workers can be one of the efficient ways of it [12]. Whereas further studies with longitudinal
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follow-up designs and larger samples are warranted to confirm our findings, our study results have called for
attention to the exposure to dusts among workers engaged in early manufacturing processes of tea.
Another suggestion is for the management to gives out and wear N95 mask which can prevent from
inhaling particulates. The more we can prevent, the better it is. It is under the duty of employer under OSH
Act1994 Section 15 (General Duties of Employer) to provide a safe working environment for the workers to do
their job.
ACKNOWLEDGEMENT
We thank the management and the workers of the palm oil mill for their participation in this study. This
study was funded by Long Term Research Grant Scheme (LRGS) (Vote No: 9305800), Universiti Putra
Malaysia.
Ethical Consideration:
The study was approved by the Ethical Committee of the institution of Universiti Putra Malaysia, and each
subject gave informed consent.
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