Research Proposal

Presented By: Dr. Rehan Shareef

Butt
 Contents
1 Introduction

2 Literature Search

3 Aims and Objectives

4 Methodology

5 Data Analysis

6 References
 Introduction
 Fertilizer
 Organic or inorganic substances either natural or synthetic

used to supply the elements (NPK) for plant growth

 Global Situation
 Fertilizer consumption has increasingly shifted towards

developing countries over the past few decades due to

environmental legislation, restricting the use of fertilizer in
developed countries and a significant growth in fertilizer
demand in developing region particularly in Asia.
 In China, Nitrogen Fertilizer produced, dominates the

structure of chemical industry. Main pollutants include Air

Emissions and Waste Water.
 In Pakistan
 Production of fertilizer has increased drastically in last two

decades due to increased demands.

 In 1995 alone, demand for fertilizer grew by 11%.
 Introduction Contd.
 Occupational Health
 Complete physical, mental and social well being of the

occupation workers.
 Although fertilizer production has contributed to a good yield of

crops but it also has posed certain dangers to the health of

workers.
 Workers are continously exposed to hazardous air emissions.

 It contributes to a variety of respiratory illnesses.

 Pollutants in industrial emissions

 Particulate matter

 Oxides of Sulphur (SO2)

 Ammonia

 Carbon Monoxide (CO)

 Nitrogen Oxides (NO2)

 Photochemical Oxidants

 Carbon Dioxide (CO2)

 Airborne Fluorides
 Introduction Contd.

Industrial Units Air Emissions Respiratory Illnesses

Bronchitis
Ammonia Plant Particulate Matter Emphysema
Urea Plant Oxides of Sulphur Asthma
NPK Plant Ammonia Recurrent RTI
Chronic Nasal and Throat
Bulk Blending Carbon Monoxide Irritation
Plant Carbon Dioxides Melignancy
Bulk Storage Oxides of Nitrogen Premature Death
Plant Airborne Fluorides Increased susceptibility to
colds.
 Literature Search
 According to IFA, CO2 generation ranges from 1.5 to 3.06 tons
of CO2 per ton of Ammonia.
 1/3rd of CO2 is from burning fuel and 2/3rd fro use of
hydrocarbon feed stock. (www.fertilizer.org)
 Another study showed respiratory and irritant health effects
of a population living in an industrial comples of Taiwan.
According to the study acute irritative symptoms (cough,
nasal irritation, throat irritation) was significantly more
common in exposed areas. (Environmental Research Vol. 74
1997)
 Another sutdy published in bulletin of the institute of
MAIRITIME and tropical medicine in GDYNIA 1987 revealed
that persons with long length of service in fertilizer industries
suffered from effects of long term fluoride influence.
 In a related study, total suspended particles were
significantly associated with increased mortality i.e. increase
in the particulates of 100 microgram per meter cube was
associated with 4% increase in mortality.
 Literature Search Contd.
 A 16 year old survey conducted by Schwartz and Dockery revealed a
strong relationship between concentration of particulate matter and
increased mortality and hospitalization for respiratory diseases.
 Quantitative Contribution of Occupational Factors to the burden of COPD
Morbidity and Mortality is about 15%.
 Another study in Nigeria showed increased prevalence rate of
respiratory diseases in workers of an industrial complex.
 Aim and Objectives
 Rationale
 This study will prove out to be helpful in describing the trends of different

respiratory illnesses in the industrial complexes and will also create

awareness in the workers as well as the policy makers for taking necessary
steps in order to improve the health status of the workers who are
continuously exposed to the hazardous industrial emissions.
 Aim
 To improve the health status of the industrial workers.

 Objectives
 Assessment of the health status of the industrial workers working in a

chemical fertilizer industry in relation to the continuous long tem exposure

to the hazardous industrial air emissions with specific focus on the
respiratory illnesses.
 To propose the recommendations and measures which should be adopted

by the workers of chemical fertilizer industries for minimizing the exposure

to hazardous industrial emissions in order to improve their general health.
 To assess the morbidity and mortality caused by different types of

respiratory illnesses in the industrial workers by the frequencies of their

hospital visits and admissions.
 Materials and Methods
 Study Design
 Descriptive cross-sectional study.
 Place of Study
 3 Industrial complexes
1. Fauji Fertilizer
2. Engro Chemicals
3. Daud Hercules Chermicals
 Duration of Study
 3 Months
 Sampling
 Sample size 100
 Sampling Technique  Convenient purposive sampling.
 Inclusion Criteria
 Those who agree to participate
 At least 3 years of employment in the fertilizer plant under study.
 Should be residing in the industrial complex for atl east 3 years.
 Exclusion Criteria
 Those who do not agree or do not fulfill the above criteria.
 Data Collection
 Planned to be collected from 1st June 2009
to 31st July 2009 by me and trained data
collection team comprising of 4
paramedical staff who will be trained
before start of the study.

 Consent
 Written informed consent.

 Tools
 Structured questionnaire
 Assessment of breathing capacity by peak
flow meter.
 Variables of Interest
 Frequency of nasal or throat irritation while on work
 Frequency of flu and cough without fever
 Frequency of flu and cough with fever
 Proportion of the workers with breathing difficulty
(shortness of breath)
 Place where shortness of breath occurs(work place,
anywhere)
 Frequency of breathing difficulty (daily, twice a week,
once a week, rarely)
 Proportion of workers using inhaler device
 Frequency of using inhaler (daily, twice a week, once a
week, daily)
 Proportion of workers on anti asthma medication
 Frequency of hospital visits (once a week, once a month,
rarely).The records of those who visit the hospital will
also be counter checked from the hospitals.
 Variables of Interest Contd.
 PEFR (peak expiratory flow rate) as a percentage of usual
or normal breathing. It will help to assess the severity of
respiratory illness.
 From the hospital records, the deaths due to respiratory
diseases in the last three years will also be noted.
 Workers who are diagnosed cases of asthma, COPD,
respiratory malignancy or cardiovascular disease. The
records will be counter checked from the hospitals and
their doctors.

 All the variables will be stratified according to

 Co existing cardiovascular disease

 Unit of work: Ammonia plant, Urea synthesis plant, Bulk

blending plant, Bulk storage plant.

 Age

 Duration of working hours

 Smoking status
 Data Analysis
 For analyzing the collected data, SPSS version 16 will be
used
 Proportions will be generated
 Chi-square test and t-test will be applied to the
proportions for determining the level of significance.

 Budget

04 Paramedical staffs will be hired Rs 6000 each 24,000 PKR

Traveling expenses 10,000 PKR

05 Peak flow meters will be Rs 2500 each 12,500 PKR

purchased
Eating expenses Rs 2000 each 10,000 PKR

Living arrangement: In each city Rs 1000 per city 3000 PKR

Railway rest house rooms will be
arranged with concession
Total Expenses 59,500 PKR
 Work Plan

• Written permission will be taken from the Institutional

Phase 1 Review Board of Health Services Academy after presenting
the research proposal.

Phase 2 • Training of the data collection team.

• Pilot study

Phase 3 • Grant of permission from Fertilizer Association of Pakistan

and administration of each fertilizer industry.

• Data Collection
Phase 4

• Data Analysis and determining the conclusions.

Phase 5

Phase 6
 References
 Unites Nations University / Institute of New Technologies, 1999
 Agro-chemical Report 2002: A publication of The Fertilizer Advisory, Development and
Information Network for Asia and Pacific(FADINAP)
 Ejupoola, 1992 www.cieh.org
 Unites States Occupational Safety and Health Administration, American National Standards
Institute, Canadian Workplace Hazardous Materials Information System, (US, OSHA, ANSI,
Canadian WHMIS)
 Use of air quality guidelines in protecting public health : A Global Update www.who.int
 Fluorides In The Air by Michael. J Prival and Farley Fisher 1973
 Ciba Foundation Symposium 175- Environmental changes and human health 2007
 Respiratory and irritant effects of a population living in a petrochemical polluted area in
Taiwan ; Chun-yuh young, Jung Der Wong, Jan 1997
 Estimation of occupational hazards on the employees of a phosphate fertilizer plant; Renke.
W Winnika ; Bulletin of Institute of Mairitime and Tropical Medicine Gdynia, 1987
 Weislander et al 1994, Hall et al 1995
 Particulate air pollution and daily mortality in Steubenville, Ohio; Joel Schwartz and Douglas
Dockery, 1995
 Death in the air; Air pollution from phosphate fertilizer production by George Glasser
 Dockery et al 1982
 Significant association between outdoor NO2 and respiratory symptoms in pre school
children; M. Rutishauer, U. Ackermann,1990
 Effects of particulate air pollution on respiratory health of subjects who live in 3 areas in
Kanpur, India; Sharma Mukesh, Kumar Narendra, 2004
 Industrial emissions and health hazards among selected factory workers at Eleme, Nigeria;
Dr Godson, Prof Minnepal, University of Ibadan
Rehan Shareef Butt