Reducing Silica Exposure Among Brick Kiln Workers in Nepal

Summary

Inhaling respirable silica increases the risk for silicosis, an incurable and debilitating lung disease. In South Asia, one high-risk industry is brick manufacturing, where more than 4 million manual laborers mold bricks by hand. In Nepal, brick manufacturing employs over 200,000 workers across 1,200 registered brick kilns. These workers are exposed to respirable silica concentrations 1.4 to 6.6 times higher than the limits set by the U.S. National Institute for Occupational Safety and Health. Preventing silicosis is paramount, as the average brick kiln worker cannot afford medical care and only 6.8% receive regular health checks. Few studies have evaluated interventions in brick kiln workers to reduce silica exposure and prevent silicosis.

One promising intervention involves providing workers who are exposed to silica above the permissible exposure limit with personal protective equipment (PPE), specifically respirators. When properly used, respirators decrease silica inhalation and the risk of silicosis. Brick kiln workers in Nepal do not use any PPE. Several studies have explored PPE barriers and have evaluated the feasibility of implementing PPE but to date none have been conducted in Nepali brick kiln workers. To close this gap, the goal of this research is a human-centered design approach to develop and pilot a PPE training program in one brick kiln in Nepal guided by the Discover, Design, Build, and Test (DDBT) framework.

This research is necessary to understand the Nepali context and to efficiently develop appropriate and feasible PPE intervention components that will be trialed in future research.

Conditions

• Silicosis

Interventions

DEVICE

N95 Respirator

The participants in this group will be provided with N95 respirator masks to protect from dust and debris while working in the brick kiln and trained on proper usage.

DEVICE

Protective Eyewear

The participants in this group will be provided with eye wear to protect the eyes from dust and debris while working in the brick kiln and trained on proper usage

OTHER

Baseline Survey

A quantitative, cross-sectional survey will be distributed to enrolled participants to understand baseline worker perceptions on silicosis and personal protective equipment (PPE).

OTHER

Design of Workshop

A co-creation human centered design workshop to elicit feedback on PPE training prototypes and types of PPE.

OTHER

Training Workshop Pilot

Qualitative workshops will be held to elicit feedback on the piloted PPE training program.

Sponsors & Collaborators

• Tribhuvan University

  collaborator UNKNOWN

• Chiesi Foundation

  collaborator UNKNOWN

• National Institutes of Health (NIH)

  collaborator NIH

• Duke University

  collaborator OTHER

• Fogarty International Center of the National Institute of Health

  collaborator NIH

• Johns Hopkins University

  lead OTHER

Principal Investigators

• William Checkley, MD, PhD · Johns Hopkins School of Medicine

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2024-01-24

Primary Completion

2024-06-20

Completion

2024-06-20

Countries

• United States
• Nepal

Study Locations