MultiTex RCT - a multifaceted intervention package for protection against cotton dust exposure among textile workers - a cluster randomized controlled trial in Pakistan: study protocol.
BACKGROUND
In the Pakistani textile industry the prevalence of workplace respiratory illnesses, including byssinosis, is high. The MultiTex RCT study aims to determine the effectiveness of a multifaceted intervention package in reducing dust levels in cotton mills, decreasing the frequency of respiratory symptoms among cotton textile workers, and improving their lung function.


METHODS/DESIGN
We will conduct a cluster-randomized controlled trial at 28 textile mills in Karachi. The intervention will comprise: training in occupational health for all workers and managers reinforced by regular refresher sessions; the formation of workplace committees to draw up, agree and promote a health and safety plan that includes wet mopping, safe disposal of cotton dust, and the use of simple face-masks, as well as further publicity about the risks from cotton dust; and provision of adequate supplies of face-masks to support the health and safety plan. Participating mills will be randomized to intervention and control arms following a baseline survey. The impact of the intervention will be determined through follow-up surveys conducted at 3, 12 and 18 months. Data collection in the surveys will include spirometry, questionnaire-based interviews and cotton-dust measurements.


DISCUSSION
If successful, the study may pave the way for simple, low-cost interventions that can help reduce cotton-dust levels in textile mills, and improve the respiratory health of textile workers in developing countries such as Pakistan.


TRIAL REGISTRATION
ClinicalTrials.gov, ID: NCT03738202. Registered on 12 November 2018.
['Nafees|Asaad Ahmed|AA|http://orcid.org/0000-0001-8174-1625', 'De Matteis|Sara|S|', 'Kadir|Muhammad Masood|MM|', 'Burney|Peter|P|', 'Coggon|David|D|', 'Semple|Sean|S|', 'Cullinan|Paul|P|']
D000395:Air Pollutants, Occupational D016902:Air Pollution, Indoor D002095:Byssinosis D032561:Cotton Fiber D004784:Environmental Monitoring D006266:Health Education D006796:Household Work D006801:Humans D019570:Inhalation Exposure D008397:Masks D015337:Multicenter Studies as Topic D016273:Occupational Exposure D016272:Occupational Health D016032:Randomized Controlled Trials as Topic D012307:Risk Factors D013783:Textile Industry D013997:Time Factors
Randomized controlled trial Textile industry Byssinosis Cotton fiber