Pulmonary function among flour mill workers: a systematic review and meta-analysis

Abstract Background Flour dust, with an inherent allergic nature, increases vulnerability to various respiratory ailments. We systemically reviewed and compared literature-reported pulmonary function parameters to quantify pulmonary dysfunction among individuals with high flour dust exposure (among...

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Main Authors: Kuldip Upadhyay, Bhavani Shankara Bagepally, Rakesh Balachandar, Ankit Sheth, Ankit Viramgami
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Public Health
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Online Access:https://doi.org/10.1186/s12889-025-21286-6
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author Kuldip Upadhyay
Bhavani Shankara Bagepally
Rakesh Balachandar
Ankit Sheth
Ankit Viramgami
author_facet Kuldip Upadhyay
Bhavani Shankara Bagepally
Rakesh Balachandar
Ankit Sheth
Ankit Viramgami
author_sort Kuldip Upadhyay
collection DOAJ
description Abstract Background Flour dust, with an inherent allergic nature, increases vulnerability to various respiratory ailments. We systemically reviewed and compared literature-reported pulmonary function parameters to quantify pulmonary dysfunction among individuals with high flour dust exposure (among flour mill workers) and relatively un-exposed groups. Methods Studies that compared pulmonary function parameters for flour dust exposed and unexposed control groups were systemically searched in PubMed, Scopus and Embase from inception to June 2024. The Newcastle Ottawa scale was used to assess the risk of bias among included studies. With the random effect model, we pooled (along with 95% CI) the mean difference for forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), the ratio of FEV1 & FVC, mid-expiratory flow (FEF25-75%), peak expiratory flow rate (PEFR) and other pulmonary function parameters. Cochran-Q test and I 2 statistics were applied to determine heterogeneity. Results This quantitative synthesis included twenty-two studies involving 2,482 flour dust exposed and 1,925 control participants. The pooled mean difference for FEV1, FVC, FEV1/FVC, PEFR and FEF25 − 75% were − 0.43 L (-0.57, -0.29; I 2 = 88.7), -0.49 L (-0.64, -0.33; I 2 = 89.3), -3.5% (-6.49, -0.5; I 2 = 89.7), -1.36 L/s (-1.70, -1.03; I 2 = 90.4) and − 0.34 L/s (-0.63, -0.06; I 2 = 77.3). The pooled odds ratio for obstructive [12.9 (3.41, 49.2); I 2 = 82.4)] and restrictive changes [5.11 (0.55, 47.4); I 2 = 81.6] were significantly higher among the exposed than controls. As per the bias assessment majority of studies rated with moderate to severe risk of bias. Conclusion Study observed pulmonary function deficits associated with exposure to flour dust. However, considering the quality of primary studies and higher heterogeneity, high-quality larger studies with longitudinal design are required to affirm the effects of flour dust on lung function.
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spelling doaj-art-e62aa82f427242af813325a917dba7ff2025-01-12T12:42:29ZengBMCBMC Public Health1471-24582025-01-0125111610.1186/s12889-025-21286-6Pulmonary function among flour mill workers: a systematic review and meta-analysisKuldip Upadhyay0Bhavani Shankara Bagepally1Rakesh Balachandar2Ankit Sheth3Ankit Viramgami4Chemical Sciences Division, ICMR-National Institute of Occupational HealthNon Communicable Diseases Division, ICMR-National Institute of EpidemiologyHealth Sciences Division, ICMR-National Institute of Occupational HealthHealth Sciences Division, ICMR-National Institute of Occupational HealthHealth Sciences Division, ICMR-National Institute of Occupational HealthAbstract Background Flour dust, with an inherent allergic nature, increases vulnerability to various respiratory ailments. We systemically reviewed and compared literature-reported pulmonary function parameters to quantify pulmonary dysfunction among individuals with high flour dust exposure (among flour mill workers) and relatively un-exposed groups. Methods Studies that compared pulmonary function parameters for flour dust exposed and unexposed control groups were systemically searched in PubMed, Scopus and Embase from inception to June 2024. The Newcastle Ottawa scale was used to assess the risk of bias among included studies. With the random effect model, we pooled (along with 95% CI) the mean difference for forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), the ratio of FEV1 & FVC, mid-expiratory flow (FEF25-75%), peak expiratory flow rate (PEFR) and other pulmonary function parameters. Cochran-Q test and I 2 statistics were applied to determine heterogeneity. Results This quantitative synthesis included twenty-two studies involving 2,482 flour dust exposed and 1,925 control participants. The pooled mean difference for FEV1, FVC, FEV1/FVC, PEFR and FEF25 − 75% were − 0.43 L (-0.57, -0.29; I 2 = 88.7), -0.49 L (-0.64, -0.33; I 2 = 89.3), -3.5% (-6.49, -0.5; I 2 = 89.7), -1.36 L/s (-1.70, -1.03; I 2 = 90.4) and − 0.34 L/s (-0.63, -0.06; I 2 = 77.3). The pooled odds ratio for obstructive [12.9 (3.41, 49.2); I 2 = 82.4)] and restrictive changes [5.11 (0.55, 47.4); I 2 = 81.6] were significantly higher among the exposed than controls. As per the bias assessment majority of studies rated with moderate to severe risk of bias. Conclusion Study observed pulmonary function deficits associated with exposure to flour dust. However, considering the quality of primary studies and higher heterogeneity, high-quality larger studies with longitudinal design are required to affirm the effects of flour dust on lung function.https://doi.org/10.1186/s12889-025-21286-6Pulmonary function testFlour dustFlour mill workersRespiratory problems
spellingShingle Kuldip Upadhyay
Bhavani Shankara Bagepally
Rakesh Balachandar
Ankit Sheth
Ankit Viramgami
Pulmonary function among flour mill workers: a systematic review and meta-analysis
BMC Public Health
Pulmonary function test
Flour dust
Flour mill workers
Respiratory problems
title Pulmonary function among flour mill workers: a systematic review and meta-analysis
title_full Pulmonary function among flour mill workers: a systematic review and meta-analysis
title_fullStr Pulmonary function among flour mill workers: a systematic review and meta-analysis
title_full_unstemmed Pulmonary function among flour mill workers: a systematic review and meta-analysis
title_short Pulmonary function among flour mill workers: a systematic review and meta-analysis
title_sort pulmonary function among flour mill workers a systematic review and meta analysis
topic Pulmonary function test
Flour dust
Flour mill workers
Respiratory problems
url https://doi.org/10.1186/s12889-025-21286-6
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AT ankitsheth pulmonaryfunctionamongflourmillworkersasystematicreviewandmetaanalysis
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