الفهرس 
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Abstract
This work was conducted in a ceramic factory (Menoufia governorate) to study health disorders which might arise among workers in this industry.
This study included an exposed group of ceramic workers (138) who accepted to participate in the study and a control (unexposed) group (138) from the workers’ relatives. Both groups were matched for age, sex, residence, marital status, socioeconomic standard and educational level.
All participants were interviewed using a predesigned questionnaire about respiratory, auditory and heat related manifestations. Also, they were examined generally and locally for chest and ears. Spirometry as well as audiometry were carried out for both exposed group and controls aiming to assess spirometric measurements and hearing thresholds; respectively. Postero- anterior chest X-rays were done for workers with abnormal spirometry.
Environmental studies were done by Environmental Study and Research Institute (ESRI) – Sadat city periodically via air sampling (using gas analyzer from the respiratory zone of the workers), assessment of noise at the level of workers ears (using sound level meter) and measuring heat stress levels (using portable thermal environmental monitor). Also, National Research Center participated in dust samples analysis.
The following results were obtained:
-The environmental measurements of the workplace were lower than permissible exposure limits (PEL) by the Egyptian Environmental Law No. 4 Decree 1095, 2011 for CO, NO2 and SO2.
- Noise level was higher than the PEL by Egyptian Environmental Law No. 4 Decree 1095, 2011 and NIOSH (1998).
- Free crystalline silica (FCS) in respirable dust level is higher than that recommended by the Egyptian Environmental Law No. 4 Decree 1095, 2011 and NIOSH (2005).
- The prevalence of respiratory manifestations e.g. rhinitis, cough, expectoration, wheezes, dyspnea, chest pain and chronic bronchitis was significantly higher among the exposed group than the controls. Regarding auditory manifestations, the exposed workers experienced a significant higher prevalence of tinnitus and ear ache than the controls. In addition, past history of heat disorders (exhaustion, cramps and syncope) were significantly higher among the exposed group than the controls. The prevalence of rhinitis, expectoration and dyspnea significantly increased with work duration increase among the exposed workers.
- Concerning the mean values of spirometric measurements the FVC%, FEV1%, FEV1/FVC %, FEF25-75% and PEF% were significantly lower among the exposed group than the controls. Abnormal spirometric measurements took genuine restrictive, genuine obstructive and combined patterns. The mean values of FVC%, FEV1%, FEV1/FVC %, FEF25-75% and PEF% significantly were decreased with work duration increase and a significant negative correlation was found between work duration and FVC%, FEV1%, FEF25-75% and PEF%. Exposed smokers experienced a significant lower mean value of the FEV1/FVC % than exposed non-smokers. On comparing non-smokers in the exposed and the control groups, FVC%, FEV1% and PEF% mean values were significantly lower in the exposed group.
- Positive radiological findings of workers with abnormal spirometeric measurements are small nodular opacities of different sizes and profusions, increased bronchovascular markings, emphysema and hilar lymph node enlargement.
- Audiometric findings showed different grades of hearing impairment. Noise induced hearing loss is bilateral with a V-dip depression in audiograph.
- Workers in this ceramic factory experienced more prevalent heat exhaustion, cramps and syncope than the controls.
from the outcome of the study it is possible to conclude that exposure to high levels of FCS in ceramic industry could adversely affect the respiratory system of workers that appear in abnormal spirometric measurements and abnormal radiological findings. Continuous exposure to noise level more than 90 dB(A) could be associated with abnormalities in audiogrph in the form of threshold shifting and V-dip dep.