Asthma, respiratory symptoms and lung function across age groups in an indigenous Mayan population in Guatemala, and relation to work in the traditional textile industry: a cross-sectional pilot study
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- Master theses 
Background: Occupational exposure to fabrics and dyes in the textile industry is associated with low lung function, higher prevalence of asthma and other respiratory symptoms. Mayan communities in Guatemala have worked in the traditional textile industry for generations, an occupation that may represent a risk factor for the development of diverse lung health problems. To our knowledge, studies in these communities that describe the respiratory health and assess the impact of their occupation in the textile industry are non-existent. Objective: We aimed to assess asthma, respiratory symptoms and the lung function in Mayan families living in the Sololá region in Guatemala, and the possible association with working in the traditional textile industry (“weaving”). Methods: A cross-sectional pilot study was developed where participants answered to a standardized interviewer-led questionnaire that investigated demographics, work and home-related exposures and their respiratory symptomatology. Anthropometric measurements, a spirometry and bio sampling were also completed. Descriptive analyses were performed to inform on the prevalence of symptoms/conditions, and simple regression models were used to analyze possible associations between working in the textile industry and respiratory symptoms/conditions (logistic regressions) and lung function values (linear regressions). Results: A total of 291 participants were included, with a mean age 34.2 years (range 14 to 77 years). 82% were female, and 40% of those asked about their job responded that they were weavers. Weavers, compared to non-weavers, appeared to have higher prevalence of wheezing (13% versus 6%) and of ever having breathing difficulty (9.2% versus 5%), as well as more symptoms like morning and chronic cough and phlegm. Only 1% of the study population responded “yes” to ever having had asthma, but 5% of weavers reported use of traditional medicine for asthma compared to <1% among non-weavers. Women weavers had significantly higher risk of wheezing (OR 2.91; 95%CI 0.99-7.92) and indicated higher risk of wheezing without cold (2.43; 0.25-23.9), wheezing with breathlessness (2.35; 0.46-11.9) and tightness in the chest (3.05; 0.60-15.4). Spirometric measurements were found to be of limited quality due to less explosive start to the maneuver. The FVC thus measured was indicated lower among weavers (-0.13L, 95%CI -0.72-0.46; linear regression model adjusting for age, sex and height). Reporting on specific occupation-related exposures was not feasible. Conclusions: Based on data from the present pilot study, we were able to study the lung health of the Mayan communities in terms of lung function and respiratory symptoms, and partially assess the associations with occupation as weaver. The weavers appeared to have poorer respiratory health, with indicated higher risk for selected respiratory symptoms and lower lung function (mostly non-significant differences). This study also has generated a valuable biobank, and experience in studying a difficult to reach indigenous population. Further studies are needed on potential respiratory health effects of specific activities and exposures, and how to reduce potential risks, in the traditional textile industry in these Guatemalan communities.