Int J Biol Med Res.

2024; 15(1): 7724-7730

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Original article
Pulmonary Function and Respiratory Symptoms among Petrol Station workers in
Debre Tabor Town, Northwest Ethiopia, 2023.
Deribew Abebaw Abuhay*
Department of Biomedical Science, Human Physiology unit, College of Medicine and Health Science, Debre Tabor University, Ethiopia

ARTICLE INFO ABSTRACT

keywords Introduction: Petrol station workers are prone to pulmonary function impairment and respiratory
Petrol station workers symptoms acquired during filling fuels and to the gases from vehicular exhaust. Decreased
pulmonary function impairments pulmonary function parameters and abnormal respiratory symptoms such as cough, wheezing, and
respiratory symptoms breathlessness were reported among petrol station workers. Objective: The study was aimed to
assess pulmonary function and respiratory symptoms; and identify associated factors among petrol
station workers in Debre Tabor town.Methods and Materials: A comparative cross-sectional study
design was conducted among 66 petrol station workers and 66 Debre Tabor University workers
(controls) between March and May, 2023. Data on socio-demographics, occupational history,
utilization of personal protective equipment and respiratory symptoms were collected using an
interviewer- administered questionnaire. A digital Spirometer (Model Contec SP10) was used to
assess pulmonary function impairments. An independent sample t-test was used to compare
spirometer results of the exposed and controls. Level of significance was set at p <0.05. Results: From
petrol station workers, the mean± SD of Forced Vital Capacity (FVC), Forced Expiratory Volume in
the first second (FEV1), FEV1/FVC%, Forced Mid-Expiratory Flow (FEF25-75%) and Forced
Expiratory Flow Rate (FEFR) were 3.72±0.64, 3.14±0.53, 81.16±10.44, 3.85±0.97 and 6.87±1.53
respectively. There was a significant decrease in these pulmonary function test scores as compared
with controls. Respiratory symptoms such as cough, phlegm, wheezing and shortness of breath were
developed in 41.4%, 26.7%, 30.4% and 16.7% petrol station study participants respectively.
Exposure to petrol fumes for more than 10 years was 3.18 times (AOR= 3.18; 95%CI=1.62- 9.73)
more prone to develop lung function impairment compared with those worked for <5 years.
Conclusion: Exposure to petrol fumes causes a significant reduction in pulmonary function among
petrol station workers. Respiratory symptoms were higher among petrol station study participants
compared with the controls.

c Copyright 2023 BioMedSciDirect Publications IJBMR -ISSN: 0976:6685. All rights reserved.

Introduction
A petrol station, also known as a gas station sells fuel and used, refinery processes available, overall balance of product
lubricant. Currently, regular gasoline, gasoil, kerosene, heavy fuel oil, demand, and product specifications. Its typical composition
light fuel oil and JTA-1 are imported in to Ethiopian Petroleum includes hydrocarbons (alkanes and alkenes) and aromatic
Supplies. Heavy and light fuel oils are imported for industrial use, and compounds, such as benzene .
JTA-1 for aviation purposes. Gasoil and gasoline are used for
transportation, construction, industry, power generation, Petrol station workers dispense gasoline, diesel, and others
agriculture, house hold cooking and lighting in rural areas. into tanks within vehicles and calculate the financial cost of the fuel
transferred to the vehicle . These workers are exposed to such
With the expansion of urbanization and increasing number of products through inhalation of vapors, contamination of fume
automobiles in Ethiopia, a number of petrol stations are currently particles during eating and drinking, skin contact from petrol
found in most towns. Petrol, also known as gasoline is a complex vapor, and vehicular exhaust. Occupational exposure to petrol
combination of hydrocarbons, additives, and blending agents . The vapor affects the normal function of different body systems,
composition of gasoline varies widely, depending on the crude oils including the respiratory, liver, and renal systems ().

* Corresponding Author : Dr. Deribew Abebaw Abuhay Exposure to harmful substances is a major cause of pulmonary
Department of Biomedical Science, Human Physiology unit, College of Medicine and function impairments and death worldwide. The International
Health Science, Debre Tabor University, Ethiopia
E-mail: [email protected]
Labor Organization indicates that 13,000 deaths worldwide were
caused by exposure to different chemicals, fuel vapor and dust in
c Copyright 2023 BioMedSciDirect Publications. All rights reserved.
 Deribew Abebaw Abuhay et al. Int J Biol Med Res. 2024; 15(1): 7724-7730

7725

the work place. Workers involved in petrol filling, mining, that irritate the airway, prostaglandins that cause bronchospasm,
construction, and dust generation are at high risk of developing increased mucus secretion, and oxygen radicals that destroy the
work- related respiratory illnesses . Consequently, occupational alveolar wall and exacerbate inflammation . Finally, it leads to
respiratory diseases lead to premature mortality, loss of mucus exudates (edema), lung parenchymal destruction (fibrosis),
productivity and disability . In India, respiratory diseases account bronchospasm, impaired muco-cilliary function, and air-flow
for 17% of the 11 million occupational diseases, and obstructive limitation .
lung diseases are responsible for 87% of work- related respiratory
diseases mortality . Conceptual Framework

Petrol station workers typically work under unhygienic

conditions and perform hazardous tasks. They are prone to
pulmonary function impairment and respiratory symptoms
resulting from occupational inhalation exposure . Decreased
pulmonary function parameters such as Forced Expiratory Volume
in the first second (FEV1), Forced Vital capacity (FVC), Forced
Expiratory Volume in the first second to Forced Vital capacity
(FEV1/FVC %), and Forced Expiratory Flow Rate (FEFR) have been
reported in several studies. Dry cough, cough with phlegm,
wheezing and breathlessness are common occupation- related Fig. 1: A conceptual framework of pulmonary function status
diseases among petrol filling workers . and respiratory symptoms and the associated factors among
study participants.
Respiratory diseases are the sixth most common causes of
death in developing countries is more prevalent in developing Methods and Materials
countries, especially Sub-Saharan Africa. In addition, petrol station
workers do not take any measures for occupational safety because Study design
of limited resources, skills, and training of employers, technologies,
low socio-economic status and low educational level . A comparative cross-sectional study design was employed from
March to May, 2023 at Debre Tabor town.
Despite these health problems, a significant number of studies
have not been conducted on pulmonary function impairments and Study area and period
respiratory symptoms among petrol station workers in Ethiopia.
The study was conducted in Debre Tabor town, located in South
This study aimed to fill this information gap by assessing pulmonary
Gondar Zone of Amhara National Regional State, Northwest
function status and respiratory symptoms among petrol station
Ethiopia. It is 97 kms from Bahir Dar, the capital of the region, and
workers in Debre Tabor town.
665 km away from Addis Ababa, the capital of Ethiopia. Currently, it
Pathogenesis of obstructive and restrictive lung diseases has ten petrol stations owned by private companies, comprising
more than 72 workers.
During the dispensing process, fuel vapor enters and is
deposited in different parts of the respiratory airways according to Source population: All petrol station workers working at
their aerodynamic diameter, airway dimensions and breathing Debre Tabor town.
patterns . Large dust particles (>5 μm) are deposited in the
Study group: Petrol station workers in Debre Tabor town who
conducting zone of the respiratory tract, including the nose and
fulfilled the inclusion criteria.
trachea. Medium- sized dust particles (1-5 μm) are deposited in
smaller airways, including the terminal bronchioles, while smaller Control group: Residents of Debre Tabor University who had
particles (<0.1 μm) are deposited in the alveoli through diffusion . similar baseline characteristics (age, sex, weight and height) as the
study groups; did not live, and had never worked in petrol stations
Once inhaled fuel vapor particles are deposited in the
in the past.
respiratory tract, they activate epithelial cells, including natural
killer cells and mast cells. Respiratory epithelial cells act as a Inclusion criteria
physical barrier in the lungs and play an important role in the
immune response to dust. These cells express different receptors · Apparently healthy workers daily working in the petrol station
such as TOLL- like receptors, c- type lecitin receptors, and protease- for six months or more
activated receptors, which can be triggered by environmental
allergens and microbial components . · Petrol station workers present at their working site during data
collection period
After receptor- mediated activation, epithelial cells produce
pro-inflammatory cytokines such as IL-6 and IL-8 in response to · Petrol station workers who were willing to participate and
allergens . This mechanism stimulates the lymphocytes, dendritic signed consent.
cells, and granulocytes. Activation of these cells releases proteases
 Deribew Abebaw Abuhay et al. Int J Biol Med Res. 2024; 15(1): 7724-7730

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· Debre Tabor University workers with similar demographic and Predictor variables
socioeconomic characteristics to petrol station workers, except for
the risk of exposure. ·Socio-demographic parameters (sex, age, marital status,
religion, level of education, monthly income)
Exclusion criteria
·Working duration
Petrol station workers and Debre Tabor University workers
who smoked tobacco, khat chewers, known Tuberculosis cases. ·History of past exposure to gasoline fumes

·Trainings given on the health impact of petrol exposure

Sample size determination and sampling techniques
·Availability of personal protective equipment
Double- population proportion formula with 95% confidence
interval and 80% power was used to select study participants ·Use of personal protective equipment

n= (Za/2+Zß)2 P(1-P) (r+1) Operational definition

r (P1-P2)2 FVC: Maximum volume of air forcefully expired after deep

inhalation. The person should continue expiring for a minimum of
Where n= sample size required for each group
six seconds .
Zα/2= the critical value at 95% confidence interval = 1.96
FEV1: The volume of air forcefully expired in the first one
second of maneuver .
Zβ= power = 0.84.
FEV1/FVC%: Percentage of vital capacity expired forcefully
P1= prevalence of respiratory symptoms among exposed groups
within one second of deep inspiration .
P2= prevalence of respiratory symptoms among non- exposed
Forced mid-expiratory flow (FEF25-75%): the mean forced
groups
expiratory flow during the middle half of the FVC .
P= average = (P1+P2)/2 between the two group
Peak Expiratory Flow Rate: Maximum air-flow rate during
r = ratio of exposed to non- exposed =1 because equal number were FVC maneuver at L/min .
used
Obstructive lung disease: FEV1/FVC ratio < 70% and percent
A similar study in Jimma Town, Ethiopia pulmonary function predicted FEV1<80%, (FEV1 much lower than FVC), however, FVC
impairment was found among 37.9% petrol filling workers and values are normal or increased .
15.2% control groups. Therefore,
Restrictive lung disease: FVC and FEV1 are reduced in
P1= 0.379 P2=0.152 proportion, however, FEV1/FVC ratio may be normal (80%) or
increased .
P= (0.379 + 0.152)/2= 0.2655
Respiratory symptoms: the presence of one or more
n= (1.96+0.84)2 0.2655(0.7345) (1+1) = 60 symptoms of cough, phlegm, wheezing, shortness of breath, and
chest pain .
(0.379-0.152)2
Cough: occurring more than 4-6 times per day, >4 days in a
week, and at least three months in a year .
After adding a 10% non-response rate, 66 study participants
from each group were included making the total number of study Chest pain: In the past year, chest pain persisted during work or
participants 132. Every petrol station worker was sampled until a daily activities .
sample size was reached. Control groups were selected at their
Phlegm is classified as sputum expectoration twice a day, 4 days
office using lottery method.
a week, and at least three months in a year .
Variables of the study
Wheezing: chest sound whistling on expiration .
Outcome variable
Dyspnea: shortness of breath at rest or at exertion .
· Pulmonary function parameters and respiratory symptoms
 Deribew Abebaw Abuhay et al. Int J Biol Med Res. 2024; 15(1): 7724-7730

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Data collection instruments and procedures logistic regression analyses were employed to show any
association between independent and dependent variables using
Three Nurses were used to collect the data with close
odds ratio. In all cases, statistical significance was set at p <0.05 .
supervision by the researcher. Two day training with practical
demonstrations on the interview techniques and measurement
Ethical consideration
procedures was provided to the data collectors. An interviewer-
administered structured questionnaire based on the American Ethical approval was obtained from Ethical Review Board,
Thoracic Society was used to collect data on socio-demography, College of Medicine and Health Sciences, Debre Tabor University,
occupational history, use of personal protective equipment, and Ethiopia. Permission was obtained from the managers at each
respiratory symptoms. petrol station. Written informed consent was obtained from every
study participant upon explaining the purpose and benefits of the
Pulmonary function status of petrol station workers and controls
study.
was assessed using a digital spirometer (Contec SP10) in a sitting
position, wearing a nose clip, and breathing through the mouth Results of the study
piece. Before performing pulmonary function tests, study
participants were informed to avoid heavy exercise. Study Descriptive analyses of study participants
participants were asked to sit on a chair and asked to take a normal
3-4 breathes through the mouth piece. Inspire slowly and deeply, One hundred thirty two participants were enrolled in this study.
and then breathe out forcefully and rapidly. Three consecutive Among petrol station workers, 62.1% were males. They were
readings were taken with five minutes interval in between the between 22 - 47 years old (mean ± SD: 30.46 ± 7.31 and 28.71± 4.25
readings. The highest score of the three readings were taken as the in petrol station workers and controls respectively). The majority
final readings for pulmonary function status parameters. Daily (68.2%) of the petrol station workers were married (Table 1).
calibration of the spirometer, and disinfection of the mouth piece
was done after every measurement and kept clean for the next Table 1: Socio-demographic characteristics of petrol station
maneuver . workers and controls at Debre Tabor, 2023.

Contec SP10 Spirometer

Mouse piece and nose clip

None of the personnel protective equipment was available and used

Fig. 2: Equipments for assessing pulmonary function by 91% of the petrol station workers. This increased the rate of
Data quality control and management exposure to volatile products. Only six (9.1%) petrol station
workers occasionally used gloves during their life time. Almost half
The quality of data was controlled through providing training (51.5%) of the study participants had worked in petrol stations for
for data collectors, pre-testing the questionnaire, spirometric five - ten years. None of the study participants had received training
measurements at a fixed time, calibration of the spirometer before or awareness regarding the hazardous effects of petrol fumes or
performing the test, and repeating the measurements. For ways to reduce their exposure to these products (Table 2).
consistency, the English version of the questionnaire was translated
in Amharic, native language. All data from the study participants Table 2: Work related data of petrol station workers in Debre
were kept confidential. Tabor town, Northwest Ethiopia, 2023

Data analysis

Data was entered in to Epi-data version 4.6 then analyzed using

Stata-14. Descriptive statistical values (mean, proportion and
standard deviation) were computed, and the results are presented
in the tables and figures. Comparison of pulmonary function scores
(FVC, FEV1, FEV1%, FEF25-75% and PEFR) of the two groups was
done by independent sample t-test. Bivariable and multivariable
 Deribew Abebaw Abuhay et al. Int J Biol Med Res. 2024; 15(1): 7724-7730

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Pulmonary function impairments and Respiratory symptoms Fig. 4: Respiratory symptoms of study participants at Debre
among petrol station workers and controls in Debre Tabor, Tabor town, 2023.
2023.

Accordingly to the independent sample t-test output, the

mean± SD of FVC, FEV1, FEV1/FVC%, FEF25-75%, and PEFR among
petrol station workers was 3.72±0.64, 3.14±0.53, 81.16±10.44,
3.85±0.97 and 6.87±1.53, respectively. The mean scores were
4.46±0.81, 3.95±0.27, 86.72±8.32, 4.16±2.05 and 7.94±1.19 among
controls; and the change was statistically significant (p<0.05)
(Table 3).

Table 3: Spirometer measurements of petrol station workers

and their controls in Debre
Factors associated with pulmonary function impairments and
Respiratory symptoms among study participants

Predictor variables with a statistically significant association (p

<0.25) in bivariable analyses were analyzed using multivariable
logistic regression to identify those factors statistically associated
with pulmonary function impairments.

Tabor town, Northwest Ethiopia, 2023. The findings showed that exposure to petrol fumes for five or
more years and the use of personnel protective equipment were
FVC= Forced Vital Capacity, FEV1=Forced Expiratory Volume in statistically associated with pulmonary function impairment
the first second, PEFR=Peak Expiratory Flow Rate, FEF25-75%= (p<0.05). According to this study, petrol station workers exposed to
Forced mid-expiratory flow, = Mean, SD= Standard Deviation, * =p < petrol fumes for more than ten years were 3.18 times more prone to
0.05, ** =p < 0.001 pulmonary function impairments compared to those exposed for
less than 5 years (AOR= 3.18; 95%CI=1.62- 9.73). Similarly, study
Pulmonary function impairment among the study participants participants working for 5-10 years were 2.56 times more prone to
was classified as obstructive or restrictive. Approximately, pulmonary function impairments than to those working for less
29(43.9%), 17(25.75%), and 5(7.5%) petrol station workers than five years (AOR= 2.56; 95%CI=1.42- 7.50).
developed obstructive, restrictive and mixed pulmonary function
impairment, respectively (figure 4). Similarly, 10(15.15%) and 8 The use of personnel protective equipment was also
(12.12%) control groups developed restrictive and obstructive statistically associated with pulmonary function status. Petrol
pulmonary impairments, respectively. station workers who did not use these equipment were 2.3 times
more risky to develop pulmonary function impairments (AOR= 2.3;
Fig. 3: Obstructive, restrictive and mixed pulmonary function 95%CI=1.45- 5.65) (Table 4).
impairments among petrol station workers, 2023
Table 4: Predictor variables associated with pulmonary
function scores in petrol station workers in Debre tabor, 2023.

The presence or absence of respiratory symptoms among study

participants was also analyzed. The result indicated that 41.4%,
26.7%, 30.4%, 16.7%, and 2.03% of petrol station workers
developed cough, phlegm, wheezing, shortness of breath, and chest
pain respectively. Similarly, the symptoms were found among
20.85%, 11.62%, 12.34%, and 4.72% of controls (Figure 5).
 Deribew Abebaw Abuhay et al. Int J Biol Med Res. 2024; 15(1): 7724-7730

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