Knowledge, Attitudes, and Practices Regarding Respirable Silica Exposure and Personal Protective Equipment Use among Brick Kiln Workers in Nepal

Abstract

Background: Brick kiln workers in Nepal are a neglected population who are exposed to high concentrations of respirable silica. We aimed to characterize the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE, and identify factors associated with current respiratory PPE use among brick kiln workers in Nepal. Methods: We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling to enroll workers aged ≥14 years and household members aged ≥9 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterize prevalence of current respiratory PPE use, and secondary outcomes were summaries of knowledge, attitudes, and practice of PPE use. Results: We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work. 3.6% of workers heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE for reducing dust exposure. Respiratory PPE users had higher income (non-brick kiln season mean monthly household income USD 206 vs. 145) and education levels (25% vs. 5.1% completed more than primary school) compared to non-users. Conclusions: Prevalence of respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce silicosis burden among brick kiln workers.