A systematic review article Exposure to cement dust and respiratory health for communities residing near cement factories: A systematic review of the literature.

Objective: To examine the strength of evidence through systematic review of published literature on the association between effects of exposure to cement dust on respiratory health of communities residing near cement plants. Design and data sources: A systematic search and review of observational studies in Medline, Embase, and Cumulative Index to Nursing and allied Health Literature (CINAHL), and other sources was conducted. Eligibility criteria: Peer reviewed articles, published from 1996 to 2022 that investigated effects of exposure to cement dust on human respiratory health (pulmonary functions and symptoms) were included. The studies must have been conducted in communities residing near a cement factory; were original research and written in English. The search key words were: cement, cement dust, cement dust exposure, respiratory health, cement respiratory health effect, cement dust exposure respiratory effect, cement pulmonary function, and cement dust pulmonary health. Results: 443 studies were retrieved and screened. Only 12 of these met the inclusion criteria. The majority of studies were assessed as being of moderate quality; seven of these studies were cross sectional study design and only five studies performed actual measurement of ambient concentration of particulate matter (PM) while the rest assumed high exposure levels based on other studies’ findings. Furthermore, all the five studies that measured exposure used environmental monitoring rather than more precise methods of measuring personal exposure. Most studies reported higher levels of PM2.5 and PM10 in the exposed compared to the controls and demonstrated a statistically significant difference in the prevalence of respiratory symptoms and reduced pulmonary functions or some degree of association. Conclusion: This review shows that despite showing some degree of association between exposure to cement dust and respiratory ill health, the existing evidence is insufficient to draw firm conclusion mainly because the studies were of low quality. To improve the quality of evidence, future studies should include panel studies, personal monitoring of the exposure, source apportionment and chemical characterisation coupled with using standardized measurement tools for exposure and outcome at predetermined intervals