Reducing Silica Exposure Among Brick Kiln Workers in Nepal

NCT ID: NCT06090370

Last Updated: 2024-06-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

98 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-01-24

Study Completion Date

2024-06-20

Brief Summary

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Inhaling respirable silica increases the risk for silicosis, an incurable and debilitating lung disease. In South Asia, one high-risk industry is brick manufacturing, where more than 4 million manual laborers mold bricks by hand. In Nepal, brick manufacturing employs over 200,000 workers across 1,200 registered brick kilns. These workers are exposed to respirable silica concentrations 1.4 to 6.6 times higher than the limits set by the U.S. National Institute for Occupational Safety and Health. Preventing silicosis is paramount, as the average brick kiln worker cannot afford medical care and only 6.8% receive regular health checks. Few studies have evaluated interventions in brick kiln workers to reduce silica exposure and prevent silicosis.

One promising intervention involves providing workers who are exposed to silica above the permissible exposure limit with personal protective equipment (PPE), specifically respirators. When properly used, respirators decrease silica inhalation and the risk of silicosis. Brick kiln workers in Nepal do not use any PPE. Several studies have explored PPE barriers and have evaluated the feasibility of implementing PPE but to date none have been conducted in Nepali brick kiln workers. To close this gap, the goal of this research is a human-centered design approach to develop and pilot a PPE training program in one brick kiln in Nepal guided by the Discover, Design, Build, and Test (DDBT) framework.

This research is necessary to understand the Nepali context and to efficiently develop appropriate and feasible PPE intervention components that will be trialed in future research.

Detailed Description

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Workers will be recruited from Bhaktapur, a district in the Kathmandu Valley.

The investigators will conduct a four-part study. Part 1 will involve a quantitative, cross-sectional survey to understand baseline worker perceptions on silicosis and personal protective equipment (PPE). Part 2 will comprise qualitative co-creation human-centered design workshops to elicit feedback on PPE training prototypes and types of PPE. Part 3 will be a small feasibility pilot of the training program and most preferred type of PPE. Part 4 will comprise qualitative workshops to elicit feedback on the piloted PPE training program.

The same participants may participate in Part 1 and 2. Participants in Part 3 will be a distinct group from those who participated in Parts 1 and 2.

Assessments will include:

Aim 1: Characterize knowledge gaps and behaviors influencing PPE use among brick kiln workers in Bhaktapur, Nepal Method: Quantitative, cross-sectional survey to understand baseline worker perceptions on silicosis and personal protective equipment (PPE). N = 100 workers.

Aim 2: Design a personal protective equipment (PPE) training program for brick kiln workers in Nepal through a human-centered design approach Method: 4 qualitative co-creation human-centered design workshops. N = 20 - 40 workers.

Aim 3: Evaluate acceptability, appropriateness, and feasibility of personal protective equipment (PPE) training through a pilot among brick kiln workers in Nepal Method: Feasibility pilot study at 1 brick kiln for 3 weeks. N = 20 workers (intervention) and N = 20 workers (control). 3 qualitative co-creation human-centered design workshops to elicit feedback after the pilot. N = 10 - 20 workers.

Conditions

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Silicosis

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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Baseline Survey: Silicosis and Personal Protective Equipment

Group Type EXPERIMENTAL

Baseline Survey

Intervention Type OTHER

A quantitative, cross-sectional survey will be distributed to enrolled participants to understand baseline worker perceptions on silicosis and personal protective equipment (PPE).

Design of Personal Protective Equipment Training Workshop

Group Type EXPERIMENTAL

Design of Workshop

Intervention Type OTHER

A co-creation human centered design workshop to elicit feedback on PPE training prototypes and types of PPE.

Pilot Study: Personal Protective Equipment Training Program

A small training program will be offered to brick kiln workers to determine preferred PPE type, feasibility in the work environment and proper usage of PPE.

Group Type EXPERIMENTAL

N95 Respirator

Intervention Type DEVICE

The participants in this group will be provided with N95 respirator masks to protect from dust and debris while working in the brick kiln and trained on proper usage.

Protective Eyewear

Intervention Type DEVICE

The participants in this group will be provided with eye wear to protect the eyes from dust and debris while working in the brick kiln and trained on proper usage

Feedback Workshop on Pilot Personal Protective Equipment Training Program

Group Type EXPERIMENTAL

Training Workshop Pilot

Intervention Type OTHER

Qualitative workshops will be held to elicit feedback on the piloted PPE training program.

Interventions

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N95 Respirator

The participants in this group will be provided with N95 respirator masks to protect from dust and debris while working in the brick kiln and trained on proper usage.

Intervention Type DEVICE

Protective Eyewear

The participants in this group will be provided with eye wear to protect the eyes from dust and debris while working in the brick kiln and trained on proper usage

Intervention Type DEVICE

Baseline Survey

A quantitative, cross-sectional survey will be distributed to enrolled participants to understand baseline worker perceptions on silicosis and personal protective equipment (PPE).

Intervention Type OTHER

Design of Workshop

A co-creation human centered design workshop to elicit feedback on PPE training prototypes and types of PPE.

Intervention Type OTHER

Training Workshop Pilot

Qualitative workshops will be held to elicit feedback on the piloted PPE training program.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Age 18 years or older
* Active Brick Kiln Workers in Bhaktapur, Nepal
* Cognitively capable to provide informed consent

Exclusion Criteria

* Less than 18 years old
* Non Brick Kiln Workers
* Not cognitively capable to provide informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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Tribhuvan University

UNKNOWN

Sponsor Role collaborator

Chiesi Foundation

UNKNOWN

Sponsor Role collaborator

National Institutes of Health (NIH)

NIH

Sponsor Role collaborator

Duke University

OTHER

Sponsor Role collaborator

Fogarty International Center of the National Institute of Health

NIH

Sponsor Role collaborator

Johns Hopkins University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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William Checkley, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Johns Hopkins School of Medicine

Locations

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Johns Hopkins University

Baltimore, Maryland, United States

Site Status

Duke University

Durham, North Carolina, United States

Site Status

Tribhuvan University

Maharajgunj, Kathmandu, Nepal

Site Status

Countries

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United States Nepal

Other Identifiers

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D43TW009340

Identifier Type: NIH

Identifier Source: secondary_id

View Link

IRB00387104

Identifier Type: -

Identifier Source: org_study_id

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