Prevalence of self-reported health complaints among shoe workers of small workshop exposed to organic solvents in Hebron City, West Bank: a cross-sectional survey

The study was conducted to estimate the prevalences of neurological disorders and mucous membrane irritation complaints among workers of shoe workshops in Hebron City, in particular to measure the associations between the occurrence of symptoms indicating polyneuropathy among workers and exposure to organic solvents in the glueing tasks. A group of 103 male workers from 30 workshops, exposed to organic solvents for more than one year were recruited to the study during the years 1996-1997. A validated Swedish neuropsychiatric questionnaire which contained questions on neurological and mucous irritation symptoms was used. Prevalence ratios were used as an indicator for relative risk. The overall prevalence of painful tingling of limbs (used as indicator of polyneuropathy) was high among the workshop workers (40%) and was significantly associated with long term exposure to organic solvents in glueing tasks (PR 2.8: 95% CI 1.0-8.3). Moderate associations were seen in other tasks. Headache and mental irritability did not show any association with organic solvent exposure in the workshop tasks. Breathing difficulty showed a moderate non-significant association with long term exposure to organic solvents (72 months) in cleaning tasks (1.9,0.7-4.8), while sore eyes also showed a moderate non-significant association with exposure to organic solvents for 25-72 months in the glueing tasks. Long term exposure to n-hexane (mainly found in the glues) could be the main cause of polyneuropathy among the workers of Hebron shoe workshops. The absence of effective ventilation systems and personal protective equipment might increase the prevalence of polyneuropathy among these workers. In conclusion, glues containing high concentrations of n-hexane are still in use in many shoe workshops in Hebron City (as well as in other developing countries), and long term exposure to n-hexane in glueing compounds could result in polyneuropathy among the workers. However, in the absence of objective measurements our results must be interpreted with caution. Well planned longitudinal studies with objective measures of exposure and disease are important for future research in developing countries.