Endotoxin, dust and exhaled nitrogen oxide among hand pickers of coffee; a cross-sectional study

BACKGROUND: Primary coffee processing takes place in countries where coffee is grown, and may include hand picking of coffee to remove low quality beans. Hand picking is mostly performed by women. No previous studies on dust and respiratory health have been performed in this occupational group, although studies indicate respiratory problems among other coffee production workers. FINDINGS: Our aim was to assess dust and endotoxin exposure among hand pickers in a coffee factory and compare the levels with limit values. In addition we wanted to examine the fraction of exhaled nitric oxide (FeNO) as a possible inflammatory marker in the airways among the hand pickers and evaluate the association between FeNO and years of hand picking. All hand pickers in a factory were examined during 1 week. The response was 100 %; 69 participated. FeNO was measured using an electrochemistry-based NIOX MINO device. Nine out of 69 workers (13 %) had levels of FeNO above 25 ppb, indicating presence of respiratory inflammation. A significant positive association was found between increasing FeNO and years of hand picking. Nine personal samples of total dust and endotoxin were taken. None of the dust samples exceeded the occupational limit value for total organic dust of 5 mg/m(3). Three samples of endotoxin (33 %) were above the recommended value of 90 EU/m(3). CONCLUSIONS: Levels of endotoxin were higher than recommended standards among hand pickers, and there was a positive association between the level of exhaled nitrogen oxide and years of work with hand picking coffee.