Abstract
Background In the Pakistani textile industry the prevalence of workplace respiratory illnesses, including byssinosis, is high. This study aims to determine the effectiveness of a multifaceted intervention package in reducing dust levels in cotton mills, decreasing the frequency of respiratory symptoms among cotton textile workers, and improving their lung function. Methods/design We will conduct a cluster-randomized controlled trial at 28 textile mills in Karachi. The intervention will comprise: training in occupational health for all workers and managers backed by regular refresher sessions; the formation of workplace committees to draw up, agree and promote a health and safety plan that includes wet mopping, safe disposal of cotton dust, and the use of simple face masks, as well as further publicity about the risks from cotton dust; and provision of adequate supplies of face masks to support the health and safety plan. Participating mills will be randomized to intervention and control arms following a baseline survey. The impact of the intervention will be determined through follow-up surveys conducted at 3, 12 and 18 months. Data collection in the surveys will include spirometry, questionnaire-based interviews and cotton dust measurements. Discussion If successful, the study may pave the way for simple, low-cost interventions that can help reduce cotton dust levels in textile mills, and improve the respiratory health of textile workers in developing countries such as Pakistan.