Raphael Kanyire Seidu, Emmanuel Abankwah Ofori, Benjamin Eghan, George Kwame Fobiri, Alex Osei Afriyie, Richard Acquaye, A systematic review of work-related health problems of factory workers in the textile and fashion industry, Journal of Occupational Health, Volume 66, Issue 1, January-December 2024, uiae007, https://doi.org/10.1093/joccuh/uiae007
Navbar Search Filter Mobile Enter search term Search Navbar Search Filter Enter search term SearchThe purpose of this study was to present a systematic review of the health-related problems of factory workers in the textile and fashion industry. These workers endure long sitting postures, poor workspace conditions, and long working hours to complete their overload of tasks. This situation results in several health problems that affect the productivity, mental health, and well-being of the workers.
The relevant data (21 article publications) were obtained from the Scopus database. Analysis of the 21 articles was grouped under 3 research themes based on the critical reading of the content and abstracts: respiratory problems, musculoskeletal disorders, and psychological stressors and other health issues.
The findings show that factory workers are exposed to dust particles of cotton and other raw materials, fumes, and chemicals from manufacturing processes. This prolonged exposure without the use of personal protective equipment (PPE) leads to respiratory diseases like byssinosis that affect the workers’ health. Additionally, working in a particular posture due to the workstation design for prolonged hours causes musculoskeletal disorders or pains. Workers also suffer from anxiety, depression, and stress from workload and pressure, hence making them unstable with reduced productivity.
Conclusions:The findings of the study reinforce the need for a safe workspace and spacious work environment, provision of PPE, training in occupational hazards, frequent health checks, and ergonomic assessment of workstations to reduce prolonged work postures. Stakeholders, employers, policymakers, and governments should collaborate to safeguard and protect the well-being and health of the workers at these factories.
The contribution of the textile and fashion industries to the society and economics of countries cannot be underrated. 1 These industries have provided foreign exchange receipts, jobs, and incomes for many people with sustained economic development. 2 Due to the different sectors comprising the industry, it provides a wide range of employment opportunities to both skilled and unskilled labor in developed and developing countries. Aside from these benefits, workers within this industry are exposed to varying work-related hazards that affect their productivity and health. Work physiology, occupational hygiene, occupational psychology, occupational toxicology, and other fields are all included in the science of workplace health hazards. 3
To give some historical context, the early industrial revolution saw the rapid introduction of machinery for significant mechanization in the production process within the textile and fashion industry. Such rapid development enhanced the production of mass textile and fashion products to meet the needs of consumers due to the transformed social structures and economic systems arising from the industrial revolution. 4 This situation resulted in the shift from craft-based methods of production to a more modern and machine-based approach for mass manufacturing. 5 Factories employed a large number of people, which led to seriously long working hours, poor workspace conditions, and exposure to harmful chemicals and substances, thereby exposing workers to a range of health hazards or issues. 4 , 6 For example, exposure to cotton dust or other fine particles and harmful chemicals used during dyeing led to respiratory disorders and other health problems. 6 There has been an exacerbation of these health issues in recent years in the 21st century due to globalization and renewed growth of the textile and fashion industry. 7 To help ensure strict adherence to safety standards by manufacturers within the textile and fashion industry, the International Labour Organization (ILO) developed a code of practice on safety and health in the textile, clothing, leather, and footwear industries, to protect workers and hence limit any harm or threats. 8
However, workers within garment factories still have to endure lengthy sitting postures and work for long hours to complete their overloaded tasks. This results in issues that frequently start as mild aches before accumulating incapacitating ailments that have an impact on the workers’ ability to go about their daily lives. 9 The work environment as described by Chattopadhyay and Gangopadhyay 10 is unhealthy and unsafe within certain sectors of the textile industry, most especially ready-made garment manufacturing units. This has both short- and long-term effects on the health of the workers. 11 For example, a study by Paul-Majumder, 12 cited in Ahmed and Raihan, 13 illustrated various diseases and illnesses among female garment workers.
These factory workers have to endure these working conditions for fear of job loss, even though they know the impact on their health and well-being. 14 Furthermore, these workers in this industry have no option or alternatives to seek redress because they lack the required skills and education and hence are forced to endure such poor working conditions at the factory. This research acknowledges a previous review study conducted by Lillypet et al 15 on health problems among garment factory workers. This study was limited to publications within the period of 2009 to 2015. Relevant findings from the review of the 17 studies identified revealed that these garment workers experienced mental illness, respiratory and cardiovascular illness, and MSDs. The latter have been investigated by Mackinnon and Novak, 16 Chandra and Dubey, 11 and Islam, 17 which indicated that repetitive and prolonged working postures are the key causes of such health problems for the worker. Another review investigated the health vulnerabilities of ready-made garment workers from 2007 to 2017. 18 Findings from this study showed that lack of safety equipment, hazardous conditions at the factories, and unsafe and unhygienic workspace environments have contributed to health problems among these workers. The aforementioned review studies were focused on specific time periods and highlighted the recurring health problems faced by workers in the workspace. Recognizing ergonomic risk factors at work is a must, and it is the first step in eliminating risks and enhancing worker safety. 3 There has not been a comprehensive systematic review of health-related problems amongst factory workers in the textile and fashion industry for a long time period.
Therefore, this systematic review was conducted to understand the health-related problems of workers within the textile and fashion industry with publications drawn from 1979 to August 2023. These relevant studies were drawn from the Scopus database, and their findings would provide insights to stakeholders, employers, policymakers, and government to safeguard and protect the well-being and health of the workers.
The relevant literature on health-related problems amongst textile and fashion workers was sourced based on guidelines and strict steps according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol developed by Liberati et al. 19 In this study, the Scopus database was used to identify the relevant publications for the systematic review. The Scopus database was selected because it houses the largest collection of abstract indexing and citation information from leading journal publishers, 20 and is less difficult to retrieve significant documents for easy analysis. 21 , 22 The PRISMA process, as shown in Figure 1, was used to perform 4 key activities: identification, screening, checking the eligibility of the documents, and critically selecting the relevant publications. The latter were included in the systematic review to analyze their key findings.
PRISMA flowchart showing the selection process.
The appropriate search terms or keywords like “health problems,” “health diseases,” and “textile/apparel/garment/fashion workers” were used to search for the relevant publications from the Scopus database. Here, the use of abbreviations was excluded from the search terms in the database. One search block (see Table 1) was used to identify the appropriate publications on the subject matter under investigation in this study. This resulted in a total of 25 documents (comprising both articles and reviews) written in different languages.
Search and exclusion strategy for retrieving documents.
| Parameter . | Settings . |
|---|---|
| Search term | TITLE-ABS-KEY (“health problems” OR “health diseases”) AND (“textile workers” OR “apparel workers” OR “garment workers” OR “fashion workers”) |
| Type | Article publications included; Article reviews, book chapters, conference papers excluded |
| Time span | No limitation (1979 to August 2023) |
| Language | English publications included; non-English language publications excluded |
| Parameter . | Settings . |
|---|---|
| Search term | TITLE-ABS-KEY (“health problems” OR “health diseases”) AND (“textile workers” OR “apparel workers” OR “garment workers” OR “fashion workers”) |
| Type | Article publications included; Article reviews, book chapters, conference papers excluded |
| Time span | No limitation (1979 to August 2023) |
| Language | English publications included; non-English language publications excluded |
TITLE-ABS-KEY, Title, Abstract and Keywords.
Search and exclusion strategy for retrieving documents.
| Parameter . | Settings . |
|---|---|
| Search term | TITLE-ABS-KEY (“health problems” OR “health diseases”) AND (“textile workers” OR “apparel workers” OR “garment workers” OR “fashion workers”) |
| Type | Article publications included; Article reviews, book chapters, conference papers excluded |
| Time span | No limitation (1979 to August 2023) |
| Language | English publications included; non-English language publications excluded |
| Parameter . | Settings . |
|---|---|
| Search term | TITLE-ABS-KEY (“health problems” OR “health diseases”) AND (“textile workers” OR “apparel workers” OR “garment workers” OR “fashion workers”) |
| Type | Article publications included; Article reviews, book chapters, conference papers excluded |
| Time span | No limitation (1979 to August 2023) |
| Language | English publications included; non-English language publications excluded |
TITLE-ABS-KEY, Title, Abstract and Keywords.
The appropriate keywords like “textile/apparel/garment/fashion workers,” “health problems,” or “health diseases” were used to form the search term (“health problems” OR “health diseases”) AND (“textile workers” OR “apparel workers” OR “garment workers” OR “fashion workers”), for the relevant publications from the Scopus database. Academic publications like book chapters, conference papers, journal articles, and review studies were all considered as potentially eligible for the systematic review. However, after a search from the Scopus database, only articles and reviews written in different languages were identified. The search results were further limited to a document type and language; hence, reviews and non-English language type studies (see Table 1) were excluded from the initial 25 documents. Subsequently, reviews and book chapters were excluded because journal articles provide empirical study evidence from field surveys. In this way, the necessary information on the health issues of workers in the fashion and textile industry could be easily identified. This resulted in 21 included full-text studies, which are used in the study.
To clearly understand some quantitative data, VOSviewer software was used to conduct science mapping for visualization of the keywords, top publishing journals, and top cited authors in the field. Additionally, Excel software was used to visualize the top contributing countries and publication trends. Endnote reference manager was used to properly cite the included studies selected for the review process, which forms the qualitative part of this article.
The purpose, methodology adopted, and related findings from the included studies were examined for appropriate understanding and discussion. This provided great insights into health-related problems faced by textile and fashion workers (factory workers) in the industry.
Reporting on health-related problems by textile and fashion workers is imperative for relevant structural and policy measures within the industry. Data obtained from the Scopus database showed fewer publications were recorded within this research area as shown in Figure 2a. The first paper was recorded in 1979 by Bouhuys et al, 23 who discussed the “priorities in prevention of chronic lung diseases” with some highlights on cotton workers. The second study was recorded a decade later, in 1989 by Brisson et al, 24 on “disability among female garment workers: a comparison with a national sample.” This sought to understand the disability prevalence among factory workers in the garment industry. Interestingly, the years 2005, 2012, 2013, 2019, and 2020 recorded the highest numbers of publications compared with none in the first half of 2023.
(a) Publication trends on health-related problems amongst the textile and fashion workers from 1979 to 2022 (as of August 30, 2023). (b) Visualization mapping of co-occurrence of keywords. (c) Publications based on country of origin. (d) Visualization mapping of co-authorship of countries.
An analysis of the keywords provides the relevant information of the main content of the research papers published in the field within the period under investigation. 25 VOSviewer is useful, as reported by McAllister et al, 26 to understand and identify the number of recurrences of a term(s) in different articles. On this premise an analysis of the co-occurrence of keywords was conducted on the authors’ keywords using VOSviewer based on a full counting method. Here, the minimum number of documents was set at 1, giving a result of 72 keywords that met the threshold. Moreover, of the 72 keywords selected, only 13 keywords from the network were connected to each other ( Figure 2b). Furthermore, using the total link strength, the following were identified as the top 4 main keywords: smoking, garment workers, textile workers, and air pollution. The interconnected keywords imply that air pollution from fine cotton and fiber dust particles from working operations in the factory coupled with smoking habits have been greatly linked to health-related issues amongst garment and textile workers. This provides valuable insights into the common health issues interlinked with future research trends.
Figure 2c illustrates the top 10 contributing countries publishing research on health-related problems among textile and fashion workers. It is evident that India has contributed about 6 published articles on the subject, followed by Bangladesh and then others. These 2 countries are among the top textile and garment manufacturing countries, with a large labor force working within the industry. A further country co-authorship analysis was conducted on 15 countries identified using the VOSviewer (after removing items such as University and Gandhigram Rural University). Of the 15, only 3 countries from the network collaborated to publish papers on health-related problems among textile and fashion workers ( Figure 2d). Further analysis of the top journals publishing research in this area revealed that the Journal of Occupational Health was the leading journal with 2 publications. The rest of the 20 journals identified (like Safety and Health at Work, Archives of Environmental and Occupational Health, and BMC International Health and Human Rights, amongst others), all published 1 paper.
The included 21 articles were grouped under 3 research themes based on critical reading of the content and abstracts. These themes were respiratory problems, MSDs, and psychological stressors, as shown in Figure 3. The following sections provide a detailed discussion of the related findings from the selected articles or studies.
Research themes after grouping the selected studies for review.
Musculoskeletal disorders, according to Bao et al, 27 are pains produced from labor-related psychological factors, extreme biomechanical exposure, and other external actions on the locomotive system. Individuals face such disorders as a result of their jobs when they are exposed to extreme mental and physical work-related overloads. 28 This phenomenon can lead to chronic or acute pain for an individual. As such, studies have been conducted to understand work-related MSDs among factory workers within the textile and fashion industry. A recent study by Biadgo et al 29 investigated one major health problem, neck pain, amongst operators of sewing machines in the city of Mekelle in Ethiopia. Due to the rapid growth of garment operating industries in the country, the authors acknowledged the importance of understanding the prevalence of neck pains as an occupational health risk. Findings revealed that continuous working without breaks, long work hours (above 8 hours), working in a static posture, and highly repetitive work were influential factors that caused neck pains amongst these operators in the factory. For example, working continuously in a static posture for a length of time imposes stress on the muscles and cervical vertebrae, which promotes muscle stiffness, hence resulting in neck pain. The latter also occurs due to prolonged bending of the neck and back during work hours. However, results from a previous study conducted by Paudyal et al 30 indicated that working postures had no association with low back pain (LBP), but that exposure to working loads, high physical exertion, mechanical loads, and psychological factors did play a significant role in causing LBP amongst workers. 30–31 In fact these work-related MSDs increase with the age of workers. 31 This is because the energetic capabilities of the young are different compared with aged persons, and could imply that the latter should work for limited hours due to their potential exposure to MSDs.
A study on health problems among female garment workers in Bangladesh conducted by Akhter et al 33 revealed similar results to the study by Biadgo et al. 29 Here, findings revealed that frequently sitting in a particular position without a backrest on the seat resulted in joint and back pains. Aside from the continuous eye pain and headache, these pains in the back and joints influenced the workers’ recurring intake of painkillers to relieve their pains. This is because these females must meet the expectations of their family, and hence they compromise their health for money. This further places more stress on their bodies, which in the medium to long term could have serious health effects. A longitudinal study by Joseph et al 34 was conducted to understand the morbidity profile changes of aliments recorded for garment workers in Bangalore within a 3-year period. Study findings indicated MSDs like pains in the shoulders, legs, and back, were the most common health problems amongst the factory workers within the study period, even though recorded cases seemed to have reduced to 40% in 2005 compared with 48% in 2002. Body pains and occupational fatigue syndrome were further identified by Chand. 14 These were some of the health-related problems identified by a research study between 1997 to 2007 in garment workers in Fiji.
A group of textile workers in a study conducted by Singh et al 35 at Rajasthan in India were exposed to a lot of physical labor. Due to the working conditions in the textile industries, these textile workers reported several musculoskeletal pains. These activities resulted in several headaches, backache, and body aches, which affected their work rate. Aside from these, abdominal pains and gynecological problems were identified as the main occupational health problems of self-employed women in India (Indore and Ahmedabad) based on findings from Chatterjee. 36 These resulted in varying pains in the back and limbs and burning sensations in the hands. Aside from these MSDs, workers within the textile and fashion industry are further exposed to other health issues such as respiratory problems, which are explained in detail in the next section.
The use of large machinery to produce fibers, for example cotton in the textile industry, releases numerous fine fibers into the air at the workspace. These particles are so small that they can easily be inhaled into the respiratory system of the human body. Frequent exposure to fine particles at the workplace without the necessary protection has resulted in workers acquiring some respiratory problems in the short to long term. One critical causal factor is cotton or fiber dust produced within the workspace of the factory. Studies conducted by Joseph et al 34 and Tefera Zele et al 37 revealed that fiber dust or cotton dust from the manufacturing process were the cause of common respiratory ailments amongst Bangalore garment workers and Ethiopian textile factory workers, respectively. These fiber dusts are produced from trimming and cutting fabrics, and without proper safety protection the fine fiber dust particles are inhaled. With continual inhalation these fine particles build up in the lungs of the worker and in the medium to long term cause serious health problems. Similar findings were reported in a study by Singh et al, 35 whereby dusty workplace environments led to some respiratory disorders in textile workers in the desert areas of Rajasthan in India. These dusty environments, which included cotton dust, negatively influenced the working speed and abilities of the workers because they were prone to bronchitis, asthma, cough, and byssinosis. The latter, commonly known as brown lung, 38 is a respiratory disease caused by prolonged exposure to cotton dust produced from raw nonsynthetic textiles during the manufacturing process. 39 , 40 Chest tightness, coughing, wheezing, and shortness of breath are all signs of this illness. In the United States in 1938 it was believed that the disease had already affected around 35 000 people and that another 100 000 people were at risk of developing it. 38 Excessive exposure to these finer dust particles and fumes leads to a build-up within the lungs, which leads to some functional loss or chronic lung diseases among cotton workers, according to Bouhuys et al. 23 Furthermore, smoking amongst these workers was also identified as a health threat that resulted in respiratory problems, hence requiring adequate control measures to reduce the recurring threats to workers. Frequent exposure to dust particles, fumes, and chemicals at the factory has led to altered immune functions amongst some garment workers. 41
Female garment workers in Bangladesh commonly have breathing difficulties due to inhalation of fabric dust and smell from sweat. 33 These are premised on the overcrowded working environment of the factories. Critical factors such as poor residential facilities and overcrowding in factories increased the risk of tuberculosis transmission amongst garment workers in Qatar. These findings were reported in a study by Al-Khal et al 42 after conducting medical examinations (Mantoux skin test and chest x-ray) on 2774 workers in the garment factories. This further implies that the workspace can promote the transmission of airborne diseases to other workers within the same space, hence posing a serious health threat that authorities should address by improving conditions at the workplace. Indoor air pollution from smoking was the leading cause of asthmatic attacks amongst workers with such health conditions in a textile factory in Denizli. 43 As a result, the authors called for “smoking recession programmes” for workers to help limit the rate of smoking, which affects workers’ health. To further understand how workspace environmental conditions affect workers’ health, Chattopadhyay and Gangopadhyay 10 adopted a comparative study design to investigate the alterations in pulmonary functions amongst workers. Their findings revealed that the pulmonary function test parameters were reduced in workers exposed to work environments compared with workers in the control group. There were, however, improvements in symptoms in workers who undertook a temporary work cessation, hence limiting their exposure.
The ginning process within textile factories is a mechanical process that first separates impurities from the cotton ball and subsequently removes the seeds from the cotton fibers. 44 This process produces a lot of fiber dust particles, which are regarded as air pollutants in the factory. A study by Saha et al 32 revealed respiratory health problems such as chest tightness and altered pulmonary function amongst workers engaged in the ginning process. These are caused by exposure of the workers to fine cotton dust, which produces a condition called byssinosis, 32 hence resulting in chronic effects on lung function amongst some workers. These conditions were further affected by the smoking habit of some workers in the ginning factory. A more recent study by Khan et al 40 was conducted to investigate respiratory diseases among Pakistani female textile workers. Their study adopted a case–control design where information was retrieved from control groups (without any exposure to cotton dust) and the study group (with exposure to cotton dust for a period). Findings revealed that about 9.3% and 21% of the workers (in the study group) reported asthma and cough, respectively. The textile workers further reported byssinosis with severity of the diseases categorized as grade 1, 1/2, and 2. Schilling 45 clearly explained these as “no symptoms of chest tightness or breathlessness on the first day of the week on Monday (Grade 0), occasional chest tightness or breathing difficulty on the first day of the working week (Grade 1/2), chest tightness and/or breathlessness on Monday only (Grade 1), chest tightness and/or breathlessness on Monday and other weekdays (Grade 2) and evidence of permanent impairment in capacity from reduced ventilator defect (Grade 3).” This health problem was common amongst workers who did overtime in the factory hence exposing them to cotton dust.
These respiratory problems amongst workers in the factories occur largely due to the lack of supply of PPE. This is affirmed by studies from Memon et al 46 and Parimalam et al, 47 which revealed the nonavailability and lack of use of PPE by workers to help protect themselves. Even though some of these workers knew the benefits of PPE for their health, some simply did not use them. 47
The health, behavior, mood, and entire well-being of an individual are affected by stressors. 48 If not properly managed these can lead to short- to long-term damage to the health of the individual hence affecting their productivity at the factory. Studies have been conducted to clearly understand how these associated stressors among textile and fashion workers affect their health and productivity levels. Depression and work stress were the main psychological health problems amongst Fijian garment workers. 14 These were largely affected by the poor working conditions in the factory such as fear of job loss, human abuse, intensified work targets, and poor salaries. Workers in this industry have no option or alternatives to seek redress since they lack the required skills and education hence have to endure poor working conditions at the factory. A case study by Brisson et al 49 revealed that garment workers experienced high levels of depression and anxiety due to the intense pressure at their workplace. This makes them unstable and influences their productivity.
Aside from the above 3 themes of health-related problems, some other health problems have been identified. Notably, fever, stomachache, and eye and skin injuries were identified in a study to investigate the health effects of pesticide exposure on cotton pickers in Pakistan. 46 These findings were largely due to the unavailability of PPE for cotton pickers to protect themselves in the field. This influenced some to adopt alternative PPE like cloths or scarves to cover their faces. Joseph et al 34 mentioned that headache, irritation, and refractive errors in the eyes are commonly linked to garment workers in Bangalore. Others such as kidney and bladder problems were identified in a study by Chand 14 among Fijian garment workers. Subsequently, due to the physically demanding nature of the job for garment workers, they experience slight to moderate disability compared with other workers in different occupations. 24 Furthermore, prolonged exposure to loud noise has been linked to hearing loss and eardrum injury. Continuous noise exposure has also been linked to other issues like exhaustion, absenteeism, irritation, anxiety, a decline in productivity, changes in blood pressure and pulse rate, as well as sleep disturbances. One of the main causes of noise pollution in the majority of units is ineffective equipment maintenance. Due to the absence of discomfort and the fact that its effects are not immediately apparent, noise exposure is frequently disregarded by textile units even though it has major health consequences. These health-related issues clearly stipulated by the identified studies provide insights for worker associations and management to improve working conditions and spaces to protect the health and well-being of workers. It is, however, apparent that certain worker behaviors like smoking and not using some provided PPE compound the problem, besides lack of good workspaces, nonprovision of PPE, and lack of training of workers on safety measures by managers. These all contribute to health and well-being within the garment factories. This should be of great importance to stakeholders and management to reinvent their efforts to create a workspace that eliminates injury and health issues for workers. The next section considers various managerial, policy, and practical implications.
The results of this review article are very important for managers, policymakers, stakeholders, and government institutions with an interest in the textile and fashion industry.
Findings from the study show that workers in this industry are exposed to dust particles from the raw manufacturing processes, chemicals, and fumes. This prolonged exposure leads to respiratory diseases that affect the entire health of the workers. In fact, one such health problem, byssinosis, is caused by prolonged exposure of the workers to cotton dust, which affects the lungs and can lead to their malfunctioning. This thus requires the provision and strict use of PPE within the industries by workers to help protect them. Frequent educational events and health screening programs should be conducted for the workers to help provide the needed information for them to ensure personal safety and provide the necessary treatments at the early stages. This further requires the management of these industries to conduct periodic checks and strict supervision of workers to comply with using PPE. The absence of these measures can result in workers not protecting themselves or in some cases adopting alternatives like clothing to cover their noses, as was observed in a study by Memon et al. 46 Aside from the provision of PPE for workers, management should also adopt modern technologies (such as improved ventilation and filtration systems, and electrostatic precipitators) within their factories to help exhaust the cotton dust in the workspace. This would help improve the quality of air and the reduce air pollutants hence limiting the amount of dust particles that could pose serious threats to the health of the workers.
With several health-related problems reported in this study, it is evident that the well-being and health of the workers in the garment and textile industries are imperative. This should be of great concern for the relevant regulatory institutions to protect the workers to limit any avoidable loss of life in the workplace. This therefore calls for effective policy direction and reinforces the need for the development of preventive strategies, policies, and safety guidelines by government for strict adherence by the industry. These measures should be backed by the relevant laws whereby a factory’s failure to adhere to the protection and safety of its workers will be severely punished. This will help improve the quality of the workers’ health and the workspace environment to limit any accidents. Additionally, these policies should protect the factory workers from working for prolonged hours or overtime whence the eventual MSDs or pains occur. For example, low back pain is regarded as the most common MSD amongst workers within the textile and fashion industry. 30 This eventually affects the effectiveness and productivity of the workers. Further policy measures should be enforced to protect workers from abuse, low wages, and poor working conditions. This will help improve the mental stability of the workers in these industries, which contribute to the economic growth of their respective countries.
The study’s findings reinforce the reinvention and development of a safe and spacious work environment in the factories. This is necessary because the overcrowded work environment of the factories, as reported by Akhter et al, 33 promoted breathing difficulties. A good workspace environment would reduce any work-related health problems for workers.
Premised on the findings from a systematic review of health-related problems of workers in the textile and fashion industry, the study highlights specific recommendations to contribute to worker productivity and well-being. Firstly, factories should initiate work-life balance programs that promote flexible working hours, regular exercise, and breaks for workers. This will help them relieve some stress, improve the circulation of blood, and aid in preventing MSDs. Maintaining or ensuring the mental and physical health of the workers is important. Thus, factories should have mental health support units to help workers address psychological stressors such as anxiety, stress, and depression that are associated with the demanding nature of the work. Additionally, periodic health checks should be conducted for workers to help monitor and treat any health-related problems in the workplace. This will ensure a timely response and interventions to prevent any short- to long-term effects on their health.
The study further recommends regular ergonomic assessments by the managers of the factories to understand any work-related hazards due to the set-up of workstations within the workspace. This will help reduce any awkward postures that workers have to adopt to complete a task and reduce or prevent any work-related MSDs. The factories should routinely provide respiratory protective equipment and conduct health safety training for workers so that they understand the need to ensure personal safety, handling, usage, and disposal of chemicals and materials at the workplace. This will provide them with the necessary information on the short- to long-term effects when exposed to these harmful fine dust particles or chemicals without proper protection. These training programs should include the best methods or techniques for physically lifting materials at the factory to help prevent any back injuries or pains. Finally, the machines at the factories produce noise which is harmful to the workers’ hearing abilities. Thus, the factories should invest in noise control measures in the workspace to help prevent any hearing loss by workers.
Aside from the relevant findings and future studies proposed, this review acknowledges some key limitations that are vital for subsequent studies to reflect on. Firstly, the Scopus database was used in gathering and analyzing the sourced publications. This might have limited the inclusion of some papers and we cannot confirm that all relevant papers within this subject area were included. This further dovetails with the search formula or keywords used in this review study. The use of the search blocks in the Scopus database might have limited the gathering of some publications. Secondly, there are also limitations to the quality of the selected articles since we summarized the key findings of the studies. We acknowledge that the quality of the selected articles was not evaluated nor was any systematic review expert contacted. Some publications that might have been important to the review may have been excluded because of the criteria used in the study. Premised on this, future studies should consider other databases for literature gathering, fully explore other search blocks or keywords, other publications, and consult experts on systematic reviews.
Studies on the economic contribution of the textile and fashion industries both nationally and globally have been reported. These provide essential details about the employment opportunities created, materials produced for varying applications, and how the changing tastes of consumers are fulfilled. However, studies on the health-related problems in these factories have received little attention. Thus, this systematic review highlights these health-related problems that workers have to face during their work activities in the factories. The issues of respiratory problems, MSDs, psychological stressors, and other health problems such as skin injuries and eye irritations have affected the productivity and well-being of the workers. These health problems have prompted calls for effective measures and strict policies and programs by both the management of these factories and governments to help protect and ensure the safety of workers. As such, research studies could be conducted to provide in-depth information for the governments, employers, stakeholders, and policymakers within the textile and fashion industry to understand and gain useful insights for the development and implementation of productive interventions to protect workers’ health. Future studies could be conducted on the specific areas as outlined below:
R.K.S. and R.A. contributed to the study conception and design. The literature search was performed by R.K.S., E.A.O., B.E., and G.K.F. The first draft of the manuscript was written by R.K.S., E.A.O., B.E., G.K.F., and A.O.A., and was critically supervised and reviewed by R.K.S. and R.A. All the authors read and approved the final manuscript.
Supplementary material is available at the Journal of Occupational Health online.
No funding, grants, or other support was received by any of the authors to assist with the preparation of this article.
The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The list of articles used for the review analysis during this current study is supplied as Supplementary information.
