Respiratory symptoms and lung function impairment among bakery employees exposed to flour dust in Abidjan, Cote d’Ivoire

Bakery workers are frequently exposed to flour dust and fine particulate, which can contribute to respiratory symptoms and impaired lung function. In Abidjan, the growth of the bakery sector is increasingly exposing workers to high concentrations of fine particulate. This study aimed to assess respiratory symptoms, impaired lung function and associated occupational factors among bakery workers in Abidjan, Côte d'Ivoire. An analytical and descriptive cross-sectional study was conducted in 40 bakeries within the Autonomous District of Abidjan between February 2019 and January 2020. Data were collected using standardized questionnaires, spirometry tests, and air quality measurements by zone (Production Zone (ZP) and Sales Zone (ZV)).The data were analyzed using Stata version 15.1. Bivariate and multivariate logistic regression analyses were carried out to identify factors associated with impaired respiratory function and small airways syndrome (SAS). Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and statistical significance was set at p < 0.05. A total of 599 employees were included in the study, comprising bakers/pastry chefs (59.7%), sales clerks/cashiers (23.5%), cleaning staff (6.3%), and administrative personnel (10.2%). The mean age was 31 years, with a male-to-female ratio of 2.2, and the majority (88.8%) had less than five years of work experience. Bakers/pastry chefs and sales clerks spent more than 20 hours per day continuously at the workplace. The most common respiratory symptoms were nasal congestion (68.1%), runny nose (46.3%) and sneezing (41.4%). Some workers had impaired FEV1 values (20.9%) and abnormal FEV1/FVC ratios (17.5%). PM2.5 concentrations reached 320 µg/m³ in production areas and 290 µg/m³ in sales areas, representing a 21.3-fold and 19.3-fold increase, respectively, over the WHO guideline value. Respiratory symptoms and impaired lung function were significant (adjusted OR = 3.25; 95% CI: 2.05-5.16; p < 0.001) among workers in production areas. The prevalence of small airway syndrome was low (7.35%). Dry cleaning of floors [aOR = 6.3 (1.06-17.29)] and workbench cleaning [aOR = 4.70 (1.11-10.80)] were significant risk factors, whilst the use of kneading machines fitted with airtight lids was protective [aOR = 0.18 (0.04-0.72)]. Bakery workers in Abidjan experience substantial respiratory symptoms and lung function impairment associated with high occupational exposure to flour dust and PM₂.₅. Preventive occupational measures including improved ventilation, wet-cleaning procedures, respiratory protection, and dust-control systems are urgently needed. Small airways syndrome was identified in a smaller proportion of workers and may represent an early marker of occupational respiratory damage.