دراسة بحثية بعنوان : الوضع الصحي والبيئي لعاملات الطابوق في العراق

مترجم الى الانكليزية

Researcher:

Abha Ali

Introduction:

Plants, animals, and humans are all affected by pollution, which impacts all elements of the environment. Pollution also alters the composition of non-living natural elements, such as air, soil, seas, and oceans.1

Pollution can be defined as the intentional or unintentional introduction of contaminants into the environment at concentrations harmful to it, resulting in changes to its original characteristics. Environmental pollution is thus defined as any quantitative or qualitative alteration in the components of the living and non-living environment that ecosystems cannot absorb without disrupting their balance, regardless of the type or part affected. This leads to risks that significantly impact on health 2

Iraq is witnessing a lack of monitoring and regulation, coupled with non-compliance with laws and legislation, occasional failure to update them, or even their complete absence.

Additionally, the country faces poor security conditions and the control of certain industrial sectors by non-governmental entities, leading to the random proliferation of brick factories. These factories often disregard geographical considerations and their proximity to residential areas, as well as fail to obey to occupational and health safety standards.

In the production of bricks, "black oil" is used as fuel despite its impurities, with inadequate purification systems and insufficiently tall chimneys. This results in the spread of black smoke containing several toxic gases, rare elements, and carbonaceous materials emitted from the fuel used. Consequently, environmental pollution spreads, particularly Studies indicate that over 70% of environmental pollution in Iraq originates from air pollution caused by industrial combustion processes. Many industrial sites in Iraq are located within or near urban areas, significantly impacting the local population. So This leads to serious health risks, especially to respiratory health.

Such health issues exacerbate pressure on hospitals and healthcare centers in cities, threatening public health security.

The main air pollutants and their effects are as follows:

1. Acidic Gases

• Examples: Hydrogen chloride and hydrogen fluoride.

• Effects: Cause irritation and sensitivity in the eyes, skin, and throat.

2. Heavy Metals

• Examples: Arsenic, manganese, and nickel.

• Effects: These carcinogenic substances, particularly harmful to the lungs, also negatively impact the heart, immune system, and respiratory system.

3. Lead

• Source: Released from the combustion of certain types of gasoline, where it is used as an ignition catalyst.

• Effects: Lead exposure contributes to severe health risks, particularly affecting the nervous system and overall health.

4. Nitrogen Oxides

• Effects: Associated with numerous respiratory diseases, significantly harming lung function and air quality.

Gas Approximate duration in the atmosphere

Carbon dioxide 100 years

Methane 12 years

Ozone oxides 120 years

Halocarbons Up to 50,000 years

Table 1:The approximate duration of gases remaining in the atmosphere

Source: Ministry of Environment, Health Protection Center, Environmental Pollution Report

Table 2: Permissible levels of air pollutants and their impact on public health

Pollutants Permissible concentration (according to WHO) Impact on health

Suspended particles 150 micrograms Increase in acute and chronic respiratory diseases such as asthma.

Sulfur oxides 260 micrograms (100–200 micrograms) Acute respiratory diseases and bronchial inflammation.

Carbon monoxide 10 micrograms Increased deaths and diseases affecting the brain and nerves.

Nitrogen oxides 80–100 micrograms Cardiovascular diseases and inflammation.

Source: Ministry of Environment/Ministry of Health, same source as above.

In a study evaluating air pollution in the Nahrawan area of Iraq, a particulate matter collection device was used to gather 8 filters carrying suspended particles. The average concentration of total suspended particles was 2391.8 µg/m³, which is significantly higher than the permissible limits both locally and globally.

Additionally, the concentrations of toxic rare elements were measured, and they were found to exceed the permissible limits at all stations. This has resulted in numerous health conditions affecting the respiratory system. 3

The image shows  the chimneys of brick factories in the Nahrawan area

In addition to the materials used in brick production, the soil (clay) employed in the process contributes to environmental concerns. A study evaluating the environmental impact of brick factories on soil pollution in the Al-Salih District examined various chemical and physical properties of the soil, as well as the concentrations of heavy metals emitted by these factories. These heavy metals, which include lead, nickel, cadmium, cobalt, and copper, have significant impacts on both the environment and public health.

Soil samples were collected in September 2021 to analyze the presence of these elements, highlighting their contribution to environmental and health risks, These pollutants are among the most impactful on health. A comparison of the results with global environmental standards revealed that stations close to pollution hotspots exceeded permissible environmental limits for factories (4).

Evidence of this impact is shown in a 2013 study titled "Some Effects of Toxic Gases on the Health of Workers in Brick Factories (Nahrawan)." This research investigated the health effects of toxic gases emitted from the use and burning of black oil, as well as residual fats from machinery and vehicles, on factory workers.

The study utilized changes in certain biochemical and blood indicators to assess the extent of these effects. Biochemical markers in blood serum included glucose, urea, creatinine, sodium, cholesterol, and triglycerides. The results revealed:

A significant decrease in blood glucose levels among workers, dropping from 5.64 mmol/L in the control group to 3.23 mmol/L.

A notable increase in urea levels, rising from 3.37 mmol/L in the control group to 11.4 mmol/L in workers.

Elevated levels of creatinine, sodium, and triglycerides among workers.

In addition to pollution of water, soil, and air, there is a lack of public health security in these areas, exacerbated by the widespread prevalence of communicable and infectious diseases around factory zones. 5

Stages of Brick Production:

Excavation of soil:

The process begins with the excavation of the required soil for brick production. Where the workers dig and extract the soil, which serves as the primary raw material for brick manufacturing.

Soil Transport:

After the soil is extracted, it is manually transported by workers from the excavation site to the brick manufacturing machines. This stage requires significant physical effort, as the soil is manually carried to the designated location where the bricks will be formed.

Brick Formation and Arrangement Before Firing:

Once the soil reaches the brick-making machines, it is processed and

The image likely illustrates the process of arranging bricks

shaped into bricks. Before the firing (baking) process, workers, particularly female workers, arrange the bricks in the firing kilns. The bricks are carefully placed inside the kilns, and their positions are monitored closely. The process may require rearranging the bricks to ensure that heat is evenly distributed during firing.

Manual Labor by Women:

Most of the tasks involving the transportation and arrangement of bricks during these stages are carried out by female workers, especially during evening shifts. This is primarily due to the low wages offered to women, which makes them the preferred labor force for these strenuous and time-consuming tasks

Aim of the the study :

This study aims to assess the environmental and health conditions of female workers in brick factories in Iraq, focusing on the negative impacts of environmental pollution caused by this industry. The study includes the analysis of pollution levels in the surrounding air, soil, and water near these factories and identifies the health risks female workers face due to continuous exposure to toxic substances and gases resulting from combustion processes.

Additionally, the study seeks to highlight the difficult conditions faced by female workers in this sector, including low wages and the lack of necessary health protection measures.

Evaluation of the Sample’s Health Status and Environmental Pollution-Related Variables

Sample:

The sample consists of randomly selected female workers in brick factories, with a total number of samples (90).

Methodology:

A questionnaire was used to assess the health status of the female workers. This questionnaire aimed to evaluate the impact of environmental pollution on their health, including factors like respiratory issues, and any other health concerns related to exposure to pollutants in the work environment.

Study gap:

The study gap refers to the aspects or areas that have not been adequately addressed or explored in previous research. Identifying the study gap is crucial for understanding the unique contributions that this study can make. Below are some gaps :

Lack of Data on Long-Term Health Effects: Previous research may have focused on the immediate health impacts of environmental pollution, but there is a lack of longitudinal studies that track the long-term health consequences for female workers exposed to high levels of pollutants in the brick industry environment over many years.

Inadequate Examination of Socioeconomic Factors: The interaction between socioeconomic conditions and environmental and health effects has not been sufficiently studied. A significant study gap lies in understanding how low wages, lack of alternative employment opportunities, and economic dependence on women force them to work in hazardous conditions. This gap also includes exploring how these factors contribute to the exacerbation of health risks for female workers.

These gaps present an opportunity for this study to provide new insights into the long-term health impacts of working in polluted environments and the role of socioeconomic factors in shaping health outcomes among female workers in the brick manufacturing industry.

Limited Research on Specific Pollutants and Their Sources:

There is a need for more detailed studies on the specific types of pollutants emitted during the brick manufacturing process, especially in Iraqi factories, and their precise sources. The research gap here includes studying how different types of fuel used in kilns contribute to air quality degradation and health problems.

Scarcity of Local Studies:

There is a lack of local research that considers Iraq’s unique environmental, cultural, and economic context, which is essential for developing effective interventions and policies.

Neglect of Psychological Effects:

This aspect remains underexplored in the context of brick manufacturing and its broader impact.

The psychological effects of working in hazardous conditions have not been adequately explored. The research gap includes understanding psychological stress and its impact on the mental health of female workers, particularly regarding their exposure to pollution and poor working conditions.

Gap in Comprehensive Analysis:

There is a lack of comprehensive analysis of the effectiveness of current environmental and labor policies in protecting the health of female workers in the brick manufacturing sector. Studies could address this gap by evaluating current regulations, identifying areas needing improvement, focusing on adapting Iraqi laws to the present situation, and raising awareness through occupational safety programs.

Inadequate Representation of Female Workers’ Voices:

Previous studies may not have sufficiently included the perspectives and experiences of female workers, particularly in this sector. The research gap lies in the need for qualitative research that captures the lived experiences, challenges, and adaptive strategies of these women in their own words.

The Importance of the Research

The significance of this research is evident in several key aspects that directly impact the environment, the public health of female workers in brick factories in Iraq, and the broader community:

1. Improving Health Conditions for Workers:

By understanding the harmful risks associated with constant exposure to toxic pollutants and adverse environmental conditions, the research can propose recommendations to enhance working conditions and ensure the health and safety of female workers.

2. Raising Environmental Awareness:

The research contributes to raising awareness about the negative environmental impacts of brick manufacturing, not only on the workers but also on the local communities surrounding these factories. This awareness could encourage the adoption of more sustainable and environmentally friendly industrial practices.

3. Providing Recommendations for Government Policies:

The research helps identify gaps in current environmental and health policies, allowing for the presentation of concrete recommendations to policymakers. These may include improving occupational safety regulations, updating environmental emission standards, and providing better healthcare for workers.

4. Advocating for Workers’ Rights:

The research strengthens the case for defending workers’ rights to a safe and healthy work environment. By highlighting the difficult conditions faced by female workers, it can encourage discussions on improving wages, providing better social protection, and ensuring workplace justice.

5. Seeking Sustainable Solutions:

The research can contribute to developing sustainable solutions for the brick manufacturing industry, such as adopting cleaner and less polluting technologies, reducing environmental and health-related impacts.

6. Advancing Scientific Research in Iraq:

This research enriches the scientific literature on environmental and occupational health in Iraq and paves the way for further studies that can build on its findings to create a more significant impact.

Research questions in the questioner:

The evaluation form for female workers in brick factories includes a set of questions designed to collect comprehensive data on the health and environmental conditions of these workers. Each question is provided specific information that helps understand the circumstances in which the workers live and how these affect their health and daily lives. Below is a breakdown of the research questions included in the form:

Personal Data (Age, Type of Work, Marital Status, Housing, Family Size):

These questions aim to collect demographic information about the workers, helping to identify the age groups most vulnerable to health risks and the types of work that might be more hazardous. They also provide insights into the workers’ socioeconomic backgrounds, such as their living conditions, family size (especially if they are the sole breadwinner), and caregiving responsibilities. Factors like living in poorly ventilated and overcrowded areas near factory chimneys are highlighted as significant contributors to various communicable and chronic diseases.

Years of Work (Continuous or Intermittent):

This question determines the extent of exposure to health risks associated with brick factory work. Continuous work over long periods may increase the likelihood of occupational illnesses, while intermittent work might have different effects. This information helps analyze the impact of work duration on health.

Chronic Illnesses and Family History of Chronic Diseases:

This question aims to assess the prevalence of chronic illnesses among workers and their link to prolonged exposure to workplace pollutants. It also highlights genetic factors that may increase workers’ susceptibility to health risks. Chronic illnesses, such as hypertension, diabetes, respiratory diseases, and cardiovascular conditions, are identified as long-term health issues with various risk factors. While the environmental conditions in these workplaces cannot be definitively established as the sole cause, they are considered a common risk factor among all study participants.

Picture shows the measurement of blood pressure.

Surgical History:

This question seeks to determine whether workers have undergone surgeries related to health problems caused by their work or exposure to pollutants. Such information is vital for understanding the impact of the work environment on health.

Health Symptoms (Headaches, Dizziness, Nausea, Breathing Difficulties, Asthma, Enlarged Lymph Nodes, Limb Numbness, Joint Diseases):

These questions collect information about health symptoms that may be directly or indirectly related to working in a polluted environment. They help identify the most common illnesses or symptoms among workers and their association with workplace conditions.

Reproductive Health (Menstrual Cycle Regularity, Age at First Pregnancy, Number of Births and Miscarriages, Ability to Breastfeed):

These questions aim to understand how working in brick factories impacts the reproductive health of female workers. The data helps determine whether environmental conditions adversely affect reproductive capabilities and women’s health in general.

Smoking:

This question analyzes the relationship between smoking and other health symptoms experienced by workers.

Mental Health:

Questions focus on how physical health impacts mental well-being and on the workers’ feelings about continuous or forced work.

These questions cover demographic, health, environmental, and social aspects, helping to understand the complex effects of the work environment on the health of female workers. Analyzing this data enables the study to propose recommendations for improving working conditions and promoting the overall health of workers.

Sample Description :

Age Distribution:

• Based on data indicating that the average age of female workers is approximately 32.6 years, most workers in this field belong to the young to middle-aged demographic.

• The large standard deviation (13.52 years) suggests a significant variation in the ages of workers, indicating a mix of adolescents, middle-aged women, and potentially older individuals. This is because entire families often work in this sector.

• The presence of a younger age group (as young as 13 years old) highlights that families resort to employing their daughters at an early age to help support the family, raising concerns about child labor and its impact on education.

• On the other hand, as workers age, the risks of developing health issues associated with physically demanding labor increase, emphasizing the need for safe work environments and effective preventive and health measures.

Figure that showes the age distrbustion

Marital status:

o The majority of the women working in brick-making are married, accounting for 62%. This suggests that they are working to support their families, indicating economic pressure pushing them to work in harsh conditions to provide extra income.

o A smaller percentage, 14%, are widowed. This implies that the loss of their primary breadwinner forces them to work in difficult conditions to meet their own and their family’s needs.

o Non-married women make up 24% of the sample which  working to support their families or to meet their daily needs.

2. Economic and Social Pressures:

o Many brick-making women experience significant economic pressure, pushing them to work under harsh conditions. This reflects a lack of other available job opportunities for women in this context.

The role of women in supporting the family is highlighted in this distribution, showing that women bear a significant part of the family’s economic burden, whether they are married, unmarried, or widowed.

Figure shows among Marriage Status of female  Workers

Place of residence:

• The largest percentage of women working in brick-making live in Diwaniya, with 42%. This indicated that the region suffers from a lack of job opportunities for women, especially those with limited formal education. Additionally, local customs in this area often require women to work. Families in Diwaniya frequently migrate to other provinces, including Baghdad, for employment opportunities.

• A significant percentage, 33%, of workers live in Baghdad, which is expected given that Baghdad is the capital of the country. The city likely offers more job opportunities, even in difficult industries such as brick-making. The presence of modern factories in Baghdad that help ease the work process increases the chances of prosperity for these workers.

• Another notable percentage, 14%, of workers reside in Samawah, indicating that this region may also serve as a secondary hub for brick production. This fits with the region’s population size and the nature of its soil, which is sandy and hampers brick production quality. As a result, women from Samawah often migrate to nearby provinces like Diwaniya or even the capital to seek better opportunities.

• The smallest percentage, 9.5%, of workers come from Najaf, suggesting fewer job opportunities in the brick industry in this area compared to others.

These data may reflect the economic and geographic factors that influence the distribution of women workers in this field. Diwaniya and Baghdad are areas with more job opportunities, or there could be a greater demand for labor in the brick industry in these regions. Proximity to raw material production centers or target markets also plays a role, making brick production more widespread in these areas. Additionally, there is a higher local demand for bricks in Diwaniya and Baghdad, explaining the large percentage of workers in these regions.

Figure :shows the percentages of residences  of the females workers .

years of practices:

The female workers have an average experience of about 6.5 years in the brick industry. This means that most of the workers have practical experience around this number of years. The standard deviation of 6 years is close to the average, indicating a significant variation in the years of work experience among the workers. Some workers may have very few years of experience, while others may have long experience.

There are workers with up to 23 years of experience in this field. This means that among the workers, there are veterans in this industry, reflecting substantial experience and deep knowledge of the practical details.

On the other hand, some workers only have one year of experience. These workers may be newcomers to the field or this job may be temporary for them.

The wide distribution of work experience:

The significant variation in years of experience (from 1 to 23 years) suggests differences in the level of expertise and skills among the workers. Those with long experience may be more efficient or possess specialized skills, while the newcomers may still be in the learning phase and adapting to the nature of the work.

Work sustainability:

The relatively low average (6.5 years) suggests that working in the brick industry may not be a long-term career for many workers, and they may leave this job after a few years. Therefore, management and government policies should create suitable conditions for the workers, both health-wise and economically and psychologically. Additionally, given the presence of new workers with only one year of experience, there may be a need to provide training and development programs to enhance their skills and increase their efficiency.

Figure shows the values (minimum and maximum )in years of working in brick production.

:

The family size :

The average family size in the sample is 7.2 members. This means that most families in the sample have about 7 members, which is relatively large, reflecting the nature of family life in the region or community from which the data was collected.

The standard deviation indicates variation in the number of family members around the average. With a standard deviation of 3.43, we can say that there is diversity in family sizes. Some families may be much smaller than the average, while others may be much larger.

The largest value indicates that the largest family in the sample contains 15 members. This is a very large family, and it may be extended (including members from different generations such as grandparents and grandchildren) or may include members of the same generation with a large number of children. On the other hand, there are families consisting of only one member. This could be due to the absence of social security programs or retirement plans for private-sector workers, forcing workers to continue working even when they need rest or retirement.

Family Size Distribution: The average and standard deviation suggest a wide range of family sizes, from small families to very large ones. This diversity may reflect a variety of social and economic factors, such as income, education level, and lifestyle.

The data suggests that the family size in the community where the data was collected is medium to large, with some very large families. This may reflect the nature of family relationships and the importance of extended families in this community, as shown in the following table:

Standard Deviation Maximum Value Minimum Value Mean

3.43 15 1 7.2

Health condition’s  among bricks workers :

Chronic Diseases:

High Blood Pressure (Hypertension): High blood pressure, also known as hypertension, is a chronic medical condition where the blood pressure in the arteries remains consistently high. Blood pressure is considered elevated when readings consistently exceed normal levels. Blood pressure is the force exerted by the blood against the walls of the arteries as it is pumped throughout the body. It can be measured using a blood pressure monitor, with readings given in two units: systolic pressure (when the heart beats) and diastolic pressure (when the heart rests between beats). Often, high blood pressure does not cause obvious symptoms and is referred to as the "silent killer." If symptoms occur, they may include:

• Headache

• Dizziness

• Shortness of breath

• Nosebleeds The blood pressure percentage in the sample of workers is 43%, while symptoms like headaches occur in 71% and dizziness in 48%. Possible causes include:

Occupational Factors:

• Physical exertion: Working in the brick industry requires significant physical effort, which can lead to strain on the heart and elevated blood pressure.

• Heat exposure: Working in hot environments, such as brick factories, can increase thermal stress, negatively affecting blood pressure.

• Chemical exposure: Some materials used in brick production may contain chemicals that impact general health, including blood pressure.

Social and Psychological Factors:

• Psychological stress: Working under continuous psychological stress, whether related to work or personal life, can contribute to high blood pressure.

• Economic conditions: Female workers in this industry may face economic pressures that lead to chronic stress, raising blood pressure.

Health and Nutritional Factors:

• Diet: A diet poor in healthy nutrients and high in salt can increase the risk of high blood pressure.

• Chronic diseases: Chronic diseases like diabetes and heart conditions may coexist with high blood pressure, as well as thyroid disorders that were noticeable among this sample.

________________________________________

Diabetes: Diabetes is a chronic disorder that occurs when blood sugar (glucose) levels are too high, either due to insufficient insulin production or ineffective use of insulin. Diabetes requires ongoing management through healthy diet, physical activity, and medication. The percentage of female workers with diabetes is 20%.

Possible reasons for the diabetes among brick factory workers include:

• Physical exertion and stress: Intense physical labor can lead to increased stress, which raises the risk of type 2 diabetes.

• Diet: Workers often have diets lacking in essential nutrients and high in carbohydrates and sugars, contributing to the risk of diabetes.

• Lack of health awareness: A lack of knowledge about the importance of a healthy diet and appropriate physical activity can lead to unhealthy eating habits and weight gain, major risk factors for diabetes.

• Genetic factors: Genetics can play a significant role in increasing the risk of diabetes.

• Lack of regular medical checks: The absence of healthcare services and regular checkups may delay early diagnosis of diabetes, making it more difficult to manage.

Uncontrolled diabetes can affect energy levels and productivity.

________________________________________

Chronic Respiratory Diseases: Respiratory diseases like asthma and allergies present a significant challenge for female workers in the brick industry, particularly given the high prevalence rates of asthma (41%) and difficulty breathing (59%).

Asthma and breathing difficulties can be severe issues for workers, affecting overall health and leading to chronic heart, circulatory, and lung problems. Sinus issues can increase the risk of respiratory irritations, as they may contribute to sinusitis and bronchitis. The use of black oil in the work environment increases exposure to air pollutants and harmful particles, raising the risk of respiratory diseases.

There is an urgent need to improve working conditions and safety in this sector, including taking measures to prevent excessive exposure to air pollutants and providing necessary protective equipment and training for workers.

________________________________________

Joint Diseases: A range of conditions affecting the joints can lead to pain, swelling, deformities, and joint movement limitations. These conditions include rheumatoid diseases like rheumatoid arthritis, as well as direct injuries and gradual wear and tear of joints, such as cartilage erosion and overuse arthritis.

86% of female workers in the brick industry suffer from joint diseases, and 67% report numbness in the limbs. Many of these issues are caused by working conditions that involve repetitive stress and heavy lifting on the joints and limbs.

It is crucial to provide a healthy and safe work environment for these workers by:

• Reducing physical load: Providing equipment or working methods that reduce pressure and heavy load on joints and limbs.

• Developing awareness programs: Offering education on the importance of joint health and preventing injuries, and providing guidance on physical techniques and exercises to strengthen muscles around the joints.

________________________________________

Chronic Kidney Diseases: A group of conditions that affect kidney function and the urinary system, leading to issues like kidney failure, bladder infections, kidney stones, and chronic kidney diseases. Kidney and urinary tract diseases are prevalent in 52% of female workers in the brick industry. One contributing factor is insufficient water intake, which leads to high concentrations of harmful substances in urine, increasing the risk of bladder infections and kidney stones. Additionally, the water used for drinking was contaminated with harmful substances, including bacteria and chemicals, leading to an increase in intestinal and urinary tract diseases.

________________________________________

Thyroid Diseases: 42% of female workers in the brick industry have thyroid problems, especially those who have undergone thyroid gland removal. Thyroid diseases are diverse and can increase the body’s need for thyroid hormones, including thyroid tumors and inflammation. These conditions significantly impact the lives of workers, affecting energy levels, concentration, and the ability to perform daily activities. Additionally, these conditions require ongoing treatment and monitoring, which may affect their work efficiency. Nutritional deficiencies, environmental pollutants, and increased mineral content in air and water have also contributed to this high rate of thyroid diseases.

________________________________________

Other Diseases:

• Ulcers (14%): A condition caused by damage to the mucous lining of the stomach or intestines, leading to ulcers that cause pain and sometimes bleeding.

• Eye allergies (40%): Caused by exposure to irritants like dust or chemicals in the work environment, this is common among workers in dusty conditions, often accompanied by other allergic issues like dermatitis.

________________________________________

Autoimmune Diseases:

• Psoriasis: An autoimmune skin condition that causes skin cells to accumulate and form thick scales.

• Lupus (Systemic Lupus Erythematosus): Another autoimmune disease affecting various parts of the body, including the skin, joints, and internal organs.

These conditions are prevalent among female workers in the brick industry and are likely linked to harsh working conditions, such as exposure to dust, chemicals, and physical stress, which directly affect overall health.

________________________________________

Infectious Diseases: 15% of female workers have been diagnosed with hydatid cysts, and 30% have symptoms of intestinal worms. The causes of transmission may include exposure to contaminated water or working with dust without proper protective equipment, combined with a lack of awareness about these diseases and preventive measures, such as water purification and food washing.

________________________________________

Gynecological Diseases:

Irregular periods (43%): Indicates hormonal imbalances or factors affecting overall health, such as physical and mental stress, which can cause hormonal changes and impact menstruation.

Bleeding during pregnancy (27%): This indicated pregnancy complications, including the risk of miscarriage or congenital anomalies, requiring proper medical care for pregnant workers.

The rate of miscarriage among female workers was 1.25%, with limited medical follow-up due to the lack of specialized centers nearby. Furthermore, awareness of the importance of regular medical follow-up is low to ensure the health of both the mother and fetus.

The average number of births among these workers is 5.8%, higher than the national average of 3.4% for 2022. This may reflect higher fertility rates, potentially linked to family size and living conditions, as well as the need for additional labor to improve family economic conditions. However, the age of the first pregnancy at 18 years is considered a reasonable age for childbirth in these communities.

Figure: show the different between values (minimum and maxmum)

.also table show the values  of age of first pregnancy and numbers of births

Breastfeeding:

Health organizations, such as the World Health Organization (WHO), recommend exclusive breastfeeding during the first six months of a child’s life, with continued breastfeeding alongside complementary foods until the child reaches two years or older, depending on the needs and desires of the mother and child.

Among the workers in the study, 38% practiced exclusive breastfeeding for a period ranging from one to one and a half years. However, the rest of the workers faced various challenges, including:

• Symptoms of malnutrition and anemia: These conditions made it difficult for some workers to produce enough milk for their children.

• Long working hours: The long work hours made it difficult for them to breastfeed, with no opportunities for breaks to nurse their children.

• Economic situation: Many workers had to return to work after one and a half months postpartum, leading to the discontinuation of breastfeeding.

• Breast infections: Some workers experienced infections in the chest area, which prevented them from continuing breastfeeding.

Conclusions:

Chronic Diseases:

1. High Blood Pressure: Many workers suffer from high blood pressure due to occupational factors such as physical effort, exposure to heat, and chemicals, with symptoms like headaches and dizziness.

2. Diabetes: Intensive physical effort, poor diet, and lack of health awareness are factors that increase the risk of diabetes among workers.

3. Chronic Respiratory Diseases: Asthma and difficulty breathing are common issues among workers, linked to exposure to environmental pollutants, such as the use of black oil in the workplace.

4. Joint Diseases: Workers experience repeated stress and heavy strain on their joints, leading to joint problems and numbness in the limbs.

5. Chronic Kidney Diseases: Many workers suffer from kidney and urinary tract diseases due to insufficient water intake and exposure to environmental pollutants.

6. Thyroid Diseases: Thyroid diseases are prevalent among workers, associated with environmental pollution and poor nutrition.

7. Transmittable Diseases: Pollution in water and the environment leads to the spread of transmissible diseases like hydatid cysts and intestinal worms.

8. Women’s Health Issues: Workers face reproductive health problems such as menstrual disorders and bleeding during pregnancy, with additional challenges in breastfeeding due to health and economic conditions.

Recommendations:

1. Improving Work Conditions:

o Reduce exposure to environmental pollutants and harmful chemicals.

o Provide personal protective equipment for workers, such as masks and gloves.

o Improve ventilation systems and reduce direct exposure to high heat.

2. Regular Healthcare:

o Establish nearby health centers for industrial areas and mobile medical units to provide comprehensive services, or allocate a plot of land for a medical clinic ("medical houses") to deliver essential services

o Provide regular medical checkups for early detection of chronic diseases such as high blood pressure, diabetes, and respiratory diseases.

o Offer healthcare support for pregnant workers to ensure regular prenatal care and provide necessary education on healthcare during pregnancy.

3. Raising Health Awareness:

o Organize awareness programs on the importance of proper nutrition and its role in preventing chronic diseases.

o Increase awareness of the prevention of respiratory and joint diseases by offering guidance on correct work techniques and appropriate physical exercises.

4. Support for Reproductive Health:

o Provide reproductive health consultations and support, including care during pregnancy and postnatal care.

o Encourage breastfeeding by providing appropriate break times for workers and helping them balance work and breastfeeding.

5. Improving Economic Work Environment:

o Improve wages and working conditions to alleviate economic pressures that can negatively affect workers’ mental and physical health.

o Offer economic support programs, particularly for women workers who face difficulties in accessing healthcare or proper nutrition.

6. Providing Clean Water:

o Ensure the availability of clean and safe drinking water for workers to reduce waterborne diseases.

o Offer educational programs on the importance of personal hygiene and adequate water intake.

o References:

1. Manisalidis, I., Stafropoulos, I., Stafropoulos, A., & Bezirtzoglou, E. (2020). Environmental and health impacts of air pollution: A review. Frontiers in Public Health, 8, 14. https://doi.org/10.3389/fpubh.2020.00014

2. Sa’doun, H. F. (2022). Environmental pollution in Iraq and its impact on health and health security. Journal of the College of Basic Education, 42(204), 793.

3. Nagy, A. S. (2018). Air pollution assessment in Al-Nahrawan area, Iraq. Al-Muthanna Journal of Engineering and Technology, 6(1), 1-9.

4. Ammah, D. H., & Al-Miyahi, I. K. A. (2022). Environmental impact assessment of brick factories in soil pollution in the Al-Isslah district. University of Basrah, College of Education for Human Sciences, Department of Geography.

5. Al-Shammari, A. G. H., & Al-Zaydi, K. A. M. (2013). Some effects of toxic gases on the health of workers in brick factories in Al-Nahrawan, southeast Baghdad. Al-Mustansiriya Journal of Science, 24(2).

These references are now listed in a standard format. Let me know if you’d like any changes!