Environmental Chemical Exposure and Occupational Health Outcomes among Workers in Selected Occupational Settings in Enugu State, Nigeria: Implications for Occupational Nursing Practice

Abstract

Occupational exposure to environmental chemical contaminants is a major public health concern, especially in low- and middle-income countries with limited occupational safety systems. This study assessed environmental chemical exposures and associated occupational health outcomes among workers in healthcare facilities, laboratories, manufacturing industries, and agro-allied establishments in Enugu State, Nigeria, with emphasis on implications for occupational nursing practice. A cross-sectional analytical design was used. A total of 320 questionnaires were distributed, and 301 were completed and returned, giving a response rate of 94.1%. Data were obtained through environmental monitoring, biological sampling, structured questionnaires, and clinical assessments. Findings showed that mean concentrations of PM₂.₅ (42.6 ± 8.7 µg/m³), PM₁₀ (87.4 ± 14.3 µg/m³), VOCs (0.82 ± 0.11 ppm), lead (0.067 ± 0.014 mg/m³), cadmium (0.006 ± 0.002 mg/m³), and formaldehyde (0.12 ± 0.03 ppm) exceeded WHO/OSHA permissible limits. Biological monitoring revealed elevated blood lead (8.41 ± 2.37 µg/dL), cadmium (1.94 ± 0.51 µg/L), mercury (4.76 ± 1.12 µg/L), urinary pesticide metabolites (0.87 ± 0.24 mg/L), and malondialdehyde levels (6.34 ± 1.47 µmol/L), indicating significant internal exposure. The most common occupational health outcomes were fatigue (60.8%), persistent headaches (57.8%), respiratory symptoms (53.8%), and eye irritation (45.2%). Significant positive correlations were observed between exposure indicators and health outcomes, including PM₂.₅ and respiratory symptoms (r = 0.612), blood lead and neurological symptoms (r = 0.693), and VOCs and fatigue (r = 0.511) (p < 0.01). Logistic regression analysis identified inadequate personal protective equipment use (OR = 4.12, 95% CI: 2.47–6.89), elevated blood lead levels (OR = 3.41, 95% CI: 2.11–5.48), prolonged exposure duration (OR = 2.84, 95% CI: 1.76–4.58), and high VOC exposure (OR = 2.63, 95% CI: 1.58–4.39) as significant predictors of occupational illness. The study concludes that workers are exposed to hazardous chemical levels associated with measurable biological uptake and adverse health outcomes. Strengthening environmental monitoring, occupational health surveillance, and nursing-led interventions is essential to reduce exposure risks and improve worker safety.