Trial reportOccupational and environmental medicine2026
Reducing respirable silica exposure among brick kiln workers in Nepal: a human-centred design and implementation science framework to develop and pilot a personal protective equipment intervention.
Trial report in Occupational and environmental medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06090370 (Reducing Silica Exposure Among Brick Kiln Workers in Nepal), which is not on this map. Not yet cited in PubMed.
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Reducing Silica Exposure Among Brick Kiln Workers in Nepal: A Human-centered Design Framework to Develop a Personal Protective Equipment Training Intervention
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Authors and funding
13 authors.
Funding
Abstract
objectivesBrick kiln workers in Nepal face high exposure to respirable silica but are not required to use personal protective equipment (PPE). We sought to understand factors influencing PPE use, design and pilot a PPE training and distribution intervention and assess its feasibility.
methodsWe used a human-centred design approach guided by the Discover, Design, Build, Test framework and conducted four pre-intervention workshops (36 participants), a 21-day randomised controlled trial (RCT) and three post-intervention workshops (19 participants) at a kiln in Bhaktapur, Nepal. Workers and leadership aged ≥18 years were purposively sampled for workshops and randomly selected for the RCT (20 intervention, 20 control). Intervention participants received PPE training, weekly reminders and free N95 respirators and eyewear. Control participants received counselling and information on where to purchase PPE.
resultsPre-intervention workshops revealed barriers to PPE use, including cost, discomfort and work efficiency concerns. Workers preferred expert-led, hands-on PPE training. We identified high feasibility (mean Feasibility of Intervention Measure, 4.6±0.5 points) among workers; leadership rated feasibility lower due to cost concerns. Observed N95 use was higher in the intervention group (78.9%, 71/90 visits) compared with none in the control group (0%, 0/93 visits; p<0.001). Post-intervention feedback showed workers felt N95s reduced dust exposure and respiratory symptoms without impacting efficiency, but eyewear needed adaptation for sustained use.
conclusionsWith worker-centred training, N95 respirators are feasible to reduce silica exposure in this setting. However, broader adoption may depend on improving the affordability and accessibility of PPE through advocacy and policy changes. TRIAL REGISTRATION NUMBER: NCT06090370.
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