Synergistic Impact of Nasal Irrigation and Health Education in Reducing Chronic Rhinosinusitis Among Cement Plant Workers: a Randomized Controlled Trial.

Abstract

Background: Chronic rhinosinusitis (CRS) is a prevalent and debilitating condition among industrial workers exposed to occupational hazards such as dust and chemical irritants. Despite its significant impact on quality of life and productivity, evidence-based interventions for occupational CRS remain limited.

Objective: This study evaluates the effectiveness of combined health education and nasal irrigation in reducing CRS symptoms among direct labor workers at the Hai Phong Cement Plant, Vietnam.

Methods: A randomized controlled trial was conducted from 2014 to 2015, involving 90 workers diagnosed with CRS. Participants were randomly assigned to an intervention group (n=45), receiving nasal irrigation kits and training, or a control group (n=45), receiving health education only. Health education sessions focused on improving knowledge, attitudes, and practices (KAP) related to CRS prevention. Nasal irrigation involved twice-daily rinsing with 0.9% saline solution. Outcomes were assessed using structured questionnaires, clinical examinations, and the Intervention Effectiveness Index (HQCT).

Results: The health education intervention significantly improved KAP scores, with a 2967% increase in positive attitudes and an 847% improvement in understanding preventive measures. Nasal irrigation demonstrated substantial efficacy, reducing moderate nasal discharge by 58% and nasal congestion by 1600%. Objective findings revealed a 1657% increase in workers reporting no nasal cavity discharge and a 158% improvement in nasal mucosal health. After six months, 60% of the nasal irrigation group reported "good" improvement, compared to 11.1% in the control group (p < 0.05).

Conclusions: This study highlights the synergistic potential of health education and nasal irrigation in managing occupational CRS. Nasal irrigation, in particular, emerged as a highly effective, low-cost intervention for alleviating CRS symptoms in high-risk industrial settings. These findings underscore the importance of integrating non-pharmacological approaches into occupational health programs to safeguard respiratory health among workers exposed to environmental hazards.