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

鼻腔冲洗和健康教育对降低水泥厂工人慢性鼻窦炎发病率的协同作用:一项随机对照试验

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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.

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