Assam: Study Flags Cases of Fungus-Induced Chronic Lung Disease in Tea Garden Workers

New Delhi: A recent research report has flagged rising instances of fungal lung infection or chronic pulmonary aspergillosis (CPA) among tea garden workers of Assam, which could be life-threatening for those with pre-existing lung damage. The north-eastern state is India’s top tea-producer and exporter.

The study, published in PLOS Neglected Tropical Diseases,  found a high prevalence of CPA among Assam's tea garden workers. The researchers said they found a 17% infection rate and a 32% antibody prevalence, “significantly higher than global averages”.

As per the report, the high rate is linked to the prevalence of tuberculosis in the population.

According to a report in The Telegraph, a research team from Assam Medical College and Hospital (ACMH), Dibrugarh, led by microbiologist Aishwarya Selvasekhar, screened about 128 workers from four tea gardens in the vicinity of the hospital and found that 17% of them had CPA. They also found that 32% of participants had antibodies to Aspergillus, the fungus that causes CPA. Nearly 48% of people with a history of tuberculosis (TB) had antibodies to Aspergillus, it was found.

The alarm bells raised by the study come on the backdrop of several reports of poverty and poor nutrition among Assam’s tea garden workers, leading to high rates of TB cases.

The ACMH doctors have called for heightened screening to allow early intervention with anti-fungal medication of CPA which, they say, remains undiagnosed due to lack of tests to detect Aspergillus infections.

The report has also called for improved diagnosis and treatment protocols for CPA, particularly considering its potential misdiagnosis as TB.

The researchers also flagged the importance of addressing neglected tropical diseases in vulnerable populations, such as tea garden workers, who are often exposed to pesticides and chemical fertilisers that impact their health.

The ACMH research findings were published in the journal PLOS Neglected Tropical Diseases earlier this week.

According to the report, CPA typically develops in individuals with pre-existing lung cavities, often as a result of previous conditions like TB. The symptoms include fatigue, tiredness, and coughing up blood, quite similar to those of TB.

The study said patients in “resource-limited settings”, such as tea gardens, are often diagnosed only after experiencing severe symptoms, such as massive hemoptysis (coughing up large amounts of blood) or severe respiratory distress.

The researchers said they chose to study the tea garden population of Assam because of the high prevalence of TB there.  The state has over 800 tea estates, including 177 in the Dibrugarh district alone. These estates account for approximately 50% of India’s tea production.

As per the study, the prevalence of CPA in this population was “unusually high” at 60 per 100,000 people. This contrasts with the global prevalence of 42 per 100,000 and the 2011 Indian estimate of 20 per 100,000.

The study said it was approved by the Institutional Ethics Committee (Human) and informed consent was obtained from all participants.