Occupational exposure and health risks among traditional copper bell makers in India: a comprehensive assessment with policy and preventive implications

PURPOSE: This study aimed to assess occupational exposures and health outcomes among traditional copper bell makers in Bhuj, Gujarat. METHODS: A cross-sectional design was used to evaluate 89 copper bell makers through environmental monitoring and clinical assessments. Workplace exposures assessed included respirable dust and PM2.5, personal and area noise levels, and heat stress. Corresponding health evaluations included spirometry for respiratory function, audiometry for hearing assessment, and structured questionnaires to capture musculoskeletal and other symptoms. RESULTS: Respirable dust concentrations (mean 4.93 ± 1.36 mg/m³) exceeded recommended limits, with 16.4% of workers showing abnormal lung function. Personal noise exposure levels were within OSHA (Occupational Safety and Health Administration) limits; however, peak noise during hammering reached 148 dB(C), and high-frequency noise exposure corresponded with a high prevalence (80.7%) of high-frequency hearing loss. WBGT (Wet Bulb Globe Temperature) values near coal-fired furnaces surpassed NIOSH thresholds, indicating considerable risk of heat strain. Musculoskeletal symptoms were reported by 70% of participants. CONCLUSION: The study highlights multi-dimensional occupational risks, the need for strengthening occupational health services and targeted interventions in informal artisanal sectors. Craft-specific Standard Operating Procedures and Periodic Medical Examination tools were developed and provided to the Handicrafts Service Centre, extending policy support to artisan sectors.