D2.180 - Direct Cost of Occupational Asthma in the Textile industry: Evidence from the private sector in central Tunisia

The textile industry is highly affected by occupational asthma (OA), particularly in low- and middle-income countries with prevalent vegetable dust exposure. Beyond clinical morbidity, OA imposes substantial direct economic costs on healthcare and social security systems. Private sector-specific data are limited. This study quantifies direct OA costs among private textile workers in central Tunisia.

A cross-sectional descriptive study was conducted using National Health Insurance Fund (CNAM) data on recognized OA cases from private textile factories in Sousse, Monastir, Mahdia, and Kairouan. Direct costs from case recognition to December 2020 included healthcare expenditures (consultations, medications, hospitalizations, transport) and disability compensation (temporary/permanent indemnities). Sociodemographic, occupational, and clinical characteristics were recorded.

A total of 124 private textile workers with OA were included (86.3% women; mean age 42.7 ± 9.6 years; mean professional seniority 16.2 ± 8.4 years). Vegetable dust exposure accounted for 78% of cases. The median total direct cost per patient was 8,247 TND (IQR: 5,128–14,392). Healthcare costs represented 42% (IQR: 28–56%), and disability indemnities 58% of total expenditures. CNAM cumulative spending totaled 1,295,689 TND (IQR: 987,432–1,684,215 TND) during the study period.

Occupational asthma generates a substantial direct economic burden on Tunisia's private textile sector, with disability compensation as the predominant cost. These findings highlight the urgent need for preventive strategies, including dust exposure control and early detection in high-risk textile industries.