Brick by brick, breath by breath

Nepali brick kiln workers fire and make bricks for twelve hours a day, breathing in crystalline silica that scars their lungs. BYU students Esther Erickson and Mariah Taylor used travel grants given by generous donors to learn more about the air the kiln workers breathe and how it affects their lungs.

Four workers stand before large walls of red brick stacked atop orange soil. Two workers carry large stacks of red bricks on their backs while two workers heave bricks onto their backs.

Red dust clings to every surface as brick kiln workers fire bricks for twelve hours a day. The dust, smoke, and dirt hang in the air with a sharpness that twinges the nose. Stained and sweat-streaked workers carry stacks of newly-fired bricks, organizing them in walls that surround the kiln. At the end of the day, they walk to their seasonal home outside and rest before repeating the process again tomorrow. This is their life in Bhaktapur, Nepal from December to late May, outside of monsoon season.

BYU travel grant recipients Esther Erickson (‘22) and Mariah Taylor (‘22) witnessed firsthand what the brick kiln workers go through every day, diving deeper than the dust-covered surface to observe the workers’ lungs as they breathed in sharp crystalline particles called silica, which is in the brick dust.

“Particulate matter and silica in the air is not something your body can get used to. It’s not like bacteria where you can develop immunity to it,” Erickson explains. “It can build up in your lungs and cause scarring.” Erickson says the kiln workers’ lungs are shaped differently than average because of the repeated exposure to the silica. This is what makes the situation different for the Bhaktapur kiln workers as compared to a regular office job, where an employee will most likely be breathing filtered air.

Nepal already has low air quality that can hardly be compared to a hazy day in Utah Valley. Erickson said statistics in Nepal show that Nepal’s every day air is more than five times worse than Utah’s is on a bad day.

Public health professor Steven Thygerson led the trip to Nepal. Erickson and Taylor worked in a team with other BYU students, including Haley McBride (‘22). The public health students were able to travel thanks to generous donations. The group researched under a Johns Hopkins University research management team to test the effects of the air the workers are breathing. The equipment and data entry system went through Johns Hopkins staff, who were trained before the BYU travel grant recipients arrived.

Erickson and Taylor spent time at different kilns in two-to-three-day increments in the five weeks they were in Bhaktapur. Taylor explains that there are hundreds of brick kilns throughout Nepal, but their research time only focused on sixty kilns in the city of Bhaktapur.

Kiln managers, employed by Johns Hopkins, selected workers to participate in the research. The workers were fitted with vests that had tubes and filters to measure the silica in the air around them as they worked. They wore the vests from 6 a.m. until about 12 p.m., measuring in increments comparable to the average American eight-hour workday. The vests were removed when the workers took their lunch break.

A brown man with a blue head covering wears a bright orange vest with a tube circling the side of it while other kiln workers look on in the background, all standing on red soil.

Researchers also asked workers what they used to heat their homes and what they used for electricity “to get a general idea of their other exposure levels not directly related to their work,” says Taylor. Then the process started over again with the next shift.

A man wearing a red camouflage shirt and blue pants holds a device in his hands and mouth with his nose pinched closed with a blue clip while a person in a blue baseball cap watches and someone in a pink coat takes notes on white paper in the foreground.

Erickson, who observed some participant CT scans, said that the workers’ lungs are shaped differently from average lungs. She described average lungs as oblong, while kiln workers’ lungs are rounded. “They’re barrel chested, kind of collapsing outwards,” Erickson describes.

Taylor compares the workers’ breathing capacity to that of a person who heavily smokes and wheezes just trying to get air in their lungs. Erickson says they gave some of the younger workers—who were in their later teens—inhalers, testing their breath before and after the inhaler. They saw a significant difference once the inhaler was used.

While Erickson, Taylor, and their team did not work on solution development for the brick kiln workers, their research will be used by the Johns Hopkins staff in Nepal, who work full-time to improve the air conditions for the seasonal workers.