Monday morning sees many workers in Pakistan’s spinning and weaving factories complain of chest pain and shortness of breath. Commonly known as ‘Monday fever’, these symptoms are actually signs of respiratory disease which resurface as employees return to work and become exposed to cotton dust. Cotton dust is a colourless, odourless, substance that is an unavoidable byproduct of the process that converts raw cotton into yarn or yarn into fabric. Exposure to this health hazard causes short-term irritation in the nose, eyes and chest; and long-term damage to the lungs leading to chronic respiratory diseases like bysinossis.In a previous study, researchers from Aga Khan University found that 90 per cent of textile labourers had little knowledge of the risks posed by cotton dust. The same set of researchers are set to partner with 28 textile mills in Karachi’s industrial areas and prominent industry trade bodies on the MultiTex randomised controlled trial. The trial will assess the effectiveness of four convenient, low-cost measures in reducing cotton dust levels in the sector which employs 40 per cent of Pakistan’s industrial workforce.Initiatives include the provision of free, disposable face masks to workers, training sessions and refresher courses for both managers and employees on health and safety, and the formation of workplace committees tasked with implementing safety procedures.The study will see researchers evaluate whether these initiatives can reduce the presence of the harmful substance in the workplace and the extent to which these interventions are improving the health of the workforce.“Respiratory illnesses are one of the leading causes of death in Pakistan,” said WHO National Professional Officer Shehzad Alam. “This study has the potential to protect textile workers from a chronic disease and to raise awareness of the need for robust occupational health and safety programmes. Moreover, since the research is being done in partnership with mills and trade bodies we anticipate that findings will be quickly implemented by industry.”The study’s objectives are in line with the Sustainable Development Goals which call for targeted efforts to reduce the burden of chronic respiratory disease (Goal 3.4.1) and to promote safe and secure workplace environments (Goal 8.8).“Our study brings together employees and managers to achieve a common good,” said Dr Asaad Nafees, an assistant professor in community health sciences at AKU. “We hope to demonstrate how such collaborations can boost employee health while delivering important secondary benefits in the form of productivity improvements, compliance with global health and safety protocols and industrial growth.”MultiTex has been funded by a grant from the UK’s Wellcome Trust which supports innovative ideas to improve health. The trial is being conducted in partnership with the Towel Manufacturers Association and talks are ongoing with other trade bodies. Co-investigators on the study include faculty from the National Heart and Lung Institute at Imperial College London.