Exposure to cement industry emissions and respiratory health outcomes: a global systematic review and meta-analysis from 2000 to 2025

Abstract

Introduction Cement manufacturing is a major contributor to industrial air pollution and releases particulate matter and toxic emissions, adversely affecting the respiratory health. Previous studies have reported respiratory impairment and its associated symptoms among exposed populations, yet the evidence remains inconsistent across occupational and residential settings. This systematic review and meta-analysis is aimed to quantify the association between exposure to cement factory emissions and respiratory health outcomes, including lung function impairment and respiratory symptoms, among occupationally and environmentally exposed populations. Methods A systematic search was conducted in PubMed, Scopus, Web of Science and Google scholar was conducted for studies published between January 2000 and December 2025. Observational studies assessing exposure to cement dust and respiratory outcomes among workers or nearby residents were included. Primary outcomes included Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), FEV1/FVC ratio, and respiratory symptoms. Random effects model was used to perform meta-analysis using standardized mean differences (SMDs) and risk differences (RDs) with 95% confidence intervals (CIs). Results A total of 18 studies were included. Exposure to cement factory dust was associated with significant reductions in FEV1 (SMD = −0.71), FVC (SMD = −0.56), and FEV1/FVC ratio (SMD = −0.57). Chronic cough was significantly more common among exposed individuals, while other respiratory symptoms showed elevated but non-significant risks. Occupational exposure to cement dust exposure demonstrated greater FEV1 impairment than residential exposure. Conclusion Cement factory emissions are significantly associated with impaired pulmonary function and increased respiratory morbidity, highlighting the need for improved occupational safety measures and environmental emission controls. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/view/CRD420251268913, CRD420251268913.