Occupational Morbidity and Associated Determinants Among Automobile Service and Repair Workers in Enugu Metropolis, Nigeria: A Cross-Sectional Study

Automobile service and repair workers in Nigeria's informal economy face chronic exposures to chemical, physical, ergonomic, and psychosocial hazards. Despite the large size of this workforce in Enugu State, South-Eastern Nigeria, their occupational health profile has remained undocumented, impeding evidence-based policy development. Objective: To assess the prevalence and pattern of occupational morbidity, personal protective equipment (PPE) usage, hazard awareness, and social security coverage, and to identify determinants of reduced pulmonary function and peripheral sensory impairment among automobile service and repair workers in Enugu metropolis. Methods: A cross-sectional observational study was conducted between January and April 2024. Of 150 workers approached from five major workshop clusters, 138 (92.0%) provided complete responses. A semi-structured bilingual interviewer-administered questionnaire collected data on sociodemographic characteristics, occupational exposures, symptoms, PPE use, and health awareness. Targeted clinical examinations included peripheral sensory assessment (2-gram Semmes-Weinstein monofilament; 10-site plantar protocol) and peak expiratory flow rate (PEFR) measurement. Chi-square tests and multivariable binary logistic regression with crude and adjusted odds ratios were used for analysis (IBM SPSS v.26.0; significance: p < 0.05). Results: Participants had a mean age of 32.4 ± 10.6 years and were predominantly male (95.7%). Petroleum product exposure was near-universal (91.3%). Only 8.7% used PPE regularly. Common morbidities included peripheral sensory impairment (47.8%), musculoskeletal complaints (46.4%), gastrointestinal symptoms (30.4%), and unintentional injuries (26.1%). Reduced PEFR (<300 L/min) was recorded in 17.4%. On multivariable regression, heavy metal exposure was the strongest predictor of both reduced PEFR (adjusted OR = 6.74, 95% CI: 2.18-20.85, p = 0.001) and peripheral sensory impairment (adjusted OR = 5.16, 95% CI: 1.62-16.42, p = 0.005). Years of service exceeding five years independently predicted peripheral sensory impairment (adjusted OR = 4.21, 95% CI: 1.88-9.43, p = 0.001). Conclusion: Automobile repair workers in Enugu carry a high and clinically significant burden of work-related morbidity compounded by critically low PPE use and near-universal absence of social security protection. Urgent priorities include occupational health surveillance programmes, mandatory PPE provision, and extension of National Health Insurance Authority coverage to informal sector workers.