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     Table of Contents - Current issue
Coverpage
May-August 2016
Volume 20 | Issue 2
Page Nos. 71-121

Online since Wednesday, January 04, 2017

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EDITORIAL  

The health of the healthcare workers p. 71
Bobby Joseph, Merlyn Joseph
DOI:10.4103/0019-5278.197518  
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REVIEW ARTICLE Top

Research in occupational heat stress in India: Challenges and opportunities p. 73
Krishnan Srinivasan, KN Maruthy, Vidhya Venugopal, Padmavathi Ramaswamy
DOI:10.4103/0019-5278.197522  
Occupational heat stress is a major health burden with several potential negative health and well-being outcomes. It is only in the recent years medical research has addressed this risk factor. The aim of this paper is to present an overview of studies in the area of occupational heat stress and its health impacts. Research in occupational heat stress in developing countries like India is limited because of several challenges and constraints. Few challenges are permission from industries to publish the data, resistance for change from employers and workers, improper record of heat/any occupational disease by the employer or worker, study design, and paucity in number of studies. Proper education and guidelines can help to overcome some of the constraints. Proper and correct guidelines will help in mitigating the effects of excessive heat exposure on the health of workers. The studies in this area are limited, and the association between occupational heat exposure and health impacts is not clearly established. Hence, carefully designed studies are required to examine this association and thereby provide valuable information to protect worker's health.
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ORIGINAL ARTICLES Top

Estimation of work capacity and work ability among plantation workers in South India p. 79
Suguna Anbazhagan, Naveen Ramesh, A Surekha, Farah N Fathima, Melina , Anjali
DOI:10.4103/0019-5278.197525  
Background: Work capacity is the ability to perform real physical work, and work ability is a result of interaction of worker to his or her work that is how good a worker is at present, in near future, and how able is he or she to do his or her work with respect to work demands and health and mental resources. Objective: To assess the work capacity and work ability and to study the factors associated with work capacity and work ability of workers at a tea plantation in South India. Materials and Methods: A cross-sectional study was conducted at a tea plantation in Annamalai, South India, from March to May 2015. Data were collected using a structured interview schedule comprising of three parts as follows: sociodemographic data, work ability questionnaire, and work capacity assessment. Results: Of the 199 subjects participated in the study, majority [90 (45.3%)] were in the age group of 46-55 years, and 128 (64.3%) were females. Of the 199 workers, 12.6% had poor aerobic capacity (by Harvard Step test), 88.4% had an endurance of more than 1 h, 70.9% had better work productivity and energetic efficiency, and the voluntary activity workers spent most time on household chores. Of the 199 workers assessed, only 9.6% had good work ability. There is negative correlation between work ability and body mass index (BMI). Conclusion: Our study found 12.6% workers with poor aerobic capacity and 9.6% of workers with good work ability. Periodic health examinations and other screening procedures should be made as routine in workplace to improve work ability and capacity.
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Excessive sleepiness, sleep hygiene, and coping strategies among night bus drivers: A cross-sectional study p. 84
Uma Maheswari Krishnaswamy, Mamta S Chhabria, Aditi Rao
DOI:10.4103/0019-5278.197526  
Background: Sleep disruption and excessive sleepiness are the known consequences of shift work. The recent spate of night-time road and air accidents, with some being directly attributed to driver sleepiness prompted us to undertake this study. Aims: To screen for excessive sleepiness, coping practices, and post-shift sleep hygiene in night bus drivers. Settings and Design: This prospective study was carried out on night bus drivers of a public transport organization in Bengaluru, Karnataka, India. Materials and Methods: Bus drivers driving for ≥8 h at night were screened with the Epworth Sleepiness Scale (ESS) and a prevalidated shift work questionnaire. Statistical Analysis: Descriptive statistics were used to analyze the compiled data using Statistical Package for the Social Sciences (SPSS) version 20. Results: One hundred and eighty bus drivers aged 22-63 years were screened. Excessive Sleepiness: Although only 2 (1.1%) drivers scored above the cutoff on ESS, 10 (5.6%) and 103 (57.2%) drivers admitted to feeling sleepy during daytime and night driving respectively. None of the drivers admitted to causing accidents related to sleepiness. The coping strategies for nocturnal sleepiness included consuming coffee/tea (16.7%), chewing tobacco (12.8%), smoking (6.1%), and walking (3.9%). Post-Shift Sleep Practices: Post-shift sleep duration ranged between 1 h and 10 h. Twenty-six (14.4%) and 16 (8.9%) drivers had difficulty initiating and maintaining sleep, respectively, while 9 (5%) reported frequent awakening during daytime sleep. Conclusion and Implications: This study has demonstrated a high incidence of nocturnal sleepiness and daytime sleep disruption among night bus drivers, thus necessitating the need for education about shift work and alertness testing among shift workers in critical professions.
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Internet use at workplaces and its effects on working style in indian context: An exploration p. 88
Apoorva Shrivastava, Manoj K Sharma, P Marimuthu
DOI:10.4103/0019-5278.197531  
Background: Internet use has revolutionized the pattern of working style at the workplace. It led to an increased use for nonprofessional activities at the workplace. It has been shown to affect productivity at the workplace. There is a dearth of literature from the Indian context in this area. Aim: This study was conducted to explore the pattern of Internet use at the workplace and its dysfunctions. Setting and Design: The present study was a cross-sectional prospective study. Materials and Methods: The objective of the study was to assess the pattern of technology use at the workplace. Two hundred and fifty employees having experience of Internet use for more than a year of various Government/Private sector organizations in Bengaluru were assessed using background data sheet. Users who were unwilling to participate were excluded from the study. Results: 29.6% of the participants used mobile phone exclusively. 58.8% of the participants used mobile along with other devices such as desktop, laptop, and tablet at home as well as at work. 64% of the participants reported change in their productivity due to nonwork-related Internet use at the workplace. 42% of the participants acknowledgemed postponement of their work due to Internet activities. 3-5% reported preference for Internet to work, meals, personal hygiene, sleep, and interaction with family members. WhatsApp was the most used application followed by Facebook and Gmail. Gaming applications and messenger applications such as hike and hangouts were used less frequently. Overall, delay in going to sleep was 1.6 hours and early morning awakening was 1.5 hours due to Internet use. Conclusions: The present study has implications for evolving psychoeducational modules for the promotion of healthy use of technology.
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Asbestos-induced lung disease in small-scale clutch manufacturing workers p. 95
Dipti Gothi, Tanushree Gahlot, Ram B Sah, Mayank Saxena, UC Ojha, Anand K Verma, Sonam Spalgais
DOI:10.4103/0019-5278.197533  
Background: The crocidolite variety of asbestos is banned. However, chrysotile, which is not prohibited, is still used in developing countries in making products such as clutch plate. Fourteen workers from a small-scale clutch plate-manufacturing factory were analyzed for asbestos-induced lung disease as one of their colleagues had expired due to asbestosis. Aims: This study was conducted to evaluate the awareness of workers, the prevalence and type of asbestos-induced lung disease, and the sensitivity and specificity of diffusion test. Materials and Methods: History, examination, chest radiograph, spirometry with diffusion, and high resolution computed tomography (HRCT) thorax was performed in all the workers. The diagnosis of asbestos-induced lung disease was suspected on the basis of HRCT. This was subsequently confirmed on transbronchial lung biopsy (TBLB). Results: None of the workers had detailed information about asbestos and its ill effects. Eleven out of 14 (71.42%) workers had asbestos-induced lung disease. All 11 had small airway disease (SAD). Three had SAD alone, 6 had additional interstitial lung disease (ILD), and 2 patients had additional ILD and chronic obstructive pulmonary disease. Sensitivity and specificity of residual volume (RV) or total lung capacity (TLC) for detecting SAD was 90% and 100%, respectively, and that of diffusion capacity of lung for carbon monoxide (DLCO) for detecting ILD was 100%. Conclusion: The awareness about asbestos in small-scale clutch-plate manufacturing industry is poor. The usage of chrysotile should be strictly regulated as morbidity and mortality is high. DLCO and RV/TLC are sensitive and specific in detecting nonmalignant asbestos induced lung disease.
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Civil construction work: The unseen contributor to the occupational and global disease burden p. 103
R Sitalakshmi, P Saikumar, P Jeyachandran, Manoharan , Thangavel , Jayakar Thomas
DOI:10.4103/0019-5278.197542  
Background: Construction industry is the second largest employment giving industry in India with many semi-skilled or unskilled workers taking up the occupation for livelihood without any training and proper guidance. Aim: To evaluate the pathogenic association of cement exposure to occupational contact dermatoses as evidenced by immune markers and to correlate their pulmonary functions with years of exposure to cement. Setting and Design: This was a cross-sectional study conducted among randomly selected cement workers. Methods and material: Evaluation of socioeconomic status (SES) and years of exposure of cement workers was done using a questionnaire. Clinical examination of skin lesions and strip patch test with application of potassium dichromate on unexposed skin was performed. Results were interpreted after 48 hours. Absolute eosinophil count (AEC) and IgE levels measured, and spirometric evaluation was performed. Statistical Analysis: Analysis of variance and Pearson's correlation test were used for data analysis. P < 0.05 was considered to be statistically significant. Results: Clinically, skin lesions were noticed in 51%, elevated AEC in 47%, and raised Anti IgE in 73%. Two participants developed positive reactions to the skin strip patch test. Duration of exposure to cement and SES were compared with clinical skin lesions. Spirometry result was normal in 81%, obstruction in 8%, restriction in 10%, and mixed pattern in 1%. Forced expiratory volume at 1.0 second, forced expiratory flow (25-75%), and  (PEFR) Peak Expiratory Flow Rate were markedly reduced with years of exposure. Workers who had greater skin lesions and with increase in exposure had increased AEC and IgE levels, although statistically not significant. Conclusions: Exposure to cement and poor SES is strongly correlated to increased prevalence of skin lesions and reduced pulmonary functions.
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Association of quality of life and job stress in occupational workforce of India: Findings from a cross-sectional study on software professionals p. 109
Giridhara R Babu, Paulomi M Sudhir, Tanmay Mahapatra, Aritra Das, Mohanbabu Rathnaiah, Indiresh Anand, Roger Detels
DOI:10.4103/0019-5278.197544  
Background: There is limited scientific evidence on the relationship of job stress with quality of life (QoL). Purpose: This study aims to explore different domains of job stress affecting IT/ITES professionals and estimate the levels of stress that these professionals endure to reach positive levels of QoL given that other determinants operating between these two variables are accounted for. Materials and Methods: We estimated levels of stress that software professionals would have endured to reach positive levels of QoL considering that other factors operating between these two variables are accounted for. The study participants comprised 1071 software professionals who were recruited using a mixed sampling method. Participants answered a self-administered questionnaire containing questions on job stress, QoL, and confounders. Results: All the domains (physical, psychological, social, and environmental) of QoL showed statistically significant positive associations with increasing stress domains of autonomy, physical infrastructure, work environment, and emotional factors. Conclusions: The respondents clearly found the trade-off of higher stress to be acceptable for the improved QoL they enjoyed. It is also possible that stress might actually be responsible for improvements in QoL either directly or through mediation of variables such as personal values and aspirations. "Yerkes-Dodson law" and stress appraisal models of Folkman and Lazarus may explain the plausible positive association.
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CASE REPORTS Top

Silicosis in the form of progressive massive fibrosis: A diagnostic challenge p. 114
Somnath Bhattacharya, Atin Dey, Amitava Pal, Saurav Kar, Sayantan Saha
DOI:10.4103/0019-5278.197548  
Silicosis is a major occupational lung disease with a relatively fatal and irreversible outcome. Early diagnosis for shifting the potential candidates to safe modes of workplace as well as for prevention of further progression is the cornerstone of management. Here, we present a complicated case of silicosis in the form of progressive massive fibrosis, which was initially interpreted as tuberculosis; radiological images had resemblance with tuberculosis and cryptogenic organizing pneumonia. Radiology-guided trucut biopsy was imperative to confirm the diagnosis.
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Occupational bronchiolitis induced by cotton dust exposure in a nonsmoker p. 118
Richa Mittal, Pawan Gupta, Sunil K Chhabra
DOI:10.4103/0019-5278.197550  
The most well-known disease caused by cotton dust is byssinosis though it is also associated with chronic obstructive airways disease, and very rarely, interstitial lung disease. Obliterative bronchiolitis has never been reported in this setting. We report a 63-year-old, nonsmoker male, who presented with complaints of cough and exertional dyspnoea for 10 years. He had worked in textile industry for 35 years and symptoms had persisted even after quitting. Examination revealed prolonged expiration with expiratory wheeze, and pulmonary function tests revealed severe airflow limitation with air trapping and impaired diffusion capacity. Arterial blood gas analysis showed type I respiratory failure. A high resolution computed tomogram of the chest showed bilateral centrilobular nodules with tree-in-bud pattern and areas of air trapping. A diagnosis of obliterative bronchiolitis induced by cotton dust exposure was established on the basis of the occupational history and the characteristic radiological signs.
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LETTER TO THE EDITOR Top

Post hoc tests in analysis of variance p. 121
Anjali Mahajan
DOI:10.4103/0019-5278.197552  
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