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     Table of Contents - Current issue
Coverpage
October-December 2022
Volume 26 | Issue 4
Page Nos. 205-290

Online since Saturday, December 24, 2022

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EDITORIAL  

Digital therapeutics in diabetes: A significant tool to address employees' health and productivity p. 205
Arbinder Kumar Singal, Rajgopal Thirumalai
DOI:10.4103/ijoem.ijoem_309_22  
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REVIEW ARTICLE Top

Identifying predictors of workplace violence against healthcare professionals: A systematic review p. 207
Archana Kumari, Piyush Ranjan, Siddharth Sarkar, Sakshi Chopra, Tanveer Kaur, Upendra Baitha
DOI:10.4103/ijoem.ijoem_164_21  
Understanding the predictors of workplace violence amongst healthcare professionals is important to develop and implement prevention and mitigation strategies. We conducted a systematic review to synthesize the recent evidence on predictors of workplace violence across healthcare settings. The review has been done as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two electronic databases (PubMed and Google Scholar) were used to search peer-reviewed studies published for the year 2009-2020 to identify studies reporting predictors of workplace violence. The significant predictors were analyzed using descriptive statistics such as proportions in most of the studies and some studies used inferential statistics such as logistic regression analysis, Chi-square test, ANOVA and Student's t-test. A total of 46 studies were identified and overall evidence was graded using an adapted GRADE approach. Some of the moderate quality predictors associated with workplace violence were the patient with a history of mental health disease, psychiatric setting, professional's gender and work experience and evening shift workers. Being a nurse was the only high-quality predictor. Healthcare professionals and administration can identify the predictors relevant to their setting to mitigate episodes of violence against healthcare personnel.
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ORIGINAL ARTICLES Top

The effect of sleep quality and mental fatigue on the learning rate of shift workers with fast shift work rotation p. 225
Seyedeh A B. Naeini, Ehsanollah Habibi, Ismail Shokrolahi
DOI:10.4103/ijoem.ijoem_439_20  
Background: Modern industrial societies are always prone to errors and accidents due to complex devices, multitasking, and shift work jobs. Therefore, behavioral tests in learning and memory are necessary to evaluate employees' perceptions to examine the brain's information processing and the physiological and psychological aspects of memory disorders. Materials and Methods: In this study, the effect of fast shift rotation, sleep quality, and mental fatigue on individuals' learning and memory was investigated using a maze device. Participants were divided into two groups (regular daytime workers and shift workers). The quality of sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), and the rate of mental fatigue was evaluated using a checklist published by the Japan Industrial Safety and Health Association. Results: Learning time and the number of learning errors at the beginning and end of the morning shifts and night shifts had a significant relationship (P value <0.0001). However, there was no meaningful relationship between sleep quality and time and the number of learning errors in day workers and shift workers. Conclusion: The results indicated that although shift workers experience rapid shift rotation, they are still exposed to this circadian sleep change's side effects such as general physical fatigue, sensory-neurological fatigue, poor perceived sleep quality, daily dysfunction, difficulty in learning, and memory. They show a significant difference compared to people working on a regular workday.
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Unequal representation of persons with disabling mental health conditions in the quota-based employment reservations notified by a public service commission p. 230
Hareesh Angothu, Sharad Philip, Prabhu Jadhav, Deepak Jayarajan, Aarti Jagannathan, M Krishna Prasad, Jagadish Thirthalli
DOI:10.4103/ijoem.ijoem_239_21  
Introduction: The Rights of Persons with Disabilities (RPwD) Act 2016 of India intends to achieve greater representation of persons with benchmark disabilities (PwBD) at government establishments and reserve at least 4% of employment vacancies for PwBD. Of this 4%, 1% is reserved for PwBD with disabling mental health conditions (PwBD-MHC) and multiple disabilities, and 1% each for PwBD due to other disabling conditions like blindness, hearing, and locomotor impairment. Methods: We analyzed all the employment vacancy announcements (EVAs) made by the Indian union public service commission (UPSC) during the calendar year 2020 for their adherence to quota-based employment reservations (QBER). Results: Eighteen vacancy advertisements made during the year 2020, for a total of 1370 posts under various departments, announced a total of 57 posts as reserved for PwBD under the QBER system, satisfying the minimum 4% quota. However, none of these posts is reserved for PwBD-MHC. Further, only 7 out of 1370 were described as suitable for PwBD-MHC, implying that 1363 are not suitable for them. Conclusions: The QBER system and the subdivision of quotas are well-intended to achieve the minimum representation of PwBD across all categories of jobs. However, the EVAs by UPSC in the year 2020 did not reserve any posts for PwBD-MHC and perhaps inadvertently excluded them from consideration for the majority of posts announced even under the unreserved category.
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Intention to get vaccinated against COVID-19 in Iranian hospital staff: Application of the theory of planned behavior p. 234
Samane Shirahmadi, Salman Khazaei, Ebrahim Jalili, Hasan Kazemian, Mohadese Sadri, Abdollah Farhadinasab, Ensiyeh Jenabi, Saeid Bashirian
DOI:10.4103/ijoem.ijoem_336_21  
Background: This study aimed to identify the predictors of the intention to receive the COVID-19 vaccine among Iranian health care workers (HCWs) based on the Theory of Planned Behavior (TPB). Methods: The study was a descriptive cross-sectional study that was conducted on 473 personnel working in hospitals of Hamadan, in May 2021 and before COVID-19 vaccination on hospital staff. The multi-stage sampling method was used for choosing participants. The survey included socio-demographic, questions related to TPB dimensions, and intention to receive a COVID-19 vaccine. Qualitative and quantitative data analyses were performed using the Chi-square test and T-test, respectively. Predictors of COVID-19 vaccination intention were determined using the logistic regression model. Results: Seventy percent of 361 eligible respondents stated their willingness to receive COVID-19 vaccine. The participants with the intention to receive COVID-19 vaccine had higher scores of attitude (7.25 ± 3.92 vs. 4.40 ± 5.14) and norm (3.04 ± 2.92 vs. -0.5 ± 3.18) (P < 0.001). Having an underlying disease and being married were significantly associated with the intention to receive COVID-19 vaccine (P < 0.05). Higher attitude and norm scores as a construct of the TPB were associated with an increase in intention to receive COVID-19 vaccine. Conclusions: The results of this study showed that the vaccination intention was affected by social, demographic, health, and behavioral features, such as age, marital status, underlying diseases, subjective norms, and attitude. Therefore, age groups below 50, single people, and those with no underlying diseases were eligible to be the target of interventional programs.
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Cumulative noise exposure and perceived effects: A comparative study among different occupational groups in Kolkata p. 240
Arup Chakraborty, Arista Lahiri, Urmila Dasgupta, Asim Saha, Salil K Bhattacharya
DOI:10.4103/ijoem.ijoem_51_22  
Background: Adverse short-term and long-term health effects following a high level of noise have been established. The current study aims to find the relationship of these effects with an environment-specific level of noise exposure. Materials and Methods: A comparative cross-sectional study was conducted among 50 auto-rickshaw drivers and 51 age-matched service-sector employees. The peak average noise exposure in decibels (dB) was measured. The duration of exposure and response regarding perceptions following noise exposure was assessed through a pre-designed pre-tested semi-structured questionnaire. Results: The mean age of the participants was 42.24 (±13.72) years. Among the auto-rickshaw drivers, 82% perceived stress, 64% had hearing difficulty, and 74% complained of lack of sleep following exposure to a high level of noise. However, the perceptions were comparable among the comparison group and the differences were not statistically significant. The mean average peak level of noise exposure among drivers and their comparison group was 91.64 (±7.37) dB and 91.98 (± 8.06) dB, respectively, but were not different statistically. Around 52.94% of the service-sector respondents and 48% of the drivers were exposed to the lower cumulative noise levels. Those having a higher level of cumulative noise exposure, had a higher odds of feeling irritated (Odds ratio [OR]: 2.182, 95% confidence interval [CI]: 0.845–5.636), feeling stressed (OR: 5.805, 95% CI: 1.552–21.708), having palpitation (OR: 3.694, 95% CI: 1.264–10.793), and lack of sleep (OR: 3.020, 95% CI: 1.006–9.066). Conclusion: Stress and lack of sleep were the most important perceived effects of noise exposure. The exposures to the higher cumulative noise level in specified groups were more important in relation to quantifying perceived symptoms than the average peak noise level.
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Explaining the challenges of coping with coronavirus crisis in the workplaces: A qualitative study p. 245
Abdolhamid Tajvar, Zahra Hosseini, Mohammadreza Farahbakhsh, Anahita Fakherpour, Atefeh Homayuni
DOI:10.4103/ijoem.ijoem_26_22  
Background: Workplaces play a highly important role in controlling or spreading the prevalence of coronavirus disease 2019 (COVID-19). Therefore, the lack of proper implementation of hygienic protocols in these environments might increase the risk of getting infected with the COVID-19 among the employees, following the increase of the COVID-19 at the family and community levels. This qualitative study aims to explain the challenges of coping with the coronavirus crisis in the workplaces. Methods: The present qualitative study was conducted with a conventional content analysis approach. We used purposeful sampling with maximum diversity in terms of working processes. Data were collected through semi-structured interviews. Interviews were performed to the point of information saturation. MAXQDA software version 10 was used for data management. Results: Through the content analysis of the interviews with the participants, we identified two main classes and nine sub-classes. The main classes included intra-organizational challenges (job nature, budget allocation problems, individual factors, disorganization, manpower and equipment, lack of commitment, and insufficient support of managers) and extra-organizational challenges (lack of accessibility to valid information, black market, and inter-sectorial coordination problems). Conclusion: The study findings indicated that organizations and industries face numerous internal and external challenges in coping with the COVID-19 pandemic. Paying attention to the mentioned limitations and attempting to eliminate them, especially by the governmental organizations, employers, and managers, could help in effectively confronting the COVID-19 pandemic.
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Effect of full-face and half-face helmet on functional vision and visual reaction time p. 251
Farhatbee N Kazi, Hiral Korani, Prema Chande
DOI:10.4103/ijoem.ijoem_459_20  
Background: Motorcycle helmets are one of the most important protective gears in the automotive industry. However, some riders think they hinder their vision, which leads to helmet non-compliance.Hence, thorough research is required to evaluate the same. Aim and Objective: To assess the effect of full-face and half-face helmets on functional vision and visual reaction time (VRT). Setting and Study Design: Comparative experimental crossover study. Methods: The subjects aged between 18 and 35 years and who gave written consent to participate were included. Functional vision and VRT were assessed with and without the helmets. Helmets tested included a full-face helmet and a half-face helmet. Results: A total of 52 subjects aged 20 ± 1.5 years, participated in the study. Of those, 16 were males and 36 were females. The mean stereopsis without any helmet was 44.42 ± 6.3 arcs of second that reduced to 60.57 ± 13.34 arcs of second with a full-face helmet and to 60.38 ± 14.27 arcs of second with a half-face helmet. Repeated-measure analysis of variance showed a significant reduction in stereopsis in both types of helmets (P < 0.05) as compared to without a helmet. However, contrast sensitivity, VRT, and visual field did not show any significant difference (p > 0.05) when compared to the baseline or within the helmet types. Conclusion: The visor significantly affects the stereopsis while viewing through it. The study did not find the exact cause of this reduction, and hence, further evaluation is recommended.
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Health problems and healthcare-seeking practices of workers processing E-waste in the unorganized sector in the slums of a South Indian City: An exploratory study p. 255
Sapna Mishra, P Sankara Sarma, Rakhal Gaitonde
DOI:10.4103/ijoem.ijoem_65_22  
Context: The precarious nature of the work in the unorganized e-waste processing sector poses a threat to workers' health by making them vulnerable to occupational injuries as well as other work-related diseases in addition to job insecurity and related issues. Aims: To systematically explore and quantify employment and working conditions along with the occupational health problems and healthcare-seeking practices of workers processing e-waste in the slums of a south Indian city. Settings and Design: Cross-sectional study conducted in the slums of a south Indian city. Methods and Material: We used a structured interview schedule among 248 randomly selected workers. Statistical Analysis Used: Descriptive statistics were utilized to summarize the results. 95% CI was calculated for select proportions. Chi-square tests were used to determine statistical significance. Results: We found a predominance of self-employment; unclear employment relationship; no paid holidays; long working hours; unequal wages; absence of work-related social security; absent workers' organization; rented units; minimal/no use of safety equipment, no concept of good ergonomic practices. The commonest occupational health concerns were injuries (17% & 41% respectively) and musculoskeletal problems (43.5%). Private/charitable clinics were the commonest source of seeking healthcare which contributed to 'irrational' practices in the form of repeated TT injections. Conclusions: Findings suggest that the precarious work in the unorganized e-waste processing sector could not only give rise to health problems but also make workers undermine the severity of their health problems. The non-responsiveness of the local public healthcare system compels them to rely on private and charitable clinics and pay for services that are otherwise freely available in UPHCs.
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Obesity burden and physical activity pattern among doctors in South India Highly accessed article p. 261
Anjana Nalina Kumari Kesavan Nair, Tony Lawrence, Pillaveetil Sathyadas Indu
DOI:10.4103/ijoem.ijoem_67_22  
Context: A career as a doctor makes him prone to develop health issues like obesity and obesity-related noncommunicable diseases. Aims: This study aims to find the burden and determinants of obesity among Modern Medicine doctors in Kerala. Settings and Design: We conducted a cross-sectional study among 240 doctors working in South Kerala from 2018 to 2019. Methods and Material: The sample size was calculated using a formula and stratified random sampling was done for the selection of study participants. An interviewer-administered structured questionnaire was used for data collection. Physical activity was measured using International Physical Activity Questionnaire. Statistical Analysis: Data were entered in MS Excel and was analyzed using Statistical Package for Social Sciences version 26.0. The significance of association was tested using the χ2 test. Binary logistic regression was done to predict the factors associated with overweight and obesity. Results: Out of 240 study participants, 128 (54%) were females and 112 (46%) were males. Among the 240 doctors, 54% (114) were either overweight or obese. A low level of physical activity was reported among 54.5% of doctors. Male gender odds ratio (OR) = 2.8 (95% confidence interval [CI] = 1.29-6.06), nuclear family OR = 2.7 (95% CI = 1.32-5.42), daily hours of sleep <6 hours OR = 4.92 (95% CI = 2.29-10.5), history of obesity among parents OR = 3.54 (95% CI = 1.04-12.02), reported the presence of private practice OR = 3.34 (95% CI = 1.25-8.96), and holding a graduation degree alone were found to be significantly associated with obesity. Conclusions: The study found that majority of the doctors (55%) were either overweight or obese. Awareness and behavior change communication among doctors on modifiable risk factors like having adequate sleep and reducing the hours spent in private practice is needed to reduce the burden of obesity among doctors.
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Driving fine and its relationship with dangerous driving behaviour among heavy vehicle Drivers p. 266
Masoud Motalebi Kashani, Hossein Akbari, Hamidreza Saberi, Reihaneh Ghorbanipour, Fahimeh Karamali
DOI:10.4103/ijoem.ijoem_45_22  
Context: There is a significant difference between actual and existing statistics of traffic fines; since some invisible fines and most of the visible traffic violations cannot be recorded by traffic officers. Therefore, dealing with driving fines and road fatalities is considered an important issue in social and public management worldwide. Aims: Explore the factors associated with unsafe behaviors and getting traffic fines among a sample of Iranian heavy-vehicle professional drivers. Settings and Design: The present cross-sectional study was conducted in Iran, from February 2019 to September 2020. Methods and Material: This study used the driver behavior questionnaire (DBQ), demographic and driving characteristics, the number of fines, and structural equation modeling. Also, in this study 320 professional drivers participated. Statistical Analysis Used: This article used structural equation modeling for Statistical analysis. Results: The results of structural equation modeling analysis indicated that the data fit well with the theoretical model proposed in this study. The number of fines was directly predicted by both demographic and driving characteristics and risky driving behaviors. A significant relationship was observed between, driving hours, driving experience, and smoking, respectively, with a mistake, slip, and risky violation. There was a negative correlation between education and all four sub-scales of risky driving behaviors. Conclusions: In order to reduce traffic fines, training courses on increasing attention and precision in drivers' observations and judgments are useful. The courses can decrease traffic violations by trying to change beliefs, attitudes, and social norms. It is therefore helpful to understand the ways to change the drivers' attitudes.
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The mental health of health care workers in the UK during COVID-19: The prevalence of anxiety, depression, and stress p. 273
Ravi Chotalia, Mohammed J Abbas, Alisha Aggarwal
DOI:10.4103/ijoem.ijoem_69_22  
Introduction: The COVID-19 pandemic had a significant impact on the mental health of health care workers (HCWs). Aim: This study investigated the mental health of HCWs working in Leicester, UK during COVID-19. Settings: Two hospital trusts in Leicester, UK. Methods: An online survey was sent to HCWs in two trusts in July 2020. The Generalized Anxiety Disorder-7 scale (GAD-7) and the Patient Health Questionnaire-9 scale (PHQ-9) were used to measure the prevalence rates of anxiety and depression. The Perceived Stress Scale-14 (PSS-14) was used to measure levels of perceived stress. Other questions were used to identify the prevalence of increased alcohol intake and possible risk factors. Statistical Analysis Used: Chi-square test, independent sample t-test, ANOVA, and logistic regression. Results: A total of 1009 HCWs completed the survey. Using a cutoff score of 5 (mild symptoms), for both GAD-7 and PHQ-9, 80.2% of participants had at least one condition and 71.5% had both. Using the cutoff score of 10 (moderate/severe symptoms), 27.2% had at least one condition and 27.25% had both conditions. In addition, 37.5% of those who did not report pre-existing mental health conditions now have at least one condition. About 33.6% of participants reported an increase in alcohol consumption. A number of risk factors were identified: having less social support, not feeling supported at work, and poor pre-existing mental health. Conclusions: The pandemic had a significant impact on mental health of HCWs. Health organizations need to monitor and address these emerging effects.
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Occupational health hazards of rickshaw pullers in lower middle income Country, India p. 281
Panna Lal, Mohit Batra, Madan M Majhi, Pragya Ahuja, Nidhi Bhatnagar
DOI:10.4103/ijoem.ijoem_113_21  
Background: Rickshaw pullers work in unorganized sector. Ignorance, poverty, and strenuous physical exertion make them vulnerable to ill health and disease. Objectives: To assess the magnitude and pattern of morbidity, associated sociodemographic factors, and health-seeking behavior of the participants. Materials and Methods: A cross-sectional study was conducted on 305 participants. Predesigned, pretested questionnaire was used for data collection. Statistical Package for the Social Sciences (SPSS) 16 version was used for data analysis. Results: About 61% of the participants had morbidity in their lifetime and 49.5% fell sick in the last 15 days. Substance abuse in any form was reported by 73.1%. Grade-1 hypertension was reported in 28.2% and 7.5% was having grade-2 hypertension. Age, monthly income, substance abuse, and availing of health services were significantly associated with the development of health problems. Conclusion: Need to devise interventions that will focus on health awareness and early health-seeking behavior among the participants.
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CASE REPORT Top

Erasmus syndrome: A case series of rare co-occurrence of silicosis and systemic sclerosis p. 285
VM Jaanakhi, Batoee Ram, Mohammad Javed Qureshi, Manisha Jain, Sumeet Sawale
DOI:10.4103/ijoem.ijoem_362_21  
Erasmus syndrome is the association of silica exposure and subsequent development of systemic sclerosis. Here we discuss five cases that presented with progressive shortness of breath, arthralgia, skin tightening, and Raynaud's phenomenon. History of exposure to silica dust was present in all cases, and further serological (Anti-Scl-70 antibody positive), radiological, and histopathological (skin biopsy) investigations confirmed the diagnosis of systemic sclerosis. Hence the diagnosis of Erasmus syndrome was made. Therefore, careful screening should be done in patients of silicosis with systemic symptoms to rule out any associated connective tissue disorder. Timely diagnosis and early intervention can prevent the patients from developing life-threatening complications and improved quality of life.
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LETTER TO EDITOR Top

Predisposition of medical professionals to cancer: Are we ignoring a demon? p. 289
Asmita Chakrabarti, Sumit R Chowdhury, Avishek Roy
DOI:10.4103/ijoem.ijoem_70_22  
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