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     Table of Contents - Current issue
Coverpage
July-September 2022
Volume 26 | Issue 3
Page Nos. 135-204

Online since Monday, September 26, 2022

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EDITORIAL  

Occupational ergonomics: A special domain for the benefit of workers' health p. 135
Somnath Gangopadhyay
DOI:10.4103/ijoem.ijoem_209_22  
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ORIGINAL ARTICLES Top

Prevalence of physical and psychological impacts of wearing personal protective equipment on health care workers during COVID-19: A systematic review and meta-analysis p. 140
K Radha, Gigini George, Abin Varghese, Jaison Joseph, N Vijayanarayanan
DOI:10.4103/ijoem.ijoem_32_22  
Background: The COVID-19 pandemic has necessitated the use of personal protective equipment (PPE) among the frontline health care workers (HCWs). Even though PPE helps in preventing infection, it poses significant physical and psychological impacts at varying levels. Correspondingly, multiple independent studies have brought out the PPE-associated problems. However, there exists a lacuna on comprehensive information of global prevalence related to the same. Aim: To estimate the prevalence and risk factors of PPE among HCWs during COVID-19 across the globe. Design: Systematic review and meta-analysis. Method: The review was undertaken as per the protocol registered in PROSPERO CRD42021272216 following Preferred Reporting Items for Systematic Reviews and Meta-Analysis(PRISMA) guidelines. Two independent reviewers have undertaken the search strategy, study selection, and methodological quality assessment. Discrepancies were addressed by the third reviewer. Heterogeneity was addressed through I2 statistics and forest plots generated by open meta-software. Results: A total of 16 articles conducted across 6 different countries among 10,182 HCWs were included in the review. The pooled prevalence of skin lesions, headache, sweating, breathing difficulty, vision difficulty, thirst/dry mouth, fatigue, and communication difficulty, anxiety, fear were 57 (47–66%), 51 (37–64%), 75 (56–90%), 44 (23–68%), 61 (21–94%), 54 (30–77%), 67 (58–76%), 74 (47–94%), 28 (24–33%), 14 (10–17%), respectively. Moreover, the various risk factors included are the use of PPE for >6 h and young females. In addition, the medical management of new-onset problems created an additional burden on the frontline health care personnel (HCP). Conclusion: The frontline HCWs encountered physical and psychological problems at varying levels as a result of wearing PPE which needs to be addressed to prevent the inadequate use of PPE leading to infections.
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Job satisfaction among resident doctors of a Tertiary Care Hospital in South Delhi p. 151
D Vinoth Gnana Chellaiyan, Sujata Gupta, J Jennifer Britto, Bhusan Kamble
DOI:10.4103/ijoem.ijoem_319_21  
Background: Doctors' job satisfaction is crucial to the health service to ensure commitment, effective training, service provision, and retention. Job satisfaction matters to doctors for their happiness, fulfilment, service to patients, and duty to employers. The quality of performance in the health sector to a large extent depends on whether healthcare providers are job-satisfied or dissatisfied. Objectives: This study assessed the level and factors determining job satisfaction among resident doctors in a federal tertiary institution. Material and Methods: A cross-sectional study was conducted among the resident doctors of a government tertiary care hospital. Data were collected using a self-reported questionnaire consisting of 49 items under seven domains of job satisfaction, where higher values indicated a higher level of satisfaction. The average scores of items were computed to construct factor scores for each individual. A Chi-square test was applied. Results: The proportion of job satisfaction among resident doctors was found to be 80.9%. On adjustment, the odds of being satisfied were found to be higher in the older age groups, among males, and doctors posted in clinical departments. Conclusion: Most respondents in this study were satisfied with their jobs with minorities satisfied with their monetary and infrastructure facilities. There is a need to address these issues to enhance healthcare quality, especially in the public sector.
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How Covid-19 affected the work prospects and healthcare-seeking of women domestic workers in Kolkata City, India? A longitudinal study p. 157
Shibaji Gupta, Debasis Das, Salil K Bhattacharya, Sharmistha S Gupta
DOI:10.4103/ijoem.ijoem_346_21  
Background: Self-negligence, societal neglect, and lack of access to adequate health care make domestic workers vulnerable to ill-health. COVID-19 has adversely affected the work prospects of people across social classes and their health care-seeking opportunities as well. We studied the impact of COVID-19 pandemic on work prospects and health care-seeking behavior of a vulnerable section of the society – the women domestic workers. Methods: A longitudinal analysis on 292 randomly selected women domestic workers residing in slums of “Kalikapur” locality of Kolkata city, West Bengal (India). Data were collected using a predesigned and pretested schedule twice: in early-2020 (before severe impact of COVID-19) and mid-2020 (during the pandemic ravaging India). Paired t-test and McNemar's test were used to check for significant changes. Result: Of all the participants, 57.2% lost jobs partially while 2.7% were completely jobless in mid-2020; the average daily work-hour decreased by 25.7%. Their average monthly pay significantly reduced (P < 0.05); mean family income in mid-2020 was lesser as well, compared to earlier (P < 0.05). Compared to early-2020, 15.8% more participants were sole bread-winners for their families during COVID-19. Number of participants visiting health practitioners significantly reduced (P < 0.05) in mid-2020. Rise in over-the-counter medicine use (P < 0.05) and increased tendency to ignore symptoms (P < 0.05) during COVID-19 was noted. Conclusion: The COVID-19 pandemic has affected work prospects and health care-seeking behavior of women domestic workers negatively. Most of them faced wage reduction, many becoming sole-earners for their families. This necessitates continued formulation and implementation of strategies ensuring social benefits including healthcare. Awareness about affordable healthcare and ill-effects of bad practices like self-medication should also be built.
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Geographical information system–Aided noise pollution mapping of urban Puducherry, South India p. 165
James T Devasia, Mahalakshmy Thulasingam, Subitha Lakshminarayanan, Bijaya N Naik, Sabesan Shanmugavelu, Hari K Raju, KC Premarajan
DOI:10.4103/ijoem.ijoem_245_21  
Context: Noise pollution and its influence on environmental and quality of human life are a major concern and hot topic of scientific research in the twenty-first century. Aims: Spatial analysis of noise pollution in urban Puducherry, South India. Settings and Design: Cross-sectional study conducted in 36 locations of urban Puducherry. Methods and Material: Noise measurements were taken using a calibrated NOR 132 digital sound level meter using the prescribed parameters set by the Central Pollution Control Board. Geo coordinates were taken using Garmin Oregon 550 GPS. Noise measurements were classified according to the Bureau of Indian Standards for town planning into five zones. Statistical Analysis Used: Noise pollution map of urban Puducherry for three time points of the day was generated using ArcGIS Desktop v10.3 with Geo-statistical module and Inverse Distance method. Results: Seventeen percent of the sites are high noise sources (80–90 dB), two thirds (65%) of the study sites fall into concentrated average noise zones (70–80 dB), and less than one fifth (18%) of the study sites are in relatively quiet zones across different measurement time slots. Conclusions: Long-term strategy for noise control should be incorporated in the development of new townships and other infrastructures in accordance with the noise control norms. Implications for future research include monitoring noise pollution levels in rural areas and health effects of noise pollution in bystanders and drivers.
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Oral health status and treatment needs of chromium mine workers in India p. 172
Sandeep Kumar, Priyaranjan , Debashish Basak, Barun Dasgupta, Syeda S Nastaran Quazi, Ashish Kumar
DOI:10.4103/ijoem.ijoem_223_21  
Background: Several diseases are related to occupation. The workers in chromium mines may be exposed to hazardous environments. The objective of this research was to evaluate the oral health condition and treatment needs of chromium mine workers. Materials and Methods: This was a cross-sectional study conducted on workers in the chromium mines located in the Jajpur district, Odisha. The study included a total of 453 mine workers. The World Health Organization (WHO) oral health assessment proforma (1997) was used to assess the oral health status and treatment needs of the workers. Face-to-face interviews were conducted to acquire information on socio-demographic data, along with clinical examinations of type III. Frequency distribution analysis and independent-sample t-test were performed. Results: The majority of mineworkers demonstrated poor oral health status with high caries experience (Decayed Missing and Filled Tooth (DMFT) = 3.13 ± 1.82). The prevalence of tobacco consumption was very prevalent among them (74.8%). Leukoplakia (13.2%) was the most commonly noted oromucosal lesions. The buccal mucosa (16.8%) and commissures of the lips (3.3%) were the most common affected sites. Most workers demonstrated poor periodontal conditions. More than half of the mine workers (53.6%) showed malocclusion. Restoration, extraction, and pulp care were needed in most of the workers. Conclusion: A critical intervention should be provided to promote oral hygiene among Indian chromium mine workers. Dental health education and tobacco cessation programs are of utmost importance to improve the health conditions of these workers.
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Work-related musculoskeletal disorders and quality of life among staff nurses in a Tertiary Care Hospital of Bangalore p. 178
Kona Chandralekha, Merlyn Joseph, Bobby Joseph
DOI:10.4103/ijoem.ijoem_25_22  
Background: Work-related musculoskeletal disorder (WMSD) is a collective and descriptive term used for the symptoms caused or aggravated by work. Significant WMSDs can affect the productivity and Quality of Life (QOL) of nurses. This study was undertaken to estimate the prevalence of WMSDs, identify their risk factors, and find the association, if any. This study also assessed the quality of life of nurses and its association with WMSDs. Methods: This cross-sectional study was conducted among 207 staff nurses at a tertiary care hospital in Bangalore for a period of 7 months (June-2018 to Dec-2018). The nurses were stratified based on their parent department into three broad categories – Medical, Surgical, and Operation Theatre. Stratified random sampling was followed to obtain the required number of nurses from each stratum. Data was collected using a pre-tested semi-structured questionnaire, Nordic Musculoskeletal Questionnaire (NMQ), clinical examination tests, and WHOQOL-BREF. Results: The annual prevalence of WMSDs among the study subjects using NMQ was 168 (81.2%). The prevalence of WMSDs based on clinical examination tests was 67 (32.4%). Repetitive movements at work (OR 9.3, 95% CI 3.4-25.7), working in abnormal postures for prolonged periods (OR 4.7, 95% CI 1.7-12.9), and working even when sick (OR 5.3, 95% CI 2.0-14.1) were the risk factors for WMSDs (P < 0.05). No significant association was found between reported WMSDs (according to NMQ) and QOL. Conclusion: Our study found that the prevalence of WMSDs was high among the staff nurses and it did not affect their QOL significantly. Workshops and training sessions on ergonomics should be regularly conducted at the workplace to prevent WMSDs.
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BRIEF COMMUNICATIONS Top

Assessment of occupational noise generation and associated noise-induced hearing loss among employees of a black tea processing factory in Darjeeling District, India p. 183
Alapan Bandyopadhyay, Rishav Ghosal, Pallabi Dasgupta, Abhijit Mukherjee
DOI:10.4103/ijoem.ijoem_356_21  
Introduction: Exposure to high levels of noise is a problem among tea factory workers worldwide, but it is poorly studied in India. Aims: This study aimed to assess noise generation in various parts of a black tea factory and find out prevalence of occupational noise-induced hearing loss (ONIHL) and its determinants among employees. Materials and Methods: An observational cross-sectional study was performed in a black tea processing factory of Darjeeling District. Noise levels and exposure data at different parts of the factory were measured using a sound level meter. Participant characteristics were obtained using a questionnaire and noise-induced hearing loss data obtained by audiometry. A sound map was generated based on noise exposure data and a multivariable logistic regression performed to assess determinants of ONIHL. Results: Sound pressure levels ranged from 58.7 to 90.3 dBA, with the highest levels in the crushing–tearing–curling (CTC) room. Noise exposure of workers was the highest during curling process and the lowest during packaging in the packing room. The prevalence of ONIHL was found to be 28.3%, most of which were of moderate degree, and the highest prevalence was among CTC room workers. Multivariable analysis showed significant association only between daily noise exposure and the presence of ONIHL (AOR 1.68, P value = 0.018). None of the study participants used any hearing protection equipment during work. Conclusions: Generation of high levels of noise is a pertinent problem in the black tea factory, which, coupled with non-use of personal protective equipment, led to a high risk and prevalence of ONIHL.
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Chronic low-dose exposure to highly toxic gas phosgene and its effect on peak expiratory flow rate p. 189
Rajnarayan R Tiwari, Sampathraju Raghavan
DOI:10.4103/ijoem.ijoem_417_20  
Introduction: Phosgene is a highly toxic gas causing irritation of the airways and eyes though at high dose exposure. The effect on airways can be assessed by peak expiratory flow rate (PEFR) which is a cheaper, simple, and easy to perform test under field conditions and routine monitoring. Thus, this study is undertaken to understand the effect of chronic low-dose phosgene exposure on PEFR and the associated factors. Methods: This study included 287 workers of phosgene production and captive units. After recording the demographic, occupational, and clinical history on a questionnaire, every participant was subjected to clinical examination, chest radiography, and measurement of PEFR using Spirovit SP-10. Results: The mean age and mean duration of the job of participants was 42.8 ± 10.4 years and 18.9 ± 9.6 years, respectively. The PEFR was significantly reduced with increasing age, increasing duration in the job, and those having direct exposure. Conclusion: PEFR is affected by chronic low-dose exposure to phosgene.
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Work related musculoskeletal disorders among bus conductors of Udupi District, Karnataka p. 193
Garima Verma, Rajnarayan R Tiwari
DOI:10.4103/ijoem.ijoem_316_21  
Background: Government bus conductors are at high risk for work-related musculoskeletal disorders (MSDs) due to the work environment and work conditions. Thus, the present study was undertaken to assess the prevalence and associated factors of musculoskeletal problems among bus conductors. Materials and Methods: This cross-sectional study included 237 bus conductors of government bus depots. The data were collected by interview technique on a structured questionnaire. Self-reported musculoskeletal pain over the last 12 months was the case definition. Results: The present study revealed that 62.4% of bus conductors had musculoskeletal pain. The multivariate analysis suggested that tobacco smoking, overweight or obesity, and lack of enough breaks during work were significant risk factors for the occurrence of musculoskeletal pain in study participants. Conclusion: Thus, to conclude, the conductors are at risk of musculoskeletal problems, which can be attributed to occupational as well as non-occupational factors.
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CASE REPORTS Top

Ross syndrome presenting as heat exhaustion: A report of two cases p. 198
Gautam K Singh, Sandeep Arora, Amit Bahuguna, Pankaj Das, Prashant Bellad
DOI:10.4103/ijoem.ijoem_107_21  
Ross syndrome is a rare clinical disorder of sweating associated with tonic pupil and areflexia. There are very few case reports of Ross syndrome in dermatology literature, most presenting with patchy hyperhidrosis. Here, we report two isolated cases who had presented to the emergency department with heat exhaustion. Multidisciplinary evaluations of the first case revealed focal anhidrosis, patchy hyperhidrosis, postural hypotension, absent deep tendon reflex, and tonic pupil while the second case had similar features except for postural hypotension, prompting the diagnosis of Ross syndrome. Presentation of these two patients highlights the importance of a high index of suspicion of dysautonomic disorder, interdisciplinary workup of a case of patchy anhidrosis, or hyperhidrosis, which may get missed in busy outpatient department (OPD) visit.
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Occupational noise-induced hearing loss in a video editor: A case report p. 201
Balachandar S Sayapathi, Sirajudeen Rowther
DOI:10.4103/ijoem.ijoem_314_21  
The diagnosis of occupational noise-induced hearing loss is rarely made in a video editor, although there is a high prevalence of hearing loss. A 37-year-old woman experienced gradual hearing loss associated with tinnitus for the past 3 years. Audiometry showed mild-to-severe sensorineural hearing loss in the right ear and mild-to-moderate sensorineural hearing loss in the left ear. There is a dip at 2 kHz, which is more pronounced in the right ear with recovery at 8 kHz. The portable listening devices risk causing hearing loss from high-output noise damaging the cochlear structures. The amplitudes on otoacoustic emission levels are decreased by using these devices, especially among long-time users. Incessant tinnitus may cause adverse effects on the quality of life. Sound therapy devices such as digital signal processing devices through hearing aids may assist this group of patients by distracting their attention from tinnitus.
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LETTER TO EDITOR Top

Personal experience and individual measures to manage physician burn-out p. 204
Karalanglin Tiewsoh
DOI:10.4103/ijoem.ijoem_294_21  
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