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2015| September-December | Volume 19 | Issue 3
Online since
January 14, 2016
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ORIGINAL ARTICLES
Perceived heat stress and health effects on construction workers
Priya Dutta, Ajit Rajiva, Dileep Andhare, Gulrez Shah Azhar, Abhiyant Tiwari, Perry Sheffield, Ahmedabad Heat and Climate Study Group
September-December 2015, 19(3):151-158
DOI
:10.4103/0019-5278.174002
PMID
:26957814
Introduction:
Increasing heat waves-particularly in urban areas where construction is most prevalent, highlight a need for heat exposure assessment of construction workers. This study aims to characterize the effects of heat on construction workers from a site in Gandhinagar.
Materials and Methods:
This study involved a mixed methods approach consisting of a cross sectional survey with anthropometric measurements (
n
= 219) and four focus groups with construction workers, as well as environmental measurements of heat stress exposure at a construction site. Survey data was collected in two seasons i.e., summer and winter months, and heat illness and symptoms were compared between the two time periods. Thematic coding of focus group data was used to identify vulnerability factors and coping mechanisms of the workers. Heat stress, recorded using a wet bulb globe temperature monitor, was compared to international safety standards.
Results:
The survey findings suggest that heat-related symptoms increased in summer; 59% of all reports in summer were positive for symptoms (from Mild to Severe) as compared to 41% in winter. Focus groups revealed four dominant themes: (1) Non-occupational stressors compound work stressors; (2) workers were particularly attuned to the impact of heat on their health; (3) workers were aware of heat-related preventive measures; and (4) few resources were currently available to protect workers from heat stress. Working conditions often exceed international heat stress safety thresholds. Female workers and new employees might be at increased risk of illness or injury.
Conclusion:
This study suggests significant health impacts on construction workers from heat stress exposure in the workplace, showed that heat stress levels were higher than those prescribed by international standards and highlights the need for revision of work practices, increased protective measures, and possible development of indigenous work safety standards for heat exposure.
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Prevalence, pattern, and factors associated with work-related musculoskeletal disorders among pluckers in a tea plantation in Tamil Nadu, India
Deepthi Vasanth, Naveen Ramesh, Farah Naaz Fathima, Ria Fernandez, Steffi Jennifer, Bobby Joseph
September-December 2015, 19(3):167-170
DOI
:10.4103/0019-5278.173992
PMID
:26957816
Context:
Musculoskeletal pain is common among tea leaf pluckers and is attributed to the load they carry, long working hours, the terrain, and insufficient job rotations. As a result of this, their health and work capacity are affected.
Aims:
To assess the prevalence, patterns, and factors associated with work-related musculoskeletal disorders (WRMDs) among pluckers in a tea plantation in Annamalai, Tamil Nadu, India.
Settings and Design:
This cross-sectional study surveyed 195 pluckers selected by simple random sampling aged between 18 years and 60 years.
Materials and Methods:
The interview schedule had four parts––sociodemographic detail, Standard Nordic Scale, numeric and facial pain rating tool, and a tool to assess factors associated with WRMDs.
Statistical Analysis Used:
Statistical Package for the Social Sciences (SPSS) version 16.
Results:
Prevalence of musculoskeletal pain in the last 12 months and the last 7 days was 83.6% and 78.5%, respectively. The most common site for last 1 year was shoulder (59%) and for last 7 days was the lower back (52.8%). Independent
t
-test revealed that the mean age of those with pain was 6.59 year more and mean years of employment was 1.38 years more among the workers with pain compared to workers without pain. Increasing morbidities among workers was also significantly associated with an increase in WRMDs on Chi-square test.
Conclusions:
The prevalence of musculoskeletal pain was high among tea pluckers and the most common site during the last 12 months and the last 7 days was the shoulder and lower back respectively was mild in character. Increase in age and duration of employment was associated with WRMDs.
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Occupational stress and health-related quality of life among public sector bank employees: A cross-sectional study in Mysore, Karnataka, India
Sowmya N Malamardi, Ramachandra Kamath, Rajnarayan Tiwari, Binu Valsalakumari Sreekumaran Nair, Varalakshmi Chandrasekaran, Sameer Phadnis
September-December 2015, 19(3):134-137
DOI
:10.4103/0019-5278.173998
PMID
:26957810
Background:
Occupational morbidities have been estimated to cause an economic loss up to 10–20% of the gross national product of a country. It is an important cause of occupational morbidity and decreased quality of life (QOL) for the workers.
Aim:
The aim of the present study is to assess the level of occupational stress and its association with the QOL among the public sector bank employees.
Materials and Methods:
The present study was conducted among employees of public sector banks in Mysore district, Karnataka, India. A cross-sectional study design was used for the study. Job stress was measured by using occupational stress index (OSI) scale questionnaire and health-related QOL was measured using the short form 12 (SF-12) questionnaire. The sample size estimated for the study was 526 and cluster random sampling technique was used. Chi-square test was used to find the association between the study variables and level of stress. Multiple linear regression model was used to find the determinants of health-related QOL among the study subjects.
Results:
The total number of the study subjects was 546 out of which 57% were males and 43% were females. The proportion of study subjects reporting to be current smokers was 4.2% and almost all study subjects reported occasional alcohol consumption. The mean physical component summary (PCS) score and mental component summary (MCS) using the original United States standardization were 47.90 and 48.30, respectively. The individuals with mild stress scored higher in both PCS and MCS than the individuals who had moderate to severe stress levels. There was significant association of health related quality of life with the age of the respondent,presence of at least one morbidity and level of stress with health-related QOL.
Conclusion:
This study has shown an association of occupational stress with the QOL. There is a need for interventions aimed at mitigating the occupational stress among employees of the banking sector.
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Dermatological and respiratory problems in migrant construction workers of Udupi, Karnataka
Mayuri Banerjee, Ramachandra Kamath, Rajnarayan R Tiwari, Narayana Pillai Sreekumaran Nair
September-December 2015, 19(3):125-128
DOI
:10.4103/0019-5278.174001
PMID
:26957808
Background:
India being a developing country has tremendous demand of physical infrastructure and construction work as a result there is a raising demand of construction workers. Workers in construction industry are mainly migratory and employed on contract or subcontract basis. These workers face temporary relationship between employer and employee, uncertainty in working hours, contracting and subcontracting system, lack of basic continuous employment, lack basic amenities, and inadequacy in welfare schemes.
Objective:
To estimate the prevalence of respiratory and dermatological symptoms among migratory construction workers.
Materials and Methods:
This cross-sectional study was conducted in Manipal, Karnataka, among 340 male migratory construction workers. A standard modified questionnaire was used as a tool by the interviewer and the physical examination of the workers was done by a physician. The statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 15.0.
Result:
Eighty percent of the workers belong to the age group of 18–30 years. The mean age of the workers was 26 ± 8.2 years. Most (43.8%) of the workers are from West Bengal followed by those from Bihar and Jharkhand. The rates of prevalence of respiratory and dermatological symptoms were 33.2% and 36.2%, respectively.
Conclusion:
The migrant construction workers suffer from a high proportion of respiratory and dermatological problems.
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Nonoccupational anthracofibrosis/anthracosilicosis from Ladakh in Jammu and Kashmir, India: A case series
Sonam Spalgais, Dipti Gothi, Anand Jaiswal, Kumud Gupta
September-December 2015, 19(3):159-166
DOI
:10.4103/0019-5278.173995
PMID
:26957815
Background:
Nonoccupational anthracosis and silicosis has been reported from various parts of the world including Ladakh in Jammu and Kashmir, India; however, anthracosilicosis has only been reported in industrial workers till date.
Materials and Methods:
Six cases from the Ladakh region in Jammu and Kashmir, India with similar clinico-radiological-pathological features, i.e., anthracosilicosis/anthracofibrosis have been analyzed. Of these, four were analyzed retrospectively and two prospectively.
Result:
All the patients were homemakers and resided in Ladakh in Jammu and Kashmir, India since birth with an age range of 42–62 years and an average age of 56 years. Their average duration of symptoms was 4 years. Spirometry showed small and/or large airway disease in 5/6 cases. On computed tomography (CT), 4/6 cases showed progressive massive fibrosis (PMF) with calcified mediastinal lymph nodes. There were random or centrilobular nodules in all the six cases. Bronchoscopy in 5/6 cases showed multiple anthracotic pigments with narrowing and distortion of the bronchus (anthracofibrosis). Malignancy was suspected clinico-radiologically in four cases and pathologically in two cases. On histopathology, anthracosis was demonstrated in all and silicosis in three cases.
Conclusion:
Anthracosilicosis can occur due to environmental exposure. Ladakh in Jammu and Kashmir, India is the only place across the globe with unique environmental features having the presence of both free silica and biomass fuel. The disease was observed predominantly in older women. Awareness would prevent unnecessary investigation for malignancy. Treatment with the bronchodilator is useful as it has evidence of airway disease. Finally, environmental measures and a proper study need to be undertaken for knowing the relative role of silica versus soot in causing the lung disease and preventing this irreversible condition.
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An epidemiological study on the predictors of health status of food handlers in food establishments of teaching hospitals of North India
Arun Singh, Rashmi Katyal, Varsha Chaudhary, Kusum Narula, Deepak Upadhayay, Shailendra Pratap Singh
September-December 2015, 19(3):145-150
DOI
:10.4103/0019-5278.173999
PMID
:26957813
Introduction:
The US Centers for Disease Control and Prevention (USDHHS-CDC 1996) revealed that the outbreaks of food borne diseases include inadequate cooking, heating, or re-heating of foods consumption of food from unsafe sources, cooling food inappropriately and allowing too much of a time lapse. As we all know that the food handlers have been working in various types of community kitchen and their health status can affect the status of food hygiene which can lead to contamination of foods attributing to acute gastroenteritis and food poisoning in various subgroups of the population e.g., medical/dental/nursing students. The background characteristics of these food handlers may have important role to affect health status of these handlers.
Methods:
The indexed study was carried out among the food handlers working in the food establishments the 5 teaching hospitals of Bareilly city in U.P. India during one year i.e., from August 2013 to July 2014. The survey method using schedule was conducted to get information about the background characteristics and food handlers and each food handler was examined clinically for assessing health status. Chi-Square test was used as test of significance and regression analysis was also done to nullifying the effect of confounders.
Results:
The health status of the mess workers was found to be significantly associated with use of gloves, hand washing after toilet and hand washing before cooking and serving food.
Conclusion:
The rationale of this study was that though many studies have been carried out to show the health status of the food handlers and their background characteristics, no study has highlighted the association of these background characteristics and personal hygiene practices with the health status of food handlers.
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Study of skin and mucous membrane disorders among workers engaged in the sodium dichromate manufacturing industry and chrome plating industry
Vijay Kumar Singhal, Balbir Singh Deswal, Bachu Narayan Singh
September-December 2015, 19(3):129-133
DOI
:10.4103/0019-5278.173994
PMID
:26957809
Background:
Inhalation of dusts and fumes arising during the manufacture of sodium dichromate from chrome ore, chromic acid mist emitted during electroplating, and skin contact with chromate produce hazards to workers.
Objectives:
(1) To elucidate the prevalence of skin and mucous membrane disorders among the workers engaged in the sodium dichromate manufacturing industry and chrome plating industry. (2) To know the relationship of prevalence with the duration of exposure to chrome mist, dust, and fumes.
Settings and Design:
A cross-sectional study was conducted among all the workers engaged in sodium dichromate manufacturing and chrome plating from several industries situated near the Delhi-Haryana border in the districts of Faridabad and Sonepat of Haryana, India from January 01, 2014 to December 31, 2014.
Materials and Methods:
All the workers available from the concerned industries for the study were interviewed and medically examined after obtaining their informed consent. A total of 130 workers comprising 66 workers from the sodium dichromate manufacturing industry and 64 workers from the chrome plating industry were examined on a pretested schedule.
Statistical Analysis:
Descriptive statistical methods (proportions, relative risk, and Chi-square test of significance with
P
value analyzed using Epi Info version 7).
Results:
All the workers were found to be males and of the adult age group. Out of the total examined, 69.69% and 56.22% of the workers had disorders of the nasal mucous membrane in the sodium dichromate manufacturing industry and the chrome plating industry, respectively. 42.42% and 28.22% of the workers had perforation of the nasal septum in the sodium dichromate manufacturing industry and chrome plating industry, respectively. 6.06% and 3.12% workers had skin ulcers in the sodium dichromate manufacturing industry and chrome plating industry, respectively. Nasal irritation and rhinorrhea were the most commonly found symptoms in both the processes . All workers were washing hands with soap in both the processes. 48.48% and 90.52% of the workers were using hand gloves in the sodium dichromate manufacturing and chrome plating industry, respectively. Only 27.27% and 37.50% of the workers were using masks in the sodium dichromate manufacturing industry and chrome plating industry, respectively. No worker was using protective clothing or barrier cream in the sodium dichromate manufacturing industry. 40.65% and 12.50% workers were using protective clothing and barrier cream in the chrome plating industry.
Conclusion:
Workers engaged in sodium dichromate manufacturing and chrome plating are at a great risk of skin and mucous membrane disorders including chrome holes and nasal septum perforation. Protective measures and awareness of the management and workers about the exposure hazards and safeguarding against them will be useful public measures to prevent these occupational hazards among workers engaged in these processes.
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Disability evaluation in acoustic blast trauma
Ganesan Raju
September-December 2015, 19(3):138-140
DOI
:10.4103/0019-5278.173993
PMID
:26957811
Introduction:
Acoustic blast trauma is different from Noise induced hearing loss. Blast trauma can damage the tympanic membrane, ossicles and cochlea singly or in combination. It produces immediate severe hearing loss and may be associated with tinnitus and vestibular symptoms. Hearing loss recovers spontaneously in many cases but may be permanent in 30-55% cases. Thirteen patients working in an explosive manufacturing unit in Andhra Pradesh were exposed to blast trauma at work place. All these workers complained of immediate hearing loss and were subjected to audiological investigations.
Methods:
Initial evaluation showed a severe sensorineural type of hearing loss 10 of the 13 cases (77%). They were referred to our Medical board for disability evaluation after 2-3 years of initial injury. Pure tone audiometry indicated severe hearing loss in 12 of 13 cases (92%) that was not correlating clinically. Re-evaluation with Acoustic reflex and ABR (BERA) tests were done and permanent disability was evaluated with the results of these investigations.
Observations:
No significant hearing loss was found in most patients and these patients had minimal disability.
Conclusion:
Objective hearing tests should be carried out after one year or more before evaluation of permanent disability.
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BRIEF COMMUNICATION
Performing CPR on a commercial diver inside the diving bell
Sourabh Bhutani, Rohit Verma, Dipak Kumar Ghosh
September-December 2015, 19(3):171-174
DOI
:10.4103/0019-5278.174000
PMID
:26957817
CPR in a diving bell is difficult. It is taught by diving companies and training institutes but has not been subjected to the tenets of evidence based medicine. The diving bell lacks space as well as a flat hard surface to lay the patient on and therefore conventional methods of administering CPR are not possible. The diver is hung from a pulley tied to the diver's harness, and the bell flooded with water to reduce pooling of blood. Airway is established using a cervical collar to hyperextend the neck and inserting an appropriate oropharyngeal airway. Cardiac compressions are administered by the bellman using his head or the knee while holding the patient with his arms from behind. The bell can be recovered to surface only when spontaneous breathing and circulation have started. Diving bell offers a unique environment for management of unconscious casualties. Even though the method is at variance with the conventional method of administering CPR, it is the only method possible inside the bell. It is important that the method be scrutinized and refined so as to be more effective and efficacious inside the bell.
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EDITORIAL
Changing scenario in the art of clinical medicine
Ganesh K Kulkarni
September-December 2015, 19(3):123-124
DOI
:10.4103/0019-5278.173996
PMID
:26957807
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ORIGINAL ARTICLES
Peculiarities of hearing impairment depending on interaction with acoustic stimuli
Iryna Myshchenko, Vasyl Nazarenko, Anatoliy Kolganov, Pavlo Tereshchenko
September-December 2015, 19(3):141-144
DOI
:10.4103/0019-5278.173997
PMID
:26957812
Aims:
The functional state of the auditory analyzer of several operators groups was study. The objective of this study was to determine some characteristics of hearing impairment in relation with features of acoustic stimuli and informative significance of noise.
Materials and Methods:
236 employees (middle age 35.4 ± 0.74 years) were divided into four groups according to features of noise perception at the workplaces. The levels of permanent shifts of acoustic thresholds were estimated using audiometric method.
Statistical Analysis Used:
Common statistical methods were used in research. Mean quantity and mean absolute errors were calculated. Statistical significance between operators' groups was calculated with 0.05 confidential intervals.
Results:
The peculiarities of hearing impairment in observed groups were different. Operators differentiating acoustic signals had peak of hearing impairment in the field of language frequencies, while the employees who work with noise background at the workplaces had maximal hearing threshold on the 4000 Hz frequency (
P
≤ 0.05).
Conclusions:
Hearing impairment depends both on energy and human interaction with acoustic irritant. The distinctions in hearing impairment may be related with the necessity of recognizing of acoustic signals and their frequency characteristics.
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© 2005 - Indian Journal of Occupational and Environmental Medicine
Published by Wolters Kluwer -
Medknow
Online since 1
st
April '05