Known since 1885 but studied systematically only in the past four decades, the healthy worker effect (HWE) is a special form of selection bias common to occupational cohort studies. The phenomenon has been under debate for many years with respect to its impact, conceptual approach (confounding, selection bias, or both), and ways to resolve or account for its effect. The effect is not uniform across age groups, gender, race, and types of occupations and nor is it constant over time. Hence, assessing HWE and accounting for it in statistical analyses is complicated and requires sophisticated methods. Here, we review the HWE, factors affecting it, and methods developed so far to deal with it.

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Preterm birth (PTB) is a significant public health concern and a leading cause of infant mortality and morbidity worldwide and often contributes to various health complications later in life. More than 60% of PTBs occur in Africa and south Asia. This overview discusses the available information on occupational, environmental, and lifestyle factors and their contribution to PTB and proposes new etiological explanations that underlie this devastating pregnancy complication. Several factors such as emotional, stress, social, racial, maternal anxiety, multiple pregnancies, infections during pregnancy, diabetes and high blood pressure, and in-vitro fertilization pregnancy have been shown to be associated with PTB. Data are emerging that occupational, environmental exposure and lifestyle factors might also be associated in part with PTB, however, they are at best limited and inconclusive. Nevertheless, data on heavy metals such as lead, air pollutants and particulate matters, bisphenol A, phthalate compounds, and environmental tobacco smoke (ETS) are promising and point to higher incidence of PTB associated with exposure to them. Thus, these observations can be used to advise pregnant women or women of reproductive age to avoid such exposures and adopt positive lifestyle to protect pregnancy and normal fetal development. There is a need to conduct well-planned epidemiological studies that include all the pathology causing factors that may contribute to adverse pregnancy outcomes, including PTB.

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Background: There is a lack of evidence on barriers faced by persons with disability in accessing employment opportunities in India. Aim: This study was undertaken to ascertain both employee and employer perceptions on barriers existing among Information Technology (IT) and IT-enabled sectors to employ persons with disabilities. Materials and Methods: Two hundred participants from six IT/IT-enabled sector organizations were included in the study; study was conducted at Hyderabad, India. A semi-structured questionnaire was administered to the participants. Results: Physical access to and within the worksite was highlighted as a concern by 95% of respondents. Majority perceived that communication, attitude of people, discrimination, harassment at work place, and information were critical barriers. Only 3.8% of employers were aware that their company had a written policy on employing persons with disabilities. Employers stated that commitment and perseverance were important facilitators among persons with disabilities. Conclusions: Evidence from this study will help in planning need-based employment for persons with disabilities.

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Aims: The purpose of this study was to evaluate web-based Knowledge, Attitude and Practice (KAP) intervention on office ergonomics – a unique method for prevention of musculoskeletal discomfort (MSD) – in corporate offices that influences behavior modification. Background: With the increasing use of computers, laptops and hand-held communication devices globally among office employees, creating awareness on office ergonomics has become a top priority. Emphasis needs to be given on maintaining ideal work postures, ergonomic arrangement of workstations, optimizing chair functions, as well as performing desk stretches to reduce MSD arising from the use of these equipment, thereby promoting safe work practices at offices and home, as in the current scenario many employees work from home with flexible work hours. Hence, this justifies the importance of our study. Objective: To promote safe working by exploring cost-effective communication methods to achieve behavior change at distant sites when an on-site visit may not be feasible. Materials and Methods: An invitation was sent by the Medical and Occupational Health Team of a multinational corporation to all employees at their offices in Sri Lanka, Singapore, and Malaysia to take up an online Nordic questionnaire, a screening tool for musculoskeletal symptoms, shared in local languages on two occasions – baseline evaluation (n = 240) and a follow-up evaluation after 3 months (n = 203). After completing the baseline questionnaire, employees were immediately trained on correct postures and office ergonomics with animation graphics. The same questionnaire was sent again after a 12-week gap only to those employees who responded to the baseline questionnaire on initial assessment. Statistical Analysis Used: Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) version 20.0 software and variables were compared using odds ratio as well as Chi-square test. Results: Of the 203 employees who responded, 47.35% had some musculoskeletal symptoms. Among them 58.7% had lower back pain, 46.9% had upper back pain, 44.1% had wrist pain, 39.5% had shoulder pain, and 37% had knee pain. The percentages are high as some participants had multiple complaints i.e. 2 or 3 complaints. However, only 40% of these employees had ongoing symptoms at the time of evaluation (past 7 days). A subsequent 3-month evaluation after web-based intervention showed a significant 41–50% decline in ongoing symptoms. Conclusions: We conclude that newer technology using web-based animation graphics is a highly efficient technique to create office ergonomics awareness and has the potential to become a best practice in countries where language is a communication barrier and an on-site visit may not be feasible due to meagre resources.

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Introduction: A cross-sectional study on occupational stress was conducted on loco pilots in 2008, in view of loco pilots being one of the high strain jobs in Indian Railways. Subsequently, a comparative cross-sectional study on occupational stress was conducted among section controllers in 2011, which is another high strain job of Indian Railways. Objective: The studies were conducted to analyze and compare occupational stress and hypertension. Setting and Design: A cross-sectional study on occupational stress and hypertension was conducted among 230 loco pilots in 2008, and subsequently, a comparative cross-sectional study was conducted among 82 section controllers in 2011. Materials and Methods: A closed end 24 item questionnaire on occupational stress was administered. Systolic blood pressure above 140 mmHg and diastolic blood pressure above 90 mmHg were considered as hypertension as per the VII Joint National Committee. Chi-square test and t-test were used for testing significance at P < 0.05. Results: The mean stress score was 8.56 in loco pilots and 7.32 in section controllers. The number of loco pilots with more than 12 stress factors was 49 (21.3%) and the number of section controllers with more than 12 stress factors was 7 (8.5%). The number employees with more than 12 stress factors in different categories of loco pilots were 30 (32%) in the goods category, 12 (12%) in the mail/passenger category, and 7 (19%) in the shunter category, and 3 (11%) in the supervisory category and 4 (7%) in the on-board category of section controllers. The prevalence of hypertension in loco pilots was 36.52% (84) and in the section controllers was 53.66% (44). The prevalence of hypertension in the category with more than 12 stress factors was 30.61% (15) in the loco pilots and 28.57% (2) in the section controllers. The prevalence of hypertension in the both the study groups were higher in the older age, with a family history of hypertension, and with a body mass index of more than 25 kg/m². The mean occupational stress and employees with more than 12 stress factors were higher in the loco pilots group. The goods category of loco pilots had highest stress factors. The prevalence of hypertension was high in the category with risk factors such as older age, family history of hypertension and BMI above 25 kg/m².

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A research study was conducted to assess the effectiveness of cool coat in reducing heat strain among workers exposed to heat in a steel plant located in south India. The study consists of assessing heat strain of workers exposed to heat in a steel plant by measuring physiological reactions of workers such as pulse rate and core body temperature with and without cool coat. The coal coat taken for this study was procured from M/s Yamuna Industries, Noida. Out of 140 employees exposed to heat hazard, 101 employees were examined in this study. Study was done in important production units in steel plant having heat hazard. Workers were interviewed and examined and information regarding thermal comfort was collected. First, the heat strain was assessed when the workers were not using cool coats. The air temperature was measured at all hot zone workplaces and found in the range of 34 0 C to 39.4 0 C (Mean: 36.54 0 C & S.D: 1.54). Physiological response such as core body temperature, pulse rate and blood pressure of workers exposed to heat hazard were measured before & after work to know the heat strain sustained by workers when they were working. Maximum core body temperature after work was found to be 39.3 0 C (Mean; 38.52 & S.D; 0.7). Maximum pulse rate of workers after work was found to be 120 beats/minute (Mean; 94.96 beats/minute, S.D: 13.11). The study indicate core body temperature of workers was found more than the permissible exposure limit prescribed by ACGIH, indicating the heat strain sustained by workers is significant, whereas the pulse rate and blood pressure was found normal & not exceeded the limits. Second, with cool coat, the heat strain was assessed among 10 workers selected from the 101 employees. Core body temperature was measured before and soon after work, The core body temperature recorded soon after work was in the range of 35.5 - 37.20C (Mean 36.36, SD= 0.52), indicating a drop in the core body temperature. In this study, a core body temperature rise in the range of 1 0 -1.4 0 C was noticed when the employees were not wearing cool coats. Whereas, with the usage of cool coat a rise in core body temperature was not found and in many coat wearing workers a drop in core body temperature (0.2 to 0.9 0 C) was noticed. Employees revealed that the cool coats was comfortable to use and provided the thermal comforts. The study concluded that the cool coat taken for this study was found effective in reducing the heat strain.

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