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     Table of Contents - Current issue
Coverpage
September-December 2016
Volume 20 | Issue 3
Page Nos. 123-153

Online since Tuesday, March 28, 2017

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EDITORIAL  

Fitness and return to work challenges for occupational health physician p. 123
Ganesh K Kulkarni
DOI:10.4103/ijoem.IJOEM_39_17  
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ORIGINAL ARTICLES Top

Physical activity levels and prevalence of low back pain in Thai call-center operators p. 125
Chaikumarn Montakarn, Nakphet Nuttika
DOI:10.4103/0019-5278.203136  
Background: Call-center operators are exposed to working conditions that indicate an increased risk of developing musculoskeletal disorders. Nevertheless, there are few studies regarding health and working condition in call-center operators. Thus, this study was designed to investigate the physical activity levels and prevalence of low back pain (LBP) in Thai call-center operators. Materials and Methods: A self-reported questionnaire was distributed to 150 operators at a call center to identify the physical activity levels, prevalence of LBP, personal characteristics, and associated work factors. Results: The questionnaire response rate was 70% (n = 105). The participants' age was 27.8 ± 3.1 years, height was 159.97 ± 6.26 cm, weight was 52.89 ± 12.89 kg, and females 86.7% (n = 91), and males 13.3% (n = 14). Participants worked at least 6 days every week, with an average of 8 hours each day. Sixty-one percent of them worked over time with an average 2 h/day. Forty percent of the participants had no exercise; 34.3% exercised 1–2 times/week. Those who did physical exercise spent less than 30 min/time. The overall self-reported prevalence of LBP was 65.7%, and they reported high severity of LBP for 42.9%. All participants reported that their LBP as recurring, and 62.9% reported that LBP was aggravating by sitting during working hours. Conclusion: The call-center operators had a sedentary work style. The majority of operators in this study had low level of physical activity and suffered from low back pain. The prevalence of low back pain was associated to their level of physical activity and work factors.
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Level of stress and its determinants among Intensive Care Unit staff p. 129
Arunesh Kumar, Prasad Pore, Sachin Gupta, Aziz O Wani
DOI:10.4103/0019-5278.203137  
Context: Stress is a usual and normal part of our daily lives. It is a normal physical reaction to an internal or external pressure that is placed on a person's system. Extended periods of stress can cause destructive changes in the body. Objectives: (1) To assess the prevalence of stress and its level among intensive care unit (ICU) staff (doctors and nurses) of various hospitals and (2) to correlate the level of stress with certain variables. Settings and Design: A cross-sectional study was conducted in the ICU of various hospital of Pune for a period of 1 month. Materials and Methods: Eighty-two ICU staff (doctors and nurses) were contacted and interviewed using pretested proforma containing DASS stress rating scale (for stress only). Statistical Analysis Used: Data analysis was performed using the Statistical Package for the Sciences (SPSS) version 19.0 software. To compare the level of stress with various parameters, we used Chi-square test. P value <0.05 was considered to be significant. Results: The overall prevalence of stress among ICU staff (doctors and nurses) was 52.43%. Prevalence of stress among ICU doctors was 36.58% and nurses was 68.29%. According to the DASS (for stress only), 19.51% doctors were mildly stressed, 14.63% were moderately stressed, and 2.44% were severely stressed. Among nurses, 48.78% were mildly stressed and 19.51% were moderately stressed. Conclusions: The result indicated that prevalence of stress among ICU staff (doctors and nurses) is high.
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Visual functions of workers exposed to organic solvents in petrochemical industries p. 133
R Indhushree, R Monica, K Coral, Narayanasamy Angayarkanni, R Punitham, BM Subburathinam, R Krishnakumar, PP Santanam
DOI:10.4103/0019-5278.203138  
Aim: The purpose of this study was to evaluate the visual functions of workers exposed to organic solvents in petrochemical industries. Materials and Methods: Thirty workers from the petroleum refinery and 30 age-matched controls (mean age) were recruited. Visual functions and occupational exposure levels were assessed among both the groups. Visual acuity, contrast sensitivity, color vision, and visual fields were evaluated at the workplace. The biological samples, namely blood and urine, were collected at the workplace and transported to the laboratory for analysis. The urinary excretion of hippuric and methylhippuric acid as well as creatinine was measured by high performance liquid chromatography. Results: The mean age of the workers and controls were 39.7 ± 7.6 years and 38.6 ± 8.1, years respectively. The mean years of experience of the workers were 15.6 ± 6.8 years. Visual acuity was >0.01 LogMAR among both the control and case groups. The contrast sensitivity was reduced at 12cpd among workers. Comparison between groups was done using independent sample t-test. The mean difference in color confusion index was 0.11 ± 0.05 (P = 0.037*). The mean difference in visual fields was −0.31 ± 0.36 dB (P = 0.933). The mean difference in urinary hippuric acid level (urinary metabolite of toluene) between the groups was 0.19 ± 0.96 g/g creatinine (P = 0.049*). The mean difference in the excretion of methylhippuric acid (urinary metabolite of xylene) was 0.06 ± 0.04g/g creatinine (P = 0.154). We also found that exposure was a significant risk factor for color vision defect with an odds ratio of 4.43 (95% CI: 1.36–14.4); P = 0.013. Conclusion: The study results showed that contrast sensitivity and color vision were affected among workers in petrochemical industry.
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Awareness of blood-borne infections and burden of occupational exposures to blood and body fluids among health care personnel in a tertiary care teaching hospital p. 138
Swetharani , KV Vinod, Abdoul Hamide, Tarun K Dutta, KT Harichandrakumar
DOI:10.4103/0019-5278.203140  
Background and Objectives: Occupational exposures (OEs) to blood and body fluids (BBFs) pose significant risk of transmission of blood-borne infections (BBIs) to health care personnel (HCP) and are grossly underreported. We aimed to study the awareness of BBIs and their prevention, burden of OEs, assess factors contributing to them and their poor reporting and assess the practices for their prevention among HCP. Materials and Methods: This cross-sectional study conducted at a tertiary care teaching hospital located in south India used a self-administered questionnaire to assess the awareness of BBIs, attitude and practice of HCP for prevention of OEs, and to quantify the burden of exposures. All formally self-reported OEs during the study period of 2 years were documented prospectively. Results: Majority (369/401, 92%) of HCP surveyed had fair general awareness of BBIs. Though 90% were aware of the concept of universal precautions (UPs), self-reported adherence to barrier precautions was acceptable in only 80%. Overall, 56% and 46% of HCP were aware of human immunodeficiency virus (HIV) and hepatitis B post-exposure prophylaxis (PEP) respectively. Eighteen percent (74/401) were either not vaccinated or incompletely vaccinated against hepatitis B. Recapping of used needles was reported by 79% (317/401). Nearly half (208/401) reported OEs over preceding year and 70% (146/208) of exposed had not formally reported them. Over the 2-year study period, 53 formally self-reported exposures were documented prospectively. Needle stick injuries accounted for 83% of the exposures, and appropriate personal protective devices were not being used during 47% of exposures. Though doctors had the highest awareness, they reported lowest adherence to barrier precautions and highest burden of exposures (P < 0.05). Conclusion: Though majority of HCP had fair awareness of BBIs, it did not translate into adequate adherence to UPs and safe practices. High burden of OEs and their poor reporting emphasize the need to motivate our HCP to adhere to safe work practices and to promptly seek professional counselling after exposures. There is an urgent need to educate HCP about the availability and effectiveness of PEP for HIV and hepatitis B. A uniform national policy for prevention and reporting of OEs has to be framed.
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Musculoskeletal morbidity among construction workers: A cross-sectional community-based study p. 144
Gopireddy M. M Reddy, B Nisha, Thangaraj G Prabhushankar, V Vishwambhar
DOI:10.4103/0019-5278.203134  
Background: Construction industry is one of the stable growing industries in India. People working in construction industries are at a risk of various occupational diseases. Musculoskeletal disorder (MSD) is the single largest cause of work-related illness, accounting for over 33% of all newly reported occupational illnesses in the general population and approximately 77% in construction workers. In spite of the high prevalence and wide range of adverse consequences, the studies highlighting the burden and impact of musculoskeletal morbidities are very scarce in India. The current study is aimed at filling this vital gap in the current knowledge. Objective: To assess the musculoskeletal morbidities among construction workers using the modified Nordisk Scale. Materials and Methods: A cross-sectional community-based study was conducted by 30 × 10 multistage cluster random sampling method in Chennai Metropolitan city. Results: Out of the 308 participants included in the final analysis, majority were 21–40 years. Working hours ranged from 8 to 12 hours. Duration of work ranged from 2 months to 20 years. Out of 308 participants, 104 workers (33.8%) had musculoskeletal problems. Three most common disorders discovered were low backache seen in 64 (20.8%), shoulder pain seen in 36 (11.7%), and wrist pain seen in 36 (11.7%) participants. The proportion of hospitalized participants in the last 1 year was 7.8%. Total duration in the construction field, duration of work hours, and higher age had statistically significant impact on musculoskeletal morbidity. Conclusion: The prevalence of musculoskeletal morbidity was very high in construction workers, with resulting adverse impact on the workers. Immense attention, in the form of appropriate prevention measures, is needed to effectively address this public health problem.
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CASE REPORT Top

Occupation-related chromium toxicity a rare cause of renal failure and rhabdomyolysis p. 150
Manjeera Jagannati, I Ramya, Sowmya Sathyendra
DOI:10.4103/0019-5278.203135  
A 21-year-old gentleman, a worker in a mobile phone shop, was admitted with rhabdomyolysis, renal failure, and pulmonary edema requiring mechanical ventilation and hemodialysis. After extensive workup and ruling out other causes, heavy metal poisoning was considered. Investigations during the course of the hospital stay revealed chromium poisoning. With repeated hemodialysis, his parameters normalized and he was discharged home in a stable condition. Diagnosis of chromium toxicity needs high index of suspicion. A history of occupational exposure might offer a clue to diagnosis. With hemodialysis and supportive care, it is a potentially salvageable condition.
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LETTER TO THE EDITOR Top

Choosing controls in a case control study p. 153
Sunil Kuma Raina
DOI:10.4103/0019-5278.203141  
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