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     Table of Contents - Current issue
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May-August 2020
Volume 24 | Issue 2
Page Nos. 51-132

Online since Wednesday, August 19, 2020

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EDITORIAL  

Antibody testing in the context of COVID-19 and return to work Highly accessed article p. 51
T Rajgopal
DOI:10.4103/ijoem.IJOEM_276_20  
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ORIGINAL ARTICLES Top

An analysis of medicolegal reporting in workman injuries referred for medicolegal examination in a Tertiary Care Hospital Of Sri Lanka Highly accessed article p. 55
I D G Kitulwatte, P A S Edirisinghe
DOI:10.4103/ijoem.IJOEM_81_20  
Introduction: A reasonable number of workman injuries are reported for medicolegal examination every year. In addition to report on the degree of severity and consistency of the injuries with the historical evidence, the medical officers are expected to opine on degree of disability as well. However, routine Medicolegal Examination Form or Report used in Sri Lanka to report these cases does not carry a section for disability or impairment. Objective: To gain an insight into the pathology of workplace injuries and to evaluate the role of medicolegal examination and reporting among the victims presented with injuries at work. Methods: A retrospective descriptive study was carried out on workmen who were referred for medicolegal examination during a period of 5 years in a Tertiary Care Hospital in the Western Province of Sri Lanka. Results: Out of 172 subjects who got injured at work, none had claimed for a report of compensation. 47% (81) of the injured workers were in the age group of 19–30 years. 81% (139) were males. Factory workers were the most vulnerable workers (34%) followed by drivers (15%). A majority 39% (67) of injuries were located on upper limbs. 52% (90) of the victims had grievous injuries. However, a majority 61% (105) had no permanent disability. Conclusions: Disability is not a direct reflection of the category of hurt. Therefore, testifying on routine medicolegal reports on cases of workman compensation will not serve justice to the patient.
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Musculoskeletal disorders of garo women workers engaged in tea-plucking activity: An ergonomic analysis p. 60
Tapsri R Marak, Deepak Bhagat, Swapnali Borah
DOI:10.4103/ijoem.IJOEM_185_19  
Background: The tea-plucking activity in Garo Hills, Meghalaya, India is performed in a traditional way making the majority of women workers, especially those who have spent more years in tea-plucking activity prone to musculoskeletal disorders. Materials and Methods: The present study was conducted on a sample of 40 women workers who had the highest field experience in tea leaf plucking. Pain as a musculoskeletal disorder was recorded using a 5-point scale ranging from very mild pain (1) to very severe discomfort (5) to quantify the stress on muscles used in work. The coefficient of correlation was used to explore the relationship between age, years of involvement, BMI of women, and their musculoskeletal problem. The analysis of discomfort in upper extremity was done by using a rapid upper limb assessment (RULA) technique. Analysis of discomfort in entire body parts was carried out using a rapid entire body assessment (REBA) technique. Results and Discussion: During tea plucking, women workers reported severe discomfort in the head (4.5), neck (4.3), both fingers (4.2), upper and lower back (4.3 and 4.4), and feet (4.3). The RULA grand score was observed seven indicating the need for immediate investigation and changes. REBA result was 11 for entire body parts leading to conclude that workers were working under high physical strain. Conclusion: Workers with severe musculoskeletal disorders can face permanent disability that prevents them from returning to their jobs or handling simple everyday tasks. Therefore, some rest periods, ergonomic intervention, and personal protective equipment are needed to minimize the discomfort of women workers in the tea-plucking activity.
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Analysis of postural risk and pain assessment in bharatanatyam dancers p. 66
Vrushali P Panhale, Prachita P Walankar, Aishwarya Sridhar
DOI:10.4103/ijoem.IJOEM_190_19  
Background: Bharatanatyam dance form is an amalgamation of emotion, rhythm, expression, and sculpturesque poses that demand high levels of physical and psychological power during a performance. Objectives: To explore musculoskeletal pain and analyze risk factors in Bharatanatyam dancers. The level of injury risk for the “Natyarambham” posture adopted by dancers was also assessed. Materials and Methods: A cross-sectional study was conducted in forty female Bharatanatyam dancers who received a minimum of 5 consecutive years of formal dance training from a recognized dance institute. A self-designed questionnaire comprising of demographic profile, dancing characteristics, presence of musculoskeletal pain, and specific area of pain according to the body region was administered. The injury risk of the “Natyarambham” posture was evaluated using a rapid entire body assessment tool (REBA). Results: Among 40 female dancers, 75% dancers (n = 30/40, 75% [95% CI 0.61, 0.89] reported pain. The most common site of pain was the low back (n = 22/40, 55% [95% CI 0.39, 0.71]). Using Bonferroni correction for multiple independent comparisons, a significant difference was identified between dancers with and without pain for average performances per year (P = 0.028). As per REBA risk level scoring for Natyarambham posture, 62.5% (n = 25/40, 62.5% [95% CI 0.22, 0.53]) dancers were in the category of high-risk level. Conclusion: The findings of this study indicated that the point prevalence of pain in Bharatanatyam dancers is high. Natyarambham posture is considered high risk based on postural assessment.
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Sleep quality and health-related quality of life in workers of Kermanshah Industrial Town: A correlation study p. 72
Seyed-Ramin Ghasemi, Mehdi Khezeli, Nader Rajabi-Gilan, Manoochehr Koulani, Nooshin Moloudi-Safa, Ali Hemati, Mojgan Afkari, Fatemeh Zolfaghari
DOI:10.4103/ijoem.IJOEM_219_19  
Background: Sleep Quality (SQ) is one of the most important predictors of quality of life in individuals. This study was conducted to evaluate the quality of life and SQ of industrial male workers in Kermanshah. Materials and Methods: In this cross-sectional study, 404 male workers selected by stratified sampling in the Kermanshah Industrial Town participated. The research questionnaires included demographic information checklist, the 36-Item Short-Form Health Survey (SF-36), and the Pittsburgh Sleep Quality Index (PSQI). Data were analyzed by SPSS18 software, using descriptive statistics, Pearson's correlation, and partial correlation tests. Results: The mean age of respondents was 35.33 ± 7.31; ranged from 20 to 62 years old. The mean score of mental health and physical health were 55.01 ± 21.62 and 54.96 ± 21.93, respectively. Out of all participants, 58.6% of participants had a score of 50 or less in terms of health-related quality of life (HRQL). Two dimensions of subjective SQ (1.48 ± 0.97) and sleep duration (1.48 ± 0.97) had the worst mean score, and sleep efficiency (0.05 ± 0.3) had the most favorable mean score. The results of the Pearson's correlation test showed that the total score of SQ had a negative and significant correlation with the main dimensions of quality of life (P < 0.001). The highest correlation was found between physical pain (r = 0.350) and mental health (r = 0.332) with SQ. Conclusion: This study showed that more than half of the workers reported poor HRQL. Besides, a considerable number of workers had some degree of sleep disorders. The results of the study showed that there is a moderate correlation between SQ and HRQL.
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Occupational morbidity of women beedi workers in Telangana p. 78
RL Lakshman Rao, Desham Chelimela, Rakesh Kakkar, Rajeev Aravindakshan
DOI:10.4103/ijoem.IJOEM_235_19  
Background: Beedi rolling is a popular small-scale industry in Telangana which provides employment to over a million people. Beedi rolling is generally done by women sitting at home. Despite the work being labor-intensive, women continue to do it as there is no other source of livelihood. Thus, this study was carried out to understand the morbidity status, working conditions, and hygiene of women beedi workers in the rural areas of Telangana. Materials and Methods: Descriptive, cross-sectional, community-based study was carried out from 2015 to 2016. Sample size calculated was 560 including a non-response rate of 10%. Multistage stratified sampling method was used to select the workers. A pretested semi-structured questionnaire was used to collect data regarding sociodemographic profile, hygiene measures, and health problems after written informed consent. Data entry and statistical analysis were done using Epi Info version 7.2. Results: The study population comprised of 528 women beedi workers. Mean age of study subjects was 40.8 (10.9) years. Most of them were (67%) illiterates. Awareness regarding occupational health hazards and hygienic practices was poor. A significant proportion of workers was found to have chronic diseases including musculoskeletal problems (50%), gynecological problems (31%), respiratory morbidity (27%), hypertension (25%), malnutrition (20%), and diabetes mellitus (2.65%). Conclusions: Beedi workers should be given complete information about the occupational health hazards and preplacement training should be given regarding occupational safety and personal hygiene measures.
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Bridging the gaps in health service delivery for truck drivers of India through mobile medical units p. 84
Subrata Chanda, Sonali Randhawa, Hardeep Singh Bambrah, Thomson Fernandes, Vishal Dogra, Shailendra Hegde
DOI:10.4103/ijoem.IJOEM_276_19  
Background: Truck drivers in India suffer from many lifestyle-related health problems. Providing primary health care services to truck drivers is essential to improve their overall health and well-being. This paper reports the findings of a community-based mobile medical unit program providing nonemergency and basic primary care services to truck drivers along the major highways of India. Piramal Swasthya Management and Research Institute launched this community-based mobile medical unit program, in partnership with Shriram Transport Finance Corporation Limited (STFCL). Materials and Methods: The paper describes the program model, its coverage, the sociodemographic profile, and common health morbidities of the truck drivers availing the program services. 2-year routine program data (April 2017 to March 2019) were accessed and analyzed. Results: A total of 1,167,210 number of unique truck drivers availed the program services during the reference period, of which 61,331 had complete data. The majority of truck drivers were male (99.1%) and just a few women (0.88%) and transgender (0.003%). The mean age was 45.5 years ± 10.91 and nearly half (49%) were in the productive age group (31–45 years). Noncommunicable and other chronic diseases (34.74%), musculoskeletal problems (24.17%), communicable diseases (14.52%), oral cavity-related problems (1.23%), and other minor ailments (17.77%) were the major consultation categories. Conclusion: Truck drivers in India have significant health morbidities. Providing primary health care services to truck drivers through mobile medical units is a step toward achieving universal health coverage.
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Sociodemographic profile of workers in the mining industry of Jodhpur district in Rajasthan, India p. 91
Pankaja Raghav, Abhishek Jaiswal, Manoj Kumar Gupta, Saranya Rajavel, Diksha Dhupar
DOI:10.4103/ijoem.IJOEM_288_19  
Introduction: Mining industry has grown sharply to satisfy demands of metal and minerals for rising infrastructure. Mining is hazardous, although it is among major occupations in India involving large work force. This study was conducted to assess sociodemographic profile of sandstone mine workers in Jodhpur and to identify their major social issues. Material and Methods: A cross-sectional study was conducted among mine workers of Jodhpur, Rajasthan. Data on socioeconomic status, and occupation of each family member were collected. Data were analyzed using Statistical Package for the Social Sciences (SPSS) software program, version 23.0. A value of P < 0.05 was considered as statistically significant. Results: A total of 1604 workers were enrolled in study. More than three fourth (78.7%) of them were male. Their age ranged between 14 and 82 years with a mean age of 37.62 ± 12.30 years. Mean age of female workers was significantly higher than of male workers. Average years of working for males were significantly higher than females. Majority were illiterate, proportion being higher in females. Approximately 13% mine workers married before legal age. Approximately 2.68% children under 14 years of age were involved in income generation activity. Conclusion: More than three fourth of workers were male. Mean age of female workers was significantly higher than males. Illiteracy, child marriage, and child labor were present among mine workers. Strengths and Limitations: Robust dataset, complete enumeration, large sample size.
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Impacts of occupational cognitive failure and subjective workload on patient safety incidents among intensive care units nurses p. 96
Mahboubeh Jarahian Mohammady, Asieh Sedighi, Tahereh Khaleghdoost, Ehsan Kazem Nejad, Nazila Javadi-Pashaki
DOI:10.4103/ijoem.IJOEM_22_20  
Background: Life-saving treatments and high-quality care techniques increase the opportunity for patient safety incidents in Intensive care unit. Aims: This descriptive correlation study aimed to determine the impacts of occupational cognitive failure and subjective workload on patient safety incidents among intensive care units nurses. Methods and Material: One hundred seventy-six nurses working in intensive care units were included using census sampling. The data collection tools consisted of demographic and occupational data, standard questionnaires of subjective workload (NASA-TLX) and occupational cognitive failure (OCFQ), and a question about frequency of patient safety incidents. Data analysis was performed using Mann–Whitney and Kruskal–Wallis, Spearman rank correlation coefficient, and logistic regression tests. Results: Occupational cognitive failure (OR = 1.043), subjective workload in dimension of “performance” (OR = 0.982), age (OR = 0.947), and gender (OR = 3.726) were important predictive variables of patient safety incidents. Conclusions: Nursing mangers and policymakers can consider the factors identified for staffing nurses and development of patient safety programs.
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Pulmonary tuberculosis among stone miners of India vis-à-vis silica exposure p. 102
Subroto Nandi, Shalvin Nimje, Umesh Dhumne, Sarang Dhatrak
DOI:10.4103/ijoem.IJOEM_272_19  
Background: Tuberculosis is one of the biggest public health concerns in India with a prevalence of 195 cases per 100000. Silica is cytotoxic to macrophage which is primary defense mechanism to tubercular bacilli and, hence, exposure to silica dust increases risk for TB. Silica exposed persons are at 2.8 to 39 times greater risk of affected by pulmonary tuberculosis in comparison to healthy subjects. Methodology: A cross-sectional epidemiological study was conducted among 935 workers in sandstone mining. Full-size posteroanterior view (PA) chest X-ray in full inspiration was evaluated and evidence of tuberculosis was noted. Fourier transform infrared spectrophotometer was used for determining the free silica in 23 dust samples. Results: 6.4% X-rays showed evidence of TB and silica dust concentration was 0.11 to 0.16 mg/m3. The TB cases significantly increased from 2% to 6% to 12.7% as the work exposure increased from <10 years to 11–20 years to >20 years respectively. 8.5% of the TB cases were seen among the workers having more than 10 years of work exposure. The odds ratio (95% CI) for work exposure more than 10 years to less than 10 years was 4.53 (1.92–10.65). Conclusion: Reduction of silica particles from work environment can significantly reduce the number of TB cases and hence wet drilling should be practiced and personal protective equipment should be regularly used.
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Identification, classification, and prioritization of effective factors in producing thermal strain in men at workplaces using fuzzy AHP technique p. 106
Saeid Yazdanirad, Farideh Golbabaei, Mohammad Reza Monazzam, Habibollah Dehghan, Abbas Rahimi Foroushani
DOI:10.4103/ijoem.IJOEM_93_19  
Background: Various factors can affect thermal strain at workplaces. To prevent heat illnesses due to the heat strain, one must identify and prioritize these factors. Therefore, the present study was aimed to determine the relative importance of the effective factors in producing thermal strain in men at workplaces using fuzzy AHP technique. Materials and Methods: This qualitative practical study was performed in 2019. Effective factors in producing heat strain were identified by a literature review. Then, an expert panel reviewed the identified factors and omitted some of them. Further, the balance theory of job design was applied to classify the heat strain factors. Later, these factors were categorized into six groups, including environmental, personal, job, clothing, administrative, and lifestyle elements. In the end, the fuzzy analytical hierarchy technique was used for prioritizing the elements and factors involved in each of them. Results: Based on the results, the environmental element had the highest relative weight and priority (0.178). Other priorities were assigned to the job element (0.171), clothing element (0.171), personal element (0.169), administrative element (0.169), and lifestyle element (0.142), respectively. Conclusion: In general, the results showed that environmental factors are the most effective ones in producing heat strain. The results of the present study can be helpful in controlling the thermal strain.
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Whole-body vibration exposure experienced by dumper operators in opencast mining according to ISO 2631-1:1997 and ISO 2631-5:2004: A case study p. 114
Shivkumar Shrinarayan Prajapati, Rahul Anup Mishra, Balram Jhariya, Anand Arun Deshmukh
DOI:10.4103/ijoem.IJOEM_134_19  
The study characterizes whole-body vibration exposure (WBV) experienced by dumper operators in opencast mining in India. Objective: Comparison of WBV risk of dumper operators as per ISO 2631-1 and ISO 2631-5 standard which are based on dominant axis RMS acceleration and estimated static compression dose (Sed), respectively. Method: Field study was conducted for 26 dumper operators. Whole Body Vibration signals were recorded using the tri-axial seat pad accelerometer and WBV data logger. Results: The results showed RMS in range 0.47–1.62 m/s2, total vibration dose value (VDVT) 6.91–21.03 m/s1.75, and Sed values 0.13–1.09 MPa for all 26 dumper operators. It was observed that 23% of dumper operators exposed to high health risk, 73% dumper operators exposed to moderate health risk, and minimal health risk was observed for only dumper operators as per ISO 2631-1:1997. While evaluation based on ISO 2631-5:2004 revealed, only one dumper with high health risk, 27% showed moderate health risk, however, 69% of dumper operators were exposed to minimal health risk. Conclusion: The predicted health risk according to the ISO 2631-1 is higher as compared to ISO 2631-5. ISO 2631-1 methodology has the upper hand during the prediction of WBV health risk as compared to ISO 2631-5. The result showed that ISO 2631-1 methodology was more appropriate than ISO 2631-5 for WBV health risk analysis of dumper operators in Indian mines.
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BRIEF COMMUNICATIONS Top

Prevalence, awareness and control of hypertension among sanitary workers employed in a tertiary care centre in Puducherry, South India p. 119
Venkatachalam Jayaseelan, Kuldeep Debnath, Yuvaraj Krishnamoorthy, Sitanshu Sekhar Kar
DOI:10.4103/ijoem.IJOEM_71_20  
Background and Aims: Sanitary workers have higher tendency to develop hypertension as they spend most of their time in polluted or stressful environments. Hence, the current study was done to determine the prevalence, awareness and control of hypertension among sanitary workers in tertiary care centre in Puducherry. Methods: A cross sectional study was conducted among the sanitary workers in tertiary care centre from May to December 2019. Socio-demographic, work related and behavioural characteristics was obtained using a pretested semi-structured questionnaire. Individuals was diagnosed as hypertensive if systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg. Results: Prevalence of hypertension among the sanitary workers was 36.6% (95% CI: 31.3-41.3%). Amongst them, only 34 (29.8%) participants were aware of their hypertension status. Prehypertension was present in 114 out of 277 participants (41.1%; 95% CI: 35.3-47.2%) without any history of hypertension. Among the 34 patients with known hypertension, only 12 (35.3%) had controlled BP. Workers in age group of 40 years (aPR = 1.22), unmarried workers (aPR-1.65), obese workers (aPR-1.25), current tobacco users (aPR-1.61) and alcohol users (aPR-1.25) had significantly higher association with hypertension. Conclusion: Current study found that more than one-third of the sanitary workers had hypertension. However, almost three fourth of the hypertensives were not aware about their status and only one-third of the known hypertension cases had controlled BP. Hence, it is important to conduct periodic screening and awareness sessions about the possible risk factors for better prevention and control of hypertension.
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Prevalence of dog bite among field workers at a primary health care level in Goa p. 125
Umesh S Kamat, Jagadish A Cacodcar, Kedar Raiker
DOI:10.4103/ijoem.IJOEM_166_19  
This study was undertaken in 121 field workers in a primary health care set up in Goa to estimate the lifetime and annual incidence dog bite, and to assess their knowledge and practices regarding post-exposure prophylaxis. The annual and lifetime incidence of dog bite was 3.3% and 22.3%, respectively. Based on the comparable figures from studies in general population, Dog-bite seems to be an occupational hazard among these workers. Only 28.9% completed the full course of anti-rabies vaccine with its cost as the major reason for discontinuation. More than 90% consulted traditional healers and wound toilet was done by 70%.The overall knowledge and practices seemed better than those reported in other studies, but continued orientation of the field workers and access to free vaccination at the workplace is of paramount importance.
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LETTERS TO EDITOR Top

COVID: A potential but preventable workplace hazard p. 128
Nipun Malhotra, Nitesh Gupta, Pranav Ish
DOI:10.4103/ijoem.IJOEM_63_20  
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Conjunctivitis in novel coronavirus disease (COVID-19) p. 129
Siddharth Madan, Sarita Beri
DOI:10.4103/ijoem.IJOEM_85_20  
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Perils of technology – Laptop induced erythema ab igne (toasted skin syndrome) on abdomen p. 131
Sumeet P Mirgh, Virti D Shah, Jehangir S Sorabjee
DOI:10.4103/ijoem.IJOEM_12_19  
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