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     Table of Contents - Current issue
Coverpage
January-April 2018
Volume 22 | Issue 1
Page Nos. 1-58

Online since Wednesday, April 18, 2018

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EDITORIAL  

Mini occupational health services for un-organized labor markets in India p. 1
Ganesh K Kulkarni
DOI:10.4103/ijoem.IJOEM_69_18  PMID:29743776
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REVIEW ARTICLE Top

Implication of emotional labor, cognitive flexibility, and relational energy among cabin crew: A review p. 2
Rithi Baruah, K Jayasankara Reddy
DOI:10.4103/ijoem.IJOEM_21_18  PMID:29743777
The primary aim of the civil aviation industry is to provide a secured and comfortable service to their customers and clients. This review concentrates on the cabin crew members, who are the frontline employees of the aviation industry and are salaried to smile. The objective of this review article is to analyze the variables of emotional labor, cognitive flexibility, and relational energy using the biopsychosocial model and identify organizational implications among cabin crew. Online databases such as EBSCOhost, JSTOR, Springerlink, and PubMed were used to gather articles for the review. The authors analyzed 17 articles from 2001 to 2016 and presented a comprehensive review. The review presented an integrative approach and suggested a hypothetical model that can prove to be a signitficant contribution to the avaition industry in particular and to research findings of aviation psychology.
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ORIGINAL ARTICLES Top

Respiratory morbidity among rice mill workers in an urban area of Burdwan District, West Bengal: A cross-sectional study p. 5
Madhab Ch Rana, Somnath Naskar, Ramaprasad Roy, Dilip Kr Das, Soumya Das
DOI:10.4103/ijoem.IJOEM_20_18  PMID:29743778
Background: Rice mill workers constitute a special group from the perspective of occupational health. Unprotected dust exposure among them adversely affects their respiratory health, which needs to be evaluated. Adequate evidence is still lacking in many parts of India including West Bengal. Burdwan is one of the main rice-producing districts in the state with abundant rice mills. Aim: The aim of the study was to find out the prevalence and pattern of respiratory morbidity and associated background characteristics of rice mill workers. Settings and Design: A descriptive cross-sectional study was conducted at Burdwan municipality area during July–December 2016. Materials and Methods: Considering 44.2% prevalence, 95% confidence interval, 15% allowable error, 10% non-response, a sample of 252 directly engaged rice mill workers were selected through multistage random sampling. With prior consent, the subjects were interviewed, clinically examined, and underwent spirometry; relevant records were also reviewed using a pre-designed schedule. Any abnormal spirometry finding was considered as respiratory morbidity. Ethical approval was obtained from institutional ethics committee. Statistical Analysis: Data were analyzed using SPSS version 20. Chi-square test and multiple logistic regression were applied. Results: Prevalence of respiratory morbidity was 40.73% with obstructive and restrictive respiratory morbidity being 24.60% and 16.13%, respectively. Non-use of any protective measure, duration (years) of working in rice mill and average daily working hours were significant predictors of respiratory morbidity. Conclusion: Respiratory morbidity is quite high in the area. Proper health education and provision of personal protective equipments need to be provided.
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Hearing threshold status and risk estimate of hearing impairment among administrative workforce p. 11
Joydeep Majumder, Ramanlal C Patel, Sanjay Kotadiya, Priyanka Shah
DOI:10.4103/ijoem.IJOEM_22_18  PMID:29743779
Background: Administrative workers working in quieter environment workplace are considered unaffected by noise-induced hearing loss (NIHL). Aim: To create a baseline data of the administrative workers so as to monitor them with prospective years of exposure with the hypothesis that workers working in the administrative jobs may not be affected by NIHL. Settings and Design: The study was conducted among men and women administrative workers working in an office in Ahmedabad city, India. The design of the study was prospective cross-sectional study. Materials and Methods: In all, 64 men and 33 women administrative workers were recruited. Pure tone air conduction (AC) and unmasked bone conduction (BC) audiometry of both ears was performed. Pure tone averages (PTAs) and air-bone gap (ABG) were calculated. Excess risk of hearing impairment was estimated using five model equations. Statistical Analysis: Descriptive statistics was used for analysis. For calculation of excess risk of hearing impairment, models in online calculator were used. Results: AC for men depicted 4 and 6 kHz notch, whereas 6 kHz for women, for both ears. Around three-fourth men and nine-tenth women recorded hearing threshold <25 dB (A) for PTA0.5-1-2-4. ABG was <15 dB at all frequencies except 6 kHz, for both groups. Highest values of average estimated excess risk were 4.89% and 1.21% for men and women, respectively. Estimated excess risk ranged up to 1% for 50%–77% men and 82%–91% women. Conclusion: Administrative workers are minimally risked of developing NIHL; however, with progressive age, hearing ability may deteriorate.
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Comparing the effectiveness of three ergonomic risk assessment methods—RULA, LUBA, and NERPA—to predict the upper extremity musculoskeletal disorders p. 17
Saeid Yazdanirad, Amir Hossein Khoshakhlagh, Ehsanollah Habibi, Asma Zare, Mohammad Zeinodini, Fatemeh Dehghani
DOI:10.4103/ijoem.IJOEM_23_18  PMID:29743780
Background: Musculoskeletal disorders are a major problem in all jobs. Several methods are available for assessing the exposure to risk factors associated with musculoskeletal disorders. This study is aimed at comparing three different ergonomic risk assessment methods—rapid upper limb assessment (RULA), loading on the upper body assessment (LUBA), and new ergonomic posture assessment (NERPA) method—to predict upper extremity musculoskeletal disorders. Materials and Methods: The study was conducted on 210 workers from three different industries including pharmaceutical, automotive, and assembly in the Isfahan province. A Nordic questionnaire was used for determining the levels of musculoskeletal disorders. Then, selected postures were evaluated with RULA, LUBA, and NERPA methods. Finally, data were analyzed with Kolmogorov–Smirnov test to check the normality distribution of data, Spearman's correlation test to investigate the correlation between the assessed levels with musculoskeletal disorders, and Wilcoxon test to identify significant differences between the values with SPSS version 16. Results: Wilcoxon test revealed a significant difference between the values related to NERPA and RULA (P < 0.001), whereas no significant relation between LUBA and RULA was shown by this test (P = 0.914). The correlation coefficients of the musculoskeletal disorders' level with RULA level, NERPA level, and LUBA level were 0.74, 0.73, and 0.69, respectively. Conclusion: Low-risk levels in NERPA, medium-risk levels in LUBA, and high-risk levels in RULA are evaluated better. The results showed that RULA was the best method for assessing musculoskeletal disorders among the three methods.
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Catastrophic health expenditure and impoverishment effects of out-of-pocket expenses: A comparative study of tannery and non-tannery workers of Kanpur, India p. 22
Gyan C Kashyap, Shri K Singh, Santosh K Sharma
DOI:10.4103/ijoem.IJOEM_168_17  PMID:29743781
Purpose: Treatment-seeking behaviors and economic burden because of health expenditure are widely discussed issues in India, and more so in recent times. The aim of this study is to identify health problems of tannery workers and their treatment-seeking behavior and their health expenditure. Data and Methods: The primary data used in this article were collected through a cross-sectional household survey of 284 male tannery workers in the Jajmau area of Kanpur city in the state of Uttar Pradesh, during January–June 2015. Results: Findings of the study revealed that around 36% of the tannery workers and 42% of non-tannery workers received treatment as outpatients in government/municipal hospital in the first spell of treatment. The secondary source of treatment was pharmacy/drug stores for 30% of the tannery workers and 24% of the non-tannery workers, an indication that a substantial proportion takes treatment without consulting a qualified medical practitioner; it also highlights that almost one-third of the tannery and non-tannery workers visited private health facility despite poor economic condition. It is evident that a substantial proportion of tannery and non-tannery workers are visiting private/non-governmental organization/trust hospital despite their poor financial situation. Conclusion: There is an urgent need to reinstate people's faith in public health facilities by developing professionalism, integrity, and accountability among different levels of health functionaries and frontline workers with the support of credible, transparent, and responsible regulatory environment.
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Effect of shift work on sleep, health, and quality of life of health-care workers p. 29
Evangelia Nena, Maria Katsaouni, Paschalis Steiropoulos, Evangelos Theodorou, Theodoros C Constantinidis, Grigorios Tripsianis
DOI:10.4103/ijoem.IJOEM_4_18  PMID:29743782
Background: Shift work is associated with sleep disruption, impaired quality of life, and is a risk factor for several health conditions. Aim of this study was to investigate the impact of shift work on sleep and quality of life of health-care workers (HCW). Settings: Tertiary University hospital in Greece. Study Design: Cross-sectional study. Materials and Methods: Included were HCW, working either in an irregular shift system or exclusively in morning shifts. All participants answered the WHO-5 Well-Being Index (WHO-5) and a questionnaire on demographics and medical history. Shift workers filled the Shift Work Disorders Screening Questionnaire (SWDSQ). Statistical Analysis: Descriptive statistics, Student's t-test, one-way analysis of variance (ANOVA), Pearson's r correlation coefficient, and multivariate stepwise linear regression analysis were applied. Results: Included were 312 employees (87.9% females), 194 working in irregular shift system and 118 in morning shifts. Most shift-workers (58.2%) were somehow or totally dissatisfied with their sleep quality. Regression analysis revealed the following independent determinants for sleep impairment: parenthood (P < 0.001), age 36–45 years (P < 0.001), >3 night shifts/week (P < 0.001), work >5 years in an irregular shift system (P < 0.001). Diabetes mellitus was the most common medical condition reported by shift workers (P = 0.008). Comparison between the two groups revealed a significantly impairment in WHO-5 total score, as well as in 4 of 5 of its items (P < 0.001). Conclusion: Shift-work impairs quality of life, whereas its duration and frequency, along with age and family status of employees can have adverse effects on sleep.
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Dental technicians' pneumoconiosis; illness behind a healthy smile – case series of a reference center in Turkey p. 35
Nur Şafak Alici, Ayşe Coşkun Beyan, Yücel Demıral, Arif Çimrin
DOI:10.4103/ijoem.IJOEM_41_18  PMID:29743783
Background: Dental laboratories include many hazards and risks. Dental technicians working in an unfavorable work environment in Turkey and other parts of the world may develop pneumoconiosis as a result of exposure to dust, depending on exposure time. In this study, we aimed to investigate the clinical and laboratory findings of dental technicians. Materials and Methods: The study consists of a case series. Between 2013 and 2016, a total of 70 who were working as a dental technician and referred to our clinic with suspicion of occupational disease were evaluated. Comprehensive work-history, physical examination complaints, functional status, chest X-ray, and high-resolution computed lung tomography (HRCT) findings were evaluated. Results: In all, 46 (65.7%) of the 70 dental technicians were diagnosed with pneumoconiosis. About 45 (97.8%) subjects were male and 1 (2.2%) was female. The mean age of starting to work was 15.89 ± 2.79 (11-23) years. The mix dust exposure time was 176.13 ± 73.97 (18-384) months. Small round opacities were most common finding. In 16 patients, high profusion being 2/3 and above were identified, and large opacity was detected in 11 patients. The radiological profusion had a weak negative correlation with FEV 1 and FVC (correlation coefficient − 0.18, P = 0.210 and − 0.058, P = 0704) and moderate negative correlation between radiological profusion and FEV1/FVC (correlation coefficient − 0.377, P = 0.010). In addition, no correlation was observed between the age at start of work and the duration of exposure. Conclusion: The presence of pneumoconiosis continues in dental technicians in Turkey, especially because there is an early childhood apprenticeship culture and almost all workers in this period have the history of sandblasting.
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High prevalence of chronic respiratory symptoms among autorickshaw drivers of Urban Puducherry, South India p. 40
Peter Stephen, Thulasingam Mahalakshmy, Rajaram Manju, Karthik B Laksham, Sudalai Subramani, Kanhu Panda, Sonali Sarkar
DOI:10.4103/ijoem.IJOEM_163_17  PMID:29743784
Context: Auto-rickshaw (three wheelers open cabin type of vehicle) drivers are exposed to traffic air pollution. Studies have demonstrated reduced pulmonary function among drivers. However, limited studies have determined the prevalence of chronic respiratory symptoms or chronic obstructive pulmonary disease (COPD) among drivers. Aims: Among auto-rickshaw drivers of urban Puducherry to determine prevalence of (i) chronic respiratory symptoms by using Indian Study on Epidemiology of Asthma, Respiratory Symptoms, and Chronic Bronchitis (INSEARCH) questionnaire and (ii) COPD by measuring peak expiratory flow rate (PEFR). Setting and Designs: Cross-sectional, descriptive study. Subjects and Methods: Cluster random sampling was used to select 297 auto-rickshaw drivers. Subjects were interviewed using the INSEARCH questionnaire. PEFR was measured using Wright's peak flow meter. We also assessed exposure to tobacco smoke. Statistical Analysis Used: Prevalence and 95% confidence interval of chronic respiratory symptoms and COPD were calculated. Results: All the auto-rickshaw drivers were male, and 75% were in the age group of 31–50 years. They spend most of the time on the roadside either driving or waiting at the auto-stand. Prevalence of nonspecific respiratory symptoms among auto-rickshaw drivers was 76% (breathlessness on exertion 68%, cough at night and phlegm in the morning 22%, wheezing 18% assessed for last 12 months). Around 28% of them had PEFR <80%. The prevalence of tobacco smoking was also high (64%), and 100% had exposure to tobacco smoke at the workplace. Conclusion: The nonspecific chronic symptoms were high among auto-rickshaw drivers as compared to the general population noted from a multicentric study done in India. We recommend that auto-rickshaw drivers should use personal protective equipment and would require regular screening and treatment for respiratory impairment.
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Effect of organic dust exposure on pulmonary functions in workers of vegetable market with special reference to its microbial content p. 45
Arun Goel, Balram Ji Omar, Rajesh Kathrotia, Prashant M Patil, Sunita Mittal
DOI:10.4103/ijoem.IJOEM_167_17  PMID:29743785
Context: Wholesale vegetable market is a rich source of generation of organic dust as loads of fruits and vegetables are loaded and unloaded here daily. Thus, regular workers are exposed to this organic dust for a considerable period of time depending on their work schedule. This study was planned to determine the microbial status of organic dust and to explore its association with pulmonary functions in the workers of wholesale vegetable market in Rishikesh. Materials and Methods: It was a cross-sectional exploratory/observational study. Thirty-five apparently healthy adult males were selected from vegetable market having no history of any chronic illness. Smokers and alcoholic were excluded from the study. The same number of age- and sex-matched controls with the same exclusion criteria were recruited from workers not working in the vegetable market and also not exposed to any other kinds of organic dust. Microbial culture of air in the vegetable market was done. It was compared with the microbial status of air in the working place of controls. Pulmonary functions of all the workers were performed with the help of digital spirometer (Helios 401). Results: Bacterial and fungal concentration was found to be significantly higher in the air of vegetable market as compared to air in the workplace of controls (such as coagulase-negative staphylococci >25 colony-forming unit (CFU) at incubation temperature vs. 10–12 CFU at incubation temperature, significant growth of Mucor, Aspergillus niger, and Candida nonalbicans in vegetable market as compared to workplace of controls). Pulmonary function parameters (percentage forced expiratory volume in 1st s (FEV1), percentage predicted forced expiratory flow in mid-half of expiration, and FEV1) of workers exposed to organic dust in vegetable market were also significantly lower (P < 0.05). Conclusion: Exposure of organic dust is associated with compromised pulmonary functions and there is a need of formulation of safety guidelines.
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Awareness of occupational hazards and associated factors among automobile repair artisans in Kathmandu Metropolitan City, Nepal p. 49
Sujan B Marahatta, Sanju Gautam, Grish Paudel, Uday N Yadav
DOI:10.4103/ijoem.IJOEM_106_17  PMID:29743786
Background: An occupational hazard contributes to severe health problems among workers due to unhygienic conditions and lack of safety at the workplace. Economic growth and productivity can be well achieved by promoting health, safety, and improved quality workplace. Aims: To assess the knowledge of occupational hazards, use of Personal Protective Equipment (PPE) and the factors associated with awareness on occupational hazards among automobile repair artisans in Kathmandu, Nepal. Settings and Design: A quantitative descriptive cross-sectional study with 400 automobile repair artisans from Kathmandu metropolitan city was conducted between March and September, 2015. Materials and Methods: Simple random sampling was adopted for recruiting study participants. Pre-tested, validated semi-structured questionnaire was used in line with study objectives to collect the data. Statistical Analysis: Logistic regression analysis was employed to identify factors associated with the awareness of occupational hazard and PPE use. Results: Of total, 56% had awareness on occupational hazard and 44.3% of artisans were using the personal protective equipments. Being educated, having job duration ≥6 years and having pre-service training for work were significantly associated with the awareness of occupational hazards. Notably, we found that those who were aware of occupational hazard (OR = 3.01, 95% CI: 1.98–4.57) were three times more likely to use the safety measures when compared to those who were unaware. Conclusions: Awareness on occupational hazard and use of PPE is very low among automobile repair artisans in Kathmandu, Nepal. Therefore, interventions on awareness raising on areas, like provision of pre-service training, promotion of safety advocacy, and enforcement of appropriate regulations for work place.
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CASE REPORT Top

Acute lung injury after exposure to fumes of pickling paste in a fabrication worker p. 54
S Bavikar Purva, K Dattarai More
DOI:10.4103/ijoem.IJOEM_162_17  PMID:29743787
Pickling paste is used for cleaning stainless steel weld seam heat marks. It is a mixture of hydrofluoric acid (HF) and nitric acid (HNO3) with surfactants and inhibitors. The substance is corrosive, toxic, and irritant. Air respirator and half mask air filter covering nose and mouth are mandatory before handling the pickling paste. This is a case report of a 28-year-old male complaining of sudden onset dyspnea at rest after accidental inhalation of pickling paste fumes. The patient developed acute lung injury and subsequently acute respiratory distress syndrome and was treated with noninvasive ventilation, steroids, and other supportive treatment.
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LETTER TO EDITOR Top

Summer heat: Making a consistent health impact p. 57
Anil K Agarwal, Shatkratu Dwivedi, Ahirwar Ghanshyam
DOI:10.4103/ijoem.IJOEM_94_17  PMID:29743788
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