Indian Journal of Occupational and Environmental Medicine   Official publication of Indian Association of  0ccupational  Health  
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     Table of Contents - Current issue
September-December 2017
Volume 21 | Issue 3
Page Nos. 99-152

Online since Wednesday, March 7, 2018

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Mental Health in the Workplace: World Mental Health Day 2017 p. 99
Ramesh Naveen
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Green Tobacco Sickness: A Brief Review p. 101
Shailee Fotedar, Vikas Fotedar
Green tobacco sickness (GTS) is the condition that mainly affects the tobacco harvesters. The condition is prevalent in Asian and South American tobacco harvesters. The present review was conducted to discuss the etiology, epidemiology, symptoms, and prevention of GTS. It is caused by the absorption of nicotine through the skin while the workers are engaged in handling the uncured tobacco leaves. The symptoms include nausea, vomiting, pallor, dizziness, headaches, increased perspiration, chills, abdominal pain, diarrhea, increased salivation, prostration, weakness, breathlessness, and occasional lowering of blood pressure. The prevalence of GTS varies from 8.2 to 47% globally. The use of personal protective equipment like water-resistant clothing, chemical-resistant gloves, plastic aprons, and rain-suits with boots should be used by the tobacco farmers to prevent its occurrence. An international-level awareness campaign has to be taken up and more stringent workers safety regulations have to be formulated.
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Compressed Air Working in Chennai During Metro Tunnel Construction: Occupational Health Problems p. 105
Ajit C Kulkarni
Chennai metropolis has been growing rapidly. Need was felt of a metro rail system. Two corridors were planned. Corridor 1, of 23 km starting from Washermanpet to Airport. 14.3 km of this would be underground. Corridor 2, of 22 km starting from Chennai Central Railway station to St. Thomas Mount. 9.7 km of this would be underground. Occupational health centre's role involved selection of miners and assessing their fitness to work under compressed air. Planning and execution of compression and decompression, health monitoring and treatment of compression related illnesses. More than thirty five thousand man hours of work was carried out under compressed air pressure ranged from 1.2 to 1.9 bar absolute. There were only three cases of pain only ( Type I) decompression sickness which were treated with recompression. Vigilant medical supervision, experienced lock operators and reduced working hours under pressure because of inclement environmental conditions viz. high temperature and humidity, has helped achieve this low incident. Tunnelling activity will increase in India as more cities will soon opt for underground metro railway. Indian standard IS 4138 – 1977 ” Safety code for working in compressed air” needs to be updated urgently keeping pace with modern working methods.
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Computer Use and Carpal Tunnel Syndrome: A Case-control Study Highly accessed article p. 109
Dinesh J Bhanderi, Daxa G Mishra, Shweta M Parikh, Deepak B Sharma
Context: Carpal tunnel syndrome (CTS) is one of the musculoskeletal disorders that is often described as an occupational hazard, including occupations involving computer use. However, clear consensus is lacking as far as the association between the use of computer and risk of possible CTS is concerned. Aim: To assess the association between CTS and computer use. Settings and Design: A case-control study. Materials and Methods: A sample size of 411 (137 cases and 274 controls) was calculated using Epi Info (version 6). Thus, 137 confirmed cases of CTS and 274 controls (matched for age and sex) were studied using a structured questionnaire. Statistical Analysis Used: Odds ratio (OR) with 95% confidence interval was calculated between the two groups to analyze the association. For control of confounding factors, logistic regression analysis was done. Results: Current use of computer was found to be significantly higher in controls rather than cases (OR = 0.47, CI = 0.27–0.84, P = 0.009). Similarly, past use of computer was also found to be higher in controls. However, the difference was not statistically significant (OR = 0.38, CI = 0.11–1.35, P = 0.20). On applying logistic regression, variables found to be significantly associated with CTS were education (OR = 0.79, CI = 0.66–0.94, P = 0.01), obesity (OR = 3.11, 95%CI = 1.92–5.04, P = 0.00), and short stature (OR = 1.06, 95%CI = 1.02–1.1, P = 0.00). Although current use of computer (OR = 0.33, CI = 0.16–0.67, P = 0.00) was significantly associated with CTS in multivariate model, OR of value less than one does not indicate positive association between this variable and CTS. Conclusion: The study did not demonstrate any positive association between computer use and CTS.
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Shift Work and Quality of Personal, Professional, and Family Life among Health Care Workers in a Rehabilitation Center in Greece p. 115
Georgia I Skoufi, Georgios A Lialios, Styliani Papakosta, Theodoros C Constantinidis, Petros Galanis, Evangelia Nena
Context: Adverse work schedules and conditions may affect the physical, mental, and social wellbeing of workers, impairing quality of life and causing conflict between family and work roles. Aims: To compare quality of life, professional quality of life (ProQOL), and work/family conflict (WFC) between shift workers and nonshift workers and explore possible associations with demographic characteristics. Settings and Design: A cross-sectional study was conducted in a rehabilitation center in Central Greece, recording demographic, occupational, and family characteristics. Materials and Methods: Participants answered the World Health Organization-5 Well-Being Index, the ProQOL questionnaire [compassion satisfaction (CS), and the burnout (BO) and secondary traumatic stress scales], and the WFC scale. Statistical Analysis Used: IBM Statistical Package for the Social Sciences version 19.0 for Windows. Results: Ninety-one employees (68.7% shift workers) participated, with mean age 33.5. Females reported higher compassion/satisfaction level (P = 0.031). Nursing profession was associated with higher levels of BO (P = 0.021), impact of work to family life (P = 0.008), and impact of family to work (FtW), and WFC (P = 0.008). Parenthood increased the impact of FtW (P = 0.008) and predispose to WFC (P = 0.023). In general, wellbeing was significantly correlated with CS (r = 0.368, P < 0.01), BO (r = −0.538, P < 0.01), and levels of WFC (P = 0.003). Work and family roles conflict was statistically significantly correlated with levels of BO (r = 0.497, P < 0.01), and CS (r = −0.288, P < 0.01). Conclusions: The interaction between general, professional, and family quality of life can guide interventions in the workplace in order to improve workers' quality of life and promote workers' health.
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Risk Assessment of Workers' Exposure to Volatile Organic Compounds in the Air of a Petrochemical Complex in Iran p. 121
Farshid Ghorbani Shanh, Samira Rahimnejad, Abdulrahman Bahrami, Maryam Farhadian
Context: Long-term exposure to volatile organic compounds (VOCs) affects the occupancies health in petrochemical complex. Objectives: The aim of this study is to apply the lifetime cancer risk (LCR) and hazard quotient (HQ) in occupational exposure to estimate the risk of VOCs in petrochemical complexes. Settings and Design: A cross-sectional study was conducted in the petrochemical complex of Iran for a period of 1 year. Materials and Methods: Sorbent tubes were used to obtain air samples from 169 workers at different petrochemical complexes in southern Iran. The compounds analyzed with gas chromatography equipped with a flame ionization detector (FID). Statistical Analysis Used: The data were analyzed by SPSS version 16. Comparison between the mean of pollutants concentration in personal samples was performed by one-way analysis of variance (ANOVA) test. Results: For all groups of workers, the results showed that exposure to carcinogenic compounds leads to LCR risks higher than 1 × 10-6. The mean of LCR for benzene is more than 10-4, and 53.3% of workers' exposed has a definite risk; the mean of LCR for workers exposed to ethyl benzene, epichlorohydrin, styrene, and trichloroethylene was between 10-4 and 10-6 and workers' exposure to these compounds was a probability risk for cancer. The mean of HQ was less than 1 for workers exposed to toluene, p-xylene, chlorobenzene, phenol, and methanol. Conclusions: The risk assessment with LCR showed that carcinogenic compounds are the main threat to workers' health and precautions should be taken to control workers' risk.
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Effort–Reward Imbalance and its Association with Health among Pluckers in a Tea Plantation in South India p. 128
Chitra Tomy, Naveen Ramesh, Farah N Fathima, Rodney L D'cunha, Kote A Chakravathi
Context: Work-related stress is associated with cardiovascular diseases, musculoskeletal disorders, psychological ailments, and work-related injuries. Imbalance between high effort and low reward at work can lead to work stress among plantation workers. Aims: To assess the effort–reward imbalance (ERI) among pluckers in tea plantations in South India and its association on chronic health problems, substance abuses, and workplace injuries. Settings and Design: A cross-sectional study was conducted among 346 tea pluckers from May to June 2015 in six selected tea plantations in Anamalai, South India. Patients and Methods: A short version of ERI questionnaire was used to assess the work-related stress among them. Along with ERI questionnaire, sociodemographic details, chronic diseases, substance abuses, and workplace injuries were ascertained. Statistical Analysis Used: Sociodemographic variables were described as frequency and measures of central tendency. Tests of association, such as Chi-square test, were applied. Results: Among the study population, 322 (93.1%) reported more effort, 23 (6.6%) reported more reward, and one (0.3%) had no imbalance between effort and reward. Those in older age group (≥51 years) experienced more effort compared to those in younger age group (≤50 years) (Fisher's exact = 21.905, P = 0.001). Educational status (Fisher's exact = 15.639, P = 0.027) and work experience (Fisher's exact = 23.122, P = 0.003) increased the effort rather than increasing the reward associated with work. No significant association was found between ERI and any chronic diseases, substance abuses, or injuries. Conclusions: Majority of pluckers in tea plantation experienced more effort compared to reward.
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Evaluation of Work-Related Musculoskeletal Disorders and Postural Stress of Female “Jari” Workers p. 132
Amitava Pal, Prakash C Dhara
Aims: The present investigation was aimed to assess the postural stress and the prevalence of musculoskeletal disorders (MSDs) of the “Jari” (golden thread) workers. Settings and Design: This cross-sectional study was carried out on 156 female workers in different areas of the Purba Medinipur, Paschim Medinipur, and Howrah districts of West Bengal, India. Materials and Methods: The MSDs of the workers were evaluated by modified Nordic questionnaire method. The postural pattern during work was assessed by direct observation method. The posture of Jari workers has been analyzed by OWAS, REBA, and RULA methods. The joint angle in normal and working posture was observed. Results and Conclusions: The prevalence of MSDs was very high among the workers. The major locations of body pains in Jari workers were lower back, upper back, neck, wrist, thigh, and shoulder. The occurrence of MSDs was higher in lower and higher age group than that of the middle age group. The total work shift of the workers was approximately 13 h including rest pause. The dominant postures adopted by the workers were sitting on the floor with stretched legs, sitting on the floor with folded knees, and kneeling posture. From the results of the postural analysis, the postures of the Jari workers had been categorized as stressful. There were a significant deviation between normal standing angles and working angles. From the overall study, it may be concluded that adoption of stressful postures for longer duration might be the cause of MSDs in different body parts of the Jari workers.
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In-depth Analysis of Pattern of Occupational Injuries and Utilization of Safety Measures among Workers of Railway Wagon Repair Workshop in Jhansi (U.P.) p. 138
Shubhanshu Gupta, Anil K Malhotra, Santosh K Verma, Rashmi Yadav
Context: Occupational injuries constitute a global health challenge, yet they receive comparatively modest scientific attention. Pattern of occupational injuries and its safety precautions among wagon repair workers is an important health issue, especially in developing countries like India. Aims: To assess the pattern of occupational injuries and utilization of safety measures among railway wagon repair workshop workers in Jhansi (U.P.). Settings and Design: Railway wagon repair workshop urban area, Jhansi (U.P). Occupation-based cross-sectional study. Patients and Methods: A cross-sectional study was conducted among 309 workers of railway workshop in Jhansi (U.P.) who were all injured during the study period of 1 year from July 2015 to June 2016. Baseline characteristics, pattern of occupational injuries, safety measures, and their availability to and utilization by the participants were assessed using a pretested structured questionnaire. Statistical Analysis Used: Data obtained were collected and analyzed statistically by simple proportions and Chi-square test. Results: The majority of studied workers aged between 38 and 47 years (n = 93, 30.6%) followed by 28–37 years (n = 79, 26%). Among the pattern of occupational injuries, laceration (28.7%) was most common followed by abrasion/scratch (21%). Safety shoes and hat were utilized 100% by all workers. Many of them had more than 5 years of experience (n = 237, 78%). Age group, education level, and utilization of safety measures were significantly associated with pattern of occupational injuries in univariate analysis (P < 0.05). Conclusions: Occupational injuries are high and utilization of safety measures is low among workers on railway wagon repair workshop, which highlights the importance of strengthening safety regulatory services toward this group of workers. Younger age group workers show a significant association with open wounds and surface wounds. As the education level of workers increases, the incidence of injuries decreases. Apart from shoes, hat, and gloves, regular utilization of other personal protective equipment was not seen.
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Exploring the Awareness Regarding E-waste and its Health Hazards among the Informal Handlers in Musheerabad Area of Hyderabad p. 143
Sapna Mishra, BR Shamanna, Srinivasan Kannan
Introduction: Occupational Health hazards of handling and management of electronic waste is a nascent subject. Improper and unscientific handling of e-waste can invite significant human and environmental health risks. Objective: To study the level of awareness about electronic waste and its health hazards amongst informal handlers in Musheerabad, Hyderabad. Methodology: Ethical approval and informed consents were obtained from Institutional Ethical Committee, University of Hyderabad and from the participants respectively before the commencement of study. This was a descriptive cross-sectional study conducted in randomly selected twenty-six waste handling centers from sixty of them in the locality. From each of the centers four handlers agedbetween 18 and 45 were randomly selected. Total of 104 handlers were interviewed using semi-structured schedule. Interviews were also conducted among 10 owners of such centres on the waste management practices. Results: About 72% of the handlers did not know the meaning of electronic waste and 71% were not aware of associated health risks, 85% did not use any protective gears, while 16% acknowledged health issues attributed to improper handling of e-waste, 77% felt their handling of e-waste was appropriate. Majority of center owners felt that informal e-waste handling does not pose any health risks, and reported that there was no awareness campaign by any agency as of then. Conclusion: This study highlights the need for awareness campaigns on proper e-waste management practices to ensure occupational safety among the waste handlers who belong to lower socio-economic strata.
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Sewage Pollution in Water Supply in Indore p. 149
Alifiya Tahir, Aayush Visaria
More than 20% of sewage waste is dumped untreated into Indore's water supply, while 80% of it's sewers are under-utilized or blocked. Such conditions may increase exposure to microbial pathogens and compromise water potability. This article reports an environmental risk assessment of Indore's Khan River based on existing literature, including hazard identification, dose-response and exposure assessment, identification of susceptible populations, risk characterization, and potential community-oriented management and communication approaches.
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Improving Workplace Ergonomics in Corporate Offices: A Comment on Madhwani et al. p. 152
Saurav Basu
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