Indian Journal of Occupational and Environmental Medicine   Official publication of Indian Association of  0ccupational  Health  
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     Table of Contents - Current issue
January-April 2020
Volume 24 | Issue 1
Page Nos. 1-49

Online since Wednesday, March 18, 2020

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Revitalizing basic occupational health services provision for accelerating universal health coverage in 21st century India p. 1
Sanjay Zodpey, Himanshu Negandhi
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Adult immunization in occupational settings: A consensus of Indian experts p. 3
Parvaiz A Koul, Subramanium Swaminathan, Thirumalai Rajgopal, V Ramsubramanian, Bobby Joseph, Shrinivas Shanbhag, Ashish Mishra, Sidram K Raut
There is an increasing focus on instituting wellness programs at the workplace among organizations in India. Such programs are aimed at improving employee health, which in turn, helps in reducing absenteeism, as well as in increasing work productivity and improving employee engagement. Of note, adult vaccination plays a significant role in ensuring the well-being of employees, as well as in keeping an organization profitable. The burden of vaccine-preventable diseases (VPDs) in adults is increasing in India, causing significant morbidity and disability. Moreover, adult immunization is an underpublicized concept in India. There is an urgent need to create awareness about adult immunization in India, particularly in occupational health settings—both at the employee and employer levels. In view of this, an expert meeting was held under the aegis of the Indian Association of Occupational Health (IAOH) to discuss key issues pertaining to the burden of VPDs in the working population in India and to formulate guidelines on adult vaccination in occupational health settings. This consensus guideline document may act as a guide for organizations across India to create awareness about adult vaccination and also to design workplace vaccination programs to promote better health among employees.
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Tackling corona virus disease 2019 (COVID 19) in workplaces Highly accessed article p. 16
Naveen Ramesh, Archana Siddaiah, Bobby Joseph
Coronaviruses are zoonotic viruses and six species of Coronaviruses are known to cause human disease such as cause common cold, severe acute respiratory syndrome and the Middle East Respiratory Syndrome. In January 2020, scientists in Wuhan, China isolated a novel coronavirus (SARS-CoV-2), responsible for an outbreak of unknown pneumonia that had not been previously reported among humans. This virus spreads from person to person, through respiratory droplets, close contact, and by touching surfaces or objects contaminated by the virus. The incubation period varies between 2 days and 14 days. Symptoms usually include fever, cough, difficulty in breathing, pneumonia, severe acute respiratory syndrome. Older age and co-morbid conditions increase the fatality. Any person with a history of travel to and from COVID-19 affected countries in the past 14 days or any person who has had close contact with a laboratory confirmed COVID-19 are suspect cases and needs evaluation. Currently no vaccine is available and treatment is mainly supportive. Measures at workplace should include- avoiding non-essential travel, identifying and isolating sick employees at the earliest, hand hygiene, respiratory hygiene, environmental hygiene and social distancing.
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Developing a holistic-comprehensive assessment model: factors contributing to personal protective equipment compliance among indonesian cement workers p. 19
Febri E B. Setyawan, Stefanus Supriyanto, Ernawaty Ernawaty, Retno Lestari
Context: Noncompliance with personal protective equipment (PPE) in industrial workers results in increased injury or illness and is commonly reported worldwide. Numerous guidelines and management policies are employed to prevent work-related health hazards, yet industrial workers still exhibit low rates of PPE compliance, especially in outsourced workers. Aims: The aim of this study was to develop a holistic-comprehensive assessment framework model summarizing the key factors in achieving the stated goals of interventions targeting PPE compliance in Indonesian cement workers. Settings and Design: An analytic observational study was conducted among 183 Indonesian cement workers from a simple random sampling technique. Methods and Material: A self-designed questionnaire was used to investigate factors influencing PPE compliance among cement workers as well as management policies in place. Statistical Analysis Used: Statistical analysis was conducted using SPSS version 24. Results were tabulated using frequency distribution and mean with a standard deviation. The logistic regression model was developed to identify the factors that affect PPE compliance. Results: The highest rate of compliance was 43.7%, a still low figure. Using correlation coefficients and logistic regression, both the behavior of the workers and the existing management policies were found to be significant contributing factors (P < 0.05). Punitive management policies were also found to be a determining factor (OR 5.22; 95% CI 1.01–1.07). Conclusions: Management policy, specifical punishment for noncompliance, was shown to be the strongest influence on PPE compliance in Indonesian cement workers.
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Combating climate change-induced heat stress: Assessing cool roofs and its impact on the indoor ambient temperature of the households in the Urban slums of Ahmedabad p. 25
Selvakumar Vellingiri, Priya Dutta, Srishti Singh, LM Sathish, Shyam Pingle, Bijal Brahmbhatt
Background: The rising global temperature and frequent heatwaves are the adverse effects of climate change. The causalities and ill impacts of the heat stress were higher among the slum dwellers because of the vulnerable household structures, which were made by heat-trapping materials like tin sheets, cement sheet (asbestos), plastic, and tarpaulin. The houses are not only dwellings but also a source of livelihood for many slum dwellers as they are involved in home-based work. The increase in the temperature of more than 40°C severely affects health and increases energy expenditures. Objective: The present study conducted to identify the efficient cool roof technologies that reduce indoor temperature of the households and improve the heat resilience of dwellings located in the urban slums of Ahmedabad. Methodology: The performances of cool roof interventions were compared with the nonintervention - roof types, namely, tin, asbestos/cement sheet, and concrete. Relative humidity/temperature data loggers (Lascar EL-USB-2-LCD, Sweden) were used to measure the indoor ambient temperature and humidity. The questionnaire-based survey also has been conducted to understand the socioeconomic status and the perceptions related to roofing and health. Results: The results revealed that selected cool roof technologies including Thermocol insulation, solar reflective white paint on the outer surface of the roof, and Modroof are effectively reducing the indoor temperature as compared to the nonintervention roofing. Conclusion: Cool roof technologies have a wider scope as number of informal settlements are increasing across the cities in India and other developing countries. The governments may not able to provide proper housing to all these inhabitants due to various reasons including the land tenure of the habitats. Validated cool roof technologies can be promoted as these structures are not requires legal sanctions and easily dismantled and installed in multiple places and safeguards the investment of urban poor.
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Indoor air quality and sick building syndrome: Are green buildings better than conventional buildings? p. 30
Sonal Gawande, Rajnarayan R Tiwari, Prakash Narayanan, Ashwin Bhadri
Indoor air quality (IAQ) influences human health, productivity and wellness. Green buildings are believed to have better IAQ. The 'sick building syndrome' (SBS) describes a set of nonspecific symptoms experienced by occupants due to time spent in a building with poor IAQ. Thus this study was undertaken to assess the IAQ in green buildings and compare it with that of conventional buildings. The prevalence of SBS in both types of buildings is also studied. In five pairs of green and conventional buildings measurements of comfort parameters (temperature & relative humidity) and indoor air pollutants using monitors was done. 148 employees which included 84 from green buildings and 64 from conventional buildings were surveyed for SBS using an interviewer-administered questionnaire. The analysis was done using SPSS16 and included Mann Whitney for IAQ pollutant concentrations and Chi-square for the SBS prevalence. Similar indoor air quality was found in both types of buildings. The mean of temperature, CO2 and formaldehyde was statistically lower in green buildings. The SBS prevalence was found to be 38.1% in green buildings and 53.1% in conventional buildings. Thus to conclude the poorly maintained green building does not have any added advantage for occurrence of SBS.
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Toxicity of organic solvent in a young painter presenting as transient hepatitis: A case report p. 33
Poonam Agrawal, Deepti Chopra, Mrinal Gupta, Santgaurav
Organic solvents widely used in paint manufacturing, painting, and shoemaking industries may be associated with hepatotoxicity. We present a case report of a patient with prolonged occupational exposure to organic solvents who developed transient hepatitis. Monitoring contact to these chemicals and early identification of biological markers of occupational exposure should be done. More epidemiological studies on the effects of solvents on the liver should be performed so as to help the policy makers to formulate appropriate measures to prevent detrimental effects of exposure of such chemicals. Additionally, early reporting of such cases of occupational hazards will be helpful in further understanding the incidence and possible mechanisms.
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Diagnosis and management of cryptogenic occupational tetanus: A case report from Rajasthan, India p. 36
Mahadev Meena, Saurabh Kumar, Maya Gopalakrishnan, Gopal Krishna Bohra, Mahendra Kumar Garg
The reported cases of non-neonatal tetanus have doubled from 2015 to 2017 in India, while neonatal tetanus has declined by half during this period. Most of these non- neonatal tetanus are acquired by occupational exposure especially in high risk populations such as agricultural workers, industrial workers and health care workers secondary to increased spore exposure or risk for minor injuries. We report a case of occupational tetanus in a steel worker and discuss the importance of recognising tetanus as an occupational hazard and address issues related to its early diagnosis and management. The report also highlights the need for policymakers and health practitioners in India to evolve a robust understanding of the needs and vulnerabilities of high risk occupational groups in order to apply specific and effective interventions to prevent occupational tetanus.
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Chylothorax in a case of accelerated silicosis with pulmonary silicoproteinosis: A unique association p. 39
Archana Sasi, Animesh Ray, Ashu Seith Bhalla, Sudheer Arava, Shubham Agarwal, Ranveer Singh Jadon, Naval Kishore Vikram
A 32-year-old gentleman, a worker in a cement-manufacturing facility with suspected silica-induced lung disease presented with acutely worsening Type 1 respiratory failure. With a negative work-up for infectious causes and no further revelations on bronchoalveolar lavage fluid or endobronchial biopsy, it was a transbronchial biopsy that ultimately led us to a diagnosis of silicoproteinosis with accelerated silicosis. Interestingly, the patient had a pleural effusion which on thoracentesis showed chylous fluid-the first reported case of chylothorax in association with silicosis.
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Symptomatic pulmonary siderosis in scissors/knife sharpening worker: A case report p. 42
Sonam Spalgais, Raj Kumar, Parul Mrgipuri
Pulmonary siderosis is a rare occupational lung disease. Traditionally, it has been considered a “benign pneumoconiosis” because of the absence of associated clinical symptoms or pulmonary fibrosis. However, few authors have reported the evidence of pulmonary symptoms with lung fibrosis on high-resolution computed tomography and lung biopsy. Symptomatic pulmonary siderosis in scissors/knife sharpening worker has not been described in past literature. We report a case of biopsy proven symptomatic pulmonary siderosis in scissors/knife sharpening worker, who was unnecessarily treated with antitubercular therapy for 3 months.
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Study of clinico-radiological profiles of patients with occupational interstitial lung disease in a tertiary care center p. 45
Sameer Vaidya, Dipti Gothi, Mahismita Patro, UC Ojha, Ram Babu Sah
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T-spot®.TB test for latent tuberculosis infection diagnosis and treatment guidance in Thai health-care professionals p. 47
Thana Khawcharoenporn, Waralee Aksornchindarat, Napat Yodpinij, Sopa Srisungngam, Janisara Rudeeaneksin, Supranee Bunchoo, Wiphat Klayut, Somchai Sangkitporn, Benjawan Phetsuksiri
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