Recent industrialization and globalizations are changing the Indian occupational morbidity drastically. Traditionally labor-oriented markets are on change towards more automation and mechanization, at the same time general awareness about occupational safety, occupational and environmental hazards were not spread in the society. This review will provide an overview of existing evidence from community based epidemiological studies and address the growing needs for evidence-based occupational health research in India. Review of all published results. Occupational research is seen as more complex issue in India, which Includes child labor; poor industrial legislation; vast informal sector; less attention to industrial hygiene and poor surveillance data across the country. While India experiencing economic transition, occupational research approach should balance between understanding the modern industrial exposures and health risks of traditional sectors like agriculture and plantations. Strategies like modern occupational health legislation, enforcement machinery in sub-district level, training to health professionals, need for epidemiological evidence and international collaborations were discussed to deal with the situation.

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Lifestyle diseases characterize those diseases whose occurrence is primarily based on the daily habits of people and are a result of an inappropriate relationship of people with their environment. The main factors contributing to lifestyle diseases include bad food habits, physical inactivity, wrong body posture, and disturbed biological clock. A report, jointly prepared by the World Health Organization (WHO) and the World Economic Forum, says India will incur an accumulated loss of $236.6 billion by 2015 on account of unhealthy lifestyles and faulty diet. According to the report, 60% of all deaths worldwide in 2005 (35 million) resulted from noncommunicable diseases and accounted for 44% of premature deaths. What's worse, around 80% of these deaths will occur in low and middle-income countries like India which are also crippled by an ever increasing burden of infectious diseases, poor maternal and perinatal conditions and nutritional deficiencies. According to a survey conducted by the Associated Chamber of Commerce and Industry (ASSOC-HAM), 68% of working women in the age bracket of 21-52 years were found to be afflicted with lifestyle ailments such as obesity, depression, chronic backache, diabetes and hypertension. The study 'Preventive Healthcare and Corporate Female Workforce' also said that long hours and working under strict deadlines cause up to 75% of working women to suffer from depression or general anxiety disorder, compared to women with lesser levels of psychological demand at work. The study cited scientific evidence that healthy diet and adequate physical activity - at least 30 minutes of moderate activity at least five days a week - helped prevent NCDs. In India, 10% of adults suffer from hypertension while the country is home to 25-30 million diabetics. Three out of every 1,000 people suffer a stroke. The number of deaths due to heart attack is projected to increase from 1.2 million to 2 million in 2010. The diet [or lifestyle] of different populations might partly determine their rates of cancer, and the basis for this hypothesis was strengthened by results of studies showing that people who migrate from one country to another generally acquire the cancer rates of the new host country, suggesting that environmental [or lifestyle factors] rather than genetic factors are the key determinants of the international variation in cancer rates. Some of the common diseases encountered because of occupational lifestyle are Alzheimer's disease, arteriosclerosis, cancer, chronic liver disease/cirrhosis, chronic obstructive pulmonary disease (COPD), diabetes, hypertension, heart disease, nephritis/CRF, and stroke. Occupational lifestyle diseases include those caused by the factors present in the vicinity like heat, sound, dust, fumes, smoke, cold, and other pollutants. These factors are responsible for allergy, respiratory and hearing problems, and heat or cold shock. So, A healthy lifestyle must be adopted to combat these diseases with a proper balanced diet, physical activity and by giving due respect to biological clock. Kids spending too much time slouched in front of the TV or PCs, should be encourage to find a physical sport or activity they enjoy. Fun exercises should be encouraged into family outings. A pizza-and-video evening should be replaced for a hike and picnic. Kids who do participate in sport, especially at a high competitive level, can find the pressure to succeed very stressful. To decrease the ailments caused by occupational postures, one should avoid long sitting hours and should take frequent breaks for stretching or for other works involving physical movements.

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Manmade nanoparticles range from the well-established multi-ton production of carbon black and fumed silica for applications in plastic fillers and car tyres to microgram quantities of fluorescent quantum dots used as markers in biological imaging. While benefits of nanotechnology are widely publicized, the discussion of the potential effects of their widespread use in the consumer and industrial products are just beginning to emerge. Acceptance of nanoparticle toxicity led to wide acceptance of the fact that nanotoxicology, as a scientific discipline shall be quite different from occupational hygiene in approach and context. Understanding the toxicity of nanomaterials and nano-enabled products is important for human and environmental health and safety as well as public acceptance. Assessing the state of knowledge about nanotoxicology is an important step in promoting comprehensive understanding of the health and environmental implications of these new materials. Very limited data exist for health effects secondary to inhalation of very fine respirable particles in the occupational environment. Nanomaterials may have effects on health due to their size, surface, shape, charge, or other factors, which are not directly predictable from mass concentration measurements. Numerous epidemiological studies have associated exposure to small particles such as combustion-generated fine particles with lung cancer, heart disease, asthma and/or increased mortality. The omnipresence of nanoparticles shifts focus of research toward efforts to mitigate the health effects of nanoparticles. Newer health assessment methods and newer techniques need to be developed for diagnosing sub-optimal health in populations exposed to carbon nanoparticles.

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The multisystem and prime environmental and occupational toxin, lead (Pb) is seldom included in the list of endocrine disruptors group like bisphenols A, B and F, nonylphenol, benzoquine, equiline etc. One hundred and thirty-seven subjects consisting of 86 lead workers and 51 unexposed individuals (as controls) participated in the study. Dietary intake including dairy products and micronutrients as assessed by 24-hour dietary recall was similar between lead workers and controls. Calcium homeostasis and haematological indices were evaluated in all subjects. Blood lead level was significantly higher in the lead workers than in controls (P<0.001). Total and ionized calcium levels were in contrast significantly decreased in lead workers compared with controls (P<0.01, P<0.001 respectively). Inorganic phosphate level though slightly raised compared to controls did not reach statistical significance (P>0.05). The haematological indices, haemoglobin, haematocrit, and mean cell haemoglobin concentration like calcium levels were all significantly reduced (P<0.001) in all cases. Semi-quantitative assessment of erythrocyte protoporphyrin was trace (±) in both lead workers and controls (i.e. similar). Serum copper level was significantly higher in Pb workers than in controls (P<0.005). These decreases are consistent with a repression of the endocrine systems regulating both erythropoiesis and calcium homeostasis resident in the proximal convoluted tubule(PCT) of the kidney; the most vulnerable site to Pb damage. Our findings therefore, appear to provide evidence or a reminder that Pb satifies the conditions defining EDCs and should be recognized as one, especially in developing countries where high environmental Pb and malnutrition co-exist and may magnify this effect

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About 673 small-scale asbestos mining and milling facilities and 33 large - scale asbestos manufacturing plants, (17 asbestos-cement product manufacturing plants and 16 other than asbestos-cement product plants) are situated in India. The present study reveals the exposure of commercial asbestos (chrysotile) in the occupational as well as ambient air environment of the asbestos-cement (AC) sheets industry using membrane filter method of Bureau of Indian Standards (BIS). The fibre concentrations in 15 samples collected in the occupational environment at ingredient feeding site, sheet-producing site, fibre godown were 0.079, 0.057 and 0.078 f/cc, respectively and in five samples from surrounding ambient air at factory gate resulted fibre concentration of 0.071 f/cc. All the samples have shown fibre concentration lower than the threshold limit values (TLVs) prescribed by BIS. Morphological analysis of samples, further under phase contrast and polarized microscopy indicates the presence of chrysotile asbestos, which acts as carcinogen as well as co-carcinogen. A clinical examination of exposed subjects reveals that there was no case of clubbing, crepitation, ronchi and dyspnea on exertion; however, obstruction and restriction were 10.9 per cent and 25 per cent in exposed subjects, respectively while in control there were 12 per cent and 28 per cent, respectively. The study revealed that chrysotile asbestos is emitted in the occupational as well as ambient environment that may cause adverse health impact.

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The constitution of India, as a part of the fundamental rights, has laid down that the State shall direct its policy towards protection of childhood and youth against exploitation and shall not be employed to work in any factory or mine or engaged in any hazardous employment. India has the largest number of urban and rural child workers in the world. The Government of India acknowledges at least 17.5 million working children.2 Footwear industry is also one of the major export oriented industry employing a large number of children. The Footwear Industry is a significant segment of the Leather Industry in India. India ranks second among the footwear producing countries next to China. The industry is labour intensive and is concentrated in the small and cottage industry sectors. While leather shoes and uppers are concentrated in large-scale units, the sandals and Chappals are produced in the household and cottage sector. The major production centers India are Chennai, Ranipet, Ambur in Tamil Nadu, Mumbai in Maharashtra, Kanpur and Agra in Uttar Pradesh, Jalandhar in Punjab and Delhi. The processes in the footwear making include last making, pattern cutting, clicking, Sewing, Assembling and Finishing. Children between 10 and 15 years old are mainly employed in assembling shoes. Some 80 percent of the children work for contractors at home. Children work on soling (fixing upper portions of shoes to leather or rubber soles) with glue. Children in cramped poorly lit rooms suffer from continuous skin contact with industrial adhesives and breathing vapors from glues. The children working in the footwear industry are exposed to physical factors like poor illumination, noise and poor ventilation, and chemicals like leather dust, benzene that is used as a solvent in glues and p-tert butyl phenols, which is used in neoprene adhesives. Thus most children suffer from respiratory problems, lung diseases and skin infections through constant exposure to glue and fumes. They are also exposed to risk of nasal cancer, neurotoxicity and adverse physical factors. It is recommended to stop child labour and let the child be bread eater rather than bread earner.

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Occupational lead exposure caused male reproductive impairment, but information on spermatozoa activity, motility, and maturation is limited. In the above perspective, spermatozoa morphology, motility, activity, and nutritional status in lead exposed workers (7-15 years exposure) were assessed. Low sperm velocity, gross, and forward progressive motility with high stationary motile spermatozoa revealed lowering of sperm cell activity after exposure (P < 0.001), which was supported by higher seminal fructose and reduced sperm ATPase activity. Lowering of seminal plasma total protein with concomitant increase in free amino acid was prevalent as exposure increased (P < 0.001), suggesting disturbance in cellular nutritional status. Prolonged liquefaction time, reduced semen volume, viscosity, seminal plasma protein, fructose, and cholesterol level among workers indicated accessory sex gland dysfunction after occupational lead exposure (P < 0.001). Deterioration of sperm density and morphology was associated with high blood and semen lead of workers (P < 0.001) leading to infertility without altering FSH, LH, and testosterone level.

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Out of fifty-six isolates screened three bacterial strains enriched with TNT either as sole source of nitrogen (for Salmonella typhimurium, Klebsiella pneumoniae) or along with co-substrate (for Acinetobacter baumannii), have been carried out nitro group reduction under aerobic conditions. During studies, S. typhimurium found to have high potential (100% of 50 mg l-l) in removal of TNT, than K. pneumoniae (70% of 20 mg l-l) and A. baumannii (52% of 40 mg l-l, in presence of co-substrate). Therefore studies were focused on S. typhimurium, which had shown good growth, and protein contents, with disappearance of TNT, and concomitantly release of nitrite over the period of time. Removal of TNT was analyzed by HPLC, and nitrite liberation was consistently found coincided with TNT disappearance from the medium. As compared to earlier reports, 100% disappearance of TNT within 30 h by S. typhimurium is encouraging, and may indicate its potential in bioremediation of TNT. This is the first report on S. typhimurium, Klebsiella pneumoniae and Acinetobacter baumannii for transformation of TNT with nitrite release into the medium.

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The need for training in Occupational Medicine in India is well known. The majority of company doctors cannot leave their work and join a residence program. The question which course delivery mode - residential or blended or distance education - is appropriate to teach working company doctors is therefore an urgent one. ADULT EDUCATION: Adults learners - in contrast to young students - have a lot prior experiences and knowledge which they want to use. They have tight personal schedules and are very practical and goal-oriented. They usually have a fulltime work. Adults need more guides than lecturers. Immediate use, practice by doing and discussion groups are the most powerful tools in teaching. Lecturing seems to be the most ineffective teaching method. Distance education is widely used already in teaching occupational health & safety and occupational medicine (OSH) in other countries. Almost 100% of all post­graduate teaching in occupational medicine is done by distance education in the U. K. A "blended" course model seems appropriate for Occupational Medicine teaching. It has contact phases and self-learning phases The Indian Association of Occupational Health could play a leading role in expending high quality teaching in Occupational Medicine. These activities would contribute to the Government's goals to strengthen Occupational Health in India. This article discusses distance education and online-teaching as one viable way to deliver high quality training in Occupational Medicine to working company doctors in India.

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A cross sectional study was done among 200 Information Technology (IT) professionals in the National Capital Region (NCR) to study the computer related health problems and role of ergonomic factors. The computer related morbidity was present in 93% of the study subjects. The visual problems were seen in 76% and musculoskeletal in 77.5% while 35% felt stressful symptoms. The study subjects having inadequate lighting and not using an antiglare had greater visual problem, i.e. 81.3 and 76.3%, respectively. Of the 152 subjects that had visual discomfort, 80.2% did not have the monitor at correct distance. This observation was found to be statistically significant (P<0.05). The musculoskeletal problems were also higher in the study subjects using inappropriate ergonomics. The study has brought forth a very high prevalence of computer related morbidity among IT professionals and it further concluded that all aspects of ergonomic variables appear to be acting in cohesion in relation to computer related heath.

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This review article deals with the growing concern of the toxicity of thallium. This article describes the characteristics of thallium, its potential sources of exposure, kinetics, and toxicity on human being and diagnosis of thallium poisoning. This article also describes some episodes of thallium poisoning arising from both occupational and nonoccupational exposure.

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Noise monitoring using "Cirrus sound level" was carried out for 30 min at a height of 1.5 m and 1 m away from the chest during October, 2002 covering 73 locations of ~781 MW power plant. Event Leq and LN cycle were studied to identify the noisy machines and to generate baseline data. Lowest avg. noise 70.37 dB(A) was found at control room while the highest avg, 95.91 dB(A) at F. D. Fan with average 88.04± 6.08 dB(A). Compressors generate second highest noise, 89.98 dB(A). Operators of F.D. Fans are having a fare chance of exposure with >90 dB(A) i.e., beyond the prescribed standard. Noise may not jeopardize employee's life immediately but might be the cause of neurobehavioral change, psychological stress and unhappiness in daily life without showing the symptoms of chronic /acute diseases. Measured data has been compared with TLV of American Conference of Governmental Industrial Hygienists. The quality of life of industrial worker is one of the prime factors for production; hence it should not be neglected. Revision of occupational Indian noise standard is recommended at par with International / European standards. Noise-reducing options are also described. This investigation may help the implementing authority to adopt better policy for better work environment.

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Spirometry appears to be a simple and inexpensive method to measure disorders of the respiratory tract. In reality however, a simple spirometry test requires knowledge and skill to correctly conduct and evaluate the test and its results. This review addresses common misunderstandings in using, evaluating and reporting spirometry results in Occupational Health practice, clinical medicine and research. Results of spirometry need to be evaluated in relation to reference values. The factory medical officer has to decide first whether the test was technically correctly executed and is acceptable for medical interpretation. The next step is to compare results of the individual to published reference values. A 10% reduction of reference values for North Indians and Pakistanis and a 12 to 13% reduction for South Indians is recommended when Caucasian reference tables are used. In occupational health practice the worker's spirometry performance over time needs to be considered. Common errors in reporting summarized results, for instance from groups of workers, are the incorrect use of tests of significance and incorrect presentation of aggregated spirometry results. The loss of respiratory function is recommended as an indicator of difference between two groups. That way, early changes in function can seen without waiting for a drop of function below the usually used 80%-of-predicted limit. This procedure increases the sensitivity of medical surveillance. In research the more precise Lower Limit of Normal should be calculated and used. Correct reference equations, good patient coaching, decision on the technical quality (acceptability) of each spirometry test and critical re-evaluation of the machine's readout are essential parts of a correct spirometry test. A good understanding how results are calculated is crucial for further statistical evaluation.

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This paper shall be useful in understanding and application of the concept and process of behavior based safety for safety professionals concerned about correcting unsafe behaviors for reduction of accidents and promoting safe behaviors for developing injury-free culture in their organizations.

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Phthalates are used in commercial products as softners of plastics, solvents in perfumes and additives to hair sprays, lubricants and insect repellents. The wide spread use of phthalate results in multiple human exposure routes i.e., ingestion, inhalation and dermal exposure. In the present review, a detailed account of respiratory toxicity, reproductive toxicity, developmental toxicity, endocrine disruptors and genotoxicity of human exposure to phthalate is mentioned in detail.

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Work in leather tanning involves exposure to a wide range of chemicals. Some of these are carcinogens or suspected carcinogens. Increased risks for a number of cancers have been reported among the tannery workers. In the present review, a detailed account of lung cancer, testicular cancer, soft tissue sarcoma, pancreatic cancer, bladder cancer among tannery workers is mentioned.

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Context: Noise of machines in various agro-based industries was found to be the major occupational hazard for the workers of industries. The predominant noise sources need to be identified and the causes of high noise need to be studied to undertake the appropriate measures to reduce the noise level in one of the major agro-based industries, oil mills. Aims: To identify the predominant noise sources in the workrooms of oil mills. To study the causes of noise in oil mills. To measure the extent of noise exposure of oil mill workers. To examine the response of workers towards noise, so that appropriate measures can be undertaken to minimize the noise exposure. Settings and Design: A noise survey was conducted in the three renowned oil mills of north-eastern region of India. Materials and Methods: Information like output capacity, size of power source, maintenance condition of the machines and workroom configurations of the oil mills was collected by personal observations and enquiry with the owner of the mill. Using a Sound Level Meter (SLM) (Model-824, Larson and Davis, USA), equivalent SPL was measured at operator's ear level in the working zone of the workers near each machine of the mills. In order to study the variation of SPL in the workrooms of the oil mill throughout its operation, equivalent SPL was measured at two appropriate locations of working zone of the workers in each mill. For conducting the noise survey, the guidelines of Canadian Centre for Occupational Health and Safety (CCOHS) were followed. Grid points were marked on the floor of the workroom of the oil mill at a spacing of 1 m x 1 m. SPL at grid points were measured at about 1.5 m above the floor. The direction of the SLM was towards the nearby noisy source. To increase accuracy, two replications were taken at each grid point. All the data were recorded for 30 sec. At the end of the experiment, data were downloaded to a personal computer. With the help of utility software of Larson and Davis, USA, equivalent SPL and noise spectrum at each reading was obtained. Noise survey map of equivalent SPL was drawn for each oil mill by drawing contour lines on the sketch of the oil mill between the points of equal SPL. The floor area in the oil mill where SPL exceeded 85 dBA was identified from the noise survey map of each oil mill to determine the causes of high level of noise. Subjective assessment was done during the rest period of workers and it was assessed with personal interview with each worker separately. Demographic information, nature of work, working hours, rest period, experience of working in the mill, degree of noise annoyance, activity interference, and psychological and physiological effects of machine noise on the worker were asked during the interview. These details were noted in a structured form. Statistical Analysis Used: Nil. Results: The noise survey conducted in three renowned oil mills of north-eastern region of India revealed that about 26% of the total workers were exposed to noise level of more than 85 dBA. Further, 10% to 30% floor areas of workrooms, where oil expellers are provided have the SPL of more than 85 dBA. The noise in the oil mills was dominated by low frequency noise. The predominant noise sources in the oil mills were seed cleaner and power transmission system to oil expellers. Poor maintenance of machines and use of bamboo stick to prevent the fall of belt from misaligned pulleys were the main reason of high noise. Noise emitted by the electric motor, table ghani and oil expellers in all the oil mills was well within 85 dBA. Subjective response indicated that about 63% of the total workers felt that noise interfered with their conversation. About 16% each were of the opinion that noise interfered in their work and harmed their hearing. About 5% of workers stated that the workroom noise gave them headaches. Conclusions: The workers engaged in the workrooms of the oil mills are exposed to high noise, which will have detrimental effect on their health. The poor maintenance of drive system was found to be the main reason for high noise level.

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The work environment in the garment manufacturing units is unhealthy and unsafe for the workers, resulting in several health problems. Analysis of garment manufacturing units using a combination of techniques revealed that the congested work area, improper ventilation, dust, unergonomic workstations, excessive noise and non-use of personal protective equipment were the major constraints faced by the workers in these units. Based on the study, interventions to improve the work environment, safety aspects and work methods have been suggested which could be adopted on a wider scale.

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Stress in nurses is an endemic problem. It contributes to health problems in nurses and decreases their efficiency. Documenting the causes and extent of stress in any healthcare unit is essential for successful interventions . Aim : Establishing the existence and extent of work stress in nurses in a hospital setting, identifying the major sources of stress, and finding the incidence of psychosomatic illness related to stress. Materials and Methods: This study used a questionnaire relating to stressors and a list of psychosomatic ailments. One hundred and six nurses responded and they were all included in the study. Stressors were based on four main factors: work related, work interactions, job satisfaction, and home stress. The factors relating to stress were given weights according to the severity. The total score of 50 was divided into mild, moderate, severe, and burnout. Results: Most important causes of stress were jobs not finishing in time because of shortage of staff, conflict with patient relatives, overtime, and insufficient pay. Psychosomatic disorders like acidity, back pain, stiffness in neck and shoulders, forgetfulness, anger, and worry significantly increased in nurses having higher stress scores. Increase in age or seniority did not significantly decrease stress. Conclusion: Moderate levels of stress are seen in a majority of the nurses. Incidence of psychosomatic illness increases with the level of stress. Healthcare organizations need to urgently take preemptive steps to counter this problem.

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The present cross-sectional and interventional study was carried out to assess the incidence of vitamin B12 / vitamin D deficiency in male office executives in the tropical city of Mumbai, India. A total of 75 senior executives were surveyed and subjected to analysis of blood levels of vitamin D (25 Hydroxy Cholecalciferol) by RIA method and vitamin B12 by CLIA method. The same was performed in a reputed analytical laboratory with NABL accreditation. History of smoking, exposure to sunlight, exercise, dietary habits, consumption of vitamin supplements, medication etc. was obtained. The results revealed 65% executives with vitamin B12 deficiency (less than 193 pg/ml) and 28% executives with vitamin D deficiency (less than 7.6 ng/ml). The prevalence of low levels of vitamin B12 is lower (58%) in those who give history of regular exercise than others. The prevalence of vitamin D deficiency is lower (25%) in those who give history of regular exercise than in others (46.2%). Prevalence of vitamin D deficiency is higher (47%) in those whose workday day started earlier than in those whose workday started later (12%). In the second phase of the survey, 58 executives with low B12/ D3 values, were given vitamin B12/D3 oral supplements for a period of three months along with counseling for lifestyle modification. A modified questionnaire was then circulated and the subjects analyzed for B12/D3 values. Significant improvements in serum B12 and D3 values were seen after the oral therapy, sun exposure and dietary modifications.

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The main purpose of this study is to assess the health risks posed by radiographers and to determine whether existing controls at work place are adequate. This small survey conducted in the year 2002. All nine (male) radiographers aged 35-45 years (median 38 years) and control subjects (24) who were matched for sex, age (within 3-5 years) interviewed using a questionnaire about symptoms experienced during and off work. There were no smokers. The total number of symptoms experienced by the radiographers was greater than controls. Symptoms like headache, and skin irritation were persistent in two radiographers during and off work. Visual observations revealed that, all the radiographers while on work used lead aprons and film badges. Results of personal exposure to ionizing radiation were within the normal limits. Identified hazards in the working environment are (i) exposure to ionizing radiation, (ii) exposure to chemical contaminants. Based on the subjective judgment of radiographers, existing work practices and personal exposure results to ionizing radiation, the estimated risk level was moderate. Risk control action plan developed to bring the risk level to tolerable.

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The occupational disease burden is growing at an unprecedented rate. The profile of occupational diseases has also changed over the period of time as a result of modernization, market liberalization and globalization which now encompasses minor allergy and injuries, systemic infections and diseases as well as the life-threatening leukemia and cancers. Trained human resources in the field of occupational health and safety are far below the requirement. Training in the area of occupational health and industrial medicine is not keeping pace with the changing industrial growth and technologies. There is an urgent need for strengthening skills, developing newer competencies and broadening our knowledge in occupational health and safety and disaster management. Traditional training in occupational health, needs to be supplemented with techniques of environmental epidemiology, environmental impact assessment and environmental risk assessment. The academic community should take the first step in demonstrating its leadership to address the long neglected concerns of occupational health and safety.

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