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   2012| May-August  | Volume 16 | Issue 2  
    Online since February 13, 2013

 
 
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REVIEW ARTICLE
High altitude pulmonary edema-clinical features, pathophysiology, prevention and treatment
Swapnil J Paralikar
May-August 2012, 16(2):59-62
DOI:10.4103/0019-5278.107066  PMID:23580834
High altitude pulmonary edema (HAPE) is a noncardiogenic pulmonary edema which typically occurs in lowlanders who ascend rapidly to altitudes greater than 2500-3000 m. Early symptoms of HAPE include a nonproductive cough, dyspnoea on exertion and reduced exercise performance. Later, dyspnoea occurs at rest. Clinical features are cyanosis, tachycardia, tachypnoea and elevated body temperature generally not exceeding 38.5°C. Rales are discrete initially and located over the middle lung fields. HAPE mainly occurs due to exaggerated hypoxic pulmonary vasoconstriction and elevated pulmonary artery pressure. It has been observed that HAPE is a high permeability type of edema occurring also due to leaks in the capillary wall ('stress failure'). Slow descent is the most effective method for prevention; in addition, graded ascent and time for acclimatization, low sleeping altitudes, avoidance of alcohol and sleeping pills, and avoidance of exercise are the key to preventing HAPE. Treatment of HAPE consists of immediate improvement of oxygenation either by supplemental oxygen, hyperbaric treatment, or by rapid descent.
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ORIGINAL ARTICLES
Respiratory morbidity among welders in the shipbuilding industry, Goa
Nateshan Bhumika, Ganapati Vasant Prabhu, Agnelo Menino Ferreira, Manoj Kumar Kulkarni, Frederick Satiro Vaz, Zile Singh
May-August 2012, 16(2):63-65
DOI:10.4103/0019-5278.107069  PMID:23580835
Context: Welding is pivotal in shipbuilding. The fumes and gases involved in welding may cause respiratory morbidity. Aim: To study the prevalence of respiratory morbidity (RM) among welders vis à vis among nonwelders and its association with certain relevant factors. Settings and Design: A cross-sectional study of 276 welders and 276 nonwelders was conducted in the shipbuilding industry. Materials and Methods: An interviewer-administered questionnaire was followed by spirometric examination. Statistical Analysis: Odds ratio and its 95% CI and two-way ANOVA. Results: Prevalence of RM was found to be significantly higher among welders compared to nonwelders (who were comparable in age, duration of employment (DOE) and smoking habits,) with odds ratio (OR) of 1.78 (95% confidence interval (CI):1.20-2.63). Obstructive type of RM was predominant in both welders (26% (n = 73)) and nonwelders (17% (n = 49)) with welders being at a significantly higher risk (OR = 1.66 (95%: 1.10-2.49)). RM was commoner after the 40 years of age or after 20 years of employment in both groups. Smoking was associated with RM among welders (OR = 1.48, 95% CI: 1.24-1.75) as well as nonwelders (OR = 2.83, 95% CI: 2.26-3.54). Work-related respiratory symptoms (WRRS) was not found to be related to RM (OR = 1.69, 95% CI: 1.00-2.84). Consistent use of personal protective equipment (PPE) was protective against RM in welders (OR = 0.33, 95% CI: 0.28-0.37). Conclusion: Welders had a greater burden of RM and this was related to increasing age, DOE, smoking and inconsistent use of PPE. WRRS were not indicative of RM.
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Impact of occupational health hazards on serum markers of bone formation in spray painters of Chennai region in Tamil Nadu
Vijaya Prakash Krishnan Muthaiah, Abel Arul Nathan, Anandan Balakrishnan, Rajiv Rose, Jayaraman Gopalsamy
May-August 2012, 16(2):84-87
DOI:10.4103/0019-5278.107084  PMID:23580840
Context: The association between spray paint exposure and bone remodeling received little attention despite the high usage of spray paints in automobile industries, steel furniture workshops etc. Aim: The present study was aimed at investigating the level of serum markers of bone formation in spray painters. The spray painting subjects were selected from automobile body repair workshops in Chennai region of TamilNadu which constitutes 30% of India's automobile industry. Setting and Design: All the study subjects, exposed to spray paint were working in a workshop without standard spraying room and did not wore any aerosol removing respirator. The controls were selected from random population irrespective of occupation. Data relevant to the socioeconomic features and personal history was collected using a questionnaire. The current study included 50 spray painters and 25 control subjects of same age group. Materials and Methods: We examined the level of serum calcium, serum phosphorus, serum differentiation markers of bone such as alkaline phosphatase (bone specific) and serum osteocalcin in which these levels were found to be high in serum of spray painters. Conclusion: The current study concludes dysregulation in bone remodeling of spray painters exposed to chronic solvents and paint pigments.
  1 2,542 80
Staff's attitude regarding hospital waste management in the dental college hospitals of Bangalore city, India
Sushma Rudraswamy, Naganandini Sampath, Nagabhushana Doggalli
May-August 2012, 16(2):75-78
DOI:10.4103/0019-5278.107077  PMID:23580838
Background : Growing urbanization has led to several changes in the healthcare sector. While on one hand, access to healthcare services are being provided to the community, thereby resulting in better health for all, improper management of biomedical waste emanating from these healthcare establishments has also given rise to many environmental and health problems (Acharya 2003). Although awareness in this issue has increased considerably over the last few years, sensitivity to this problem has been limited. Most hospitals are not actively involved in addressing this problem. Materials and methods : The present study was conducted to assess the attitude of waste management among staff of dental hospitals in Bangalore city, by issuing a pre-tested structured questionnaire. Results : While 82.6% of attenders said that it is necessary to segregate waste into different categories at the point of origin, 61.5% of auxiliaries strongly disagreed that segregation of waste at source increases the risk of injury to waste handlers. As many as 33.5% of dentists strongly disagreed that segregation of waste at source increases the risk of injury to waste handlers and 53.6% agreed that segregation of waste at source does not increase the risk of injury to waste handlers. Conclusion : The findings of this study suggest that the staff had good attitude towards waste management among.
  1 4,239 163
CASE REPORT
Accidental inhalation injury of phosgene gas leading to acute respiratory distress syndrome
Anand Kumar, Sudhir Chaudhari, Luv Kush, Suraj Kumar, Atul Garg, Anurag Shukla
May-August 2012, 16(2):88-89
DOI:10.4103/0019-5278.107088  PMID:23580841
Irritant gas exposure may lead to significant respiratory distress as is seen in the present case of 25 year old male worker who suffered accidental phosgene inhalation. He remained asymptomatic for six hours but later landed up in Acute Respiratory Distress Syndrome in the hospital and required ventilatory support. No investigative feature is diagnostic of the nature of irritant gas. Similarly there is no antidote available to the phosgene. Only timely administered supportive management may lead to successful outcome.
  - 2,844 51
EDITORIAL
Risk assessment: A neglected tool for health, safety, and environment management
Damodar Vishnu Lele
May-August 2012, 16(2):57-58
DOI:10.4103/0019-5278.107064  PMID:23580833
  - 2,308 123
LETTERS TO THE EDITOR
Assessment of environmental sanitation in rural areas of Pune Maharashtra
Harshal T Pandve, Kevin Fernandez, PS Chawla, Samir A Singru
May-August 2012, 16(2):90-90
DOI:10.4103/0019-5278.107091  PMID:23580842
  - 2,083 82
Nail polish remover poisoning: What caused methemoglobinemia?
Subramanian Senthilkumaran, Namasivayam Balamurgan, Ritesh G Menezes, Ponniah Thirumalaikolundusubramanian
May-August 2012, 16(2):91-91
DOI:10.4103/0019-5278.107092  PMID:23580843
  - 2,660 62
Smoking ban in restaurants in Mumbai, India: Scope for improvement
Sanjeev Mohan Choudhary
May-August 2012, 16(2):92-92
DOI:10.4103/0019-5278.107093  PMID:23580844
  - 1,723 50
ORIGINAL ARTICLES
Socio-economic status of workers of building construction industry
Guddi Tiwary, PK Gangopadhyay, S Biswas, K Nayak, MK Chatterjee, D Chakraborty, S Mukherjee
May-August 2012, 16(2):66-71
DOI:10.4103/0019-5278.107072  PMID:23580836
Background: Informal/unorganised sector covers 92% of the total work force in India. About 50% of the construction industrial workers belonged to informal/unorganised sector. Material and Methods: The present study was undertaken to know the socio-economic status of construction worker and availing of the social security measures by this working group. Results and Conclusion: The study covered 150 subjects with an average age of 32 years and mean duration of work was nine years. They were poorly paid with an average income of Rs. 4956/-per month. Though the literacy rate was high (79%) yet most of them were addicted to different habits like drinking alcohol, smoking bidi, tobacco chewing etc., Abusing the family members were noted in (30%) of the cases. Their regular intake of food, usually inadequate in quantity and was mainly consisted of rice, pulses, vegetables. Though most of the subjects (73%) were living in kacha houses yet the latrine facilities were available to 62% of total covered houses. Majority of them were unaware of the different social security schemes/measures. The details have been discussed here.
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Working condition and health hazards in beedi rollers residing in the urban slums of Mumbai
Rupali V Sabale, Shobha S Kowli, Padmaja H Chowdhary
May-August 2012, 16(2):72-74
DOI:10.4103/0019-5278.107075  PMID:23580837
Background: Beedi rollers are exposed to unburnt tobacco dust through cutaneous and pharyngeal route. They are not aware of their rights. Studies have been conducted on beedi workers but not many studies are carried out in urban areas. Thus, study was carried out to understand working condition and health hazards in beedi workers residing in the urban slums of Mumbai and to know whether beedi roller are in better condition in urban areas. Aim: To study working condition and health hazard in beedi rollers in the urban slums. Materials and Methods: Descriptive, cross-sectional, community based study was carried in the urban slums of Mumbai with population of 8985 from April 2011 to June 2011. With snow balling sampling technique, 52 beedi workers were interviewed regarding their socio-economic status, working conditions and health problems after informed consent. Data entry and statistical analysis were performed using the SPSS windows version 14.0 software. Results: The mean age was 45 years with SD of 12 years. All were Hindu females. Around 42.31% were illiterate. Mean years of service were 30 years and they work on an average for eight hours. Children were not involved in beedi rolling. Most common morbidity was fatigue. None were aware of the benefits provided for them. Awareness regarding health hazard and safety measures was poor. Conclusions: The working condition of beedi rollers in the urban areas is not favourable.
  - 3,344 173
Ergonomic implementation and work station design for quilt manufacturing unit
Deepa Vinay, Seema Kwatra, Suneeta Sharma, Nirmal Kaur
May-August 2012, 16(2):79-83
DOI:10.4103/0019-5278.107081  PMID:23580839
Background: Awkward, extreme and repetitive postures have been associated with work related musculoskeletal disorders and injury to the lowerback of workers engaged in quilting manufacturing unit. Basically quilt are made manually by hand stitch and embroidery on the quilts which was done in squatting posture on the floor. Mending, stain removal, washing and packaging were some other associated work performed on wooden table. their work demands to maintain a continuous squatting posture which leads to various injuries related to low back and to calf muscles. Material and Method s: The present study was undertaken in Tarai Agroclimatic Zone of Udham Singh Nagar District of Uttarakhand State with the objective to study the physical and physiological parameters as well as the work station layout of the respondent engaged on quilt manufacturing unit. A total of 30 subjects were selected to study the drudgery involved in quilt making enterprise and to make the provision of technology option to reduce the drudgery as well as musculoskeletal disorders, thus enhancing the productivity and comfortability. Results: Findings of the investigation show that majority of workers (93.33 per cent) were female and very few (6.66 per cent) were the male with the mean age of 24.53±6.43. The body mass index and aerobic capacity (lit/min) values were found as 21.40±4.13 and 26.02±6.44 respectively. Forty per cent of the respondents were having the physical fitness index of high average whereas 33.33 per cent of the respondents had low average physical fitness. All the assessed activities involved to make the quilt included a number of the steps which were executed using two types of work station i.e squatting posture on floor and standing posture using wooden table. A comparative study of physiological parameters was also done in the existing conditions as well as in improved conditions by introducing low height chair and wooden spreader to hold the load of quilt while working, to improve the work posture of the worker. The average working heart rate values were found to reduced by performing the activity using improved technology followed by energy expenditure (6.99 kj/min), total cardiac cost of work (1037.95 beats), physiological cost of work (103.79 beats) and rate of perceived rate of exertion to the score of 2.6 Results of postural analysis that is change in motion at cervical region reveal that range of motion in case of extension was found beyond the normal range in existing setup where as it reduced to normal range in improved work station. Conclusion: The finding of the study concludes that to ensure safety and to reduce occupational health hazards while performing the activity, an ergonomically designed work station by introduction of improved technology option will be a right choice which also enhances the productivity.
  - 3,064 89