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-March 2021
Volume 25 | Issue 1
Page Nos. 1-54

Online since Monday, April 26, 2021

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Women and work Highly accessed article p. 1
Sashikala Chandrasekar
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Thyroid-stimulating hormone and free thyroxine alterations in subjects with occupational hearing loss Highly accessed article p. 4
Nastaran Ranjbar, Hossein Namvar Arefi, Mohammad Maarefvand, Akram Pourbakht, Ali Shahbazi
Context and Aim: Occupational hearing loss (OHL) is caused by exposure to industrial noise. Alterations in the thyroid-stimulating hormone (TSH) and free thyroxine (FT4) levels are related to hearing loss. The purpose of this study is to investigate the TSH and FT4 level alterations in OHL. Methods and Material: Among 428 subjects, 144 male workers with normal hearing (NH), noise-induced hearing loss (NIHL), and high tone loss (HTL) (N = 48 in each group) were included in this study. All the subjects had normal TSH and FT4 levels. Results: The TSH level is higher in the HTL and NIHL groups in comparison to NH, but it is only significant in the HTL group. The FT4 level is significantly lower in the NIHL group; however, the lower FT4 level in the HTL group is not significant when compared to the NH group. Discussion: The NIHL group may turn into the HTL group over time. This process could be monitored by alteration in their TSH and FT4 levels. Conclusions: Alterations in the TSH and FT4 levels could be considered as a pathophysiology for OHL. More research is required to investigate the electrophysiological, physiological, and histological correlations of TSH and FT4 and different types of hearing loss caused by noise exposure.
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A diagnostic assistant tool for work-related low back pain in hospital workers p. 11
Oopara Saengdao, Buranatrevedh Surasak, Patumanond Jayanton
Aims: The study objective was to develop a clinical risk score to assist occupational medicine physicians in diagnosing hospital workers' occupational lower back pain (LBP). Settings and Design: A cross-sectional data collection design was conducted at Saraburi Hospital, Thailand. Methods and Materials: The sample consisted of 220 hospital workers who cared for patients and had LBP. They were assessed for the frequency of targeted activities (CPR, lifting, transferring patients) and other activities from work as well as ergonomic assessments, and diagnosed with LBP by three occupational medicine physicians. Statistical Analysis Used: Predicted factors of multivariable logistic regression were analysed to find clinical risk scores to help the diagnosis. Results: The physicians agreed on the diagnosis, based on ergonomic risk factors and their experiences that 86 persons have occupational LBP.   A diagnostic assistant tool consists of six predictors: the duration of LBP, having LBP within the last 7 days, bending, twisting, lateral bending, and reaching. The scores predicted occupational LBP correctly with an AuROC of 90.0% (95% CI; 84.8–93.5%). The positive likelihood ratio for occupational LBP was 0 in the low risk category (<6 points) and 16.8 (95% CI; 8.0–35.6) in the high risk (>8 points). Conclusions:   A diagnostic assistant tool is used to assist occupational medicine physicians in diagnosing hospital workers' occupational LBP.
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The effect of exposure to rubber production emissions and physical activity on pulmonary function indices among tyre manufacturing employees in Iran p. 17
Ehsan Rafeemanesh, Habibollah Esmaily, Fatemeh Ahmadi, Mohammadali Sardar, Golnoosh Ghooshchi
Background: Exposure to rubber production emissions can cause respiratory problems. There is some evidence that physical activity might have protective effects against respiratory obstruction. Aims: This study, was investigated the effect of physical activity on potential respiratory damages induced by the exposure to rubber production chemicals. Methods: This cross-sectional study was carried out during 2019 on the staff of a rubber manufacturing company in Khorasan, Iran. Employees of a rubber manufacturing company were recruited in this cross-sectional study (n = 385), and were classified into exposed (n = 266) and unexposed (n = 119) groups. Baecke Physical Activity Questionnaire (BPAQ) was used to assess the level of physical activity. Logistic regression was used to evaluate the effects of exposure, physical activity and confounding variables on pulmonary function test (PFT) results. Results: Work, leisure time and total physical activity scores were significantly higher in exposure group compared with control group subjects. Although no significant differences were observed between the exposure and control groups in most spirometric parameters, FEF25-75 was significantly lower in the exposure group (P = 0.035). Abnormal PFT was observed in 93 participants (24.2%) and in the multivariate model was significantly associated with exposure (OR = 1.80, CI95: 1.01-3.22) and age (OR = 1.08, CI95: 1.02-1.14) but not physical activity score. Conclusion: Exposure to rubber manufacturing chemicals nearly doubles the odds of abnormal PFT, and the self-reported level of physical activity had no protective effect against these occupational hazards.
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An analytical cross-sectional study to compare pulmonary function and respiratory morbidity-related quality of life between construction workers with age-and gender-matched controls p. 22
Praveen K Chittaluru, Raj K Korra, Vinay K Asuri, Pratyusha Annakula, G M M Reddy
Context: Respiratory morbidity among construction workers is one of the most neglected occupational diseases, in spite of the high risk. Aims: The aim of this study is to compare the respiratory symptoms, pulmonary function, and respiratory morbidity-related quality of life between people working in construction sites and the age- and gender-matched controls. Settings and Design: It is an analytical cross-sectional study. Methods and Material: People working in the construction sites (mason/daily laborer) for at least 5 years and control group working in other occupations were included. People other than mason/daily laborer and people with a past history of COPD/bronchial asthma before joining the construction industry were excluded. Statistical Analysis Used: Pulmonary function test was done and St. George respiratory questionnaire was used to the quality of life. Unpaired t-test and Chi-square test/Fisher's exact test were used to compare numeric outcomes and categorical outcomes respectively. Results: We have included 120 construction workers and 120 age- and gender-matched controls. The Forced Vital Capacity (FVC) (mean difference [MD] 0.20, 95% CI 0.025–0.381, P value 0.025), FEV1 (MD 0.21, 95% CI 0.061–0.364, P value 0.006), and FEV1\FVC% predicted (MD 5.01, 95% CI 1.11–8.92, P value 0.012) were significantly lower among the construction workers. The overall SGRQ score was also significantly higher among the construction workers indicating poor overall respiratory morbidity-related quality of life (MD 12.69, 95% CI 10.59–14.80, P value <0.001). Conclusions: Pulmonary function and respiratory function-related quality of life are considerably poor among people working in the construction industry.
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Depression, anxiety, stress and workplace stressors among nurses in tertiary health care settings p. 27
Akshiti Kaushik, SR Ravikiran, K Suprasanna, Malathi G Nayak, Kiran Baliga, Sahana Devadasa Acharya
Background: Chronic job stress adversely impacts both mental health of nurses and patient care. There is paucity of data regarding workplace stressors and negative emotions among nurses. Aims: To assess depression, anxiety and stress among nurses and analyse their association with workplace stressors. Settings and Design: A hospital based cross-sectional study was conducted in two tertiary care hospitals. Methods and Material: Four hundred and thirty one nurses completed nurses rated depression, Anxiety and Stress instrument (DASS-21) and a questionnaire probing perceived workplace stressors on a 4 point Likert scale . The stressors across subgroups of workareas were compared. Satistical Analysis: Association between stress, anxiety or depression and workplace stressors were analysed using binary logistic regression. Results: 50.8% of nurses had stress; 74% had anxiety; 70.8% had depression. 79.1% had at least one of them. Stressed, anxious or depressed nurses were more concerned about lack of job satisfaction and conflicts with supervisors. Work-place stressors varied with work areas: private hospital, no job satisfaction, conflicts with doctors and patients; government hospital, acquiring infectious diseases; ICUs, inadequate salary; non-ICUs, odour and sounds in workplace and conflicts with patients. Conclusions: Prevalence of depression, anxiety and stress was high. Workplace stressors varied across different working areas. Interventions need are to be tailored accordingly.
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A comparative study on the health problems and substance abuse among the tobacco farmers and non-tobacco farmers in hassan district, Karnataka p. 33
Sundar Muniswamy, Steffi F Maliakel
Background and Aims: India ranks third in the worldwide tobacco production (2017), and it is increasing every year. Hassan is an important tobacco growing district in Karnataka with over 12,000 growers. These growers are exposed to health risks during cultivation of tobacco, pesticide exposure, long duration of work, mental stress, and nicotine toxicity – Green Tobacco Sickness (GTS) due to direct handling of green tobacco leaves. Objectives: To determine the prevalence of health problems associated with tobacco farming. To determine the extent of substance abuse in tobacco farmers as compared to non-tobacco farmers. Methodology: Study design: Cross-sectional study. Duration: 3 months. Sampling technique: 30 × 7 Cluster sampling technique. House-to-house survey was conducted in 30 tobacco growing villages of Hassan. Seven tobacco growers and seven non-growers were interviewed in each village. Alcohol use disorder identification test (AUDIT) & Fagerstrom nicotine dependence (FND) scale was used to assess the extent of substance abuse. Results: Symptoms of GTS like nausea, dizziness, poor appetite, insomnia were reported more in tobacco growers (p < 0.01). On FND assessment, 63% had moderate to high dependence. On AUDIT assessment, 55.07% growers who had drinking habit had hazardous drinking behavior. Logit function model was used to assess parameter estimate (OR) on substance abuse. Conclusion: Lack of knowledge regarding health effects of tobacco farming, lack of use of PPE, dust and smoke exposure during curing, intense physical and mental stress maybe some reasons for health problems in tobacco growers.
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Spectrum of occupational injuries presenting to the emergency department p. 39
A Indhu Ragavi, JS Jisha, M Sanjay, Darpanarayan Hazra, Kundavaram Paul Prabhakar Abhilash
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Occucon Abstracts p. 42
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Scientific Programme p. 52
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Shared Experiences p. 53
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Reviewer list p. 54
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