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     Table of Contents - Current issue
Coverpage
September-December 2020
Volume 24 | Issue 3
Page Nos. 133-207

Online since Monday, December 14, 2020

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EDITORIAL  

COVID-19—Practicing prevention in the workplace Highly accessed article p. 133
Bobby Joseph, Nancy G Angeline, Sakthi Arasu
DOI:10.4103/ijoem.ijoem_460_20  
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ORIGINAL ARTICLES Top

Assessment of the level of organic dust and mould spores in the work environment of baker p. 137
Lukasz Wlazlo, Bożena Nowakowicz-Dębek, Anna Chmielowiec-Korzeniowska, Piotr Maksym, Halina Pawlak, Jacek Kapica
DOI:10.4103/ijoem.IJOEM_51_19  
Aim: This study was conducted to determine the level of fungal contamination of the air in bakeries to assess health hazards for workers. Materials and Methods: Six bakeries producing traditionally baked goods were selected for the study. After a background survey, samples of exhaled air were collected to test for fungal aerosols. The inhalable and respirable fraction in the bakery air environment was measured by the gravimetric method. Statistical Analysis Used: All data analyses were performed using Statistica software (v 8.0). Results: The mean concentration of fungi and particles in the bakeries did not exceed the recommended levels. The air in the bakeries had a low level of microbial contamination. The identified fungi included biological agents from hazard group 2. Conclusions: Proper employee training and the introduction of preventive measures (including both individual and group protection) can significantly reduce employees’ exposure and thus their occupational risk.
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Measuring the drudgery and time-poverty of rural women - A pilot study from rural Rajasthan p. 142
Abhijeet V Jadhav
DOI:10.4103/ijoem.IJOEM_151_19  
Context: Women’s hard-work toward family responsibility is rarely examined from a health perspective. Excessive physical work translates into musculoskeletal disorders (MSDs). It is essential to understand certain parameters of this burden. Subjects and Methods: This was a cross-sectional study of 565 rural women. The participants were selected using a stratified random sampling method. A pre-tested questionnaire was used, focusing mainly on physical activities, durations, and health complaints. Results: The self-reported mean durations of various physical were quite high. On average, a woman spent around 11 h per day in domestic work-related physical activities. Older women (more than 50 years) spent similar durations for most of the physical activities compared to younger women (50 years or less). In the sample, 53.4% (n = 302) participants reported at least one Chronic MSD, and 16.99% (n = 96) took medication for the same in the last one year. Point prevalence of low back pain (LBP) was 29.2% (CI 25.5 to 33.1). Women worked even with MSDs as there was no significant difference in the mean durations among women with and without MSDs for most of the activity categories except for ‘work in bending position’ and ‘work in farm’. General caste women spent higher time in domestic work. Conclusions: Higher self-reported MSDs were likely to be contributed by continuous and repeated strenuous domestic work. Women had to continue working even with MSDs or higher age. Women got very less time for rest. Provision of basic amenities like electricity, water, cooking fuel, etc. at doorstep can help. Below poverty line women seem to have higher burden of MSDs.
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Fatigue analysis to evaluate workloads in production area at crumb rubber factories of Padang city, West Sumatra Indonesia p. 148
Taufiq Ihsan, Tivany Edwin, Yasinta Azwir, Vioni Derosya
DOI:10.4103/ijoem.IJOEM_252_19  
Background: Work fatigue had the potential to cause work accidents that had an impact on losses to the company. This study aimed to analyze the level of subjective-work fatigue and evaluated the effect of workload on fatigue in the production area at The Crumb Rubber Factories of Padang City, West Sumatra, Indonesia. Methods: The research respondents were all workers in the production area in the three largest crumb rubber factories in Padang, totaling 348 workers. The respondents consisted of 135 workers in the wet division and 213 workers in the dry division. Subjective fatigue analysis uses the Industrial Fatigue Research Committee (IFRC) questionnaire method. Measures workload based on Indonesian Standards No. 7269 of 2009 concerning Workload Assessment based on Calorie Level according to Energy Expenditures. Results: The percentage of work fatigue in the production area was 26.32% light level, 72.63% medium level, and 1.05% heavy level. The workload had a significant effect on work fatigue, with a P value of 0.003. Conclusion: On the basis of the results of multiple regression analysis of all the variable characteristics of the respondents and work area, the most influential factor affecting the occurrence of fatigue in a crumb rubber factory was the workload. All crumb rubber factories in Padang should make improvements related to workload in controlling work fatigue.
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Relationship between noise annoyance and high blood pressure in workers exposed to chronic noise among the workers of an automotive industry p. 153
Iraj Alimohammadi, Fakhradin Ahmadi Kanrash, Shahram Vosoughi, Soqrat Omari Shekaftik, Kazem Rahmani, Mohammad Hossein Chalak, Mohammad Anbari
DOI:10.4103/ijoem.IJOEM_259_19  
Background: Chronic exposure to noise in workplaces is one of the most important physical agents that affects workers’ health and causes social and individual problems. The aim of this study was to investigate the relationship between noise annoyance and blood pressure (BP) of workers of an automotive industry. Methods: In this cross-sectional study, 250 workers were randomly selected. The subjects were classified in two groups based on the exposure to sound pressure levels lower and higher than 85 dB (106 and 144 workers, respectively). In this study, BP was measured using an ALPK2 mercury pressure gauge. To measure annoyance levels, an annoyance questionnaire containing a numerical question numbered 0–11 was used. Results: The mean age of the subjects was 36.19 (±3.75) years. The results showed that the systolic (SBP) and diastolic blood pressure (DBP) of the subjects exposed to the sound pressure levels higher than 85 dB were significantly higher than those exposed to a sound pressure level lower than 85 dB (P < 0.01). Also, the results of the multivariate regression showed a significant relationship between the annoyance and DBP and SBP caused by chronic exposure to noise and sound pressure levels (P < 0.01). Conclusion: The results of this study showed that the annoyance caused by exposure to chronic noise in the workplace causes stress in the workers and, in the long term, could increase the risk of high SBP and DBP.
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Posture-related musculoskeletal problems among hotel receptionists in Mumbai: A cross-sectional study p. 157
Manjit Kaur Chauhan, Ankita Sondhi
DOI:10.4103/ijoem.IJOEM_275_18  
Background: Receptionists are the front-liners carrying the image of the hotel. They are involved in 8-h shift work in prolonged standing positions, exposing them to various risks. Objective: The aim of the study was to identify the work-related musculoskeletal problems and health problems experienced by receptionists. Materials and Methods: A cross-sectional study was conducted on 50 receptionists from 11 hotels working in 15 three-star and 35 five-star hotels in Mumbai, using a questionnaire that included background information, Rating Scale for Discomfort Intensity, Nordic Musculoskeletal Questionnaire (NMQ), and OWAS posture assessment tool. The statistical analysis of the quantitative variables was performed using Statistical Package for the Social Sciences (SPSS) software program, version 16.0. Results: Receptionists generally suffered from sleeplessness (37.50%) and frequent headaches (34%) due to the change in shift timing. Severe discomfort was found in low back, calf, neck, and ankle/feet by the end of the day. The strong association between standing posture and calf pain (Phi value: 0.736; P ≤ 0.05) and standing posture and ankle pain (Phi value: 0.881; P ≤ 0.05) was found. Conclusion: Prolonged standing increased the lower limbs musculo-skeletal disorders among the receptionists, whereas change in shift timing affected their sleep pattern.
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Assessment of BTX concentration around fuel station in Eastern Province Kingdom of Saudi Arabia p. 163
Khaled F Salama, Eltigani O. M. Omar, Mubashir Zafar
DOI:10.4103/ijoem.IJOEM_157_19  
Aim: The aim of this study is to determine the benzene, toluene, and xylenes (BTX) concentration levels in and around fuel station and its expected health risks in the City of Dammam and Al-Khobar, Saudi Arabia. Method: Forty fuel dispensing facilities were randomly selected on the basis of three different areas, residential, traffic intersection, and petrol pump locations (refueling stations). coconut shell charcoal cartridges were used for samples collection and portable Ambient Analyzer was used for measuring BTX (benzene, toluene, and xylenes) concentration. Results: Results show that the average concentration of benzene, toluene, and xylenes level around fuel stations was 10.30, 4.09, and 2.47 ppm, respectively. All means of concentration values of BTX around residential, traffic intersection, and fuel stations are exceeding the limits of air quality standards values (P < 0.01). The mean concentration of BTX around residential area, side street, and direct street was benzene 8, 12.2, and 11.5 ppm, toluene 2.5, 5.95, and 3.37 ppm, and xylenes 2, 2.13, and 2.7 ppm. Hazard Quotient (HQ) was more than >1 which showed that carcinogenic probability has increased those exposed to this toxic chemical. Conclusion: Ambient concentration of BTX was high compare to neighboring residential area and 100 m from the fuel station which can negatively affect on health of several residences. The Environmental contamination associated with BTX in petrol fuel stations impulses the necessity of preventive programs to reduce further air quality deterioration and reduce the expected health risks.
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Self-Care, burnout, and compassion fatigue in oncology professionals p. 168
Diti Kohli, P Padmakumari
DOI:10.4103/ijoem.IJOEM_201_19  
Context: With the rising number of cancer cases in India, the stress levels of the treating team have increased. It has affected their self-care and made them susceptible to problems like burnout and compassion fatigue that adversely affect the quality of patient care. Aims: The aim of the study was to assess and compare the levels of burnout, compassion fatigue, and self-care in three groups of oncology professionals (clinical oncologists, nurses, and psychologists). Settings and Design: The study included 134 oncology professionals working in New Delhi, Bengaluru, and Mumbai. Methods and Material: Sociodemographic data sheet, Professional Quality of Life Scale V and Self-Care Assessment Worksheet were used. Statistical Analysis Used: Kruskal-Wallis, Mann-Whitney U test, and Correlation Analysis. Results: The majority of the professionals reported moderate levels of burnout (60.4%) and compassion fatigue (56%). Oncology nurses reported an elevated risk as they scored significantly higher on these domains and had a lower degree of self-care. Interestingly, psychologists reported comparatively lower levels of burnout and compassion fatigue, despite the fact that they interact with the patients at a deeper level, looking after their psychological and emotional needs. Young age and a poor degree of self-care were identified as major risk factors. Conclusions: The moderate levels of burnout and compassion fatigue, though not severe, are a cause of concern and cannot be overlooked. The study highlights the need for self-care in this regard and suggests that individual and institutional level interventions, particularly for nurses and young professionals, would prove useful.
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Lower limb varicose veins among nurses: A single center cross-sectional study in Mansoura, Egypt p. 172
Hala S Abou-ElWafa, Aml A M. El-Metwaly, Abdel- Hady El-Gilany
DOI:10.4103/ijoem.IJOEM_264_19  
Background: Lower limb varicose veins are common among nurses due to occupational and nonoccupational risk factors. Aims: To estimate the prevalence of lower limbs varicosity and its associated risk factors. Settings and Design: A cross-sectional descriptive study was carried out among 201 nurses at Mansoura University Hospital from January 1st to May 31st, 2018. Methods: A questionnaire was used to collect sociodemographic data, risk factors for varicose veins, and occupational details. Varicose veins were diagnosed by Doppler ultrasound. Statistical Analysis: Univariate and logistic regression analyses were done. Results: The prevalence of varicose veins was 18.4%. Significant independent predictors are being ≥25 years old, working in emergency rooms and ICU/operative rooms, and using oral contraceptives with adjusted odds ratios [95% Confidence Interval (CI)] of [8.7 (2.6–28.4)], [10.8 (2.6–45.9)], [16.2 (3.9–67.4)], and [4.2 (1.3–13.2)], respectively. Conclusions: Independent predictors, other than age, are modifiable and those with highest AOR are occupationally related.
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Cognitive behavioral therapy for occupational stress among the intensive care unit nurses p. 178
Mohammad Hosein Fadaei, Mahya Torkaman, Naval Heydari, Maryam Kamali, Fariba Ghodsbin
DOI:10.4103/ijoem.IJOEM_286_19  
Background and Aims: Nurses working in the intensive care units (ICU) are faced with numerous stressors that can pose a serious threat to their self-efficacy and affect the quality of care. The aim of this study was to evaluate the effectiveness of Cognitive Behavioral Therapy (CBT) on the ICU nurses’ occupational stress. Methods: This interventional study was conducted in a hospital in southeast of Iran. The participants included 120 nurses, who were randomly assigned into the control (n = 60) and intervention (n = 60) groups. In the pre-test, the occupational stress was assessed using Osipow questionnaire. Later, the intervention group attended the CBT course conducted in six 90 minute sessions. One month after the intervention, the post-test data were collected from both groups. Results: The means of occupational stress and its dimensions were not significant before the intervention between the intervention and control groups (P = 0.47). The means of occupational stress and its dimensions were moderately high at pretest for all nurses. In the post-test, the stress level and all its dimensions reduced from moderate-high to moderate-low (P < 0.001), except for the physical environment dimension that remained at the moderate-high level (P = 0.32). Conclusion: The findings showed that CBT was effective on the nursing stress. Therefore, CBT training is suggested in in-service training programs for nurses.
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Low Back Pain (LBP) incidence, ergonomics risk and workers’ characteristics in relations to lbp in electronics assembly manufacturing p. 183
Sunisa Chaiklieng, Pornnapa Suggaravetsiri
DOI:10.4103/ijoem.IJOEM_4_20  
Aims: Electronics industry workers might have increased the risk of low back pain (LPB). This cohort study aimed to investigate LBP incidence and provide a baseline of ergonomic factors and workers’ characteristics associated with LBP. Methods: A six-month monitoring phase was designed using 196 electronic workers to identify LBP incidence. Baseline data were collected for ergonomic risk by RULA and lighting intensity measurement. Personal factors and work stress were surveyed by job content questionnaires (JCQ). Results: Ergonomic risk related to sitting posture was indicated at inspection with lamp (66.7%; change needed). High risk was shown among standing workers at punching and E-check processes. The lighting intensity did not meet the recommended standard in the arm range zone 2 of inspection and E-check stations. Dissatisfaction was reported due to work stress, workload, work rhythm, and job control. The six-month LBP incidence was 52.5%. Work experience less than three years (RR = 1.41; 95% CI: 1.031.90) and chronic diseases (RR = 1.41; 95% CI: 1.091.82) were significantly correlated with LBP incidence. Conclusions: Ergonomic and lighting conditions at E-check and inspection should be improved, and the promotion of short break exercise during shiftwork period is suggested. LBP should be closely surveilled in workers who had less job experience and underlying diseases.
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Prevalence of acute pesticide poisoning among pesticide applicators in cardamom plantations: A cross-sectional study from Idukki District, Kerala p. 188
Harikumar Reshma, Rajeev Jayalakshmi
DOI:10.4103/ijoem.IJOEM_72_19  
Background: Pesticide poisoning is a burning occupational health issue across the world. The pesticide use in the cardamom plantations of Idukki district, Kerala, India is one of the world’s highest. However, limited studies addressed its ill effects on the health of pesticide applicators. Aims: To assess the magnitude of acute pesticide poisoning (APP) among pesticide applicators and understand the nature of severity based on their occupational characteristics. Settings and Design: A descriptive cross-sectional study was conducted in 2018. A total of 300 pesticide applicators with minimum 1-year experience (79.3% males) were selected from 30 randomly selected cardamom plantations in Udumbanchola Taluk. Methods: WHO Field Surveys of Exposure to Pesticides Standard Protocol and Murphy’s method of Farmer Self-Surveillance system of pesticide poisoning were used for assessing pesticide exposure and APP, respectively. Statistical analysis used: Descriptive (frequencies) and exploratory statistical analyses (Pearson’s Chi-square test) were done using IBM SPSS 23.0. Results: The prevalence of APP in this study was 100% as all the pesticide applicators reported at least one sign and/or symptom of APP. The mild APP was more prevalent (80.7%), followed by moderate (18.7) and severe (0.60). Decrease in duration and frequency of spraying, use of motor pump sprayer, safe storage and disposal of pesticides, and proper personal hygiene were found to reduce the severity of APP. Conclusion: All the pesticide applicators in cardamom plantations of Idukki are at risk of APP. It is important to train them about the measures to prevent the same.
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Completeness of ascertainment of construction site injuries using First Information Reports (FIRs) of Indian police: Capture-recapture study p. 194
Sajjan S Yadav, Phil Edwards, John Porter
DOI:10.4103/ijoem.IJOEM_202_20  
Background & Objectives: The construction industry is a leading contributor to occupational injuries. First Information Reports (FIRs) of Indian Police are a potential data source for construction injuries. The aim of this study was to estimate the completeness of ascertainment of construction site injuries by FIRs. Methods: This was a two-sample capture-recapture study of construction site injuries sustained in the year 2017 in Delhi, India. The first capture sample was data extracted from FIRs. The second capture sample comprised data extracted from the Employee State Insurance Corporation (ESIC) and the Commissioners of Workmen Compensation. The Chapman estimator was used to estimate, with 95% confidence intervals, the total numbers of fatal and non-fatal injuries. Results: FIRs ascertained 374 injuries (110 fatal and 264 non-fatal) while the combined data of ESIC and workmen compensation claims ascertained 80 injuries (48 fatal and 32 non-fatal). The capture-recapture analysis estimated that 1,011 (95% CI: 873 to 1149) injuries: 258 (95% CI: 221 to 295) fatal injuries and 873 (95% CI: 765 to 1053) non-fatal injuries were sustained in Delhi in 2017. Interpretation & Conclusions: FIRs ascertain approximately one-third of all construction site injuries. In the absence of any other data source, FIRs may be used as the basis of a construction injury surveillance system, recognizing that any estimates made using these data must be adjusted to allow for the approximately two-thirds of injuries not reported to the police. Further research is needed to identify reasons for some injuries not being reported to the police, in order to help to develop a strategy to improve the completeness of ascertainment of construction site injuries for the future.
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BRIEF COMMUNICATION Top

Awareness, prevalence and factors associated with respiratory morbidities among selected petrol pump workers in Bengaluru City? p. 199
Jisha Saru Thomas, PJ Mercy, Merlyn Joseph, Bobby Joseph
DOI:10.4103/ijoem.IJOEM_19_20  
Introduction: Petrol pump workers are exposed to fumes emanated during petrol filling and vehicular exhaust thus falling prey to several respiratory diseases. Objectives: To assess the awareness and prevalence of respiratory morbidities among petrol pump workers of selected petrol pumps in Bangalore. Methodology: This cross-sectional study was conducted among 158 petrol pump workers from 11 selected pumps in Bengaluru. Following IEC approval, the baseline socio-demographic data, knowledge regarding respiratory morbidities and current morbidity pattern were ascertained. Medical examination and Peak Expiratory Flow rate (PEFR) was estimated. Results: The 158 workers were all male, mostly between 18-27 years (65.19%) and high school educated (49.37%). Knowledge regarding respiratory morbidities was 56%, while prevalence of respiratory morbidity was 61%. Those workers who had completed their higher education (>10th standard), earning monthly income (>Rs. 5000) had better knowledge regarding respiratory morbidities. Recommendation: Pre-employment and regular medical examination including lung function tests and promotion of use of PPEs to be implemented.
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CASE REPORT Top

The medical concrete cancer of the lung: A unique case report p. 203
Mario Tamburrini, Unnati Desai, Umberto Zuccon, Carlo Barbetta
DOI:10.4103/ijoem.IJOEM_94_19  
A 53-year-old 10 pack year smoker and concrete worker for 12 years presented to us with a lung mass proven to be small cell lung cancer on lung biopsy. An industrial terminology of concrete cancer already exists defining the wear and tear in concrete due to various interactions. The interactions of concrete and smoke on lung, predisposed and increased the risk of lung cancer probably as an additive effect which we label as the medical concrete cancer of the lung.
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LETTER TO EDITOR Top

A rare cause of bilateral wrist drop p. 206
Abhishek Juneja, Kuljeet S Anand
DOI:10.4103/ijoem.IJOEM_13_20  
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