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Healthy worker effect phenomenon
Divyang Shah
May-August 2009, 13(2):77-79
DOI:10.4103/0019-5278.55123  PMID:20386623
The Healthy Worker Effect (HWE) phenomenon has been under debate since some years. Some epidemiologists regard HWE as an ordinary method problem while others consider it a field of science by itself. This article gives definitions of HWE explained with historical background; discusses factors affecting it and suggests methods to minimize problems associated with it.
  34 8,006 405
Stress causing psychosomatic illness among nurses
Pratibha P Kane
January-April 2009, 13(1):28-32
DOI:10.4103/0019-5278.50721  PMID:20165610
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.
  19 20,538 853
A study on oxidative stress and antioxidant status of agricultural workers exposed to organophosphorus insecticides during spraying
SK Rastogi, P.V.V Satyanarayan, D Ravishankar, Sachin Tripathi
September-December 2009, 13(3):131-134
DOI:10.4103/0019-5278.58916  PMID:20442831
Oxidative stress status and Acetylcholinesterase (AChE) activity were studied in blood samples obtained from 61 agricultural workers engaged in spraying organophosphorus (OP) insecticides in the mango plantation, with a minimum work history of one year, in the age range of 12-55 years. Controls were age-matched, unexposed workers, who never had any exposure to OP pesticides. They were evaluated for oxidative stress markers MDA (end product of lipid peroxidation), reduced glutathione (GSH), and Acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) levels in blood. The results showed a marked inhibition of the AChE and BChE activities in the sprayers as compared to the controls. The malondialdehyde(MDA), the last product of lipid peroxidation was found to be increased significantly in sprayers(p<0.05), while depletion in the concentration of antioxidant glutathione(GSH) was also observed in the sprayers but the difference was statistically not significant. It was concluded on the basis of biochemical analysis that pesticides sprayers are exposed to more oxidative stress as evidenced by the changes in antioxidant status. The measurement of the AChE and BChE activities in agricultural workers who spray OPs could be a good biomonitoring factor and is recommended to be performed on a regular basis.
  19 5,870 401
An overview of occupational health research in India
Ramanakumar V Agnihotram
January-April 2005, 9(1):10-14
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.
  17 41,625 1,778
A preliminary cytogenetic and hematological study of photocopying machine operators
PK Gadhia, D Patel, KB Solanki, DN Tamakuwala, MA Pithawala
January-April 2005, 9(1):22-25
The incidences of chromosomal aberrations(CAs) as well as sister chromatid exchange frequencies (SCEs) was evaluated from 12 photocopying machine operators working on an average 8-9 hours per day for more than five years. A complete blood picture of each individual was assessed with an automatic particle cell counter. Additionally, blood pressure was measured at the time of blood collection from all photocopying machine operators. For comparison, the control group included another 12 individuals matched according to age, sex, socioeconomic conditions as well as other personal habits. The observations of the present study are indicators of health hazard for, although small, there was a significant increase in the percentage of aberrant cells (P<0.05), total aberrations (P<0.01) as well as total aberrations excluding chromatid gaps (P<0.01) among photocopying machine operators when compared to controls. However, results on SCE analysis of photocopying operators revealed no significant difference from the controls. At the same time all photocopying operators exhibited normal hematological parameters as well as blood pressure values.
  16 13,087 324
The exposure to and health effects of antimony
Ross G Cooper, Adrian P Harrison
January-April 2009, 13(1):3-10
DOI:10.4103/0019-5278.50716  PMID:20165605
Context: This minireview describes the health effects of antimony exposure in the workplace and the environment. Aim: To collate information on the consequences of occupational and environmental exposure to antimony on physiological function and well-being. Methods: The criteria used in the current minireview for selecting articles were adopted from proposed criteria in The International Classification of Functioning, Disability and Health. Articles were classified from an acute and chronic exposure and toxicity thrust. Results: The proportion of utilised and non-utilised articles was tabulated. Antimony toxicity is dependent on the exposure dose, duration, route (breathing, eating, drinking, or skin contact), other chemical exposures, age, sex, nutritional status, family traits, life style, and state of health. Chronic exposure to antimony in the air at levels of 9 mg/m 3 may exacerbate irritation of the eyes, skin, and lungs. Long-term inhalation of antimony can potentiate pneumoconiosis, altered electrocardiograms, stomach pain, diarrhea, vomiting, and stomach ulcers, results which were confirmed in laboratory animals. Although there were investigations of the effect of antimony in sudden infant death syndrome, current findings suggest no link. Antimony trioxide exposure is predominant in smelters. Mining and exposure via glass working, soldering, and brazing are also important. Conclusion: Antimony has some useful but undoubtedly harmful effects on health and well-being and measures need to be taken to prevent hazardous exposure of the like. Its biological monitoring in the workplace is essential.
  16 11,752 529
Zinc toxicology following particulate inhalation
Ross G Cooper
January-April 2008, 12(1):10-13
DOI:10.4103/0019-5278.40809  PMID:20040991
The current mini-review describes the toxic effects of zinc inhalation principally in the workplace and associated complications with breathing and respiration. The International Classification of Functioning, Disability and Health Criteria were used to specifically select articles. Most of the commercial production of zinc involves the galvanizing of iron and the manufacture of brass. The recommended daily allowance for adults is 15 mg zinc/day. Metal fume fever associated with inhalation of fumes of ZnO is characterized by fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste and salivation. ZnCl 2 inhalation results in edema in the alveolar surface and the protein therein the lavage fluid is elevated. Particular pathological changes associated with zinc intoxication include: pale mucous membranes; jaundice; numerous Heinz bodies; and marked anemia. Adequate ambient air monitors for permissible exposure limits, excellent ventilation and extraction systems, and approved respirators are all important in providing adequate protection.
  15 12,142 314
Renal effects of environmental and occupational lead exposure
SK Rastogi
September-December 2008, 12(3):103-106
DOI:10.4103/0019-5278.44689  PMID:20040966
  14 5,778 454
E-waste hazard: The impending challenge
Violet N Pinto
May-August 2008, 12(2):65-70
DOI:10.4103/0019-5278.43263  PMID:20040981
Electronic waste or e-waste is one of the rapidly growing problems of the world. E-waste comprises of a multitude of components, some containing toxic substances that can have an adverse impact on human health and the environment if not handled properly. In India, e-waste management assumes greater significance not only due to the generation of its own e-waste but also because of the dumping of e-waste from developed countries. This is coupled with India's lack of appropriate infrastructure and procedures for its disposal and recycling. This review article provides a concise overview of India's current e-waste scenario, namely magnitude of the problem, environmental and health hazards, current disposal and recycling operations, existing legal framework, organizations working on this issue and recommendations for action.
  13 15,946 622
Assessment of association of exposure to polycyclic aromatic hydrocarbons with bronchial asthma and oxidative stress in children: A case control study
Ram Suresh, Shally Awasthi, AA Mahdi, DK Patel, VK Singh, Misra Rita
January-April 2009, 13(1):33-37
DOI:10.4103/0019-5278.50722  PMID:20165611
Background: Polycyclic aromatic hydrocarbons (PAH) originate from the incomplete combustion of organic matter and ambient air pollution by these is increasing. There is also an increase in the global prevalence of asthma, for which environmental pollution has been recognized as one of the important factors. Exposure to pollutants and other allergens induces chronic airway inflammation by generation of reactive oxygen species, causing oxidative stress. Therefore, the objective of the present study was to assess association, if any, between exposure to PAH and asthma as well as oxidative stress in children. Method: In this hospital-based case control study, cases of bronchial asthma aged 1-14 years and healthy matched controls were included. Oxidative stress was measured by assessing the levels of enzymes catalase, superoxide dismutase, malondialdehyde (MDA), and reduced glutathione (GSH). Results : Forty-two cases and 20 controls were enrolled. Mean blood level of phenanthrene, a PAH, was 63.11 ppb 115.62 and 4.20 ppb 10.68 ppb in cases and controls, respectively ( P = 0.02). Mean blood levels of GSH was significantly lower in cases and controls (27.39 mg/ml 11.09 versus 47.39 g/ml 13.83; P -value = 0.001). Likewise, mean blood level of MDA in nanomole/ml was significantly higher in asthma as compared with controls (12.85 5.40 versus 8.19 5.16; P -value = 0.002), suggestive of increased oxidative stress. Conclusions: Because elevated blood level of phenanthrene is associated with bronchial asthma as well as with oxidative stress, measures to reduce exposure to PAH may possibly lead to reduced incidence and severity of bronchial asthma.
  12 6,724 378
Occupational lifestyle diseases: An emerging issue
Mukesh Sharma, PK Majumdar
September-December 2009, 13(3):109-112
DOI:10.4103/0019-5278.58912  PMID:20442827
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.
  12 41,823 2,276
Occupational noise-induced hearing loss in India
Subroto S Nandi, Sarang V Dhatrak
May-August 2008, 12(2):53-56
DOI:10.4103/0019-5278.43260  PMID:20040978
Noise is the insidious of all industrial pollutants, involving every industry and causing severe hearing loss in every country in the world. Exposure to excessive noise is the major avoidable cause of permanent hearing impairment. Worldwide, 16% of the disabling hearing loss in adults is attributed to occupational noise, ranging from 7 to 21% in the various subregions. The estimated cost of noise to developed countries ranges from 0.2 to 2% of the gross domestic product (GDP). Noise-induced hearing loss (NIHL) is bilateral and symmetrical, usually affecting the higher frequencies (3k, 4k or 6k Hz) and then spreading to the lower frequencies (0.5k, 1k or 2k Hz). Other major health effects are lack of concentration, irritation, fatigue, headache, sleep disturbances, etc. The major industries responsible for excessive noise and exposing workers to hazardous levels of noise are textile, printing, saw mills, mining, etc. Hearing protectors should be used when engineering controls and work practices are not feasible for reducing noise exposure to safe levels. Earmuffs, ear plugs and ear canal caps are the main types of hearing protectors. In India, NIHL has been a compensable disease since 1948. It is only in 1996 that the first case got compensation. Awareness should be created among workers about the harmful effects of noise on hearing and other body systems by implementing compulsory education and training programs. There are very few published studies of NIHL in India. More extensive studies are needed to know the exact prevalence of NIHL among the various industries in India.
  12 10,243 732
Monitoring of plasma butyrylcholinesterase activity and hematological parameters in pesticide sprayers
SK Rastogi, Vipul K Singh, C Kesavachandran, Jyoti , M.K.J Siddiqui, N Mathur, RS Bharti
January-April 2008, 12(1):29-32
DOI:10.4103/0019-5278.40813  PMID:20040995
To evaluate the health impact of spraying organophosphorus insecticides (OPs), 34 male sprayers in the mango belt of Malihabad, a small town located 27 km from Lucknow in North India was selected. Plasma butyryl cholinesterase (PBChE) and complete blood count were assessed among sprayers after spraying pesticides and the findings obtained were compared with those determined in a reference group ( n = 18). The most common symptoms observed were burning sensation in the eyes (8.82%), itching/skin irritation (23.52%) and chest symptoms (32.35%) in the exposed workers. Plasma butyrylcholinesterase (PBChE) was significantly decreased in workers. The results indicated significant decrease in the mean value of hemoglobin, hematocrit and platelets count; however, significantly higher count of leukocytes was also observed in the exposed group (sprayers) compared to that observed in the control group (P < 0.05). Monitoring of PBChE in pesticide sprayers could be useful to predict and prevent health hazards of OPs.
  11 8,627 324
Malignant pleural mesothelioma in Italy
Claudio Bianchi, Tommaso Bianchi
May-August 2009, 13(2):80-83
DOI:10.4103/0019-5278.55124  PMID:20386624
This study reviews a series of 811 malignant pleural mesothelioma cases, diagnosed at hospitals in Trieste and Monfalcone districts of north eastern Italy, a narrow coastal strip with a population of about three lakh, in the period 1968-2008. The diagnosis was based on histological examination in 801 cases, and cytological findings in 10. Necropsy was performed in 610 cases. Occupational histories were obtained directly from the patients or their relatives through personal or telephone interviews. Routine lung sections were examined for asbestos bodies in 500 cases. In 143 cases asbestos bodies were isolated and counted by chemical digestion of the lung tissue using the Smith-Naylor method. The series included 717 men and 94 women aged between 32 and 93 years (mean 69.2 years). Detailed occupational data was obtained for 732 cases. The majority of patients had marine jobs - shipbuilding (449 cases), maritime trades (56 cases), and port activities (39 cases). The nature of work of other patients included a variety of occupations, with non-shipbuilding industries being the most common. Thirty-four women cleaned the work clothes of family members occupationally exposed and hence had a history of asbestos exposure at home. Most of the patients had their first exposure to asbestos before 1960. The latency period ranged between 13 and 73 years (mean 48.2). Latency period among insulators and dock workers were shorter than other categories. Asbestos bodies were detected on routine lung sections in 343 cases (68.6%). Lung asbestos body burdens after isolation ranged between two to 10 millions bodies per gram of dried tissue. Despite some limitations in the use of asbestos in this area since the 1970s, the incidence of tumor remained high during the last years.
  11 5,686 284
Oxidative stress, melatonin level, and sleep insufficiency among electronic equipment repairers
Mohamed El-Helaly, E Abu-Hashem
September-December 2010, 14(3):66-70
DOI:10.4103/0019-5278.75692  PMID:21461157
Background: Exposure to extremely low frequency electromagnetic field (ELF-EMF), especially among electronic equipment repairers may induce oxidative stress and affect sleep quality. Aims: This study was carried out to (a) investigate the effect of exposure to ELF-EMF on the malondialdehyde (MDA) levels among electronic equipment repairers as an indicator of oxidative stress; and melatonin hormone levels; and (b) to study the prevalence of sleep insufficiency among electronic equipment repairers exposed to ELF-EMF. Materials and Methods: A cross-sectional study was carried out on 50 electronic equipment repairers at high risk of exposure to ELF-EMF, and a matched control group at lower risk of exposure to ELF-EMF. All the participants completed a self-administered questionnaire about medical and occupational histories; and sleep sufficiency. The plasma melatonin and MDA levels of the study subjects were assessed. Results: The mean level of serum melatonin in the electronic equipment repairers was lower than that of the controls (P < 0.01). Moreover, serum MDA mean level of the electronic equipment repairers was higher than that of the controls (P < 0.01). Sleep insufficiency was more frequent among electronic equipment repairers (18.00%) in comparison with the controls (8.70%) (P > 0.05). Conclusion: The electronic equipment repairers, exposed to ELF-EMF, are at a risk of oxidative stress and sleep insufficiency, which could be explained by lower plasma melatonin levels and higher MDA levels. Health education about the hazards of ELF-EMF, shortening of exposure time per day, and taking antioxidant vitamins should be done to ameliorate the oxidative effect of EMF on those workers.
  11 6,328 183
Occupational health risks among the workers employed in leather tanneries at Kanpur
Subodh Kumar Rastogi, Amit Pandey, Sachin Tripathi
September-December 2008, 12(3):132-135
DOI:10.4103/0019-5278.44695  PMID:20040972
In a cross-sectional study, a random sample of 197 male workers drawn from different sections of 10 leather tanneries in Kanpur were selected for the assessment of health risks. A control group comprising of 117 male subjects belonging to a similar age group and socioeconomic strata, who never had any occupational exposure in the leather tanneries, were also examined for the comparison purpose. The findings revealed a significantly higher prevalence of morbidity among the exposed workers in contrast to that observed in the controls (40.1% vs. 19.6%). The respiratory diseases (16.7%) were mainly responsible for a higher morbidity among the exposed workers whereas the gastrointestinal tract problems were predominant in the control group. The urinary and blood samples collected from the exposed group showed significantly higher levels of chromium, thereby reflecting the body burden of Cr in the exposed workers as a result of a high concentration of environmental Cr at the work place.
  10 9,146 443
High-altitude medicine
Swapnil J Paralikar, Jagdish H Paralikar
January-April 2010, 14(1):6-12
DOI:10.4103/0019-5278.64608  PMID:20808661
Sojourns to high altitude have become common for recreation and adventure purposes. In most individuals, gradual ascent to a high altitude leads to a series of adaptive changes in the body, termed as acclimatization. These include changes in the respiratory, cardiovascular, hematologic systems and cellular adaptations that enhance oxygen delivery to the tissues and augment oxygen uptake. Thus there is an increase in pulmonary ventilation, increase in diffusing capacity in the lung, an increase in the cardiac output and increase in the red blood cell count due to an increase in erythropoietin secretion by the kidney, all of which enhance oxygen delivery to the cells. Cellular changes like increase in the number of mitochondria and augmentation of cytochrome oxidase systems take months or years to develop. Too rapid an ascent or inability to acclimatize leads to high-altitude illnesses. These include acute mountain sickness (AMS), high-altitude cerebral edema (HACE) and high-altitude pulmonary edema (HAPE). Acute mountain sickness is self limiting if recognized early. Both HACE and HAPE are life threatening and need to be treated aggressively. The key to treatment of these illnesses is early recognition; administration of supplemental oxygen; and descent if required. Drugs like acetazolamide, dexamethasone, nifedipine may be administered as recommended.
  10 9,410 401
Occupational health hazards in sewage and sanitary workers
Rajnarayan R Tiwari
September-December 2008, 12(3):112-115
DOI:10.4103/0019-5278.44691  PMID:20040968
An estimated 1.2 million scavengers in the country are involved in the sanitation of our surroundings. The working conditions of these sanitary workers have remained virtually unchanged for over a century. Apart from the social atrocities that these workers face, they are exposed to certain health problems by virtue of their occupation. These health hazards include exposure to harmful gases such as methane and hydrogen sulfide, cardiovascular degeneration, musculoskeletal disorders like osteoarthritic changes and intervertebral disc herniation, infections like hepatitis, leptospirosis and helicobacter, skin problems, respiratory system problems and altered pulmonary function parameters. This can be prevented through engineering, medical and legislative measures. While the engineering measures will help in protecting against exposures, the medical measures will help in early detection of the effects of these exposures. This can be partly achieved by developing an effective occupational health service for this group of workers. Also, regular awareness programs should be conducted to impart education regarding safer work procedures and use of personal protective devices.
  10 11,790 575
Occupational exposure to sharps and splash: Risk among health care providers in three tertiary care hospitals in South India
S Tetali, PL Choudhury
January-April 2006, 10(1):35-40
Occupational exposure to blood and body fluids places Health care providers at risk of infection with blood borne viruses including HIV. To understand Health Care Providers' (HCP*) perception of risk of occupational exposure to needles, blood and body fluids, to find out the correlates of exposure and to identify groups of HCP at high risk of sustaining maximum number of such exposures. A cross sectional survey was conducted on HCP in three tertiary care hospitals in Kerala, between August 20th and October 30th, 2004 Chi square test, independent-sample T test and one-way ANOVA was used for analysis. Overall, 74.5% (95% CI 71.3 to 78.2) of the respondents were exposed at least once in the last 12 months. Surgeons were exposed most frequently, with a mean of 3.8 injuries per person per year. Injection needles were responsible for 68% of the injuries. Those who underwent the in-service training program on needle safety were less injured ( P =0.001). Only 4% of surgeons had undergone needle safety training. Almost half the surgeons, anesthetists and medical students did not know the reporting procedure and only 10% of anesthetists knew about the provision of Post Exposure Prophylaxis (PEP). A considerable proportion of respondents (85%) (95% CI- 81.2 to 88.5) were concerned about acquiring blood borne infections and 90% were immunized against Hepatitis B. Training of Health care providers is absolutely essential for injury reduction and should take into account the varying incidence of exposure across different occupation groups.
  9 11,162 415
Occupational Stress and Job Satisfaction among Managers
Chandraiah K., Agrawal S.C., Marimuthu P., Manoharan N.
May-August 2003, 7(2):6-11
Full text not available  [PDF] [CITATIONS]
  8 3,348 597
Issues and concerns of health among call center employees
VP Sudhashree, K Rohith, K Shrinivas
September-December 2005, 9(3):129-132
  8 47,633 772
Global warming: Need to sensitize general population
Harshal Pandve
May-August 2007, 11(2):86-87
DOI:10.4103/0019-5278.34536  PMID:21938223
  8 6,358 277
Using spirometry results in occupational medicine and research: Common errors and good practice in statistical analysis and reporting
NL Wagner, WS Beckett, R Steinberg
January-April 2006, 10(1):5-10
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.
  8 18,005 732
Risk from vibration in Indian mines
Bibhuti B Mandal, Anup K Srivastava
May-August 2006, 10(2):53-57
Equipment-induced vibration is widely recognized as a health hazard. It is a physical stressor to which many people are exposed at workplace. Mining industry is no exception. In spite of extensive research undertaken in the developed countries, information on the magnitude of the problem in India is not available. An estimated 1 million workers were engaged in the Indian mining industry in the year 2003. The actual figures could be much higher. Analysis of employees' database of several mines reveals that 18% employees in the Indian mining industry are occupationally exposed to vibration. Large-scale mechanization considerably adds to the severity and complexity of the problem because of 1) increase in the percentage of exposed population and 2) longer duration of exposure. The clinical picture and health outcomes of exposure to hand-arm vibration and whole-body vibration are scantily documented in the Indian context. In view of the health risk and action taken in other countries, we submit that there is an urgent need to develop a practical management strategy for evaluation, monitoring and control of equipment-induced vibration in the mining industry.
  8 12,937 362
Thallium toxicity: A growing concern
A Saha
May-August 2005, 9(2):53-56
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.
  8 29,193 481
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