Agreement between chest radiography and high-resolution computed tomography in diagnosing dust-related interstitial lung fibrosis

Although it has been suggested that high-resolution computed tomography (HRCT) scans can be obtained when plain radiographs are equivocal for the presence of interstitial lung fibrosis (ILF) caused by inhalation of dust, such as silica, asbestos fibres, etc., the specificity of the findings remains in question. The present study was carried out to compare the relative efficacy of chest radiography by conventional method and HRCT in evaluating ILF which included 22 workers exposed to fibrogenic dust, who were subjected to clinical examination, pulmonary function testing, posteroanterior chest radiography and HRCT. In the six subjects who had findings suggestive of ILF on HRCT, four had normal chest x-ray (CXR) while one each has been diagnosed as having tuberculosis and ILF on CXR. The agreement analysis between HRCT and CXR suggests that there was a poor agreement between HRCT and CXR (kappa = 0.34).

Eyestrain in working children of footwear making units of Agra, India

Children of footwear making units are working in the soling process. The process includes fixing of upper part with the sole of the footwear. The adhesives contain a mix of organic solvents, which are released in the working environment and cause irritation and lacrimation of eyes. In addition poor illumination and ventilation further aggravates the eyestrain. The present study was carried out to find out the prevalence and the associated factors of eyestrain in working children of footwear making units. The study included 139 exposed and 160 comparison group subjects. Self-reported eyestrain was recorded through personal interview. The prevalence of eyestrain in child laborers was 25.9%, which was significantly more than the 12.4% prevalence in comparison group subjects (P=0.01). Working children of footwear making units were at 2.4 times higher risk of developing eyestrain as compared to comparison group subjects, though statistically non significant. Significantly higher proportion of eyestrain was reported in those aged >12 years, males and those working daily for >4 hours. The higher prevalence of eyestrain in the working children of footwear units may be attributed to exposure to workplace factors.

Situational analysis of nursing education and work force in India

Nursing care has been mentioned in the Indian culture from the times of the Vedas. However, according to World Health Organization, the nursing workforce in India is still insufficient to meet the needs of the country. The purpose of this article is to examine the status of nursing education and the nursing workforce in India and the challenges faced by the profession. Data supporting the statements made in the article were obtained from the Nursing Council of India, the Ministry of Health and Family Welfare, the Government of India Web sites, printed journals and communication with experts in the field. In India, there is a need to train approximately a million nurses to meet the current shortfall of health workers in the country. The nursing "brain drain" suggests that it may be one of the factors responsible for this shortfall. Further, nursing education faces challenges, such as streamlining nursing education, enriching the curriculum, strengthening faculty development and increasing the use of innovative teaching and learning techniques.

An epidemiological study of low back pain among oil drilling workers in India

Many episodes of low back pain are disabling, thus making it one of the costly occupational health problem. The proper alignment and lifting operations during drilling process frequently exposed the oil-drilling workers to unusual strain on the spine and thus make them susceptible for developing low back pain. The present cross-sectional study was carried out in 71 oil-drilling workers. The prevalence of self-reported low back pain was found to be 29.6%. Higher prevalence was found in those working in awkward working posture (c 2 = 6.41; df = 1; p < 0.01). No other factors, namely, age, obesity, duration of exposure, smoking habit, family history of musculoskeletal disorders, exposure to vibration, lifting of weights and past history of injury was found to be statistically significant. Furthermore, using univariate and multivariate analysis, none of the factor was found to have excess risk of occurrence of low back pain, which can partly be attributed to small sample size.

Need and supply gap in occupational health manpower in India

Industrial growth in India has resulted in increased employment opportunities, thereby inflating the size of the workforce engaged in both organized and unorganized sectors. This workforce is exposed to various occupational factors at workplace and hence is susceptible to occupational diseases, which requires trained occupational health manpower. The present study is undertaken to estimate the need and supply gap of occupational health manpower, based on present regulations. The total workforce in the organized sector in India is 26.92 million. There are 254,951 working registered industrial factories in India, with about 11.16 million workers. These factories have employed 6953 factory medical officers (FMOs) and 2308 safety officers (SOs). Hence, for 26.92 million of total workforce engaged in organized sector, we would require a total of 16,728 FMOs and 5619 SOs, thereby estimating the deficit of 58% for FMOs and 59% for SOs based on current ratio of employment.

Tuberculosis among workers exposed to free silica dust

Tuberculosis (TB) is a global emergency. Poverty, increasing migration, homelessness and the compulsions to live and work in high-risk environments are making people increasingly susceptible to the disease. Those working in mines, construction work, stone-crushing and in other similar occupations where there is a greater level of exposure to silica dust are specially vulnerable. Though the association between TB and silicosis has been firmly established by the results of epidemiologic studies no attempts have been made to study the epidemiological features of radiologically active TB among free silica exposed workers. Thus the cross sectional study was carried out among slate pencil workers and quartz stone crushers to assess the prevalence of TB and some associated epidemiological factors. It included 253 quartz workers and 102 slate pencil workers. Clinical history and chest radiographs were used for labeling the subjects as tuberculotic. The pulmonary functions of the subjects were measured using Spirovit SP- 10. Statistical analysis was carried out using statistical software package Epi Info 3.3.2. Among stone crushers the prevalence of TB was found to be 10.7% while among slate pencil workers it was as high as 22.5%. Among the quartz stone-crushers the workers aged ≥35 years, those exposed for ≥3 years and those who were smokers had higher risk TB while among the slate pencil workers, only those exposed for ≥10 years had higher risk. Though the FVC and FEV₁ values of the workers having TB were lower than those having normal radiographs, the differences were found to statistically non-significant.

Occupational health problems of highway restaurant workers of Pune, India

To meet the ever-increasing demand for new cuisines, the catering industry in India is becoming more prominent day by day. According to a recent estimate, more than two million restaurants are now dominating the present scenario of the Indian catering industry. The health hazards in restaurants vary according to the place that a worker is employed. The hazards among kitchen staff include several different types of accidents such as burns from deep fryers, slipping on grease and cuts from knives, whereas musculoskeletal disorders are more common among waiters and helpers who usually bear load. The present cross-sectional study included 127 workers from 15 restaurants and dhabas situated at Pune-Mumbai high way. Interview technique followed by clinical examination was the tool for data collection. Musculoskeletal symptoms such as low back pain, fatigue, body ache and pain in limbs were present in 18 (14.2%) of the workers. Gastrointestinal complaints such as heartburn, abdomen pain, stomatitis, etc. were reported by 12 (9.4%) subjects, while skin-related symptoms, such as itching and discoloration were reported in 12 (9.4%) subjects. Seventy-three (57.5%) of the subjects were free from any symptoms.

Mapping 'Occupational Health' courses in India: A systematic review

The occupational health scenario is undergoing a paradigm shift in developing countries with rapid industrialization. Inadequate human resource is, however, a concern. The creation of Basic Occupational Health Services will demand a further increase in specialist manpower. The current training capacity of occupational health specialists has been mapped by a systematic review in India. Twenty-one institutes have been identified all across the country. They have an existing capacity for training about 460 specialists. This number is inadequate considering the population of India's working class. A mixture of strategies must be urgently planned for addressing this issue.

Risk factor analysis in self-reported diabetes in a rural Kerala population

AIM

To find the prevalence of self-reported diabetes mellitus (DM) in rural Kerala.

METHODOLOGY

Interview schedule was used to collect the information on pre-designed and pre-tested proforma. Self-reported DM was taken as outcome measure. All these patients were diagnosed by their respective physicians and were on anti-diabetic drugs. Body weight was measured to the nearest 1 kg using bathroom scale; while height was measured using a nonstretchable tape to the nearest 1 mm. Standard classification of obesity and waist circumference was used.

RESULTS

The present cross-sectional study was carried out in the Venganoor village of Kerala. Four hundred and sixty four subjects, 64.4% women and 35.6% men, were selected randomly. Nearly half of the subjects were in the age range of 25-54 years, while about one-third of the subjects were over 55 years. Among the men, 38.5% were ever smokers, while 5.5% were in the habit of consuming alcohol. 27.8% of the subjects were found to be obese, while 20.3% of the subjects reported raised waist circumference. The level of physical activity in the majority of the subjects was either sedentary or mild. On multivariate analysis, increasing age was found to be significantly associated with self-reported diabetes (OR = 1.07; 95% CI: 1.04-1.09). The other factors namely sex, smoking habit, alcohol use, obesity, waist circumference and physical activity were found to be statistically nonsignificant.

CONCLUSION

The prevalence of self-reported diabetes was found to be 13.1% and that it was seen to be associated with increasing age.

Comparison of respiratory morbidity between present and ex-workers of quartz crushing units: Healthy workers' effect

BACKGROUND

Quartz stone grinders are one such group of workers who are exposed to silica and thereby at risk of developing silicosis. However due to increased campaigning against silicosis the scenario has changed.

OBJECTIVES

To compare the respiratory morbidities among the present quartz stone workers and the ex-quartz stone workers who have left the job.

MATERIALS AND METHODS

This cross-sectional study included, 134 ex-workers and 182 current workers of quartz grinding units. All these subjects were subjected to chest radiography and pulmonary function tests.

RESULTS

For 134 ex-workers, the mean age was 31.77 ± 9.99 years and the mean duration of exposure was found to be 2.74 ± 1.65 years while for the present workers, the mean age was 26.74± 7.12 years while the mean duration of exposure was 1.36 ± 2.68 years. The study revealed silicosis in 24 (17.9%), radiological suspected tuberculosis in 17 (12.7%) and silico-tuberculosis in 33 (24.7%) ex-workers while in present workers, radiological suspected tuberculosis in 10 (5.5%) subjects and silicosis grade 1/1 in one subject were found. Among the ex-workers, 14 (10.4%) had a combined type of pulmonary function impairment while 8 (6.0%) and 28 (20.9%) were having restrictive and obstructive type of pulmonary impairments, respectively. Among the present workers, pulmonary function testing revealed the combined type of functional impairment in 1 (0.5%), restrictive type in 13 (7.1%), and obstructive type of functional impairment in 17 (9.2%) subjects.

CONCLUSION

The high prevalence of respiratory morbidity in ex-workers as compared to current workers can be attributed to the out-of-the-job healthy workers' effect.

Occupational health hazards in sewage and sanitary workers

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.

Occupational skin problems in construction workers

Background

Construction workers handle cement which has constituents to produce both irritant contact dermatitis and corrosive effects (from alkaline ingredients, such as lime) and sensitization, leading to allergic contact dermatitis (from ingredients, such as chromium).

Aim:

The present study has been carried out among unorganized construction workers to find the prevalence of skin problems.

Materials and Methods:

The present cross-sectional study was conducted in 92 construction workers of Ahmedabad and Vadodara.

Results and Discussion:

All the workers were subjected to clinical examination after collection of information regarding demographic characteristics, occupational characteristics and clinical history on a predesigned proforma. Of them, 47.8% had morbid skin conditions. Frictional callosities in palm were observed in 18 (19.6%) subjects while 4 (4.3%) subjects had contact dermatitis. Other conditions included dry, fissured and scaly skin, infectious skin lesion, tinea cruris, lesion and ulcers on hands and/or soles.

Conclusion

The skin conditions were common in the age group of 20–25 years, males, those having ≥1 year exposure and those working for longer hours. Half of the workers not using personal protective equipment had reported skin-related symptoms.

Blood chromium levels of children working in gem-polishing industries in India

The gem-polishing industry in Jaipur, India employs a substantial proportion of children. The process of polishing may result in exposure to chromium in working children. Thus, this study aims to find out the levels of chromium in these working children and the associated factors. Blood samples were analysed for chromium using atomic absorption spectrophotometer. The mean blood chromium levels were 2.51 ± 1.11 mg/100 ml and 2.33 ± 1.10 mg/100 ml in working and school children, respectively, which is well within the permissible levels. However, the practice of employing children should be totally curbed.

Knowledge and attitude regarding mercury handling and disposal in students

The present cross-sectional study was carried out in higher secondary schools of the science specialty in Ahmedabad. A total of 653 students (196 taught in English, 395 taught in Gujarati and 62 taught in Hindi) from seven schools were included. The interview technique was used for data collection using a predesigned questionnaire. A total of 457 (70%) were boys and 196 (30%) were girls. About two-thirds of the study participants had handled mercury at sometime in their life and home was the common place where it was handled. More than half of the Hindi-taught students did not know about its physical appearance. The majority of the Gujarati-taught students knew that mercury is harmful to health whereas one-third of the English- and Hindi-taught students considered mercury to be harmless. A total of 46% of the Gujarati-taught and 44% of the English-taught students had encountered spilled mercury at sometime in their life and 21.6% of English-taught and 25% of Hindi-taught students had either smelled or played with spilled mercury. More than two-thirds of the English- and Hindi-taught students recommended the usual cleaning method whereas 81.8% of Gujarati-taught students suggested a special method should be used for the disposal of spilled mercury. The majority of the students did not know whether mercury could be substituted by a harmless substance.

Asthenopia (eyestrain) in working children of gem-polishing industries

Working children of gem-polishing units are exposed to poor illumination and improper workstations. Also processes require lot of visual and mental concentration for precision. This may result in eyestrain. The study included 432 exposed and 569 comparison group subjects. Self-reported eyestrain was recorded through personal interview. Eyestrain included symptoms like itching, burning, or irritated eyes; tired or heavy eyes; difficulty seeing clearly (including blurred or double vision); and headache. The study variables included age, gender, daily working hours, and duration of exposure. The prevalence of eyestrain in child labourers was 32.2%, which was significantly more than the comparison group subjects. Also, the working children of gem-polishing units were at 1.4 times higher risk of developing eyestrain. Age (3)14 years and female gender were significantly associated with the eyestrain. The prevalence of eyestrain in child labourers was 32.2% and was associated with age (3)14 years and female gender.

Silica exposure and serum angiotensin converting enzyme activity

BACKGROUND

Silicosis is known in industrial workers for centuries. Till recently, the mainstay of its diagnosis and progress was clinical examination of the respiratory system, pulmonary function test and chest radiography. Several biomarkers such as serum angiotensin converting enzyme (ACE) activity have been examined to determine the extent of silicosis.

OBJECTIVE

To elucidate the effect of age, gender, duration of exposure to silica dust, smoking habit, and pulmonary function status on the serum ACE activity among quartz stone workers without disease.

METHODS

A cross-sectional study was carried out on 134 (111 men and 14 women) workers of quartz stone crushing units were studied. Standard diagnostic criteria were used for diagnosing silicosis and tuberculosis. Pulmonary functions of the participants were also assessed.

RESULTS

The mean±SD age for participants was 26.1±6.3 years (26.6±6.3 for men and 21.9±4.3 for women). The mean±SD duration of exposure was 1.1±1.9 years. In the present study, only one case of silicosis and eight cases of tuberculosis were found. The mean±SD serum ACE levels for those with and without respiratory disease were 68.44±11.61, and 66.9±14.4 IU/L, respectively (p>0.05).

CONCLUSION

We could not observe any association between serum ACE activity and age, gender, duration of exposure, smoking habits and pulmonary function status. However, elevated levels of serum ACE was found in a solitary case of silicosis.

Respiratory morbidities among working children of gem polishing industries, India

There are millions of working children worldwide. In gem polishing industry, exposure to occupational hazards of dust and chemicals used in polishing of gemstone may result in respiratory symptoms and respiratory disorders. The present study included 586 exposed and 569 comparison group subjects. Data was collected through personal interview, clinical examination, and chest radiography. The respiratory morbidity was diagnosed on the basis of clinical signs and symptoms and chest radiography. The study variables included age, sex, daily working hours, and duration of exposure. The mean age of the child laborers was 11.31 +/- 5.34 years. Prevalence of respiratory morbidity was significantly high in the female child laborers. The other study variables namely age, duration of exposure, and daily working hours were found to be statistically non-significant. The prevalence of respiratory morbidity among child laborers of gem polishing industry in Jaipur was found to be 7%.

Metallic vaginal ring pessary: a rare entity

Vaginal pessaries still have role in the management of uterovaginal prolapse especially in elderly women, unfit for surgery and as a temporary relief for women waiting for surgery. Forgotten vaginal pessaries may cause serious complications. We here by present a case wtih metallic vaginal ring pessary for 16 years without significant symptoms.

A study on human risk factors in non-fatal road traffic accidents at Nagpur

A cross sectional study was conducted among 423 victims of road traffic accidents reporting to Indira Gandhi Medical College, Nagpur for treatment during 1999-2000. Data was collected on pre-designed proforma by interview technique. Majority of the victims were male (85.8%) and of 18-37 years (74%); 64.5% of the subjects were consuming alcohol regularly and 5.9% were drug abusers; 43.7% and 10.2% had visual and hearing impairment respectively; 43.5% were not having any driving experience and 74.4% of the victims with two wheelers were not using any helmets at the time of accidents. Findings highlight the need for sustained health education and enforcement of traffic laws.

Morbidity profile of steel pipe production workers

Objective:

To study the different morbid conditions among steel pipe producing workers.

Methods:

The present cross-sectional study has been carried out among the workers of one of the steel pipes and tubes manufacturing factory of Gujarat. Hundred workers from the four major departments of the steel pipe production plant, namely welding, pressing machine, X-ray welding and loading/transportation department were covered. The information regarding demographic, occupational, clinical characteristics and diagnosis were recorded on a pre-designed proforma. Statistical analysis included calculation of percentages and proportions and was carried out using the statistical software Epi Info Version 3.3.2.

Results:

The mean age of the study subjects was found to be 38.7±7.1 years. The mean duration of exposure was found to be 9.0±3.4 years. Forty-four percent of the subjects had an upper respiratory tract infection, as evidenced by symptoms like dry cough, cough with rhinitis and cough with fever. Symptoms suggestive of allergic bronchitis were observed in 12% of the subjects while symptoms suggestive of heat stress such as prickly heat, dehydration, perspiration and pyrexia were observed in 13% of the subjects.

Hypertension and epidemiological factors among tribal labour population in Gujarat

A cross sectional study was carried out in 2005 to find out the magnitude of hypertension among 154 tribal labourers of Gujarat belonging to Naika, Rathwa and Damor tribes. WHO classification of hypertension was taken as operational criteria and data was collected in pre-designed, pretested schedule. Blood pressure measurement was done twice on each subject using mercury sphygmomanometer. Overall magnitude of hypertension was found to be 16.9%, and only smoking was found to have significantly associated with it.

A risk scoring system for prediction of haemorrhagic stroke

The present pair-matched case control study was carried out at Government Medical College Hospital, Nagpur, India, a tertiary care hospital with the objective to devise and validate a risk scoring system for prediction of hemorrhagic stroke. The study consisted of 166 hospitalized CT scan proved cases of hemorrhagic stroke (ICD 9, 431-432), and a age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. On conditional multiple logistic regression five risk factors- hypertension (OR = 1.9. 95% Cl = 1.5-2.5). raised scrum total cholesterol (OR = 2.3, 95% Cl = 1.1-4.9). use of anticoagulants and antiplatelet agents (OR = 3.4, 95% Cl =1.1-10.4). past history of transient ischaemic attack (OR = 8.4, 95% Cl = 2.1- 33.6) and alcohol intake (OR = 2.1, 95% Cl = 1.3-3.6) were significant. These factors were ascribed statistical weights (based on regression coefficients) of 6, 8, 12, 21 and 8 respectively. The nonsignificant factors (diabetes mellitus, physical inactivity, obesity, smoking, type A personality, history of claudication, family history of stroke, history of cardiac diseases and oral contraceptive use in females) were not included in the development of scoring system. ROC curve suggested a total score of 21 to be the best cut-off for predicting haemorrhag stroke. At this cut-off the sensitivity, specificity, positive predictivity and Cohen's kappa were 0.74, 0.74, 0.74 and 0.48 respectively. The overall predictive accuracy of this additive risk scoring system (area under ROC curve by Wilcoxon statistic) was 0.79 (95% Cl = 0.73-0.84). Thus to conclude, if substantiated by further validation, this scorincy system can be used to predict haemorrhagic stroke, thereby helping to devise effective risk factor intervention strategy.

Peak expiratory flow and respiratory morbidity: a study among silica-exposed workers in India

BACKGROUND

The present cross-sectional study was carried out among 136 quartz stone grinders with the objective of studying the peak expiratory flow (PEF) and the associated epidemiological factors.

METHODS

Interview technique was used to record demographic characteristics and occupational history on a predesigned proforma, which included questionnaires regarding demographic, occupational and clinical characteristics. This was followed by complete medical examination and measurement of PEF using Spirovit SP-10. The study included 75 (55.1%) male and 61 (44.9%) female silica-exposed workers. The mean age of the subjects was 31.77 +/- 9.99 years whereas the mean duration of exposure was 2.74 +/- 1.65 years. The mean PEF was found to be 5.16 +/- 2.1 L/min.

RESULTS

In the present study the PEF was significantly reduced in those having respiratory morbidity on both unadjusted and adjusted analyses.

CONCLUSIONS

This suggests that along with the restrictive pathology caused by free silica dust, obstructive changes are also encountered in silica-exposed workers.

Injury pattern among non-fatal road traffic accident cases: a cross-sectional study in Central India

RESEARCH QUESTION

What is the pattern of injuries among non-fatal cases of road traffic accidents?

OBJECTIVE

To study the pattern of injuries among non-fatal cases of road traffic accidents.

STUDY DESIGN

Cross-sectional study.

SETTING

Nagpur, a city in central India.

PARTICIPANTS

423 non-fatal cases of road traffic accidents reporting for treatment to Indira Gandhi Medical College, Nagpur during 1999-2000.

STUDY VARIABLES

Demographic characteristics, accident characteristics.

STATISTICAL ANALYSIS

Percentages, proportions, Chi-square test.

RESULTS

Out of total 423 subjects, 363 (85.8%) were male while only 60 (14.2%) were female subjects. Majority of the victims (75%) were in the age group 18- 37 years. Sideways collision was the most common type of accident seen in 269 (63.59%) cases. Two wheelers and LMV were the common vehicle being involved in accidents (69.97%) and these accidents were almost equally distributed in both half of the day. Fracture of the bones was the common injury afflicted to the victims followed by multiple injuries like blunt injury, abrasions and lacerations. Lower extremity was involved in 192 (45.39%) cases while multiple sites were affected in 114 (26.95%) cases.

CONCLUSIONS

In the present study, the fractures were the commonest injury among the victims of non-fatal road traffic accidents.

How does lobeline injected intravenously produce a cough?

In order to examine, whether the lobeline-induced cough is a true reflex or a voluntary effort to get rid of its irritating sensations in the upper respiratory tract, we systematically studied the cough response to lobeline, of subjects who were unable to make conscious discriminations i.e. were either comatose (n=4) or anaesthetized (n=5). 8 microg/kg lobeline injected into the right atrium of one and 29 microg/kg intravenously (i.v.) into another evenly and spontaneously breathing comatose subject produced a cough after 4s and 12s, respectively. Cough was repeatable and showed a dose response relationship i.e., its latency decreasing and its duration/intensity increasing with the dose. In a third subject, capable only of weak spontaneous respiration, a relatively high dose injected into the right atrium (44 microg/kg) generated a pronounced cough-like respiratory movement superimposed on the artificial ventilation and also during the apnoea after disconnecting the pump. No respiratory response was evoked in a fourth subject who had no evidence of brainstem reflexes. In five normals, cough was elicited with a mean dose of 35+/-5 microg/kg i.v. (latency 14+/-2 s; duration 10+/-3 s). After thiopental anaesthesia, injecting 41+/-7 microg/kg produced a cough within 13+/-2 s that lasted for 12+/-2 s. It may be noted that neither the later dose nor the latency or duration of cough that it produced were significantly different from the pre anaesthesia values (P>0.05). These two sets of results show unequivocally that the lobeline-induced cough is evoked reflexly; its magnitude in the conscious state could vary by subjective influences. We discuss the likelihood of its origin from juxtapulmonary capillary receptors.

Serum copper levels among quartz stone crushing workers: a cross sectional study

The present cross sectional study was carried out among 134 workers of quartz stone crushing units to assess the serum Cu activity among quartz stone workers without disease. Demographic and occupational details of the subjects were recorded on the predesigned proforma. Standard diagnostic criteria were used for diagnosing silicosis and tuberculosis. The pulmonary functions of the subjects were measured using Spirovit SP-10. The mean age for male was found to be 26.63 +/- 6.28 years while that for female was 21.93 +/- 4.29 years and for the whole group was 26.13 +/- 6.26 years. In the present study only one case of silicosis and seven cases of tuberculosis were found. The mean serum Cu levels of those having respiratory disease was found to be 91.5 +/- 19.8 microg/dl while mean serum Cu level of those free from respiratory disease was 86.8 +/- 21.3 microg/dl The difference was found to be statistically non-significant (t = 0.64, df= 1, P > 0.05). Thus, in the present study, though the elevated level of serum Cu was found in solitary case of silicosis, no association could be established between the silica exposure and serum copper levels as suggested by non-significant effect of duration of exposure (P = 0.53).

Occupational health research in India

India being a developing nation is faced with traditional public health problems like communicable diseases, malnutrition, poor environmental sanitation and inadequate medical care. However, globalization and rapid industrial growth in the last few years has resulted in emergence of occupational health related issues. Agriculture (cultivators i.e. land owners + agriculture labourers) is the main occupation in India giving employment to about 58% of the people. The major occupational diseases/morbidity of concern in India are silicosis, musculo-skeletal injuries, coal workers' pneumoconiosis, chronic obstructive lung diseases, asbestosis, byssinosis, pesticide poisoning and noise induced hearing loss. There are many agencies like National Institute of Occupational Health, Industrial Toxicology Research Centre, Central Labour Institute, etc. are working on researchable issues like Asbestos and asbestos related diseases, Pesticide poisoning, Silica related diseases other than silicosis and Musculoskeletal disorders. Still much more is to be done for improving the occupational health research. The measures such as creation of advanced research facilities, human resources development, creation of environmental and occupational health cells and development of database and information system should be taken.

Spirometric measurements among quartz stone ex-workers of Gujarat, India

The present cross sectional study was carried out among 134 ex-workers from quartz stone crushing units. Using the interview technique as a tool for data collection, demographic and occupational details of the subjects were recorded on the predesigned proforma. Standard diagnostic criteria were used for diagnosing silicosis and silico-tuberculosis. The pulmonary functions of the subjects were measured with Spirovit SP-10. The mean age of the males was found to be 33.18 +/- 10.39 yr and that of the females was 30.10 +/- 9.3 yr and for the whole group was 31.77 +/- 9.99 yr. Mean duration of exposure was 2.74 +/- 1.65 yr. The study variables included age, sex, duration of exposure, smoking and respiratory morbidity. Forced Vital Capacity (FVC) which suggests lung parenchymal disorders was found to be significantly reduced with female sex, presence of smoking, increasing duration of exposure and presence of pneumoconiosis, whereas the lung function parameters indicating the status of airways were found to be significantly reduced with all the factors. Therefore, it was concluded that quartz stone workers exposed to approximately 100% free silica had deteriorated lung function which can be attributed mainly to respiratory disorders along with other epidemiological factors such as age, sex, duration of exposure and smoking.

Knowledge and practices regarding injury care among stone quartz workers

The present study designed as cross sectional study was carried out to study the knowledge and practice regarding injury care among stone quartz workers of Chhotaudepur. A total of 137 stone quartz workers were included in the study, which consisted of 54.7% males and 45.3% females. 85.4% of the workers were illiterate and almost all the workers belonged to lower socio-economic strata according to the Modified Kuppuswamy's socio-economic scale. Majority of the subjects (56.2%) responded that they would consult doctor if they get injured while 32.2% responded that they would neglect the wound, as it will heal spontaneously. Thus the present study suggests that the knowledge regarding injury care among stone quartz workers was poor. Even the attitude and practice regarding injury care was also inappropriate.

Environmental risk factors: a study in Kutch region

The environment risk factors particularly drinking water status and vector breeding status. In the earthquake--affected villages in Kutch region are presented.

Gender differentials in the social and family life of leprosy patients

A study was carried out at the Leprosy Control Unit, Government Medical College, Nagpur, India, to investigate gender differentials in the social and family life of leprosy patients. The study included 486 (268 males and 218 females) leprosy patients, who were diagnosed and registered at least 1 year prior to the data collection. It was observed that leprosy patients were isolated and refrained from various activities in the family. However, the effect of disease on this isolation was significantly greater in females as compared to males. Similarly, although, men and women were both affected in terms of their social life, women suffered more isolation and rejection from the society. The current study describes the gender differentials in the social and family life of leprosy patients in Central India.

Risk factors for haemorrhagic stroke: a case-control study

A hospital based pair-matched case-control study was undertaken to identify risk factors for haemorrhagic stroke. The study took place in the Government Medical College Hospital, Nagpur, India, a tertiary care hospital. The study consisted of 166 hospitalised computerised tomography scan proved cases of haemorrhagic stroke (International Classification Diseases 9, 431-432), and an age and sex matched control per case. The controls were selected from patients who attended the study hospital for conditions other than stroke. The study included hypertension, serum total cholesterol, alcohol intake, smoking, diabetes mellitus, obesity, physical inactivity, type A personality, use of anticoagulants/antiplatelets, family history of stroke, history of cardiac diseases, past history of transient ischaemic attack, history of claudication and oral contraceptive use in women, as risk factors for haemorrhagic stroke. Bivariate analysis included odds ratio (OR), 95% confidence intervals (CI) for OR and McNemar's chi2 test. Multivariate analysis was carried out by conditional multiple logistic regression analysis. Attributable Risk Percent (ARP), Population Attributable Risk Percent (PARP) and their 95% CI were estimated for significant factors. On conditional multiple logistic regression five risk factors-hypertension (OR=1.9, 95% CI 1.5-2.5), serum total cholesterol (OR=2.3, 95% CI 1.4-4.9), use of anticoagulants and antiplatelet agents (OR=3.4, 95% CI 1.1-10.4), past history of transient ischaemic attack (OR=8.4, 95% CI 2.1-33.6) and alcohol intake (OR=2.1, 95% CI 1.3-3.6) were significant. Estimates of ARP and PARP for these factors confirmed their etiological and preventable role respectively. The current study recognised the significance of five risk factors, which are preventable. These risk factors may be considered for devising effective risk factor intervention strategy for haemorrhagic stroke.

Delayed immunization against vaccine preventable diseases--factors responsible among children under 5 years of age

In the present case-control study, out of the the eleven risk factors of delayed immunization, only seven, namely family size, sex, number of children < 5 years, material education, paternal education, distance from health centre and low socio-economic status were found to be significantly associated. The common causes for delayed immunization were negligence on part of parents, unawareness about the use of vaccine and sickness of child. Thus, health education of the parents is recommended.

Peak expiratory flow rate in flour mill workers

The current cross-sectional study with a comparison group was undertaken to investigate peak expiratory flow rate (PEFR) in flour mill workers and to study relationship between reduction in PEFR and age, smoking, exposure to grain dust and respiratory morbidity. The study included 286 flour mill workers and equal number of neighbourhood controls group-matched for age. PEFR was measured by using Wright's Peak Flow Meter. PEFR was significantly reduced in flour mill workers as compared to comparison group. The decline in PEFR was significantly associated with grain dust exposure, duration of exposure, tobacco smoking and presence of respiratory morbidity.

Obesity: as rural females perceive it

Out of 318 rural females studied, 17.3% were found to be obese. Most of them are aware of their obese status except for 10.9% who were unaware. Majority of the females considered eating more, childbirth and reduced activity as the possible cause of their obesity and also obesity in other persons. Though 48.1% and 33.6% of the females mentioned dieting and exercise/walking respectively as the method of prevention still 52.5% mentioned that medicine is the only method for prevention of obesity. Regarding remedy of obesity again 48.4% females mentioned medicine as the method.

Peak expiratory flow rate in handloom weavers

The present cross-sectional study with a comparison group was carried out to investigate peak expiratory flow rate (PEFR) in handloom weavers and to study relationship between reduction in PEFR with age, smoking, duration of cotton dust exposure and respiratory morbidity. This study include 319 handloom weavers and equal number of individuals (group matched for age and pair matched for sex) in comparison group. The decline in PEFR was significantly associated with advancing age, longer duration of exposure to cotton dust, tobacco smoking and presence of respiratory morbidity on univariate analysis, whereas on multivariate analysis longer duration of exposure to cotton dust and tobacco smoking was found to be non significant.

Effectiveness of bacillus of Calmette-Guerin (BCG) vaccination against tuberculous meningitis: a case-control study

A hospital-based pair-matched case-control study was carried out at Government Medical College Hospital, Nagpur to estimate the effectiveness of bacillus of Calmette-Guerin (BCG) vaccination against tuberculous meningitis. The study included 92 cases of tuberculous meningitis in the age group of 0-12 years and equal number of controls, matched for age, sex and socio-economic status. The protective effectiveness and prevented fraction were higher for the subjects in the age group of 0-6 years, males and subjects from upper strata of socio-economic class. The overall vaccine effectiveness and prevented fraction were estimated to be 86.54% (70.38-93.88%) and 65.54% (39.22-80.64%) respectively. Results of this study thus indicated that BCG vaccination was highly effective against tuberculous meningitis and played significant role in its prevention, in this population.