Occupational health and the environment in an urban slum in India

Factors Associated With Health Complaints Among Leather Tannery Workers in Bangladesh

Background: Few studies have reported associations between occupational exposure to tannery chemicals with breathing difficulty and skin diseases and none have been conducted in Bangladesh. The aim of this study was to investigate the associations of health complaints with types of work and length of employment among tannery workers in Bangladesh, where occupational health and safety regulations are less restricted compared with the developed world. Methods: One hundred sixty-seven (n = 167) workers from 10 tanneries were interviewed using a questionnaire adapted from the European Community Respiratory Health Survey (ECRHS) and the Tasmanian Longitudinal Health Study (TAHS) to collect information on occupational exposures and health outcomes. Workers' length of employment was examined, as well as their areas of work including beamhouse, wet finishing, dry finishing, and miscellaneous. Univariate and multivariate logistic regressions were performed to investigate potential associations while controlling for confounders. Results: Length of employment was positively associated with breathing difficulty (odds ratio [OR]: 1.32, 95% confidence interval [CI]:1.07-1.64). Workers involved in the wet finishing (OR: 11.75, 95% CI: 2.12-65.10) and dry finishing (OR: 13.38, 95% CI: 1.00-181.70) had higher odds of breathing difficulty; while, working in the beamhouse was associated with an increased risk of developing skin diseases (OR: 4.36, 95% CI: 1.10-17.32). Conclusion/Application to Practice: Length of employment and types of work were associated with increased risk of health complaints, including breathing difficulty and skin disease among tannery workers. Stronger regulations with regular enforcement, regular health surveillance, and worker and employer education are necessary for reducing these exposures and improving the health outcomes of the tannery workers.

Inventory of the chemicals and the exposure of the workers' skin to these at two leather factories in Indonesia

PURPOSE

Tannery workers are exposed to hazardous chemicals. Tannery work is outsourced to newly industrialized countries (NICs) where attention into occupational health hazards is limited. In this study, we investigated the skin exposure to hazardous chemicals in tannery workers and determined the prevalence of occupational skin diseases (OSDs) at tanneries in a NIC.

METHODS

A cross-sectional study on the observation of the working process and an inventory and risk assessment of the chemicals used. Classification of chemicals as potential sensitizers/irritants and a qualitative assessment of exposure to these chemicals. Workers were examined and interviewed using Nordic Occupational Skin Questionnaire-2002/LONG.

RESULTS

The risk of OSDs at the investigated tanneries was mainly related to the exposure of the workers' skin to chemicals in hot and humid environmental conditions. In 472 workers, 12% reported a current OSD and 9% reported a history of OSD. In 10% of all cases, an OSD was confirmed by a dermatologist and 7.4% had an occupational contact dermatitis (OCD). We observed that personal protective equipment (PPE) used was mainly because of skin problems in the past and not as a primary protection against OSD.

CONCLUSION

We observed a high frequency and prolonged exposure to many skin hazardous factors in tannery work although PPE was relatively easily available and which was generally used as a secondary preventative measure. The observed point-prevalence in this study was at the same level as that reported for other high-risk OSDs in Western countries and other tanneries in NICs. However, the observed point-prevalence in this study was lower than that reported in India and Korea. The results of our study and those of other studies at tanneries from other NICs were probably influenced by Healthy Worker Survivor Effect (HWSE).

Effects of leather industry on health and recommendations for improving the situation in Pakistan

The leather industry and its associated sectors contribute significantly to the Pakistani economy. There are around 600 tanneries in Pakistan that are concentrated in 3 major cities (Kasur, Karachi, Sialkot). Waste discharge from tanneries pollutes the air, soil, and water, causing serious health problems. Exposure to such contaminated environmental milieu has been seen to culminate in a multiple array of disease processes such as asthma, dermatitis, hepatic and neurological disorders, and various malignancies. An overall dearth of research on the occupational hazards of employment in the leather industry as well as its effects on pediatric population was observed during literature review with particular reference to Pakistan. It is recommended that research should be conducted about the health hazards in the leather industry in Pakistan as well as globally to gather data that can be translated into effective prevention programs for both adults as well as pediatric populations.

Prevalence and determinants of asthma in adult male leather tannery workers in Karachi, Pakistan: a cross sectional study

Background

This study aimed to estimate the prevalence and to identify some risk factors of adult asthma in male leather tannery workers in Karachi, Pakistan.

Methods

A cross sectional study was conducted from August 2003 to March 2004 on leather tannery workers of Karachi, Pakistan. Data were collected from 641 workers engaged in 95 different tanneries in Korangi industrial area selected as sample of convenience. Face to face interviews were performed using a structured pre-tested questionnaire by trained data collectors.

Results

Prevalence of adult asthma was 10.8% (69/641) in this study population. The prevalence of perceived work-related asthma was 5.3% (34/641). Multivariable logistic regression model showed that after taking into account the age effect, the leather tannery worker were more likely to be asthmatic, if they were illiterate (adjusted OR = 2.13, 95% CI: 1.17–3.88), of Pathan ethnicity (adjusted OR = 2.69; 95% CI: 1.35–5.36), ever-smoked (adjusted OR = 2.22, 95% CI: 1.16–4.26), reportedly never used gloves during different tanning tasks (OR = 3.28; 95% CI : 1.72–6.26). Also, the final model showed a significant interaction between perceived allergy and duration of work. Those who perceived to have allergy were more likely to have asthma if their duration of work was 8 years (adjusted OR = 2.26; 95% CI: 1.19 – 4.29) and this relationship was even stronger if duration was 13 years (adjusted OR = 3.67; 95% CI: 1.98–6.79).

Conclusion

Prevalence of asthma in leather tannery workers appears to be high and is associated with educational status, ethnicity, smoking, glove use, perceived to have allergy and duration of work.

Health impact of occupational risks in the informal sector in Zimbabwe

Information about occupational health in the informal sector is lacking, despite its growing contribution to employment. The author describes a survey of occupational health in urban and rural informal-sector workers in Zimbabwe. Common hazards included poor work organization, poor hygiene, ergonomic hazards, hazardous hand tools, and chemical exposures, particularly to pesticides and solvents. An annual occupational mortality rate of 12.49/100,000 was half the formal-sector rate. Reported rates of 131 injuries/1,000 workers and 116 illnesses/1,000 workers exceeded formal-sector rates tenfold and a hundredfold, respectively, although the distribution of injuries by economic sector correlated significantly with formal-sector rates. The survey found high levels of musculoskeletal and respiratory illness, thought to be underdetected in formal systems. A fifth of the injuries had resulted in permanent disability, with little consequent job loss, but no compensation granted. The author recommends improvements to occupational health in the informal sector, and suggests a broader survey of occupational morbidity in all sectors of employment.

Assessment of exposure to chemical agents and ergonomic stressors in tanneries in Kanpur, India

In developing countries qualitative assessment of exposure at the workplace may be an essential tool in evaluating hazardous working conditions. This survey reports on qualitative assessment of exposure to chemicals, dust, and ergonomic stressors among 298 workers in 15 tanneries in Kanpur, India. In general, chemical exposure and dermal exposure were highest among beamhouse workers, less for workers involved in dry finishing activities, and lowest for those performing the wet finishing of hides. Dermal exposure was rated as high to very high during beamhouse activities, reflecting direct contact with wet hides and manual handling of hides in soak tanks. Relevant dust exposure was observed only during dry finishing activities. Most workers experienced severe postural load due to working in trunk flexion and rotation for more than 50% of their daily work time. In addition, manual materials handling with loads over 20 kg frequently occurred. The size of the tannery, in general a reflection of state of technology, showed no systematic influence on exposure profiles. The survey suggested that mechanization of material transfer and application of trolleys reduced the work time with trunk flexion and rotation and implied less manual lifting. The presence of local exhaust ventilation in large tanneries seemed to reduce the chemical exposure. This survey has demonstrated the importance of rapid appraisal techniques for evaluating hazardous conditions at the workplace. In developing countries this approach may facilitate occupational hygiene research and practice.

Respiratory disorders, skin complaints, and low-back trouble among tannery workers in Kanpur, India

In a cross-sectional survey health complaints among 418 laborers in 15 Indian tanneries were studied. Low-back pain (61%), asthma (38%), dermatitis (23%), and chronic bronchitis (14%) were the most frequently reported complaints in the 12 months prior to the survey. In general, beamhouse workers reported the highest prevalence but only chronic low-back pain was significantly elevated compared with workers in the finishing departments. When using individual exposure estimates, clear associations were presented among manual lifting over 20 kg and low-back pain (OR = 3.5) and skin exposure and dermatitis (OR = 2.6). Frequent lifting of loads was also associated with self-reported asthma. About 44% of the laborers reported at least one period of sickness absence, and 17% were involved in a serious occupational accident that required a visit to the local physician. Logistic regression analysis showed that sickness absence occurred more often in small tanneries (OR = 2.7) and also was significantly associated with low-back pain (OR = 3.3) and occupational accidents (OR = 2.2). This epidemiologic survey on health complaints in tannery workers is among the few in occupational populations in low-income countries. For many reasons these populations are easily overlooked. The results of this descriptive study indicate that there is a clear need for epidemiologic surveys in these countries to obtain information on working conditions and associated health problems.

Industrial Counseling: Linking Occupational and Environmental Health in Tanneries of Kanpur, India

This paper describes an occupational health program in tanneries in Kanpur, India. The program was instituted as part of a bilateral cooperative effort of India and The Netherlands focusing on providing engineering solutions to prevent industrial waste and community sewage from polluting the Ganges river. The occupational health program was linked to the environmental activities by adopting the concept of industrial counseling. This method aims to increase production and product quality of enterprises and at the same time improve working conditions in these enterprises. The tanneries in Kanpur were targeted for industrial counseling by the Indo-Dutch Environmental and Sanitary Engineering Project Kanpur- Mirzapur under the Ganga Action Plan. Recovery of chrome from wastewater, automation of hydraulic press machines, use of an air-pollution-prevention system in the spray-painting section, and automation of transport are examples of measures used to increase productivity and improve leather quality. Working conditions were improved by adding local exhaust ventilation, mechanizing material transfer, instituting safer procedures for storage and use of toxic materials, and introducing breathing apparatus for operations done in confined spaces to prevent hydrogen sulfide intoxication. The linkage of occupational health problems to environmental issues proved to be effective in drawing attention to working conditions. Also, the application of simple survey techniques to identify and evaluate environmental and occupational hazards substantially increased awareness of these hazards and comprehension of the need to adopt changes among employers, workers, and occupational health professionals. The article discusses the core elements of this successful program.

An occupational health programme for adults and children in the carpet weaving industry, Mirzapur, India: a case study in the informal sector

The Indo-Dutch Environmental and Sanitary Engineering Project under Ganga action Plan in Kanpur and Mirzapur is being executed within the framework of Indo-Dutch bilateral development cooperation. The project aims to integrate technological, social and health related improvements. It is expected that the development approach and methodology can be replicated in other urban settlements in India. The project is being supplemented by a training and institutional strengthening programme, which will facilitate the transfer of new technologies and improvements in operation and maintenance of these new technologies. One of the project's goals is to improve living conditions in the targeted areas by installing drinking water and drainage systems. A socio-economic unit (SEU) in the project supports these technical interventions by encouraging the community to participate in project activities. The Occupational Health Programme in Mirzapur was conceived by the SEU to improve the health and living conditions of child and adult weavers. At the start of the programme, 200 weavers and 60 non-weaver workers from Mirzapur city, matched for age and socio-economic status, were interviewed and underwent a physical examination. The mean age of the weavers is 27 years, reflecting the relatively large percentage of child labour (13.5%). Illiteracy among them is 73%, whereas 14% have had only a primary education. 64.5% of the carpet weavers are Muslims and 35.6% are Hindus. 61% own a loom or work in a family owned loom shed. 95% of the weavers have a monthly income of less than 600 Rs. Complaints of a persistent cough and cough with expectoration, backache, the common cold and joint pains occurred more often in the weaver population than in the comparison group and have been identified as 'occupational hazards'. An intervention programme has been implemented based on the results of the occupational health survey. These interventions include awareness camps, installment of plexiglass tiles for light improvement in the loom sheds, training of community health volunteers and house-to-house health education. Another essential part of the programme is the provision of functional literacy classes for child and adult labourers in the carpet weaving industry. Occupational health as an entry point proved to be a successful approach in this segment of the informal sector, where child labour plays an important role.