Occupational Injuries and Health Status Among Rural Tribal Non-Traditional Fishing Communities in the Coastal Region of Tamil Nadu, India

OBJECTIVES

This study evaluated the occupational injuries and health hazards associated with fishing as an occupation among non-traditional rural tribal fishing communities in the coastal region of Tamil Nadu, India.

METHODS

This cross-sectional study included a total of 170 individuals belonging to a fishing community, comprising both male (n = 82) and female (n = 88) participants. The demographic details including occupational history, lifestyle characteristics, socio-economic status, personal habits, and health status were assessed through the questionnaire survey.

RESULTS

The fishing community has a low socioeconomic status and poor literacy, lifestyle, and personal habits. The mean age of the participants was 38.8 yrs (male 34.8; female 39.9 yrs). Only 10% reported usage of personal protective equipment (PPE), and the work duration varied from 8 to 24 hrs in a day. While male subjects reported smoking habits (12%) and alcohol consumption (23%), none of the females reported alcohol consumption and smoking habits. The major occupational injuries that occurred were due to catfish (72%) and oysters (48%). A large number of female subjects reported musculoskeletal pains. The body mass index of about 28% of fishermen was above the normal range. Abnormal blood sugar, blood pressure, and respiratory and neurological symptoms were the other major health complaints. The major environmental hazards reported were salinity, solar radiation, tides, and high wind.

CONCLUSION

Injuries from handling fish and oysters were observed to be the major occupational burden. Additonally, a high prevalence of musculoskeletal pain and chronic health illness was commonly observed among the fishers. Adequate training and awareness programs are required for effective management of occupational health hazards and health promotion.

Assessing Health Seeking Behaviors and Economic Consequences of Morbidity in Indian Construction Workers: A Multicenter Study

Background

Construction laborers succumb to poor health due to the inherent workplace health hazards and poor socio-economic living conditions. With rising healthcare expenses, the increased risk of poor health may aggravate their economic status, pushing them deeper into poverty.

Settings and Design

The current cross-sectional multicenter study comprehensively investigated the determinants of health, health-seeking behavior, and poor economic impact regarding catastrophic health expenditure (CHE) among construction laborers.

Methods and Material

We collected details on illnesses among self and family members of the construction laborers that required healthcare visits during the previous year and their approximate expenses. Among the 1110 participants with complete data, 37% reported illness requiring a healthcare visit either for self or a family member.

Results

Regression models to ascertain demographic and living condition determinants of perceived illness revealed an increased risk of illness when the kitchen is shared with the living space (OR = 1.87) and use unhygienic smoky cooking fuels (OR = 1.87). More than 25% of those who reported illness incurred CHE.

Conclusion

We conclude that the frequency of perceived illness and the economic impact, i.e., CHE is relatively higher among the construction laborers. Our results demonstrate that poor living conditions add to the burden of morbidity in construction workers and families. Providing healthcare coverage for this population and engaging and educating them about affordable healthcare are necessary future steps to prevent the worsening of the economic situation.

Geospatial assessment of variations in the heavy metals and pesticides concentration in the agricultural environment of Kasaragod District, Kerala, India

The impact of heavy metals and pesticides in our environment largely varies based on their chemical composition and the geographical conditions where they are present. This study assesses the variation in the concentration of heavy metals and pesticides in Kasaragod District, Kerala, Southern India. For the assessment, soil samples were collected from eight different locations of agricultural land during the three different seasons of 2017 and 2018. All the samples were tested for physicochemical characteristics, levels of heavy metals, and pesticides. The spatial distribution of trace metals and pesticides in the study area was performed by using the software Arc GIS, version 10.6. Significant variation in the physicochemical properties was observed during the different seasons. Similarly, the variation in the concentration of heavy metals in the soil ranged from 0.01 to 1018 [Formula: see text]g/kg. Among various heavy metals detected, aluminum (Al) was the most abundantly detected metal in the region of Malakallu, and cobalt (Co) was the scarcely detected metal in the region of Panathady. The average levels of organochlorine pesticides (OCPs) and organophosphorus pesticides (OPs) in the soil samples were from below detectable level (bdl) to 610 [Formula: see text]g/kg and bdl to 441 [Formula: see text]g/kg respectively. Thus, our study indicates the continuous occurrence and persistent nature of contaminants in the agricultural soil of Kasaragod. Therefore, periodic monitoring of soil contaminants is recommended in Kasaragod to assess its effect on the ecosystem and to develop an effective remediation strategy.

Evaluation of work place pesticide concentration and health complaints among women workers in tea plantation, Southern India

BACKGROUND

Women contribute fifty percent of the total work force in tea plantation sector. The continuous use of chemical pesticides in plantation may increase the risk of exposure and can cause detrimental health effects.

OBJECTIVES

To assess the health status of women worker exposed to pesticides in tea plantation and to evaluate the pesticide levels in work environment.

METHODS

A cross sectional study was performed (n = 204) to assess the health complaints among exposed women workers (n = 116) and non-exposed women (n = 88) using a predesigned questionnaire. Work environmental air samples collected using PUF sampler and personal samplers were analyzed for various pesticides.

RESULTS

Musculoskeletal disorder, skin color changes, allergies and asthma were the most commonly reported health complaints. Notably, only 16% of the women used personal protective equipment (PPE) while 68% reported to have experienced tea plantation work up to 6 month of their pregnancy period. Chlorpyrifos methyl (8.3%), carbendazim (6.7%), thiamethoxam (4.2%), ethion (4.2%) and thiophanate methyl (2.1%) were detected in work place air samples.

SIGNIFICANCE

This study is the first to characterize pesticide levels in work place of women workers in India. Women are continuously exposed to pesticides through their work and environmental exposure. Preventive measures are essential to mitigate the adverse health effects of pesticides among women workers.

Levels and distribution pattern of organochlorine pesticide residues in eggs of 22 terrestrial birds from Tamil Nadu, India

Long-term monitoring is essential to assess the patterns and distribution of the residues of organochlorine pesticides (OCPs) in biota. Bird eggs have several advantages than other environmental matrixes, which have been used extensively to portray the accumulation and distribution of OCPs. The present study investigated the organochlorine pesticide (OCP) residues in eggs of 22 species of terrestrial birds collected from Tamil Nadu, India. Eggs found abandoned were collected during nest monitoring between 2001 and 2008 and analyzed for the presence of organochlorine pesticide residues. The results showed that the mean concentrations of total hexachlorohexane (∑HCHs), total dichlorodiphenyltrichloroethane (∑DDTs), heptachlor epoxide, and dieldrin ranged from non-detectable (nd) to 2800 ng/g, nd to1000 ng/g, nd to 700 ng/g, and nd to 240 ng/g on a wet mass (wm) basis, respectively. The variation in magnitude of contamination among the species and feeding guilds were not significantly different (p > 0.05). Among the OCPs analyzed, the residues of β-HCH and p,p'-DDE were found to be the abundant in concentration. Similarly, among various bird species studied, the highest concentrations of ∑OCPs (> 5000 ng/g wm) were recorded in the eggs of gray junglefowl, scaly-breasted munia, and red-whiskered bulbul. This may be due to their widespread occurrence of their habitat at proximity to the agricultural fields, where organochlorines were in use until recently. Among the various contaminants analyzed, concentrations of p,p'-DDE and heptachlor epoxide exceeded the threshold levels of toxicity for wild birds in > 5% of the egg samples. Hence, this study indicates the need for continued monitoring and further systematic ecotoxicological investigation of these compounds not only in eggs but also in other environmental media.

Mitochondrial DNA copy number and cytogenetic damage among fuel filling station attendants

Fuel filling attendants are constantly exposed to the complex mixture of gasoline and all refinery environments are probably carcinogenic for humans. These workers are considered as an unorganized group in India and unaware of the risk. The present study was focused to monitor workplace pollutants (particulate matter size 10 [PM10 μm], total volatile organic compound [VOC], and carbon monoxide [CO]), benzene exposure (phenol), and to evaluate their genotoxicity effect with reference to relative mitochondrial DNA copy number (MtDNAcn), 8-OHdG (8-hydroxy-2'-deoxyguanosine), and micronuclei (MN) frequency (%) among fuel filling attendants. This study recorded 318 ± 134 and 1,050 ± 260 μg/m³ time-weighted average concentration of PM10 and CO, respectively. However, total VOC levels recorded were below the detectable level (BDL) to 290 ± 50 μg/m³ . A total of 53 subjects (26 exposed and 27 control) participated in this study with similar sociodemographic information. It was noticed that fuel filling attendants were not using proper personal protective equipment (PPE) and are younger generation. The significantly (p = <.001) higher level of phenol, a metabolite of benzene, was detected in the exposed group. The significantly elevated level of urinary 8-OHdG (p = .01), MN frequency (p = .001), and relative MtDNAcn (p = .001) was observed in exposed group as compared to the control group. The study exemplify that workers were exposed to the benzene, workplace pollutant, and observed genotoxicity suggest malignancy risk. This study highlights the importance of biomonitoring in occupational settings to avoid malignancies. The possible engineering controls, frequent health check-ups, awareness about the risks, and PPE use can reduce health hazards.

Levels of organochlorine pesticide residues in fresh water fishes of three bird sanctuaries in Tamil Nadu, India

Organochlorine pesticide (OCP) residues were determined in nine species of fresh water fishes caught from three bird sanctuaries in Tamil Nadu, India. A total of 302 fishes were analyzed for various types of OCPS. OCPs, namely hexachlorocyclohexane (HCH), dichloro diphenyl trichloroethane (DDT), heptachlor epoxide, endosulfan, and dieldrin were detected among various species of fishes. Among the various OCPs analyzed, HCH was the most frequently detected pesticides. Among the HCH isomers, β HCH contributed more than 50% to the Σ HCH. p,p' DDT, the metabolites of DDT, had high percentage of occurrence. Among the cyclodiene insecticide residues, endosulfan was detected in more than 60% of the fishes. Varying levels of ΣOCPs (a sum of Σ HCH, Σ DDT, Σ endosulfan, heptachlor epoxide, and dieldrin) were detected in various fish species, although it was not significant (p > 0.05). However, significant variations in OCPs were observed among location and between seasons (p < 0.05). However, continuous monitoring is recommended to facilitate the early identification of risks not only to the fishes, but also to fish-eating birds breeding in these sanctuaries.

Comparison of Two Sampling Methods for Assessing Halyomorpha halys (Hemiptera: Pentatomidae) Numbers in Soybean Fields

Sampling soybean fields for the brown marmorated stink bug, Halyomorpha halys Stål (Hemiptera: Pentatomidae), can be challenging. Both adults and nymphs have a "startle response" and drop to the ground with even the slightest disturbance. This behavior could reduce the effectiveness of the traditional sweep net and ground cloth sampling methods. In 2013 and 2014, in Virginia, Delaware, and Maryland, we evaluated a visual plant inspection method that consisted of counting the number of brown marmorated stink bug nymphs and adults seen on soybean plants in a 2-min inspection period while walking carefully between two rows. After a 30-min interval, which allowed the stink bugs to reposition in the canopy, the area was resampled using 15 sweeps with a 38-cm-diameter sweep net. In total, 76 soybean fields and 2,042 paired comparisons were used to determine a strong linear relationship between sampling methods (y  =  0.984x  +  0.4359, R2  =  0.6934, where y  =  brown marmorated stink bugs/2-min visual count and x  =  brown marmorated stink bugs/15 sweeps). An average visual count of 5.4 brown marmorated stink bugs in 2 min was estimated as being equivalent to the current economic threshold of 5 stink bugs per 15 sweeps. Visual inspection appears to be an effective method for assessing brown marmorated stink bug populations in soybeans.

Drug resistance profile of human Mycobacterium avium complex strains from India

PURPOSE

To determine minimum inhibitory concentration (MIC) of various anti-tuberculosis drugs for Mycobacterium avium complex (MAC) strains isolated from clinical samples.

METHODS

Forty-nine human isolates of MAC were tested for susceptibility to nine chemotherapeutic agents. All isolates were from Indian patients suffering from chronic pulmonary mycobacteriosis. Drug susceptibility was performed both by agar dilution and MIC method. MIC values were analysed, both visually and by enzyme-linked immunosorbent assay reader.

RESULTS

More than 40% of the MAC isolates were sensitive to ciprofloxacine (48.98%), amikacin (46.94%) and roxithromycin (42.86%) by the MIC method. In contrast, the isolates showed high degree of resistance to the first line antituberculosis drugs: only 28.6% were sensitive to rifampicine, 22.85% to isoniazid and ethambutol each and 36.7% were sensitive to streptomycin. In addition, 22.85% of the strains were sensitive to clofazimine and 34.7% to kanamycin.

CONCLUSIONS

Results of the study confirm the suitability of the rapid broth micro dilution (MIC) method as a simple yet reliable method to assay for the drug susceptibility of nontuberculosis mycobacterium.

Mania in hiv infection

Mania in HIV infected individuals is an uncommon clinical presentation. It can, however, complicate any stage of the HIV infection. We herewith report a set of three case reports of patients with HIV infection who developed manic episodes. The cases highlight some aspects of the plausible relationship between HIV infection and mania. HIV infection could be revealed by manic episode, it could itself also be associated with increased cycling in bipolar patients. Mania could be secondary to HIV or zidovudine therapy (though the etiological role of the latter is as yet unclear). Mania could also occur as a reaction to awareness to having HIV infection. These relationships are important for both the physician and the psychiatrist as they have important therapeutic and prognostic implications.

Depression in medical disorders

This review highlights the occurrence of depressive disorders in medically ill patients. It discusses the difficulties in diagnosing depression in the medically ill due to the vegetative symptoms of depression which are also a feature of many medical diseases. Depression in the medically ill may be due to the disease itself, its psychological reaction, due to complications because of metabolic or other disturbances, or due to the medications for the treatment of the disease. The role of active consultation liaison between medical specialists and mental health professionals will help provide total care to the medically ill.

Depression: psychosocial basis

Normal emotions like sadness need to be differentiated from depressive illnesses. A number of psychological and social theories have been proposed to explain depression in the psychosocial context in which it occurs. A multifactorial bio-psychosocial approach to causation of depression provides a holistic understanding of the patient and also helps to plan appropriate pharmacological and psychosocial therapies to treat the patient.

Mental hospitals in India

This review traces the history of the mental hospital movement, initially on the world stage, and later in India, in relation to advances in psychiatric care. Mental hospitals have played a significant role in the evolution of psychiatry to its present statusThe earliest hospital in India were established during the British colonial rule. They served as a means to isolate mentally ill persons from the societal mainstream and provide treatments that were in vogue at the time. Following India's independence, there has been a trend towards establishing general hospital psychiatry units and deinstitutionalization, while at the same time improving conditions in the existing mental hospitals.Since 1947, a series of workshops of superintendents was conducted to review the prevailing situations in mental hospitals and to propose recommendations to improve the same. Implementation of the Mental Health Act, 1987, and grovernmental focus upon mental hospital reform have paved way for a more specific and futuristic role for mental hospitals in planning psychiatric services for the new millenium, especially for severe mental illnesses.

A questionnaire survey of psychiatrists attitudes towards genetic counselling

Genetic counselling in psychiatry aims at facilitating mentally ill patients and their relatives to make informed choices after understanding what is known about the genetics of a given mental disorder This area of practice is a recent development in mental health care. This study surveyed the attitudes and practices of Indian psychiatrists towards genetic counselling. Fifty-nine out of 150 randomly selected psychiatrists completed a semi-structured questionnaire assessing various aspects of genetic counselling in practice.The results show that there is a felt need for genetic counselling among patients. Most of the respondents provide information regarding the hereditary nature and risk of inheritance of mental illnesses in single sessions of less than 30 minutes duration in clinical situations. Most psychiatrists (76%) felt that genetic counselling is feasible in practice, but 24% felt inadequate knowledge, illiteracy among patients and time constraints as some hindering factors for the same. Genetic counselling was considered to be important in planning management for patients by most respondents. The need to improve their knowledge and skills in the genetic understanding of mental illnesses was also reported. These results have implications for future practice of genetic counselling in the Indian setting.

A case report of carisoprodol dependence

Carisoprodol is a centrally acting skeletal muscle relaxant whose active metabolite is meprobamate. There have been few reports of carisoprodol abuse from India. This is a report of a case with carisoprodol dependence. The patient also had poly substance abuse of alcohol, nicotine, benzodiazepine and dextropropoxyphene. Although no specific withdrawal syndrome could be identified, the patient had symptoms of anxiety, insomnia, restlessness and craving. Clinicians must be aware of the dependence potential of carisoprodol and need to be cautious in its prescription, especially in view of its free availability in the Indian market.

Expression, purification and kinetic characterization of wild-type human ornithine transcarbamylase and a recurrent mutant that produces 'late onset' hyperammonaemia

Ornithine Transcarbamylase Deficiency, an X-linked disorder, is the most common cause of inherited urea cycle disorders. Approx. 90 mutations that produce reduced levels of ornithine transcarbamylase (OTCase) activity have been identified in patients [Tuchman (1993) Hum. Mutat. 2, 174-178; Tuchman and Plante (1995) Hum. Mutat. 5, 293-295]. A model of the three-dimensional structure of OTCase, developed on the basis of its homology to the catalytic subunit of Escherichia coli aspartate transcarbamylase (ATCase) [Tuchman, Morizono, Reish, Yuan and Allewell (1995) J. Med. Genet. 32, 680-688], and in good agreement with the crystal structure of Pseudomonas aeruginosa OTCase [Villeret, Tricot, Stalon and Dideberg (1995) Proc. Natl. Acad. Sci. U.S.A. 92, 10762-10766], indicates that many mutations that produce severe clinical symptoms are at the active site or buried in the interior of the protein. However, one of the few recurrent mutations, R277W, an alteration that produces a milder phenotype of ornithine transcarbamylase deficiency, is located in the model in a loop remote from the active site that is analogous to a similar loop (the 240's loop, a flexible loop of the catalytic chain of Escherichia coli aspartate transcarbamylase, comprised of residues 230-250) of ATCase. Human wild-type OTCase and the R277W mutant have been cloned and overexpressed in E. coli and a rapid and efficient purification method utilizing the bisubstrate analogue, Ndelta-(phosphonacetyl)-L-ornithine, has been developed and used to purify both proteins. Gel chromatography indicates both are trimeric. The pH dependence of the kinetic parameters of the wild-type enzyme is similar to that of E. coli OTCase [Kuo, Herzberg and Lipscomb (1985) Biochemistry 24, 4754-4761], suggesting that its catalytic mechanism is similar, although its maximal activity is approx. 10-fold less. Compared with the wild-type, the R277W mutant has nearly 70-fold lower affinity for L-ornithine, shows no substrate inhibition, and its thermal stability is reduced by 5 degrees C. Its reduced affinity for L-ornithine, which in turn results in lower activity at physiological concentrations of ornithine, as well as its reduced stability, may contribute to the clinical effects that it produces.