Abstract
Background:
Women roll beedis from a young age and expose continuously to unburnt tobacco dust for many years. Due to poverty, ignorance, and lack of literacy, women and young individuals engage in less profitable occupation. The study was conducted in a large sample to know the occupational health morbidities in rural women.
Materials and Methods:
Women beedi rollers and nonbeedi rollers living in villages of Jagitial and Nizamabad districts were selected for the study. Individuals who signed consent are interviewed about their health profile using a predesigned standard questionnaire.
Result:
A high frequency of general health problems was observed in the present study. Hypertension, body pains, and headache are the most prevalent health issues observed in more than half of beedi rollers.
Conclusion:
Awareness programs must be implemented to decrease the health hazards and provide alternate job opportunities for better health.
Keywords: Beedi rolling, joint pains, headache, hypertension, tobacco, women
INTRODUCTION
In Telangana, Beedi rolling is a home-based business providing employment primarily for women in villages. According to labor statistics (2021–2022), Telangana is home to 458,040 registered beedi workers.[1] The majority of people working in this field are uneducated. Inspite of labor-intensive work and payment of fewer wages, women continue to take up the job as there is no other source of livelihood. Women have been rolling bidis since a very young age, rolling between 500 and 1000 bidis every day using 250 to 400 grams of tobacco.[2] During the process of rolling beedis unknowingly, they are continuously exposed to nicotine, tar, unburnt tobacco dust, and other toxic particles that pass through cutaneous and pharyngeal routes, leading to enormous health issues.[3] Studies showed that beedi rollers are suffering from various health issues such as respiratory and orthopedic, ophthalmic problems, pain in the shoulder or neck, backache, headache, generalized weakness, and skin diseases due to occupational exposure to tobacco and poor working posture.[2,4,5] People who work in tobacco factories and farms also experienced many health issues like cough, running nose, skin diseases, itching of eyes, headache, nausea, dizziness, weakness, breathing problems, and allergy.[6,7] Increased levels of tobacco constituents were found in the urine of beedi workers, which suggests increased systemic exposure to tobacco.[8] The present study aims to find out the health issues in women beedi rollers in rural settings of northern districts of Telangana state in a large sample size.
METHODS AND MATERIALS
Study subjects
A cross-sectional study was carried out in 1039 women beedi rollers and 755 women who live in the same area and with the same socioeconomic status who were not exposed occupationally to any chemical including tobacco dust and gave their consent to participate in the study, and they were included as control subjects. Women beedi rollers of Ibrahimpatnam, Varshakonda, Sattakkapally, Mularampur, Vellulla, Bandalingapur, Chinthalpet, Yousufnagar, Korutla, Athmakur, Aarapet, Athmanagar, Godhur, Kanapur, Jaggasagar, Kathlapur, Metpally, Mogilpet, Thimmapur, Vemulakurthi of Jagityal District and Kammarpally, and Bhemghal of Nizamabad District, Telangana state, India, were included in the study. Women beedi rollers exposed to tobacco dust for a minimum period of ≥ 1 year and control subjects in the age group of 15–50 years were included in the study. Pan, Gutka, and tobacco chewers in beedi rollers and control subjects and those who were suffering from chronic diseases were excluded from this study. Beedi rollers and the study participants who gave consent were only recruited for the study.
The present study was approved by the Institutional Ethics Committee (IEC) of Bhagwan Mahavir Hospital and Research Centre, Hyderabad, Telangana. The study was carried out at the Department of Genetics, Bhagwan Mahavir Hospital and Research Centre, Hyderabad, Telangana. Information was collected from all the study subjects on age, marital status, education, hygienic conditions, socioeconomic status, work hours, duration of occupation, medical history, and so on by using a standard proforma. Anemia, thyroid problems, renal problems, gastric problems, and other health conditions were detected by taking into consideration both self-reporting of the study subjects and documentary medical reports. The complete information imported into Microsoft Excel sheets was analyzed and is shown as tables and then statistically examined for significance using an online statistical tool.
RESULTS
The results showed a high frequency of different health problems such as hypertension, body pains, headache, joint pains, anemia, shoulder pain, eye problems, renal problems, oral ulcer, thyroid and respiratory problems, neck pain, neurological problems, weakness, gastric problems, hypotension, heart problems, chest pain, spine problems, asthma, and stomach pain in beedi rolling women compared to controls. 70.3% beedi rollers as against 5.8% control subjects had hypertension. In beedi rollers, 59% and 7% in control subjects reported body pains. 54.4% versus 11.8% with headache, 41.1% versus 10.7% with joint pains, 26.6% versus 5.4% with anemia, 26.6% versus 8.1% with shoulder pain, 4.4% versus 0.4% with eye problems, 4% versus 0.4% with renal problems, 3.8% versus 0% with ulcer, and 3.6% versus 0.5% with thyroid were reported among beedi rollers and control subjects [Table 1]. The results analyzed statistically using an online statistical tool showed that the frequency of anemia, body pains, eye problems, gastric problems, headache, hypertension, joint pains, neurological problems, neck pain, renal problems, shoulder pain, and ulcer and thyroid problems was statistically significant in women beedi rollers compared to control groups.
Table 1.
Health problems in beedi rollers and control subjects
| Health problem | Control subjects n=755 (%) | Beedi rollers n=1039 (%) | P |
|---|---|---|---|
| Anemia | 41 (5.4) | 276 (26.6) | ˂0.0001 |
| Asthma | 0 | 1 (0.1) | 1 |
| Body pain | 53 (7) | 613 (59) | ˂0.0001 |
| Chest pain | 0 | 2 (0.2) | 0.512 |
| Eye problem | 3 (0.4) | 46 (4.4) | ˂0.0001 |
| Gastric problem | 0 | 15 (1.4) | 0.0003 |
| Headache | 89 (11.8) | 565 (54.4) | ˂0.0001 |
| Heart problem | 0 | 3 (0.3) | 0.268 |
| Hypertension | 44 (5.8) | 731 (70.3) | ˂0.0001 |
| Hypotension | 1 (0.1) | 4 (0.4) | 0.4053 |
| Joint pains | 81 (10.7) | 427 (41.1) | ˂0.0001 |
| Neck pain | 1 (0.1) | 16 (1.5) | 0.002 |
| Neurological problem | 0 | 10 (1) | 0.006 |
| Renal problem | 3 (0.4) | 42 (4) | ˂0.0001 |
| Respiratory problems | 24 (3.2) | 32 (3.1) | 0.891 |
| Shoulder pain | 61 (8.1) | 276 (26.6) | ˂0.0001 |
| Spine problem | 0 | 2 (0.2) | 0.512 |
| Stomach pain | 0 | 1 (0.1) | 1 |
| Thyroid | 4 (0.5) | 37 (3.6) | ˂0.0001 |
| Oral ulcer | 0 | 40 (3.8) | ˂0.0001 |
| Weakness | 6 (0.8) | 9 (0.9) | 1 |
DISCUSSION
The studies carried out in Telugu states of Andhra Pradesh and Telangana on morbidity in beedi rollers in home-based setup in villages are very meager. The present study was carried out for the first time in a larger sample size in rural women beedi workers in the northern region of Jagityal and Nizamabad districts of Telangana state. The results showed a significant increase in the health problems such as hypertension, body pains, headache, joint pains, and shoulder pain in the women beedi rollers compared to the control subjects. The results of the present study are in agreement with that of the preliminary study carried out by Baluka et al.,[9] (2017) who showed a high frequency of the health problems in beedi rollers from the villages of Jagityal district. Laxman Rao et al.[10] (2020) reported a high incidence of respiratory problems, hypertension, joint pains, and body pains in women beedi rollers in rural areas of Nizamabad. They have also observed increased incidence of health problems such as musculoskeletal problems, breathlessness, visual impairment, and giddiness increasing with age and duration of service and concluded a positive correlation between age, duration of exposure, and health hazards. Neck pain, shoulder pain, elbow, knee pain, lower back pain, and cough were reported from Bihar.[11] Headache, backache, neck pain, leg pain, respiratory disorders, and asthma were reported from West Bengal.[12] Occupational health problems studied in Uttar Pradesh,[5] North Karnataka,[4] and Kannur districts in Kerala[13] also observed significant health problems in women beedi rollers. Studies carried out in the workers of farm lands of tobacco by Keshav Kumar et al., 2023,[7] and in beedi factory workers by Gourab Biswas[14] and Patel et al., 2022[6] also showed similar health problems. The health problems might be due to continuous exposure to tobacco dust which contains nicotine, tar, and other metabolites.[3]
CONCLUSION
In conclusion, it is important to raise awareness among beedi rollers about effective methods to control and prevent health hazards. Encouraging the use of gloves and masks and promoting hygienic practices are essential preventive measures. Additionally, providing alternative employment opportunities for rural women is recommended to enhance overall well-being. Conducting comprehensive studies on various aspects of health and reproductive outcomes is crucial for implementing targeted welfare programs and preventive measures.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Acknowledgement
The authors would like to thank Indian Council of Medical Research (ICMR), New Delhi for funding the project under Grant Number-5/10/FR/55/2020-RBMCH. The authors would also like to thank Mr. Mahendra Ranka, Chairman, Bhagwan Mahavir Medical Research Centre and Mrs. Sunita Kumar, Managing Director, MAA Hospitals for their constant support.
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