Skip to main content
NCBI home page
Indian Journal of Occupational and Environmental Medicine logoLink to Indian Journal of Occupational and Environmental Medicine
. 2020 Jan;24(Suppl 1):S21–S41.

OCCUCON Abstracts

PMCID: PMC7224253
Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 1: Demonstration of Application of Ergonomics in an Industry

Jakkula Vijay Rao 1

Abstract

Objective: The main objective of the present study is to demonstrate the advantage of adhering to suitable Ergonomic practices by operators carrying out manual operations on a routine basis in an industry enable them in minimizing the chances of falling prey to common morbidity such as backache.

Background: In industry, it is essential for operators to carry out operations, the activities manually on routine basis in the absence of mechanization. Such cases adhering to wrong practices even inadvertently can become potential hazard as such wrong practices enhance the chances of the operator falling prey to any common morbidity such as backache over a period of time. Thus, adhering to suitable ergonomic based practices help in minimizing the impact of the morbidity on already affected operators and/or prevents the new operator from not getting affected from such a morbidity. This paper describes the systematic study carried out on operators involved in manual operations of material handling with respect to backache. This study demonstrates how application of suitable Ergonomic principles in manual material handling is helpful in minimizing the impact of backache on the already affected operators and can also lead to its prevention among the new operators. This paper reviews retrospective case history data of backache cases observed during 1990 to 2016.

Methodology: Analysis of medical data recorded prior to the systematic study and that obtained after the implementation of the remedial measures.

Results: It shows a significant reduction in incidences of backache in post study era. Thus, the present study demonstrates the how application of principles of Ergonomics suitably can minimize the impact of Backache in persons carrying out manual operations routinely.

Therefore, it is recommended that all concerned and particularly Occupational Health Practitioners should avail the benefits of Ergonomics as a tool for prevention of backache.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 2: Cobots: - Game Changer of Industrial Automation: A Novel Material Handling Technology to Reduce Ergonomic Risk Factors

Ravimohan Hanasoge Vasudeva Murthy 1

Abstract

Many robots perform repeatable tasks in highly structured environments, so safety measures have typically consisted of a cage to prevent humans from getting dangerously close to a bot. But now, the tide is turning. In the recent years, vision-enabled cobots that are sensor-laden, can operate cage-free alongside humans, without posing safety hazards. With low cost disruptive innovations, automation is no longer a costly prescription to reduce work related MSDs. Industries are now focussing on elimination of non-value added tasks using cobots, which eventually reduces ergonomic risk factors. Current discussion is to orient OH physicians to identify the potential process or tasks for automation, to begin with.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 3: Epidemiological Correlates of Wellbeing at Work Place and Hazards Identification and Risk Assessment amongst Saw Mill Workers in Anand, Gujarat

Deepak Kumar B Sharma 1, Utkarsh Shah 1, Uday Shankar Singh 1

Abstract

Introduction: Saw mills in India by and large are in the small-scale enterprises and unorganized. The nature of the work carries huge risk as the workers are exposed to various life-threatening hazards like moving machine parts, ergonomic hazards, vibratory works, heat, excessive noise, ocular injuries by flying objects, high voltage current and respiratory hazards. In any industry, wellbeing of the workers is always at the forefront, besides productivity and forms the economic triad.

Objectives of the study: The present study was conducted to know the

  1. Work place wellbeing of the saw mill workers

  2. Occupational hazards identification and risk assessment including hazard communication

  3. Occupational accidents, injuries and diseases in saw mill workers

Materials and Method: The study was a cross sectional study amongst workers of saw mills. Out of total 221 saw mill workers whom we approached, 2 didn't give consent for the study and therefore we interviewed 219. “Work place wellbeing”, was studied by using the “Workplace Wellbeing Questionnaire - Black Dog Institute” which includes four areas of workplace wellbeing viz. 1. Work satisfaction 2. Organizational respect for the employee 3. Employer care 4. Intrusion of work into private life. The “Wellbeing at work place” questionnaire was checked for the validity (face, content, construct) and also linguistic validity. Reliability analysis was done and Cronbach's alpha was found. Association was found between the wellbeing and other demographic and occupational variables.

Results: “Work satisfaction” was high in only 2 (0.9) workers and medium in 217 (99.1). “Organizational Respect for the Employee” was high in 44 (20.1) workers. Opinion on “Employer care” was high in 84 (38.4) workers. Opinion regarding “Intrusion of work into private life” was low in 33 (15.1). Personal Protective equipment usage was 80%. Injury prevalence was 8.21%. Specific disease prevalence was highest for Back ache - 72.1%. Hazard communication was done in 40% workers.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 4: Feasibility of Training Key Factory Staff in Provision of Basic Counselling Services – Findings from Tirupur, South India

Nancy Angeline Gnanaselvam 1, Bobby Joseph 1, Rathna Kumari S 1

Abstract

Introduction and Objectives: In developed countries, workplace counselling has been observed to be useful for employees evidenced by a reduction in sickness absence and psychological symptoms. In the garment industry of Tiruppur, we aimed to assess the feasibility of training key factory staff on provision of basic counselling services to the employees of their respective factories.

Materials and Methods: By purposive selection, we recruited 5 key staff from 3 garment factories such as human resource professionals, floor supervisors, hostel wardens and recruitment officers. We trained these 15 individuals on counselling skills, interpersonal communication, stress management, crisis management and problem solving therapy. Pre and post-test assessments were done. Mann Whitney U test was done to assess the difference between scores. Interviews with workers were conducted to assess the effectiveness of the counselling services.

Results: Significantly increased knowledge on basic counselling skills was observed among the participants with a mean pre-test score of 9.7 out of 15 as compared to a mean post-test score of 13.7 (p < 0.001). Except for counselling skills and crisis management modules, in the other 3 modules significantly increased knowledge from post-test to pre-test scores was observed (Table 1). Simplifying the module to the needs of a basic factory counsellor could have improved the post-test knowledge scores. In the interviews, workers commented that they are utilising factory counselling services for workplace and personal issues and the entire working environment has changed positively due to the presence of counsellors who are empathetic and non-judgemental.

Conclusion: Provision of workplace counselling services using key staff members who are trained in basic counselling skills is feasible. Despite the lack of significant improvement in knowledge in 2 modules, the practice of counselling in factories was adequate. Workplace counselling services are utilised by employees and it changes the work environment positively.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 5: Weight Reduction - Innovative Approach Through Gamification

Nitin Jadhav 1

Abstract

Introduction and Objectives: Obesity is one of the major risk factor for life style related diseases. It requires lot of motivation for person to change his behaviour and adopt healthy life style. Main objective of this study is to motivate employees for weight reduction by maximizing their participation through team in different events organized for defined period.

Materials and Methods: 575 employees participated last year in 12 weeks programs. 115 teams were formed each comprising of 5 team members. Body Mass Index of 453 participants was more than 23. Rest of the employees joined various groups for giving encouragement to colleagues. Different programs like sessions by Dietician, Fitness experts, yoga session, skipping, squats and push up sessions were organized. Programs were organized every week and weight of employees was monitored. After 12 weeks, again weight was recorded. Out of 575 employees, 429 participants also registered for this year's FitNext 3.0 program. Their weight was also again recorded. Weightage system: Scoring matrix was finalized by giving weightage to Team diversity, Initial joining point, Target setting points, Weekly milestone points, Target completion points, FitNext challenges and event participation.

Results: 3 teams were rewarded and recognized for achieving desired milestones. 211 team members were also felicitated for maximum participation in events. 3 individual winners were also rewarded for achieving desired targets.320 employees (70%) out of 453 participants were successful in weight reduction. After one year 187 employees (43%) were still able to maintain reduced weight or able to further reduce weight.

Conclusion: Gamification creates interest amongst participants. It motivate them to attend events and remain focussed on main objective of adopting healthy life style. It is a collaborative approach with win-win situation.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 6: A Cross-Sectional Study on Health Profile (Non-Communicable Diseases) Among the Mining Workers of an Iron Ore Mine in Jharkhand

Amala Sankar Chatterjee 1, Dhirendra Kumar 1

Abstract

Introduction and Objectives: Non-Communicable Diseases (NCDs) have emerged as leading causes of mortality and morbidity affecting both males and females globally. Due to increased industrialization, socio-economic development, changing lifestyles, non-communicable diseases continues to be an important public health problem worldwide. Over the last few years, India is experiencing a rising burden of non-communicable diseases which mainly includes: cardiovascular diseases, stroke, diabetes, cancer, MSD, chronic respiratory diseases, accidents and injuries. The objective of the study were to know the health status of mining workers, to find out the spectrum, epidemiological profile and prevalence of NCDs among them, to study factors associated with it and give recommendations for prevention.

Materials and Methods: Study type: A cross-sectional study conducted through health check-up with the objective Study Population: 185 workers in an Iron Ore Mine in West Singhbhum district of Jharkhand. Study period: May-August, 2018.

Results: The study revealed, mean age of employees was 44.74 ± 10.06 years. Most of them (49%) were pre-obese or obese with a BMI > 25, followed by Hypertension, MSD and Diabetes-22%, 20% & 16% respectively. Few were suffering from Ischemic Heart Disease (9%), chronic respiratory diseases (7%) & cataract (2%). BMI was significantly associated (at p < 0.05) with hypertension (x2 = 6.2414, p = 0.01248) and diabetes (x2 = 4.6532, p = 0.030996). Smoking also showed statistically significant association (x2 = 5.6872, p = 0.017089, at p < 0.05) with hypertension.

Conclusions: NCDs were common among the mining workers. Strategically planned efforts with proper monitoring should result in inculcation of healthy lifestyle, thus reduction in exposure to risk factors and improved quality of life. The study emphasized the need for implementation of population-based screening programs, community-based wellness program along with some specific approach like weight management plan, hypertension and diabetes control plan, de-addiction program, stress management session to prevent NCDs among the mining workers.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 7: A Structured Approach Towards Occupational Health Surveillance in Oil Exploration and Production Industry – A Case Study of Onshore and Offshore Rigs and Installations

Jeevan Shankarrao Waghmare 1

Abstract

Introduction and Objectives: Oil and Natural Gas Corporation Limited (ONGC) is in the primary business of exploring oil and gas which lights the lamp today and promises a better tomorrow. Surveillance of the working environment is one of the main tasks of Occupational Health Services (OHS). This paper gives a broad idea about the processes and associated hazards present at Onshore and Offshore rigs and installations and also suggests control measures to prevent these hazards.

Materials and Methods: Study design: Descriptive study. Study period and set up: Occupational Health Survey conducted at Offshore rig and installation, Mumbai Region (1st April 2013- 31st March 2014) and at various Onshore rigs and installations, Ahmedabad Asset (01st April 2015- 31st March 2016) A detailed Occupational Health Survey including Noise Survey, Vibration Survey and Hazard Assessment and Periodical Medical Examination (PME) Status of employee especially hearing impairment vis a vis job profile of employees was conducted on offshore rig and installation, Mumbai Region (2013-14) and onshore rigs and installations (2015-16), as part of Occupational Health Project.

Results and Discussion: Survey of Noise and Vibration level measurement was carried using calibrated Sound Level Meter and Vibration level meter. Similarly, Hazard assessment survey and Periodical Medical Examination (PME) Status of an employee especially hearing impairment vis a vis job profile of employees was carried out at these offshore and onshore locations and various physical, chemical, biological hazards were identified.

Conclusions: Workers are exposed to various types of physical, chemical and biological hazards which may lead to localized or systemic infections. Various control measures including engineering, administrative, medical and personal protective equipment should be used to prevent or mitigate these hazards

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 8: Study of General Health and Health Determinants of Unorganized Labourers belonging to Scheduled Tribe Community in Eastern Uttar Pradesh

Poonam Singh Kharwar 1

Abstract

Introduction: Unorganized labour sector covers more than 90 percent of the total work strength of India and agriculture is the largest sector having huge workforce. The present study aims to assess the health and health determinants of the Scheduled Tribe (ST) workers engaged in the unorganized sector in Eastern Uttar Pradesh (U.P.) to identify the key thrust area and evaluate the progress.

Methodology: Primary survey was conducted by a medical team covering 11416 family members of ST labourers from 474 villages in five U.P. districts (Sonbhadra, Varanasi, Ghazipur, Deoria, and Ballia) by cluster random sampling method using semi-constructed questionnaire.

Results: Only 33.16% of the ST families have limited family size, 73.4% have low socioeconomic status, 47.1% are not employed, 83.2% of employed are irregular labourer, 63. 58% of the family earns Rs. 2500- 5000, 96.8% did not have their own agriculture field and worked on a meagre daily wage. 31.4% of them are illiterate and 55.9% primary to high school, only 9% have the sanitary latrine in their house. 13. 5% of them are underweight (BMI =>18) and 14% of adults are suffering from hypertension. The majority of children were undernourished and women are anaemic and most of them avail treatment from Govt Hospital facilities for treatment. They differ more in hilly terrain.

Conclusion: Although workers are major contributors to the socio-economic development of the nation but their health and health determinants are comparatively poor to overall national data. The government has made provisions of several facilities within their approach and is being utilized by these labourers but the outcome is still poor because of several factors. Although the government has multi-pronged strategies for these marginalized groups to address and overcome these shortcomings but ground-level achievement is not satisfactory.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 9: Study of Happiness, Body Mass Index, Occupation Stress, Hypertension and Socio-Economic Profile among Laboratory Assistants Working in Indian Institute of Technology, Kharagpur

Abhishek Kumar 1

Abstract

Introduction: It is globally reported that personal and institutional stress, depression, obesity and hypertension are the major problems in contemporary scenario and; well educated middle class workers are also in the grip of these kinds of psychophysical imbalance. Present study aims to assess the happiness, body mass index (BMI), occupational stress, hypertension and socio-economic profile of laboratory workers to enhance their physical and mental well-being and to identify the key thrust area including awareness of health determinants for targeted health education which will lead to satisfactory occupational health in these prone educational institutes.

Methodology: Primary survey was conducted among 50 laboratory assistant working in IIT, Kharagpur by incidental sampling method using semi-constructed questionnaire assessing happiness, occupational stress, and socio-economic status including BMI and blood pressure measurement.

Results: Majority of the Laboratory Assistants responded to have average happiness, middle socio economic status, normal BMI and hypertension comparable to general population. Their good educational status and employment although temporary in nature contribute significantly to their happiness, satisfactory awareness to health and lifestyle contribute significantly to maintain normal B.M.I. and appropriate blood pressure amongst them.

Conclusion: Although these well educator workers are major contributors to socio-economic development of the nation but their stress, happiness, health and health determinants are comparable to overall national data. The Government has made provisions of several facilities within their approach and is being utilized by these workers but the outcome is still not better because of several factors. Identification of key thrust area including periodical health checkup programmes and targeted health education is necessary to enhance their psychophysical balance and physical fitness.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 10: Selected Morbidities among Workers of an Adhesive Plaster Industry in Goa

Mahika V Naik 1, Kalyani S 1, Jagadish A Cacodcar 1

Abstract

Introduction: The toxic nature of chemicals & pollutants associated with adhesive plaster industry is well established. A disastrous health sequel would occur among workers of these industries due to exposure to pollution, created & stored wastes, and constant noise & bright light. There have been a lot of health issues related to adhesive plaster industries in the last few decades which needs to be brought to light.

Objective: To assess selected morbidities among workers in an adhesive plaster industry in Goa.

Methodology: The study was conducted over a period of two months during which, the data of the workers was obtained from an OHS Centre catering to an adhesive plaster industry in North Goa which conducted periodic medical check-ups of these workers. The data included socio- demographic details and details regarding selected morbidities among the workers of the adhesive plaster industry.

Results: The mean age of the workers was 40.96 ± 11.1 years. Majority of the participants were males. It was observed that 5 (3.7%) were diabetic & 48 (35.6%) were hypertensive. Near vision abnormalities were seen in 66 (48.9%) & 60 (44.4%) had uncorrected far vision abnormalities. Obesity was detected in 6 (4.4%) whereas 40 (29.6%) were overweight. ECHO/TMT tests were advised for 4 (3%). Obstructive & restrictive respiratory diseases were seen in 3 (2.2%) & 40 (29.6%) respectively. Audiometry reports revealed 4 (3%) workers having mild to moderate hearing loss.

Conclusion: Workers in the adhesive plaster industry suffered from several lifestyle diseases like diabetes, hypertension, obesity, audio-visual impairment as well as obstructive & restrictive lung diseases. This study emphasizes the importance of periodic medical examinations for timely detection & appropriate treatment of the health conditions among the workers.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 11: Assessment of Musculoskeletal Problems among Desk Job Employees of a Tertiary Care Hospital in Goa

Jennifer Mendes 1, Hemangini K Shah 1

Abstract

Introduction: Musculoskeletal Disorders (MSDs) are a leading cause of disability and the most frequent cause of all health-related absence from work. There is lack of information about MSDs among desk job employees.

Objectives: To estimate the prevalence of MSDs among desk job employees of a tertiary care hospital and to assess workstation ergonomics.

Materials and Methods: The cross sectional study, carried out among desk job employees engaged in administrative work at a tertiary care hospital in Goa involved, data collection on MSDs using Standardised Nordic Musculoskeletal Questionnaire (NMQ) and workstation ergonomics assessment using NIH (National Institute of Health) checklist.

Results: Among 110 respondents, 50 males and 60 females, majority (42.7%) were from age group 31-40 years. As per the NMQ, one-year prevalence of MSDs was highest in lower back (55.5%), followed by neck (48.2%); and the lowest in ankles (4.5%). Regular postural breaks were not taken by 59 (53.6%) of the total participants, of which 41 (37.3%) complained of at least one MSD and the association was statistically significant. (P = 0.001). On ergonomic assessment, 62 (56.4%) had chairs with poor lower back support, of which 44 (40%) complained of lower backache; 20 (18.2%) were uncomfortable during keyboard use and 18 (16.4%) with desk setup. Of the 40 (36.4%) participants with continuous computer use for 4-5 hours, 27 (24.5%) complained of neck pain and there was a significant association found between continuous computer use and neck pain. (P = 0.003).

Conclusion: Based on the findings, ergonomic training workshops should be conducted, and the workstation design needs to be improved to reduce the burden of work-related MSDs.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 12: Use of Electronic Medical Records, Medical Algorithms and Protocols in an Occupational Health Centre Setting – The Future

Cheranda Mandanna Appayya Belliappa 1

Abstract

The presentation will cover data storage, data retrieval and uploading of health data. The presentation will look at decision support systems both from top down and bottom up data interpretation. This presentation will look at some of the EMRs being presently used. It will discuss briefly artificial intelligence and machine learning aspects. The presentation will discuss the uses of algorithms and medical protocols to empower physicians to treat patients better. It will look at the use of replacing repetitive tasks by use of bots in healthcare. It will address the importance of EMR and how it will transform into a truly physician assist. Future trends and developments will be discussed.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 13: Healthcare Seeking Behaviour and Awareness Regarding Snakebites and its First Aid Management among Farmers of Rural Maharashtra

Ashwini Baburao Sapkal 1, Anuradha Mohapatra 1, Swati Deshpande 1

Abstract

Background: In rural India, snake bite is a major health problem with high morbidity and mortality. It is also an occupational health problem mainly related to farmers. This study was taken up to assess the healthcare-seeking behaviour and awareness regarding snakebites and its first aid control among farmers of the tribal village of Maharashtra.

Methods: This cross-sectional study was conducted from September to December 2018. The sample size was 272. Farmers above the age of 18 years were selected by simple random sampling. A pre-validated semi-structured questionnaire was used for data collection.

Results: The mean age of the farmers in our study was 39.6 years. The majority of the farmers (88.3%) knew that not all snake bites are poisonous; 51.3% could correctly identify 7 out of 9 snakes accurately. The most common hiding place of snakes was reported as grass/vegetation by farmers, followed by holes. About 70% farmers mentioned that the rainy season was the most active season for snakes;76.6% farmers believed that there are chances of survival after snake bite;80.3%could name at least one local sign/symptom following snake bite; 94.33%could name at least one sign of envenomation. Around 27.8% used some kind of protective measure to prevent snake bite in them. Only 51% had knowledge regarding first Aid management. Allopathic treatment in a government hospital was preferred by 67% of farmers.

Conclusion: The knowledge regarding snake bites is good in farmers, however, the knowledge regarding its prevention and first aid measures is poor. Allopathic treatment is preferred over traditional/ alternative medicine. Government hospitals are preferred over private.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 14: The Role of Heavy Work Load in Inducing Heat Strain among Workers Exposed to Heat Stress - Study Results from Select Indoor Occupational Sectors in Southern India

Rekha S 1, Latha PK 1, Manikandan K 1, Vidhya Venugopal 1

Abstract

Introduction: Thermally stressful environments and physically exerting jobs may aggravate symptoms of heat strain and risk of heat-related health illnesses among the workers labouring in indoor workplaces. There is a need to generate such epidemiological evidence to develop protective adaptation strategies and preventative policies.

Methods: We conducted a cross-sectional study in about 800 workers from 4 sectors viz., Steel, Foundry, Auto parts, and Garment industries between 2014 -2019. We made quantitative measurements of Wet Bulb Globe Temperature (WBGT) and physiological heat strain indicators viz., Core Body Temperature (CBT), Urine Specific Gravity (USG) and, Sweat rate (SwR). A structured questionnaire was administered to the workers to capture the self-reported heat-related health symptoms.

Results: Our study results showed that WBGTs were in the range of 20.1°C – 42.2°C, with an average temperature of 29.5°C ± 3.8°C. Workers exposed to WBGT above safe limit had significantly increased odds of measured heat strain symptoms (OR = 3.1, 95% CI 2.01-4.5, p-value=<0.0001) compared to the unexposed workers. Heavy workload was also significantly associated with self-reported heat-related health symptoms (X2=17.7, p-value = <0.0001) compared to workers with moderate workload. Nearly 32% of workers had above standard SwR, USG and rise in CBT with mild dehydration.

Conclusion: Heavy workload is a key driver for heat strain in hot working conditions. Lack of cooling interventions are very common in many Indian occupational settings, could create a silent epidemic of heat-related illnesses without appropriate work practices especially in rising temperature scenario.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 15: Assessment of the Thermal Discomfort Effects on Workers' Health and Productivity – A Case Study in Southern India

P K Latha 1, Rekha S 2, Manikandan K 2, Vidhya Venugopal 2

Abstract

Introduction: The rise in temperatures across the globe is predicted to adversely impact the thermal comfort in the workplaces with consequent health and productivity risks.

Methodology: We used a cross-sectional study design to profile the heat stress exposures of ~740 workers from 6-industrial sectors using a Ques Temp WBGT monitor and quantified heat strain indicators viz., rise in Core Body Temperature (CBT), Sweat Rate (SwR), and Urine Specific Gravity (USG). We collected the workers' perceptions of thermal discomfort and related health impacts using a structured questionnaire.

Results: Heat exposures exceeded the Threshold Limit Value for moderate/heavy work (Avg. WBGT of 28.9°C ± 3.4°C) for 65% of workers. The workers who perceived thermal discomfort (56%) had a significantly higher risk of high-heat exposures (OR: 12, 95% CI: 8.140-19.058, p-value=< 0.00001) and productivity losses (OR = 2.11, 95% CI: 0.849-5.257). Among the exposed workers (n = 464), a rise in CBT > 1°C was significantly higher (9%) in workers who perceived thermal discomfort and a significant positive association with the measured heat strain indicators was observed (p-value =<0.017). 6% of workers who reported thermal discomfort had urine specific gravity >1.020, an indirect indication of dehydration.

Conclusion: Thermal discomfort due to occupational heat exposure causes adverse health and productivity outcomes in the exposed worker population. The predicted rise in temperatures due to climate change is further expected to aggravate the workplace heat and protection via cooling intervention and development of strategies for comprehensive protective labour policies is mandatory to avert adverse occupational health and productivity consequences for millions of workers globally.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 16: Heat Stress Prevention Measures During Shutdown Activities in Summer Season in a Petrochemical Industry

Gaurav Saxena 1, Awadh Kulkarni 1, Nikunj Desai 1

Abstract

Introduction and Objectives: Over the years, it has been observed that the shutdown maintenance activities are planned during the summer season when the ambient temperature and humidity are on rise. The maintenance activities are usually carried out by contract employees and are conducted in the open areas, leading to the possibility of employees suffering from Heat Stress disorders, which include heat stroke, heat cramps, heat exhaustion, and fatigue. This may lead to human, property loss and decrease in productivity. A Heat Stress-intervention Programme was developed in order to minimize the Heat Stress disorders during the Shut Down Activities.

Materials and Methods: Forming a Team comprising of members from Process, Safety and Occupational Health and by using different Tools like Brain storming sessions, Walkthrough surveys etc. defines the areas of concern. The measurements are conducted using the Area Heat Stress Meter and the risk associated is evaluated at the identified locations. The Final planning and implementation of controlling the risks by best fitting controls i.e. using the Hierarchy of Control Measures is then done with the help of the generated data. Total Number of Intervention Group = 700 Manpower

Results and Discussion: WBGT was measured above 31oC at some of the identified locations against the ACGIH, 2019 established TLV of 30oC considering a 50% work-rest cycle in the Plant area. Heat Stress measurements were conducted at 15 locations in the plant area. The Occupational Health Physician conducted training session on Heat Stress awareness in the Plant areas. Water coolers were provided at strategic locations. Heat Stress awareness posters were placed in the Plant Areas in English as well as local languages. In addition, Heat Index emailer was circulated on daily basis to the Plant Process Team so that they are aware of the danger levels during the day and can plan the activities. Same resulted in The Comparative Data of Low Incidence of Heat related Ailments in the Intervention Group (Contract workers) as compared to the Heat related ailments Recorded during Last Summer, With a p Value of Statically Significance (P > 0.05)

Conclusion: By taking a proactive approach and making the employees aware of the Heat Stress disorders and its health effects was key in reducing the heat stress related illness cases during the shutdown activities. Comparative Data of Low Incidence of Heat related Ailments in the Intervention Group (Contract workers) as compared to the Heat related ailments Recorded during Last Summer, With a p Value of Statically Significance (P > 0.05)

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 17: Exposure Levels of Arsenic, Lead and Volatile Organic Compounds in Different Regions of India among Younger Population: Preliminary Observations from a Nation-Wide Neurodevelopmental Cohort

Amit Chakrabarti 1, Sanjit Roy 1, Anupa Yadav 1, Surajit Das 1, Eesha Sharma 2, Nilakshi Vaidya 2, Bharath Holla 2, Vivek Benegal 2

Abstract

Introduction: Environmental neurotoxins, most derived as consequence of environmental pollution, can affect brain development even at low levels of environmental exposure not considered as toxic. The Consortium on Vulnerability to Externalizing Disorders and Addictions (c-VEDA) is a unique nation-wide longitudinal study investigating the effects of specific environmental influences including environmental neurotoxins that might influence brain development, and consequent differences in temperament, cognitive abilities and psychopathological states.

Methods: The study established a longitudinal cohort of n = 8765 within age range of 6-23 years across seven (7) sites from eastern (coal mines in West Bengal), north east, northern and southern India. The phenotypic characterization included behavioural and anthropometric assessments and biological samples for epigenetic studies. A deep phenotyping subset (n = 1,000) were further assessed by MRI brain scans and exposure to environmental neurotoxins (urinary arsenic, plasma lead and urinary metabolites of volatile organic compounds).

Results: Mean urinary arsenic among participants across all sites was 11.89 ± 7.49 ug/L with significantly higher concentration in northern (Chandigarh) and southern (Bengaluru) sites (F = 3.62, p = 0.02, n = 144). However, mean plasma lead across all sites was 1.31 ± 1.13 ug/L with no significant difference (F = 1.97, p = 0.16, n = 656). Significant site differences in exposure were observed for hippuric acid (toluene metabolite) with higher levels from Chandigarh site (F = 9.96, p < 0.001, n = 426) and tt-muconic acid (benzene metabolite) with higher levels from Bengaluru site (F = 3.61, p = 0.06, n = 165).

Conclusions: Preliminary observations support the hypothesis that low grade chronic exposure to developmental neurotoxins is present in developing societies like India. Interestingly, higher levels of background arsenic exposure in urban areas provide clues for further studies. In the coal mine site observed exposure to arsenic was lower than urban sites and exposure to volatile organic compounds was not significantly higher. Further analyses are in progress to identify the association of exposure to such environmental neurotoxins with behaviour, brain development and epigenetic changes.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 18: Prevalence of Occupational Injuries and its Economic Burden in Organized Sector Workers

Omkar Kalidasrao Choudhari 1, Umesh Chandra Ojha 2

Abstract

Introduction: India is one of the fastest developing economy with rapid industrial growth in all the sectors. With industrialization, the probability of increase in incidence of occupational injuries/diseases is also an accompaniment. On one side it is bringing prosperity to the nation but on other side working population is exposed to occupational risks/hazards. These occupational injuries contribute in a substantial way in loss of earning capacity of workers and return to work.

Objectives: To study the nature of work related injuries and loss of earning capacity in organised sector workers.

Materials and Methods: The data is collected from various regions in organized sector workers covered under ESIC at Institute of Occupational Health and Environmental Research, Basaidarapur, Delhi. Disability is measured by guidelines laid down by Society of Participatory Research in Asia (PRIA), New Delhi and loss of earning capacity is measured as per ESI Medical Manual guidelines.

Results: Over five years, data collected from 4332 workers were evaluated. Out of which 4309 were male and 23 were female. The most common injury was right thumb amputation involves 51% (n = 2209) workers causing 30% loss of earning capacity. Right hand index finger injury consisting of 23% (n = 996) workers responsible for 14% loss of earning capacity, followed by amputation of left hand fingers in 14%(606) workers causing one of the significant loss of earning capacity of 32%. Total amputation below knee was reported in 0.34% (n = 14) patients causing maximum loss of earning capacity reaching 50% while Eye trauma with unilateral loss of vision is reported in 0.62% (n = 26) of patients with 40% loss of earning capacity.

Conclusion: It is high time to address the causative factors behind occupational injuries. In our cases, probable causes include poor sleep hygiene, poor machinery, lack of personal protective equipment etc. Adequate knowledge and training would definitely help in reducing occupational injuries. The scenario might be worse in unorganized industrial workers, where reporting and registry are inadequate.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 19: Impact of Weight Reduction on Sugar Profile and Lipid Profile among Overweight and Obese Employees Participated in “#90daysweightloss” Programme at Petrochemical Industry: A Before After Quasi Purpose Study

Sahajanand Pravin Thakar 1

Abstract

Introduction: Obesity is a common and preventable disease of clinical and public health importance. There is presently a global epidemic of obesity in all age groups and in both developed and developing countries. In general, obesity is associated with a greater risk of disability or premature death due to type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD). Studies have shown that weight reduction reduces the long-term complications associated with NCDs and gives better glycaemic control.

Objective: To know association between sugar and lipid profile with weight loss

Materials and Methodology: #90days weightloss programme was launched from 15/02/2019 to 17/5/2019 among RIL DMD employees. Criteria for participation included BMI more than or equal to 25. Baseline Data Blood investigation (FBS, HbA1C, Lipid Profile), anthropometric measurement taken. Active interaction done with participants in form of Diet counselling, dietician sessions, activity like Yoga, Zumba, exercises tips by expert, daily health tips on WhatsApp and weight tracking. After 90 days, post challenge data collected and analysed using MS Excel.

Results and Conclusion: Total 350 employees enrolled in programme; Out of which total 133 continued till end. Out of 133, 92% participants had reduced their weight. Out of these 92% participants reduction in FBS seen in 59%, Reduction in HbA1C seen in 66%, reduction in cholesterol, triglyceride, and LDL seen in 65%, 64%, and 68% respectively, while improvement in HDL seen in 54%. Overweight and Obesity are major risk factor for diabetes and dyslipidaemia. Reduction in weight gives better glycaemic control and lipid control.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 20: Awareness and Use of Personal Protective Equipment among Power Loom Workers in Villages of Sarjapur PHC, Anekal Taluk, Bangalore Urban District – A Cross Sectional Study

J Joeberate Vinshula 1, Snigdha Priya Gurrala 1, Josvin George 1, Jomol John 1, Mervyn George 1, Farah Naaz Fathima 1, Twinkle Agrawal 1

Abstract

Introduction: Power loom industry is predominantly an unorganized sector and its workers are exposed to vibration, cotton dust and noise leading to musculoskeletal disorders, respiratory illness and noise induced hearing loss, respectively. Correct and consistent use of personal protective equipment (PPE) will protect workers from occupational hazards.

Objectives: To assess the awareness and use of PPE and its associated factors among power loom workers residing in villages of Mugalur Sub-centre, Sarjapur PHC, Anekal Taluk, Bangalore Urban District.

Methodology: A community-based, cross-sectional survey was done to identify adult power loom workers in the study area and 139 consenting power loom workers were administered a face validated semi-structured questionnaire. Awareness, practice and factors associated with use of PPE were assessed.

Results: Among the study population 69.1% were males with a mean age of 37.2 ± 10.7 years and mean duration of work per day was 10.7 ± 3.1 hours. In our study, 53 (38.1%) study participants had heard of PPE while only 11 (7.9%) used any form of PPE. The commonly used PPE was ear plugs (4, 3.6%). The frequent reasons attributed for disuse among the remaining 128 were, 'felt it was not required' (43.9%), 'were not aware' (39.6%) and 'were uncomfortable' (5%). Workers who were aware of PPE were more likely to use PPE (Fischer's exact test statistic = 19.4, p < 0.05).

Conclusion: Awareness and use of PPE among power loom workers in our study population was low. Lack of knowledge leads to absence of practice therefore resulting in increased occupational health risks. This indicates the need for regular health education sessions among the target population.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 21: Work Place Stressors; Ways of Coping and Demographic Characteristics as Predictors of Physical and Mental Health of Doctors and Interns

Akhila N 1

Abstract

Introduction: The practice of medicine is unique and challenging than any other profession in the world. It is associated not only with a great degree of personal and professional satisfaction, but also with a high level of occupational stress and burnout. A very few studies from India have evaluated psychological issue, stress, and burnout among medical professionals.

Aims and Objectives:

  • To investigate the effect of working environment on the doctors emotional, physical and mental health.

  • To assess the various psychological problems (perceived stress, level of depression) and coping strategies by Doctors and Interns.

  • Understand mental health issues and factors influencing it.

Materials and Methods: A descriptive correlational study carried out among 210 doctors and interns after obtaining consent to participate. The survey comprised of questions pertaining to demographic and personal characteristics, and identifying perceived stress level by PSS scale level of depression by PHQ-9, and coping strategies by brief COPE scale. Those do not wish to participate excluded.

Results: Out of 210 doctors participated in study 24 doctors were having sleep duration < 4 hrs. In order to overcome stress 16 doctors are depended on alcohol. 102 doctors working hrs is more than 60 hrs per week. Confidentiality issues and fear of side effects are the main barriers in seeking medical help. In most of the participants opinion workload and patients demand were the main reason for their workstress.140 doctors experienced physical /verbal abuse from patient in their work.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 22: HOT Module: Digital Platform for Pre-Employment - Reliance Experience

Ratnakar Koyande 1, R Rajesh 1

Abstract

Background: RIL is India's largest private sector company, with advent of Jio, spread of Reliance Industries Ltd. increased to Pan India locations. RIL has more than 1500 offices across the country. Pre-employment for corporate offices is always a challenging process due to various aspects like legal clarity, resource availability, job requirements, medical validation and fitment of candidates. Our aim was to provide a platform which is accessible to Candidates, HRs and Medical team which will be equally effective in metros, cities & smaller towns in offices spread across India. Challenges: Undervaluation of medical document verification process by HRs. Referral for selective validation of abnormal reports vis-Ã-vis 100% referrals by HR. Mis-directed communication from HR and lack of co-ordination between Medical services & HR teams. Over reliance upon e-mail as primary mode of communication. Doctor: HR & Recruiter ratio is skewed with limited tracking mechanism. Time line: Average response time to validate pre-employment report was more than 7 days.

Objective: Creation of accessible digital platform for candidate & HR, Automated tracking and response mechanisms.

Methods: Brainstorming session with HR, Recruiters and Medical team. Integration of IT team for managing challenges at different levels. Development of software for this platform. Training of HRs, Medical team for Module. Beta version for testing of HOT module. Successful launch of HOT module for Jio. Extending HOT module to other businesses of RIL.

Results: More than 75,000 pre-employment cases done through HOT system till Oct 2019 since inception. Customer satisfaction: Positive feedback from Recruiters, HR, Medical team. Success stories of diagnosis & timely intervention of various lifestyle diseases. Turnaround time: Improved turnaround time with less than one working day

Conclusion: Digital platform for pre-employment has improved quality, response, monitoring with ease of access, has made pre-employment process seamless despite significant hiring for new projects.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 23: Prevalence of Lower Extremity Work Related Musculoskeletal Disorders among Nurses in Tertiary Care Setting Hospital – A Cross Sectional Study

Vrunda Rajendrakumar Makwana 1, Shyam K Krishnan 1, Amitesh Narayan 1

Abstract

Introduction and Objectives: Work Related Musculoskeletal disorders [WRMSDs] interfere with individual's productive work and quality of life. WRMSDs are common among healthcare workers. The nursing population constituting about 33% of the hospital workers, has been accounted for 60% of the reported occupational injuries. Factors associated with WRMSDs include individual characteristics, such as age, height, weight, gender, muscular strength and body mass index (BMI), occupational influences and non-work related exposures. Till date there is no retrievable research work which has tried to analyse the lower extremity work related musculoskeletal disorders in the same population of nurses in India. Hence the objective of the current study is to find the prevalence of lower extremity work related musculoskeletal disorders among nurses.

Materials and Methods: Demographic data form and Nordic Musculoskeletal questionnaire (NMQ). The study design is a cross Sectional study. 116 participants who Practicing nurses of either gender, in the age group of 20-60 working in hospitals were included in the study. After receiving the necessary permission, clearance and explanation those who willing to participate in the study was recruited for the same after signing the written informed consent form. Then subjects were screened for the inclusion and exclusion criteria.

Results: Sixty-one point one of the nurses have had WRMSDs once or more in their occupational lives. The 12-months period and point prevalence rate of WRMSDs at any body region was 64.7% and 53.4% respectively. WRMSDs occurred mostly in low back (13.8%), hip (1.7%), knees (11.2%) and Ankle (9.9%). Nurses with > 10 years of clinical experience are about more likely to develop WRMSDs.

Conclusion: A high proportion of nurses reported WRMSDs at some body site in their occupational lives with the low back being injured most followed by lower extremities. Educational and interventional strategies for LE-WRMSDs are required.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 24: Need for Psychological Stress Management in Cancer Patients, in Two Occupational Groups

Kshama Vairagi 1, Gauravi Mishra 1

Abstract

Introduction and Background: Occupational stress refers to the ongoing or progressing stress, an employee experiences due to the responsibilities, conditions, environment, or other pressures of the workplace. This stress can further be aggravated because of major illness such as cancer. Psychological Stress Management is essential to reduce the stress levels. Stress Management consists of making changes in life and managing response to stressful situations when they occur. The present study is a part of a research conducted for Psychological Stress Management for cancer patients.

Objective: To assess the Psychological Stress level in the cancer patients before and after counselling in two occupational groups. To provide counselling services for stress management.

Materials and Methods: Cancer patients visiting Indian Management Academic, Ahmadabad, were included in the study. Two categories of occupation, that is, Business and Service people were included in the study. A sample of 100 Business and 100 Service people, who agreed to participate, were enrolled on first come first basis. The Stress Metre Questionnaire was used as Instrument of Testing, to assess Psychological Stress level. The same Questionnaire was used for Post Counselling. Monthly, counselling sessions were conducted for three months.

Results: The stress level was found to be high in both the groups before Psychological counselling. 73% business population were under high stress before counselling which reduced significantly (P value =0.0001, 95%CI = 28.52-53.28) after counselling and only 31% were under high stress. 57% service population were under high stress before counselling which reduced significantly (P value =0.0001, 95%CI = 18.49-43) after counselling and only 25% were under high stress.

Conclusion: Psychological Counselling contributes in reducing work related stress level, in Cancer patients, in working population. Psychological Counselling is recommended for general population, as per Psychological assessment and requirement.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 25: Respirable Pet Coke Dust Exposure Reduction at Crusher Unit, Gasification Complex through Effective Control Methods

Hemal Chaniyara 1

Abstract

Aim and Objective: The primary objective of the study was to reduce exposure of pet coke dust and its health hazards to the workers. To access exposure, airborne exposure measurement (breathing zone samples) of respirable particulates (< 4 microns) was collected for identified workers.

Methods: To access exposure, airborne exposure measurement (breathing zone samples) of respirable particulates (< 4 microns) was collected for identified workers. The airborne contaminants were measured near to the breathing zone with approved method NIOSH 0600 to detect the Petcoke (Respirable) dust. The dust was collected using personal sampler (Make-SKC, Model-Air Check 2000 & 5000) at a flow rate 2.5 Lpm for the duration of 7-8 hours. The sample was collected on 37 mm PVC filter having pore size of 0.5 microns.

Intervention: After Qualitative and quantitative survey, meeting with all stakeholders conducted. Control measures (Water fogging, close cabins for operators, appropriate PPEs) identified according to hierarchy of controls

Results: In baseline survey, out of six samples all samples were found above the occupational exposure limit recommended by ACGIH. The exposure limit was compared with Anthracite coal dust due to similar property structure of petroleum coke. After implementation of control measures, exposure was found within limits.

Conclusions: Effective control measures implementation and awareness for hazards control and PPEs helps in reduction of pet coke dust exposure to the workers. This will ultimately help to maintain workforce healthy.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 26: Evaluation of Occupational Health Risks on Ragpickers of Ahmedabad

Divya Fulwani 1, Divya Chandel 1

Abstract

Introduction and Objectives: Rag picking is one of the inferior economic activities which includes collecting, sorting and selling of recyclable waste materials from dumping sites and is largely undertaken by Women and Children belonging to socio-economically backward sections. They are highly susceptible to diseases due to exposure to hazardous waste materials while working on dumping sites. Hence, the present study was aimed to analyse the socio-economic and health status of women rag pickers at Pirana dumpsite, Ahmedabad.

Materials and Methods: A total of 250 female individuals have been included out of which 160 were rag pickers from the dumping site and 90 were age-matched controls with same socio-economic background. An informed consent and detailed Performa were filled for both the groups. Statistical analysis was done by 'chi-square test' using Graph-Pad Prism – 6 software.

Results: The rag pickers showed significantly higher musculoskeletal disorders as they carry heavy loads of materials over long distances. Some of these rag pickers had suspected tuberculosis. Significant prevalence of headache, fever, cough, nasal irritation, dimness of vision, throat congestion, injuries through sharp materials, irregular menstruation, hypertension and weight loss were observed in them compared to controls. Inhalation of noxious gases like methane lead to respiratory ailments amongst these rag pickers. They also complained about frequent skin infections due to pathogen transmission and severe gut infections.

Conclusion: This study reveals that women rag pickers had financial constraints and were malnourished. They developed addictions of chewing pan and tobacco which act as confounding factors and could further aggravate the effects of occupational exposure. Due to increased exposure, exertion and stress, the rag pickers developed hormonal imbalance leading to further health deterioration. Lack of precautionary safety measures and unawareness regarding health were the main causes of such health issues.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 27: Occupational Stress, Job Burnout and Associated Factors in Doctors of Government Hospitals in Delhi, India

Monalisha Sahu 1

Abstract

Occupational stress is a generally treated as normal component of life and a number of mechanisms exist to cope with its effects. The stresses that challenge doctors in current society may result in failure of these coping mechanisms with resultant stress-induced illness. The purpose of this study was to explore the status of stress and the job burnout of doctors and the variables associated with this in Delhi. The sample consisted of 247 doctors from three hospitals Delhi. The occupational stress inventory revised edition was used to measure the two dimensions of occupational adjustment (including occupational stress and coping resources) and the Maslach Burnout Inventory-General Survey was used to measure burnout. The participants' scores were evaluated and analysed.

The main results were as follows. The scores of job burnout of the obstetricians, orthopaedicians and physicians were significantly higher than the others (p < 0.05). The score of exhaustion (EX) was significantly higher in the 30- to 40-year age group than that in any other groups. The score of occupational stress (OE) decreased with age. Occupational stress was significantly positively related to all burnout dimensions (p < 0.05), while coping resources correlated negatively to all burnout dimensions.

On multiple regression application, the main significant predictors of EX were role overload, responsibility, lack of infrastructure and resources. The main significant predictors of OE were role insufficiency, lack of social support and cognitive coping (p < 0.05).

Measures like institutional efforts aimed at reducing occupational stress by adding counselling session and strengthening their coping resources could help prevent job burnout.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 28: Visual Impairment and Ocular Co-Morbidities among Salt Pan Workers – Study Results from Occupational Optometry Services of Tertiary Eye Care Centre

Rashima Asokan 1, Dhanalakshmi S 1, Janani S 1, Santanam PP 2, Krishnakumar R 2

Abstract

Introduction and Objectives: Salt pan workers are exposed to salt vapours, UV light exposure and glare which can cause ocular problems. The current study aims to assess the ocular comorbidities among the salt pan workers

Methods: Salt pan industry located at a coastal region, Marakkanam in Tamil Nadu was identified for the current cross-sectional study. Comprehensive eye examination was performed for all the workers. Eye examination included detailed history including assessment of symptoms such as irritation, glare sensitivity and vision related problems, refraction, intraocular pressure assessment, slit lamp examination to assess the anterior segment of the eye and fundus photography to assess the posterior segment of the eye.

Results: We have recruited 100 employees of a salt pan industry of which 43% were male and 57% were female. Their mean age was 52.3 years (SD: 11.5). The mean years of experience was found to be 23.3 (SD: 12.4). We observed that 80% of the patients had complaints of difficulty in vision of which 9% had mild, 25% had moderate and 9% had severe visual impairment. We found refractive error (17%), cataract (25%) and retinal Pathology (1%) to be the reasons for visual impairment. Musculoskeletal disorder complaints were noticed in 50% of the workers. The major ocular complaint was glare (64%) followed by irritation (18%). On anterior segment evaluation we found 16% of workers to have pterygium, 22% to have pinguecula and 33% have cataract. 18% were already using spectacles and 70% were prescribed with new glasses of which 95% were prescribed with photochromatic to avoid glare.

Conclusion: The current study enumerated the ocular comorbidities among salt pan workers. Majority of them had ocular surface changes and cataract due to exposure to UV light. The study recommended the use of photochromatic spectacles while at work.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 29: Prevalence of Risk Factors and Detection of Oral Cancers and Pre-Cancers among Mumbai Police

Vasundhara Y Kulkarni 1, Gauravi Mishra 1, Sharmila Pimple 1, Kunal Oswal 2, Alay Parikh 2, Heena A Shaikh 1, Parmesh CS 1

Background: The morbidity and mortality attributable to oral cavity cancers can be reduced by tobacco control, tobacco cessation and oral cancer screening. Police work is considered as a stressful occupation and many are addicted to tobacco and alcohol.

Objectives: To identify the prevalence of risk factors for oral cavity cancers among Mumbai Police and screen them for early detection.

Materials and Methods: A cancer awareness and oral cavity screening camp was organised for Mumbai Police. Totally, 206 police men participated. Their risk factor profile was recorded in a questionnaire, followed by invitation to participate in cancer awareness and oral cancer screening by oral visual Inspection. Screen positives were referred to Tata Memorial Hospital for further diagnostic procedure, treatment and tobacco cessation. In this abstract we present the data of 206 police men. We are initiating screening camps for Police personnel and would be compiling data of thousand participants in the final presentation.

Results: 206 police personnel were enrolled. 69 were tobacco users (33.49%). Amongst them 42 (60.86%) were screen positive for oral pre-cancers and one was diagnosed with invasive oral carcinoma. 27.1% were alcohol users. According to univariate analysis, male gender, belonging to age group 40-50 years, being smokeless tobacco user and alcohol users were significant predictors of oral pre-cancers, while graduates and above were significant protective factors. In multivariate logistic analysis, being male, OR 5.76 (CI 1.21-27.52; p = 0.028) and being a smokeless tobacco user, OR 31.43 (CI 11.3-87.5; p < 0.001) were significant predisposing risk factors for oral pre-cancers.

Conclusion: The findings of this study suggest that tobacco and alcohol addiction are high among Mumbai police and has resulted in very high incidence of oral pre-cancers as noted in this screening programme. There is an urgent need for implementation of de-addiction services and oral cancer screening for Police workforce.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 30: Visual and Ocular Profile among Drivers in Automobile Industry

Dhanalakshmi S 1, Janani S 1, Rashima A 1, Krishnakumar R 1, Santanam PP 2

Abstract

Introduction and Aim: Automobile industries have various sectors where drivers are engaged in accessing different types of vehicles. The current study aims to assess the visual and ocular profile among drivers in automobile industry.

Materials and Methods: Drivers were screened for ocular pathologies in the occupational optometry camp at a private automobile industry from June 2019 to July 2019. All underwent comprehensive eye examination by a team of trained occupational optometrists. Comprehensive eye examination includes History taking, Clinical refraction, Colour Vision testing, Binocular vision assessment (stereopsis - forklift operators), Confrontation testing, Anterior segment evaluation, Intraocular pressure check-up, Posterior segment examination, Counselling, providing visual fitness certificate and issuing prescription for drivers in need.

Results: A total of 1089 drivers were examined. The mean age of these subjects were 33 ± 8 years. They were bus drivers (263), forklift operators (218), reach stack operators (4), car drivers (361), tow truck operators (187) and truck drivers (32), tractor drivers (4) ambulance drivers (20). Common ocular symptoms presented were vision related complaints 107 (10%) headache 17 (2%) and other complaints (Irritation, watering and redness) 15 (1.3%). Uncorrected refractive error was found in 266 (24.42%) and were dispensed with spectacles, and 39 of them were asked to continue to use their old spectacles. Twenty-four (2.2%) employees were diagnosed with colour vision defects. However, employees did not have any difficulty in seeing traffic signals (Inside the plant/on road) and control lights at work place. Anterior segment abnormalities were observed in 439 employees (meibomitis-81, pingecula-176, pterygium-51, lenticular changes-90 and cataract- 9. Posterior segment abnormalities were noted among 31 drivers out of which 58 were referred to tertiary eye care centre for further evaluation

Conclusion: This study shows that 266 employees require spectacle correction and 58 employees require further examination in tertiary eye care centre and depicts importance of spectacle correction while driving.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 31: Near Visual Correction and the Spectacle Compliance among the Hairdressers in Unorganized Sector

Janani S 1, Santanam PP 2, Rashima Asokan 1, Krishnakumar R 2, Dhanlakshmi S 1

Abstract

Introduction and Objectives: Hairdressers are prone to more occupational health risks such as prolong standing usually with poor posture, mechanical load on joints and long working hours with no breaks. Their work also demands high visual need and there is no study on visual needs of the hairdressers. This study aims at assessing spectacle compliance and visual performance at work among hairdressers in unorganized sector.

Materials and Methods: Visual task analysis was carried out in different saloons at Chennai and Visual demand for various tasks is determined. The worker in saloon performs various tasks like haircutting/trimming, beard and moustache shaving, removing grey hair from moustache and applying hair dye. Near visual acuity and, depth perception was found to be demanding visual factors for this occupation. With battery of tests identified following visual task analysis, comprehensive eye examination was done for 258 male hair dressers. Spectacle intervention was provided for the workers who did not meet the required visual demand for their work. Following the eye examination, spectacle compliance was assessed 1 month from spectacle dispensing.

Results: Among 258 male hairdressers with mean age of 49 years (SD: 6.1), 175 of them were prescribed new spectacles. On assessing the spectacle compliance, 90% workers were compliant with spectacles. 71% workers reported with increased work efficiency and better visual performance during various task at their work.

Conclusion: Current study provides vision standards and battery of test to be done for the occupation, hair dressing. It also showed that there is improvement in work ability with the near vision correction.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 32: Review of Abnormal Chest x-rays during Pre-Employment and Periodic Health Check-Up in Reliance Corporate Park

Vivek Malpure 1, Jyothykumar S 1, Satish Patkar 1

Abstract

Introduction: Chest radiography is a diagnostic tool that is widely available, non-invasive and relatively inexpensive. It is one of the initial examinations in individuals suspected of having chest disease of any cause. Hence it is being extensively used not only in symptomatic patients but also in asymptomatic individuals as a screening tool in preventive Health check-ups. Chest X-ray is a mandatory part of health check-up in factory set up where inhalational chemical exposure is present. But in corporate office set-up its routine use is debatable.

Aim: 1. The aim of this study was to review the abnormal chest X-rays presenting during health check-up for the period of one year & determine the prevalence of various radiological abnormalities. 2. To specify the importance of chest radiography as a screening tool in view of associated radiation hazards.

Materials and Methodology: A retrospective review of the chest X-rays of employees and pre-employment candidates undergoing health check-up in reliance corporate park was carried out for a period of one year. Chest X rays of 5130 employees were examined. Result: Out of 5130 radiographs, 5022 (97.9%) were normal but 108 (2.1%) presented abnormal images. The observed lesions were dominated by parenchymal lesions (56 cases), pleural lesions (22 cases), cardiac abnormalities (14 cases) followed by diaphragmatic variations (11 cases). Out of 78 pleuro-parenchymatous abnormalities 26 were having active disease process requiring further evaluations & treatment. One of the cardiomegaly cases was diagnosed as pericardial synovial sarcoma.

Conclusion: Chest radiology is an invaluable tool and of utmost necessity in pre-employment & periodic health check-ups in the corporate set-up, enabling occupational health physicians to screen for pleuro-parenchymal lesions as well as some of the cardiovascular abnormalities that may be undetected during routine clinical examination.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 33: Snakebite and its Treatment-Seeking Behaviour among Agriculture Labourers in the Rural Area of Lucknow

Absar Ahmad 1

Abstract

Background: Snakebites cause considerable morbidity and mortality worldwide which can be reduced through awareness of the population to avoid snakebite and to take preventive actions and prompt management

Objectives: To study the knowledge of snakebite and its first aid management among agriculture labourers in Lucknow district in Uttar Pradesh, India

Methods: A cross-sectional study was carried out in four adopted villages under the Rural Health Training Centre of Career Institute of Medical Sciences and Hospital in October 2018. Agriculture labourers were identified through house listing.

Results: A total of 200 agriculture labourers were studied among which more than three-fourths were males, constituting about half of them in the age group of 21-40 years, were studied. Forty-three percent of labourers had knowledge about the differentiating features between poisonous and non- poisonous snakes on the basis of the colour of dorsum, habitat, and size. The knowledge of complications occurring after snake bite was found to be significantly associated with caste (p < 0.01) and religion (p < 0.05) of the labourers. The Knowledge of first aid and treatment of snakebite was also significantly related to the religion of the labourers (p < 0.05).

Conclusion: It is important to implement awareness programs on snake bite especially in the community at risk in a rural area such as agriculture labourers. Therefore, there is a need to educate the labourers in order to increase awareness about the first aid treatment related to snakebites.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 34: Impact of Accreditation on the Quality of Healthcare Services (Study on DAOH and FWC, JCI, NABH, NABL Multispecialty Hospital)

Nasib Narayan Jha 1, R Rajesh 1, Paresh Shah 1, Amit Raiyani 1

Abstract

Aim and Objective: Accreditation is usually a voluntary program in which trained external peer reviewers evaluate a healthcare organizational compliance and compare it with pre-established performance standards. The aim of this study was to evaluate the impact of accreditation programs on the quality of healthcare services.

Materials and Method: We did a systematic review of the policies, standard operating procedures (SOPs), guidelines as per JCI, NABH and NABL standards and objective elements to evaluate the impact of accreditation programs on the quality of healthcare services.

Results: We evaluated the impact of accreditation for medical emergency services, trauma, surgical care, infection control, pain management, fall risk, laboratory quality control, chemical hazard management, equipment management, utility services and contractual services management. It was found that there is significant improvement in the process/level of care provided by healthcare services by improving the structure and healthcare facilities system. Our study also showed that accreditation programs greatly improved clinical outcomes and the quality of healthcare services and also found enormous positive impact in different subspecialties including emergency management, trauma management and industrial disaster management.

Conclusion: There is consistent evidence that shows that accreditation programs improve the process of care provided by healthcare services. There is considerable evidence to show that accreditation programs improve clinical outcomes of a wide spectrum of clinical conditions. Accreditation programs should be supported as a tool to improve the quality of healthcare services

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 35: Relationship Between DNA Damage & HSP70 In Workers Exposed to Occupational Heat Stress

Manikandan 1, Latha PK 1, Rekha Shanmugam 1, Solomon FD Paul 1, Vidhya Venugopal 1

Abstract

Introduction: Workers exposed to chronic high-heat conditions in their work place for prolonged periods may potentially be subjected to high physiological strain with cell injury, genetic damage and consequent up regulation of HSP70, that act as protective molecular chaperones to repair damaged proteins.

Methods: We conducted a cross-sectional study among workers exposed to chronic high-heat occupational environments (n = 76) and unexposed workers (n = 44) from 4 sectors. Quest Temp WBGT monitor was used to evaluate heat exposures and heat strain indicators viz., Core Body Temperature, Sweat Rate and Urine Specific Gravity were quantified using standard protocols. In the blood lymphocytes, DNA damage was estimated by Micronucleus test and HSP levels using RT PCR.

Results: WBGT ranged between 22.1°C – 41.7°C in various work sectors. Physiological strain as indicated by the rise in CBT >1°C, SwR > 1 L/hr and USG > 1.020 was higher among exposed workers compared to the unexposed workers. There was significant DNA damage in exposed workers compared to the unexposed workers (X2=47.1; p < 0.0001). The frequency of MN in exposed workers and unexposed workers was 59 vs 5. Exposed workers had 23 times higher risk of DNA damage (Adj. 95% CI 8.003-70.81, p=<0.0001) compared to the unexposed workers even after adjusting for all confounders. HSP70 up regulation was higher among the exposed group compared to the unexposed group with a statistically positive association (t =-132.68, df = 127.84, p-value < 0.0001). A significant strong negative correlation between HSP70 and DNA damage among the exposed workers (r = -0.80, p < 0.0001) was observed.

Conclusion: This preliminary study results show that heat exposures induces DNA damage and up regulation of HSP70 among workers with chronic high-heat exposures and indicate a clear association between DNA damage and HSP70 levels in human subjects.

Keywords: DNA damage, HSP 70, lymphocyte, micronucleus, occupational heat stress

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 36: Work Related Physiological Exertion and Psychological Stress among Flower Farm Workers of Sarjapur Primary Health Centre, Bangalore Urban District

Madonne Rufina Dishani M 1, Jackson Thomas 1, Avono Dominica 1, Jeena Chacko 1, Geofferey Bareh 1, Twinkle Agrawal 1, Farah Naaz Fathima 1

Abstract

Introduction: Flower farm workers are exposed to chemicals, extremes of temperature, physical strain leading to risk of respiratory tract diseases, heat cramps and musculoskeletal problems resulting in physiological exertion and psychological stress.

Objective: To assess the level of physiological exertion, psychological stress and their associated factors among flower farm workers in Sarjapur PHC area.

Materials and Methods: A cross-sectional survey was conducted among all the 197 adult flower farm workers of Sarjapur PHC area. A structured interview schedule was used to assess socio-demographic characteristics. Physiological exertion during work was rated using Borg's rated perceived exertion scale with a score age;13, indicating hard exertion. Stress was measured using perceived stress scale with a score age;14, indicating presence of stress. Blood pressure and pulse rate were measured using digital blood pressure measuring device.

Results: Mean age of the study participants was 44.4 +/-14.0 years with similar proportion of males and females. While harvesting flowers, 39.2% of study participants perceived hard level of physiological exertion and 56.9% perceived stress. Being married (χ2= 5.55), tobacco consumption ((χ2= 11.29), high blood pressure (t statistic = 7.28) and increasing pulse rate (t statistic = 3.29) were significantly associated (p < 0.05) with higher physiological exertion. Increasing age (t statistic = 0.58), low socio- economic status ((χ2= 8.19), tobacco consumption ((χ2= 14.92), high blood pressure (t statistic = 6.89), hard level of exertion ((χ2= 35.35) were factors significantly associated (p < 0.05) with higher level of perceived psychological stress.

Conclusion: Flower farm workers experience high levels of physiological exertion and psychological stress. Tobacco consumption and high blood pressure were associated with both physiological exertion and psychological stress. Health education on harmful effects of tobacco, blood pressure monitoring and psychiatrist evaluation for those with high stress are recommended to reduce the factors associated physiological exertion and psychological stress.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 37: Tobacco use amongst the Unorganized Zari Workers

Parishi Majmudar 1, Sharmila Pimple 1, Gauravi Mishra 1

Abstract

Introduction and Objectives: In India, around 43.7 crore people work as unorganized labours. They face various problems such as job insecurity, occupational hazards, poor wages, lengthy working hours, migration issues, poverty and indebtedness, etc. The present study is a part of a larger study related to tobacco cessation for Zari Workers population, conducted by Department of Preventive Oncology, Tata Memorial Hospital, Mumbai. The following are the objectives of this study: To assess the socio-demographic features of Zari Workers in Mumbai. To assess the tobacco, use among this population. The assess reasons attributed to tobacco use by the participants. To create awareness on health hazards of tobacco.

Materials and Methods: Owners of Zari Work Units were approached in Dharavi and Govandi. The workers, who consented and whose Unit Owners permitted, were included in the study. Thus, the first 300 workers, from each area, were taken as participants. A single unit, on an average had 7 to 8 workers. A Pre-Intervention questionnaire was administered for all the participants. Health Talk on health hazards of tobacco and counselling were provided, in each Unit, even for non-participants.

Results: All the Zari Workers were males with minimum education. Majority had migrated from Bihar and 95% were staying and working at the same place. They lived in the small working place with colleagues. Almost 60% had long working hours. More than 70% used tobacco among which smokeless tobacco was prevalent. Majority attributed tobacco use to the inappropriate working conditions.

Conclusion: The prevalence of tobacco use is high among Zari Workers. This may be attributed to a large extent to the non-conducive working and living conditions. Tobacco control efforts are required for unorganized labour.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 38: Multicomponent EMS Approach Including Capacity Building, Clinical Audit System and Innovative Actions for Quality Emergency Services

Sunny Girish Jani 1

Abstract

Aim and Objectives: The aim of implementation of multicomponent EMS approach is to improve patient outcome in emergency and making it at par of global EMS system.

Methodology:

  1. First responder capacity building scoring system

  2. Clinical audit of emergency handling (emergency assessment compliance)

  3. Objective based mock drills and audits

  4. Emergency preparedness scoring

  5. Customer satisfaction index measurement

Interventions and Approaches:

Capacity building

  • Paramedic evaluation scoring system implementation - Scoring system has parameters like communication, On site assessment, assessment during transfer, BLS, ATLS skills etc

  • In house- BLS, ACLS (advance cardiac life support), ATLS (Advance trauma life support) course development

  • Training through international faculties.

Emergency assessment compliance – clinical audit system

  • Emergency assessment audit includes audit of parameters like doctor's emergency assessment, care plan, Initial nursing assessment, Patient monitoring during transfer, referral note etc.

EMS scoring system: changed from subjective to objective basis and more weightage given to structured mock-drills and trainings.

Innovative actions

  • Weight based Colour coded drug dose chart and crash cart development, empower competition (EMS competition amongst first responders), EMS cards, GPS based tracking of ambulance response implemented.

Result: Multicomponent EMS approach improves paramedic capacity in emergency management. Paramedic evaluation score improves from 6/10 to 7.5/10. Baseline compliance in emergency assessment improves from 85% to 94%. EMS scoring improved and sustained above 93%. Overall improvement in quality of emergency services and patient outcome.

Conclusion: Multicomponent EMS approach significantly improves the first responder capacity, golden hour management and overall emergency preparedness which delivers best quality care as per global standards.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 39: Calorific Assessment of Food Served in an Industrial Canteen

Priyadarshini Gunaseelan 1, Bala Venkataramani 1, Paari Krishnan 1, Seshadri Varadarajan 1

Abstract

Objectives:

  • The primary objective of the study is to assess the calorific value of food provided in the canteen of a manufacturing industry in Chennai.

  • The secondary objective is to ascertain if it meets the protein needs of a worker. Administer a meal satisfaction questionnaire with scoring on Likert's scale on a representative population of the workers.

Materials and Methods: 1 month menu of food provided was collected between 01.04.2019 to 30.04.2019 were collected in a proforma. The Canteen team also aided the investigator in portion size calculation based on the absolute raw material used and also volume of the katori used in food service. A pre validated food satisfaction questionnaire was administered on a representative population on simple random sampling.

Results: The Canteen is open throughout the day. They provide vegetarian food only. Average calories content of food provided across the various shifts is 1661.92 calories. The average fibre provided per person is 27.89 grams. The mean protein provided irrespective of shift is 50.58 grams (almost 85-90% of protein requirement of an average adult. Descriptive statistics on employee satisfaction of the food provided in their canteen is shows that the food served to them was hot and refilled at prompt intervals. The variety and taste scored averagely.

Conclusion: The average calorie provided by the factory is 1661.9 calories. The average protein provided in 50.58 grams and average fibre provided is 27.89 grams. The energy, protein and fibre provided are calculated from the actual quantity of food cooked. This might not ensure that every worker is getting the RDA of each nutrient thus making wise informed food choices imperative by each and every employee. Ignorance, indifference and improper selection are causes of poor food habits.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 40: Quality of Life of Medical Residents in Teaching Hospitals of Pune – A Cross-Sectional Study

Zubin Ajay Mahajan 1, Sameera Rajendra Mehta 1, Varsha Vaidya 1

Abstract

Introduction: Quality of life (QOL) is defined as the standard of health, comfort, and happiness experienced by an individual or group. This article discusses the issue of health and QOL of medical residents.

Objectives: To assess and compare QOL of medical residents across various departments in government and private hospitals of Pune.

Materials and Methods:

Study design-Cross sectional descriptive.

Study population- Medical residents of government and private hospitals of Pune who have been enrolled for at least 6 months in residency.

Study duration- January-May 2019.

Study tool- Pre-structured online questionnaire.

Sample size- 293 residents.

Tests for statistical significance- Chi Square Test.

Results: Threats and abuses from patients' relatives were experienced by 28 (9.55%) residents Anxiety and depression were experienced by 171 (58.36%) residents.

Conclusion: The overall satisfaction is more with residency programs of private hospitals because of better work life balance. During medical graduation, students should adequately assess various residency specialities and then choose a speciality that is suitable for their expectations and working capacity. It is necessary to follow strict guidelines regarding working hours thereby preventing burnout and improving efficiency and QOL of the residents as well as preventing its detrimental effect on patient care.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 41: Ocular Glitches – Threat to Road Safety!

Vidya Kiran Bhat 1, Rishikesh Naik 2

Abstract

Introduction: In India, the total deaths due to road accidents is around 1,50,000 per year which is equal to 400 accidents per day. In 2017, road accidents led to 3 deaths every 10 minutes. 45% accidents are happening on national & state highways. In this regards, fitness of truck drives is of paramount importance. Aditya Cement works recognise this risk and proactively implemented occupational health program in this regard.

Methods: Occupational Health services of Aditya cement works with marketing team and local truck driver association, conducted Medical examination of 30 truck drivers every Thursday of week at OHC. Health promotion and corrective actions are supported.

Result: All the parameters of Medical examination as company driver/HEMM operator are checked including proper vision tests. The point of discussion here is alarmingly high rate of (33%) visual acuity problems found among Truck drivers as shown in table below. All these cases were referred to ophthalmologist for further checks and corrective glasses were provided free of cost.

Total Truck Driver Medical Examination

Age in years Total No. Tobacco addiction HTN DM Vision Defect Abnormal ECG
20-30 142 69 6 0 9 2
31-40 151 72 19 0 44 3
41-50 108 59 22 11 62 6
51-60 34 13 10 2 29 5
Total 435 213 57 13 144 16
Open in a new tab

Conclusion: 33% of truck drivers having unidentified vision defects is a risky situation and warrant immediate attention. A focused and unique approach of dedicated checks of drivers and followed up till corrective glasses are provided, has been found very useful. If all organisations do this small activity, a huge reduction of on road risk can be achieved.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 42: Work Demands and Chronic Low Back Pain: 18 Months Worker Follow Up

Florentino Serranheira 1, Antãnio Sousa-Uva 1, Mafalda Sousa-Uva 1, Francisco Heranz 2, Francisco Kovacs 2

Abstract

Low back pain (LBP) and other musculoskeletal disorders are among the main causes of work disability, and absenteeism, namely when worker physical demands exceed their capabilities. This study aims at analysing the associations between physical demands at the workplace, LBP episodes, and LBP related absenteeism among workers with different occupational backgrounds in an 18 months follow up. Four companies participated in the study, including one public hospital, two large privately owned companies, and a state-owned company (A, B, C and D). Workers completed a first questionnaire providing data on socio-demographic profile, professional background, general health, LBP characteristics in the last 12 months, and intensity of work physical demands. After 18 months workers were asked for LBP symptoms and related absenteeism.745 workers completed the questionnaire. Most were female (51.4%), manual workers (52.3%), work at night (21%), and 11.6% in shifts. Regarding the intensity of work-related physical demands, 38.7% performed a sedentary work; 34.2% work with low to moderate physical environment; and 27.1% had a physically demanding work. Most of individuals (43.3%) considered their work as sedentary. About 70% of self-reported participants had experienced between one or two episodes of LBP in the last 12 months (1st questionnaire), which lasted within 2 to 14 days in 76.5% of the cases. At the second moment (2nd questionnaire) 255 (31.9%) workers have LBP and 198 (24.8%) still present LBP after 18 months. Some workers (6.3%) had been on sick leave for LBP at some point during the previous12 months (1st questionnaire), and the mean duration of the sick leave was 31 days. Only 15 (2.3%) workers were absent from work during the 18 months between the questionnaires. LBP related absenteeism was associated with subjects with a work with intense physical demands.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 43: Occupational Risks Associated with 532 nm CW Laser Exposure on Skin and Eye

Kiran Bora 1, Bhuvnesh Kumar 1, Satish Chauhan 1, Satya Prakash 2, Pronobesh Chattopadhyay 3

Abstract

Introduction: Over the past decades, green lasers have gained widespread applications in medical and military sectors such as treatment of vascular & pigmented lesions, tattoo inks, development of non-lethal weapons. Unfortunately, with expanding utility, various accidental and targeted injuries have been reported. Our study, here, is aimed at investigating the effects inflicted by different doses of 532 nm CW laser on exposure to skin and eye.

Methods: Dorsal hair of male Sprague-Dawley rats were shaved and irradiated with single probe 532 nm CW laser at 0.1, 0.25, 0.5, 1 and 1.5 W/cm2 for a duration of 10 sec. Temperature fluctuations post exposure were recorded using IR thermal camera. Green laser induced effects on skin were evaluated through histopathological analysis followed by expression profiling of various tissue damage markers such as TNF-α, PARP1, caspases, ceramide, etc and via fundoscopy and OCT in Dutch-Belted rabbit eyes, respectively.

Results: Significant elevation of tissue damage markers viz. TNFα, PARP1, caspases, ceramide, bradykinin etc was observed following laser irradiation on skin, followed by noteworthy histopathological changes exhibiting dose-dependent alterations such as epidermal ulceration, dermal necrosis and collagen damage at medium and higher fluences with respect to non-irradiated sham group. Development of clearly visible superficial haemorrhage in the eye was observed in exposed group at higher fluences 24 h post exposure.

Conclusion: Present study outlines the CW green laser associated skin and eye damage at and above 0.5 W/cm2 and 300 mW/cm2 respectively. Higher laser fluences has demonstrated elevation of various tissue damage markers in skin accompanied by dose-dependent damage at tissue level like neutrophilic debris accumulation, epidermal ulceration, collagen damage, whereas development of superficial haemorrhage was observed in the eyes. Our study, thus, helps in comprehending the occupational risks associated with green laser exposure which would help in determining probable outcomes to ameliorate laser-inflicted injuries.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 44: Musculoskeletal Disorder (MSDs) Condition at the Offices in Tata Steel

Abdul Malik 1

Abstract

Introduction: Application of the knowledge of the Ergonomics principle is a multi-disciplinary approach concerning with the interaction/ interface between the man-machine /work equipment and man working process occupational musculoskeletal disorder is a common problem among office workers specifically IT professional who are used to perform work in a fixed table, chair, computer setup for hours together day after day. Repetitive and forceful awkward posture leads to development of occupational musculoskeletal disorder. Poor work stations setup, awkward posture, lack of physical exercise, inadequate self-care is the major source of musculoskeletal disorder. Through this survey conducted by prepared questionnaire we want to explore / investigate work factors and the magnitude of various types of health problems faced by IT professionals and application of Ergonomics principles suggesting remedial measures.

Objective: To describe the prevalence, characteristics and impact of musculoskeletal disorders (MSDs) in IT professionals in Tata Steel.

Materials and Methods:

Type: ILO Ergonomics checkpoints, Duration: 3 months (July – August 2019)

Inclusion Criteria: All employees, male and female of IT department

Sample size is 116, Number of male employees-88, Number of female employees-28

Results and Discussion:

  • 24% employees have discomfort /stress/pain in their lower back.

  • 9% of employees have both neck and Lower back pain.

  • 7 employees were hospitalized due to lower back problem and 2 due to neck problem.

  • Employee responds that their work activity is slowed down due to the discomfort / stress / pain the body parts.

Conclusion: In view of the high prevalence of musculoskeletal disorders due to the poor design of the chair and the workstation. Change required in the design of chair and the workstation as well as the awareness of the stretching during the working hours.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 45: Evaluation of Respiratory Health of Construction Workers using SGRQ Questionnaire: Vapour Gas Dust Fumes (VDGF) Study Group

Omkar Kalidasrao Choudhari 1, Umesh Chandra Ojha 2

Abstract

Introduction: With the growing economy and development of infrastructure, the construction industry is growing at a rapid pace and comorbidities among workers are also raised. Since workers in the unorganised sector have to depend on the public health sector/private for their healthcare needs which is already overwhelmed with numbers. So the data pertaining to occupational induced respiratory disorders are sparse. To add to this is poor training pertaining to occupational health and time constraints makes healthcare worker at a disadvantageous position.

Objectives: To evaluate the respiratory health status of construction workers in an unorganized sector

Materials and Methods: The data is collected from various regions in the unorganised sector of construction workers by the Institute of Occupational Health and Environmental Research, Basaidarapur, Delhi. A Hindi validated Saint George Respiratory Questionnaire (SGRQ) was used with prior permission. All the participant response was noted and the answers were evaluated to see the respiratory health status of workers.

Results: Total of 100 workers were evaluated. A total of 91 males and 9 females participated in the study.55% of the participants were smoker. At the time of study only 44% workers felt healthy and free from any respiratory complaint. In last 3 months from the date of study, all the workers had one or more episode of chest related complaints while,78% workers have one or more episodes of sputum expectoration and 68% of workers have breathlessness and wheezing, predominantly in smokers.

Conclusion: The participants of this questionnaire- based study were not on any treatment from any clinic/Hospital for their respiratory ailment. This signifies an upcoming epidemic among construction workers and the importance of occupational health education, use of Personal protective equipment (PPE) & safe working environment, are immediate things to be addressed. The scenario could just be tip of the iceberg and actual condition could be worse.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 46: 90 Days Weight Loss Challenge: A Short-Term Behavioural Weight Loss Intervention to Manage Lifestyle Disorders among Industrial Workers

Subhasree Ray Kale 1, R Rajesh 1, Paren Shah 1

Abstract

Introduction: Overweight and obesity are significant public health concerns in Indian working population. High BMI and central obesity are two major risk factors for various lifestyle disorders. '90 days weight loss challenge' is a cross-sectional, 90 days long prospective study with a cohort (age = more than 20 years) having BMI of ?25 kg/m2 to assess the effect of short term behavioural weight loss intervention (BWLI) in reducing BMI followed by measuring any significant changes in biomarkers, associated with obesity or overweight induced life-style disorders among industrial workers.

Materials and Methods: Participants (n = 250) enrolled in a 90 days BWLI that included weekly group sessions on lifestyle modification, a prescribed energy restricted-low fat-moderate protein diet and moderate-to-vigorous physical activity. Intervention outcome assessments included weight in Kg, Body Mass Index (BMI), Waist Circumference (WC), Hip Circumference (HC), total lipid profile, fasting & post prandial blood sugar (FBS and PPBS) and glycated haemoglobin (HbA1C).

Results: Compliance was 53.6% (n = 134; BMI: 28.3 (25.2, 35.4) kg/m2). Participants completed 87.5% (76.1%, 95.5%) of scheduled intervention contacts. Weight (mean reduction = 3 (0.1, 13.7) kg), BMI (mean reduction = 2.1 kg/m2), WC (mean reduction = 2.79 (84, 114) cm) and HC (mean reduction = 2.51 (103, 117) cm) decreased (p < 0.01). Physical activity ≥10 minutes increased up to 40 ≥ minutes/day (p < 0.01). Significant changes are observed in other crucial biomarkers.

Conclusion: The 90 days weight loss challenge program produced significant changes in dietary intake and physical activity among industrial workers. The BWLI also elicited favourable changes in weight, BMI and other vital health outcomes to manage lifestyle disorders associated with excess BMI or central obesity.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 47: Case study of Respirable Fly Ash Coal Dust Exposure Reduction in Shutdown Activity at Coal-Based Power Plant

Mayursinh Vaghela 1

Abstract

Introduction: The use of coal combustion for electric power production results in the production of waste products that include coal residue known as fly ash. Workers engaged in maintenance and operations activities may be exposed to airborne coal ash particulates. Coal Fly ash has a relatively small particle size, may easily become airborne, and a significant fraction is in the respirable size range.

Aim and Objective: The aim of the study was to assess exposure of Fly Ash respirable dust exposure during shutdown activity. To assess exposure, airborne exposure assessment of fly Ash was conducted for identified workers.

Methods: To measure breathing zone airborne contaminants, we have considered Helper which was found more likely to be risk of dust exposure. Respirable dust air samples were collected by using personal air sampler with PVC filter used at a flow rate of 2.5 lpm from worker breathing zone during full-shifts according to NIOSH method 600. Results were compared with the current ACGIH threshold limit value (TLV) of 3 mg/m3.

Results: PBZ measurement of Respirable Dust was conducted during the Ash draining activity. All the samples of respirable fly ash dust were found above the action level (50% of TLV) but lower than the Occupational exposure limit.

Conclusion: The respirable dust concentration was found above the 50% of the action level but lower than the Occupational exposure limit. To control the fly Ash exposure during the ash draining activity, we have provided the manual ash handling with pneumatic ash conveying for eliminate the dust exposure and after resampling results were found the within exposure TLV.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 48: Morbidity Profile and Occupational Determinants of Female Class IV Employees (aayas and mehatranis) in a Municipal Tertiary Care Teaching Hospital in Mumbai, India

Sujata Ramachandra 1, Bhaghyshree Gawari 1, Gajanan D Velhal 1

Abstract

Introduction: Occupational health should aim at the promotion and maintenance of the highest degree of physical, mental and social wellbeing of workers in all occupations. The job of being a class IV employee entails several occupational hazards which pose a great danger to the health and wellbeing and life of the worker. Class IV workers are exposed to accidental hazards and suffer from occupational hazards like musculoskeletal and respiratory disorders, eye ailments, skin and gastrointestinal problems and injuries. The problems of women are overlooked and hence are at a major risk of occupational related diseases. The occupational determinants to which female class IV employees are exposed can be classified as under physical, environmental, psychological and as a result of movements. Hence the objectives of the present study to assess the morbidity profile and to study the Occupational Determinants amongst female class IV employees of municipal tertiary care teaching hospital in Mumbai city.

Methods: A cross-sectional study was carried out amongst 287 female class IV employees (Aayas and Mehatranis) of municipal tertiary care teaching hospital in Mumbai during the period of April 2017 to December 2018. A semi-structured interview schedule was prepared comprising of occupational determinants influencing health and morbidity profile.

Results: Data was entered in MS Excel and analysed in the form of percentage and proportions whenever necessary.

Conclusion: In the present study, large proportion of class IV employees suffered from work related symptomatic morbidities mainly of musculoskeletal, respiratory, eye, skin, and gastrointestinal problems, hypertension and diabetes mellitus.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 49: Noise Exposure, Medical Monitoring and Implementation of Control Measures to Mitigate Noise Hazards at Crude Oil Refinery - Effective OH IH Assessment

Sumit Jayantilal Ghodasara 1

Abstract

Aim and Objective: To reduce the noise production in various plant areas in crude industry which ultimately helps to eliminate noise exposure hazards.

Materials and Methods: Through task-based health risk assessment study, annual OH IH surveys and shutdown health risk assessment studies, we have identified various high noise exposure locations (Qualitative Survey). By using Sound Level Meter (SLM), make – 3 M Noise-Pro, quantitative survey done. AC-300 instrument was used for Sound Level Meter calibration. Baseline and follow up audiometry studies done for exposed persons in plant. Meeting done with plant persons, industrial hygienist, safety officers and vendors, Control measures are identified consisting of modification of process, engineering controls, administrative controls and PPEs awareness.

Results: Above mentioned hierarchies methods including Elimination, Engineering Control and Administrative Control give excellent results in noise reduction. FCC plant 109.6dBA to 89.4 dBA, Paraxylene plant 100 dBA to < 85 dBA, CFP plant 110 dBA to < 85 dBA, Hydrotreater plant 95.4 dBA to 91.8 dBA. Audiometry studies are within normal limits.

Conclusion: Noise exposure in high noise area is significantly reduced to optimum level through effective OH IH assessment. This helps to prevent acute and chronic noise exposure health hazards which creates healthy workforce and workplace.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 50: Prevalence of Diabetes and Hypertension and their Risk Factors among Mumbai Police

Heenakauser Aslam Shaikh 1, Gauravi Ashish Mishra 1, Sharmila Anil Pimple 1, Kunal Oswal 2, Alay Parikh 2, Vasundhara Kulkarni 1, Pramesh CS 1

Abstract

Background: The police employment has been identified as a stressful occupation by many research groups. Police personnel face many stress factors like chronic exposure to critical incidents, high responsibility, contact with criminals, heavy work load and irregular duty hours. Thus police workforce becomes a special occupational group, at high risk of Non Communicable Diseases. Currently, there are very few risk factor assessment studies conducted among police personnel in India.

Objectives: To identify the risk factor exposure and prevalence of Diabetes and Hypertension among Mumbai Police.

Methods: An awareness and screening camp for non- communicable diseases was conducted for Mumbai Police at one of the locations in Mumbai. 186 police personnel and 19 family members of police personnel participated in this camp. This camp data of 206 participants has been analysed and presented in this paper. We are soon initiating regular awareness and screening programme for the police personnel and will compile this data of over 1000 participants in the final presentation for the conference.

Results: The prevalence of major risk factors of Non communicable diseases among the police personnel were as follows; tobacco use (33.49%), alcohol use (27.1%) and obesity (70%). The prevalence of hypertension (systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg) was 22% and the prevalence of Diabetes was 17% (Random Blood Sugar ≥ 150).

Conclusion: This program shows high prevalence of major risk factors of NCD among police work force as compared to general population. This has translated in high prevalence of Diabetes and Hypertension among Police personnel as demonstrated in this abstract. Hence, it is utmost important to raise awareness, implement preventive measures and screen this special occupational group to reduce risk factors and ultimately morbidity and mortality among police personnel.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 51: Prevention of Knee and Shin Injuries thereby Creating Ergonomically Safe Work Stations

Leon Andrade 1

Abstract

Introduction and Scope: This is to create workplaces that are, work friendly safe and ergonomically well designed. The work station of the average packer in the FMCG sector involves a conveyor which carries the SKU which has to be packed in cartons. Prevention of injury to the Knee and Shin as well as create an interface between the Occupational Health Consultant, the Engineering Design Dept and the Safety Dept. thus resulting in a safe and ergonomically friendly work station.

Materials and Methods: Absenteeism and subtle complaints of pain in knee/shin area, due to blunt injuries got us thinking. It was observed that the clutter beneath the conveyor was not only unnecessary but involved a number of 'Sharps and Edges' that hampered and sometimes caused injury during the entry and exit into the work, sometimes inclining them to stand during their entire eight hour due to fear of injury and the inconvenient posture they had to maintain. The engineering and safety departments, and Occupational Health Consultant together designed an 'Ideal Work Station'. The Sharps and Edges were eliminated, bare essential equipment was installed, edges were ground, and rounded off and foam packing was placed where required – below the conveyor, seating height was adjusted, thus preventing injuries, creating a level of comfort and seating the worker ergonomically.

Conclusion: Team work between Engineers, Safety Executives and Occupational Health Consultants can actually create magic in terms of safety and workstation ergonomics, thereby preventing injuries, sickness absenteeism and long term illnesses like Muscular Skeletal Disorders. This Document will be substantiated with photographs in the PPT.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 52: Diabetes Control Mission and its Impacts at Hazira Manufacturing Division, RIL 2019-20

Gulamenasir Ahmednasirwala 1, R Gupta 1, R Rajesh 1

Abstract

Background: Diabetes continues to be a disease of epidemic proportions in India. The overall prevalence of diabetes in the country is 11.8%. According to WHO (2014) the global prevalence of diabetes is 8.5%. Diabetes Control Mission (DCM) is a central project of Reliance Industries Limited (RIL). At RIL Hazira we have taken up this program, where all pre-diabetic employees are identified during periodical medical examination (PME) with Fasting Blood Sugar (FBS) from 100 to 125 (698 employees) and uncontrolled diabetes mellitus (DM) cases with Glycosylated Haemoglobin (HbA1C) above 7 (173 employees).

Materials and Methods: Medical Services at RIL identified the employees during PME. The mode of intervention was diet counselling, periodic biomarkers examination and various physical activities. There was a structured intervention in which all identified cases were given personal & group counselling by our doctors & dietician. Specific workout training including stretching, yoga, pranayama, meditation, laughing exercises was done by trained professionals and quarterly follow-up for biomarkers (FBS, PP2BS & HbA1c) monitoring was performed at our biochemistry laboratory to assess the outcome. Site administration also participated actively during the program.

Results: A total of 698 pre-diabetics and 173 uncontrolled DM cases were enrolled in the program. The study shown conversion of 14.98% pre-diabetic employees to normal, 1.02% pre-diabetic employees converted to diabetic and 1.91% of pre-diabetic employees left the organization. The conversion of uncontrolled DM to controlled DM amounted to 30.63% employees. 0.51% Diabetics left the organization.

Conclusion and Clinical Significance: DCM is an inclusive program with awareness, personalized counselling and adapting a healthy lifestyle which resulted in approx. 15% reduction of pre-diabetic cases. At Hazira Manufacturing Division we desire to continue the program for a larger pool of employees to decrease the diabetic and prediabetic burden among employees as evident from this study.

Indian J Occup Environ Med. 2020 Jan;24(Suppl 1):S21–S41.

Abstract 53: Appraisal of Mine Workers regarding Prevention of Silicosis in Jodhpur District of Rajasthan

Pankaja Ravi Raghav 1, Manoj Kumar Gupta 1, Neeti Rustogi 1, Saranya R 1, Mehul Patel 1, Yachana Choudhary 1, Nitesh Kumar 1, Dileepan S 1, Shazia Shafi 1, Vaishali Gautam 1, Abhishek Jaiswal 1

Abstract

Background: Mining is the primary economic activity in 19 of the 33 districts in Rajasthan involving millions of labourers working in 33,513 stone mines and quarries. 90% of these mines operate without a statutory OSH officer and as a result, 95% of the workers do not have any safety equipment or insurance mechanisms. Silicosis is preventable with simple cost-effective dust suppression mechanisms and use of personal protective equipment, however, due to complete neglect of enforcement and/or inspection and/or penalty, the iniquitous practice prevails to date.

Aims: To assess the knowledge, behaviour, and practice relating to silicosis among mine workers in Jodhpur, Rajasthan.

Methods: Community-based cross-sectional study involving 228 mine workers from Jodhpur, Rajasthan. Semi-structured pretested questionnaire was used to assess the knowledge, behaviour, and practice relating to silicosis disease.

Results: Out of the 228 mine workers interviewed none had heard the term silicosis, yet they used another term in their regional language for the disease caused by dust particles which had similar symptoms and was the cause of death for their relatives involved in mining. Most of the mine workers knew the symptoms of silicosis disease. Almost all of the mine workers knew about the compensation provided by the government for silicosis patient and death due to silicosis, but only some knew the correct amount of compensation. None of the mine workers reported usage of wet drilling at their mines. Also, none of them were using masks or other personal protective gear. None of them had previous training for prevention of silicosis. No personal protective gear was provided to the mine workers for protection by the employer.

Conclusions: Although most of the mine workers could enumerate the symptoms of the silicosis disease, the term was not known to them. Also, behaviour and practice relating to the prevention of silicosis was poor.

Articles from Indian Journal of Occupational and Environmental Medicine are provided here courtesy of Wolters Kluwer -- Medknow Publications

RESOURCES