Abstract
Introduction:
Health of individuals and community. Occupation, being a significant determinant of health, plays a vital role in the outcome of health. Mining being an occupation has it's own characteristics and occupational hazards. One such factor, being tobacco consumption has been sparsely reported among thermal power station workers.
Aims and Objectives:
To assess the prevalence of tobacco consumption among thermal power station workers in south India.
Materials and Methods:
Simple random sampling was used to collect data from the study in the subjects working in thermal power station. Pretested questionnaire was used to collect demographic and prevalence data pertaining to tobacco consumption. Descriptive statistical analysis was done for the data to express the same in frequencies.
Results:
Among the 401 study subjects, 121 of them consumed tobacco. Among them 59%(n=72) of them used smoking form of tobacco and about 23%(n=28) of them used smokeless form of tobacco. Vast majority73%(n=52) of the smokers used cigarette and 14%(n=19) used bidi.
Conclusion:
A significant number of workers in thermal power station were found to use tobacco. Further studies are required to be conducted on a larger scale followed by analytical studies to establish the strength of association between the occupation related variables and tobacco consumption.
KEYWORDS: South India, thermal, tobacco
INTRODUCTION
Health is defined as a state of complete physical, mental and social well-being and not merely an absence of disease or infirmity.[1] Health is essential for an individual's entire well-being, to maintain a peaceful mind, and to live a productive and efficient life. Every individual has the right to the best possible health, and it is a global social goal. This objective inspires health care workers to conduct research, respond to changing community needs, and have evidence-based understanding of all elements of health sciences. Previously, health was thought to be defined solely by the absence of sickness; however, with recent advances in social sciences, a holistic approach to health is now generally accepted and implemented. As a result of this perspective, health has been recognized as a multi-faceted term.
Various environmental determinants which influence health are both internal and external. The external environment can be physical, biological, and social environment. The occupational environment is a type of social environment which influences the health of individuals. Occupational environment refers to the sum of external conditions and influences which prevail at the place of work and which have a bearing on the health of the working population.[2]
Mine is a place where an excavation in the earth from where ore or minerals can be extracted. Mining is the act, process, or industry of extracting coal, ores, etc., from the earth. Mining can be broadly classified into two major types namely surface mining and sub–surface mining. Coal mine being an opencast mine has relatively less risk of accidents for the mineworkers than in subsurface mines. Among the principal health hazards of mines are those related to inhalation of air containing a high amount of dust which is released from operations such as drilling, blasting, and tipping. This may be manifested as wheezing, dyspnea, chronic bronchitis, and asthma. Further, the high temperature prevailing within the mines may lead to high fever, cessation of sweating, convolutions, muscle cramps, dehydration, headache, dizziness, tachycardia, and hypotension.[3]
Across the nations, tobacco use is a significant public health problem which can be prevented. Tobacco contributes majorly toward death across the globe. It has been attributed to oral cancer in India. In addition, it increases the chance of acquiring lung cancer.[4] Usage of tobacco has been shown to have negative effects on the workplace, like absenteeism.[5]
Higher consumption of both smoking and smokeless form of tobacco was reported by M. Parashar et al., in a study conducted among construction workers. The dependence on tobacco ranged from moderate to severe for 50% of those workers.[6]
Around half of the plywood workers used tobacco.[7] In a study conducted among businesses process outsourcing workers, almost half of them used tobacco.[8] There were no studies conducted to assess the prevalence of tobacco consumption or oral mucosal conditions among power station employees in India. Hence, the present study aimed to assess the prevalence and pattern of tobacco usage among workers in the thermal power station.
MATERIALS AND METHODS
Study design
A cross-sectional descriptive study.
Study area
Neyveli is a well-known place in Tamil Nadu as it has the largest mining sector in South India. In the year 1956, it was declared a corporate body under the Government of India. From its inception, it is governed as a Central Government public sector undertaking. There are nearly 40 units of employment including the mines, thermal power stations, vigilance, education, sports, and medical branch in which 17,516 employees are employed.
Study population
The present study was carried out to determine the prevalence and pattern of tobacco usage among thermal power station workers in Tamil Nadu.
Sample size determination
The sample size was calculated to be n = 401.
Sampling technique
Simple random sampling technique was employed to recruit the study subjects.
Inclusion criteria
Subjects who were currently working in the thermal power station
Subjects who have a minimum of 2 years of work experience
Subjects who were present on the day of examination.
Exclusion criteria
Subjects who did not give consent to participate in the study.
Survey instrument
Tobacco usage status was collected by using the pre-tested questionnaire.
Statistical analysis
Data obtained were compiled systematically in Microsoft Excel spreadsheet and transferred to the Statistical Package for the Social Sciences software (SPSS Inc., Chicago, IL, USA). Frequency distribution was computed.
RESULTS
Among the 401 study participants, 56 (14%) were belonged to 18–28 years, 76 (19%) were belonged to 29–38 years, 112 (28%) were belonged to 39–48 years and 157 (39%) were belonged to 49–58 years age group [Table 1].
Table 1.
Distribution of study participants based on age group
| Age (years) | Number | Frequency |
|---|---|---|
| 18-28 | 56 | 14 |
| 29-38 | 76 | 19 |
| 39-48 | 112 | 28 |
| 49-58 | 157 | 39 |
| Total | 401 | 100 |
Among the 401 study participants, 381 (95%) and 20 (5%) were males and females, respectively [Figure 1].
Figure 1.
Distribution of the study participants based on gender
Among the 121 study participants, the predominant types of tobacco used were Smoked tobacco 72 (59%), smokeless tobacco 28 (23.5%), and both 21 (17.5%). We found the use of smoked tobacco to be higher as compared to smokeless tobacco [Table 2].
Table 2.
Distribution of study participants based on the type of tobacco use
| Type of tobacco | Number | Frequency |
|---|---|---|
| Smoked tobacco | 72 | 59 |
| Smokeless tobacco | 28 | 23.5 |
| Both | 21 | 17.5 |
| Total | 121 | 100 |
Among the 72 study participants, the predominant types of smoked tobacco used were Cigarette 52 (73%), Bidi 14 (19%), and others 6 (8%). We found the use of cigarette smoking to be higher as compared to bidi smoking [Figure 2].
Figure 2.
Distribution of the study participants based on the type of smoked tobacco
Among the 28 study participants, the predominant types of smokeless tobacco used were Pan chewing 14 (50%), gutkha 11 (39%), and others 3 (11%). We found the use of pan chewing to be higher as compared to gutkha [Figure 3].
Figure 3.
Distribution of the study participants based on the type of smokeless tobacco
Among the 121 study participants, 43 (36%) were leukoplakia, 27 (21%) were lichenplanus, 19 (16%) were ulceration, 13 (11%) were candidiasis and 19 (16%) were other oral mucosal lesions [Table 3].
Table 3.
Distribution of study participants based on various oral mucous lesions
| Oral mucosal lesions | Number | Frequency |
|---|---|---|
| Leukoplakia | 43 | 36 |
| Lichen planus | 27 | 21 |
| Ulceration | 19 | 16 |
| Candidiasis | 13 | 11 |
| Others | 19 | 16 |
| Total | 121 | 100 |
DISCUSSION
The literature related to tobacco usage patterns among thermal power station workers is sparse. Hence, the present study was undertaken. Epidemiological studies are a very useful tool in describing the health-related problems. The present study was conducted among 401 subjects. The vast majority of them were male (381 workers) and few were females (20 workers), with age groups ranging from 18 years to 58 years.
There are various factors influencing the health of thermal power station workers. Some nuclear power station workers are exposed to ionizing radiation. Some power station workers are exposed to noise pollution.[9] Nuclear power station workers have better mental health as compared to coal-fired plant workers. The perceived stress of coal-fired plant workers is less in comparison to nuclear power plant workers.[10]
The study was conducted by using simple random sampling technique after the inclusion criteria were met by the study participants. The study was done using a pre-tested questionnaire in both English and local language Tamil. Oral examination for checking the presence of oral mucosal lesions was done using mouth mirrors, kidney trays, gloves, and mask.
During data collection chemical method of disinfection was done using Krosolex (gluteraldihyde - 7 g; polymethyl urea derivatives - 11.6 g; 1,6 dihydroxy 2,5 droxyhexane - 8.2 g) diluted by adding water. Used instruments were washed and placed in disinfectant solution for 30 min. After evey day of examination, all instruments were autoclaved. Statistical analysis was done using SPSS 19, software after regulating the data in Microsoft excel sheet.
In the current study, about 21% of the subjects had leukoplakia. This is higher compared to the study conducted by Solanki et al., where the prevalence of leukoplakia was 10%.[11] The reason may be attributed to increased smoking habit among the study subjects. In the present study, ulceration was found to be around 11% of the subjects. This is almost twice as compared to the findings of Dr. Ramya Balasubramanian, where the prevalence of ulceration was only 5.7%. The reason may be attributed to the increased smokeless tobacco consumption among the present study subjects.[12] The strength of the present study is that this is the first study to assess the pattern of tobacco use among power station workers.
The number of workers in power station who used smoking types of tobacco was higher than that of the workers who used smokeless type of tobacco. The reason may be attributed to the abundance of availability of smoking type of tobacco. The reason for the usage of the smoking type of tobacco might also be a matter of personal preference.
CONCLUSION
A significant number of workers in thermal power station were found to use tobacco. Further studies are required to be conducted on a larger scale followed by analytical studies to establish the strength of association between the occupation related variables and tobacco consumption.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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