Asim Saha

Ocular morbidity and fuel use: an experience from India

The association of fuel use and ocular morbidity in a village in western India was investigated in a cross sectional prevalence survey involving 469 randomly selected subjects. All subjects were interviewed and underwent medical and ophthalmological examination. Wood use was found to be an important factor in the aetiology of age dependent cataract (OR 2.12, 95% CI 1.03–4.34). When comparing wood only and LPG only users, the odds ratio was 3.47 (95% CI 1.05–11.50). In cases of eye irritation, coal use (OR 2.04, 95% CI 1.13–3.68) and cattle dung use (OR 1.83, 95% CI 1.35–2.47) were shown to be important factors, while male sex posed a lesser risk.

Pulmonary function and fuel use: A population survey

BackgroundIn the backdrop of conflicting reports (some studies reported adverse outcomes of biomass fuel use whereas few studies reported absence of any association between adverse health effect and fuel use, may be due to presence of large number of confounding variables) on the respiratory health effects of biomass fuel use, this cross sectional survey was undertaken to understand the role of fuel use on pulmonary function.MethodThis study was conducted in a village of western India involving 369 randomly selected adult subjects (165 male and 204 female). All the subjects were interviewed and were subjected to pulmonary function test. Analysis of covariance was performed to compare the levels of different pulmonary function test parameters in relation to different fuel use taking care of the role of possible confounding factors.ResultsThis study showed that biomass fuel use (especially wood) is an important factor for deterioration of pulmonary function (particularly in female). FEV1 (p < .05), FEV1 % (p < .01), PEFR (p < .05) and FEF25–75 (p < .01) values were significantly lower in biomass fuel using females than nonusers. Comparison of only biomass fuel use vs. only LPG (Liquefied Petroleum Gas) use and only wood vs. only LPG use has showed that LPG is a safer fuel so far as deterioration of pulmonary function is concerned. This study observes some deterioration of pulmonary function in the male subjects also, who came from biomass fuel using families.ConclusionThis study concluded that traditional biomass fuels like wood have adverse effects on pulmonary function.

Thallium toxicity: A growing concern

This review article deals with the growing concern of the toxicity of thallium. This article describes the characteristics of thallium, its potential sources of exposure, kinetics, and toxicity on human being and diagnosis of thallium poisoning. This article also describes some episodes of thallium poisoning arising from both occupational and nonoccupational exposure.

Living environment and self assessed morbidity: a questionnaire-based survey

BackgroundHealth complaints have been reported to be higher among the industrial area residents when compared with reference community.MethodsSuch reports being only a few, a questionnaire survey was conducted in three different areas (Industrial, Residential, Commercial) of Ahmedabad city of India to determine the pattern of morbidity and to do a comparative analysis of different areas within the city.ResultsA total of 679 families (243 from commercial, 199 from residential and 237 from industrial area) were included in this study. This study revealed that apart from presence of industry in close proximity to residence (99.2%), industrial area residents are having many other disadvantages from the point of view of public health like waste water stagnation (87.4%), problem of cooking smoke (33.2%) and presence of garbage dumps near residence (72.8%). Consequently, problems like coughing, wheezing, eye irritation, skin irritation, jaundice, asthma, and dental caries have been observed to be more common in industrial area. Comparative risk calculated in terms of odds ratio for different such problems have ranged from 1.83 to 6.2 when industrial area was compared with commercial area. Similarly on comparison of industrial area with residential area, odds ratio for different problems have ranged from 1.82 to 11.5.ConclusionThis study has pointed out the need of separate planning and implementation of specific upliftment programs for addressing the environmental as well as public health issues of industrial localities.

Blood chromium levels of children working in gem-polishing industries in India.

The gem-polishing industry in Jaipur, India employs a substantial proportion of children. The process of polishing may result in exposure to chromium in working children. Thus, this study aims to find out the levels of chromium in these working children and the associated factors. Blood samples were analysed for chromium using atomic absorption spectrophotometer. The mean blood chromium levels were 2.51 ± 1.11 mg/100 ml and 2.33 ± 1.10 mg/100 ml in working and school children, respectively, which is well within the permissible levels. However, the practice of employing children should be totally curbed.

Respiratory morbidities among working children of gem polishing industries, India.

There are millions of working children worldwide. In gem polishing industry, exposure to occupational hazards of dust and chemicals used in polishing of gemstone may result in respiratory symptoms and respiratory disorders. The present study included 586 exposed and 569 comparison group subjects. Data was collected through personal interview, clinical examination, and chest radiography. The respiratory morbidity was diagnosed on the basis of clinical signs and symptoms and chest radiography. The study variables included age, sex, daily working hours, and duration of exposure. The mean age of the child laborers was 11.31 ± 5.34 years. Prevalence of respiratory morbidity was significantly high in the female child laborers. The other study variables namely age, duration of exposure, and daily working hours were found to be statistically non-significant. The prevalence of respiratory morbidity among child laborers of gem polishing industry in Jaipur was found to be 7%.

Occupational injury surveillance: A study in a metal smelting industry

An investigation of occupational injury was undertaken in a metal smelting industry to examine the occurrence and nature of occupational accidents where analysis of occupational injury records was carried out. At the same time, all the workers were interviewed to collect data in relation to personal and occupational characteristics. With this information, the study aimed to examine the role of different factors in the causation of occupational accidents. High incidence of superficial injuries of limbs due mostly to stepping / striking against objects and overexertion / wrong movements of the workers and the frequent association of handling of small tools with work injuries, observed in this study indicated the role of human error in these accidents and highlighted the necessity of proper safety training of the workers. This study also highlighted the need of elevated safety status during summer months and in evening and night shifts (more so in the second half). Moreover, this study could categorize some high-risk groups e.g. young workers, less-experienced workers, obese workers, workers having smoking / chewing habits etc, who need special attention so far as workplace safety is concerned.

Ceruloplasmin as a marker of occupational copper exposure

Estimation of serum copper to indicate copper status in the human system in the context of moderate chronic occupational copper exposure requires a sophisticated and expensive method. Hence, a search for a suitable marker has been made and few studies have found potential in serum ceruloplasmin. In this context, the present study was initiated to explore whether ceruloplasmin could serve as a predictor of occupational copper exposure. An interviewer-administered questionnaire survey (personal, occupational and health-related information) was undertaken involving 185 employees of a copper handling industry. Serum alkaline phosphatase, serum glutamic pyruvic transaminase (SGPT), serum ceruloplasmin and serum copper were estimated in all the subjects. Multivariate analysis was undertaken using a linear regression model to understand the contribution of serum copper on serum ceruloplasmin values adjusting for the role of other confounders. Serum copper and serum ceruloplasmin values were found to have a statistically significant positive correlation (R=0.169, adjusted R2=0.024) after adjustment for other predictors like age, nature of job (department), job duration, smoking, serum alkaline phosphatase and SGPT. This study concludes that the serum ceruloplasmin level can act as a reliable indicator of copper status in the human body following copper exposure in cases of chronic moderate occupational exposure to copper.

Injuries and Injury Care among Child Labourers in Gem Polishing Industries in Jaipur, India

Athough life had been made comfortable due to technological development, it also brought some disadvantages. These include fatal and non-fatal injuries. These injuries can be afflicted at any place of which the workplace is one. At the workplace, injuries, if they occur can either lead to permanent or temporary disability or mortality and account for a significant proportion of deaths and disabilities. These types of injuries are mostly recorded as the victims of these types of grave injuries are often provided with monetary compensation through legislation enacted for the welfare of the workers. But, in many industries, such serious injuries are not common but trivial injuries are frequent and usually remain unnoticed and unreported. These trivial injuries if not properly cared for can lead to wound contamination and sepsis that can be life threatening. The gem polishing industry at Jaipur is one such industry which exposes the workers to such frequent minor injuries. In Jaipur, approximately 200,000 people are employed in this industry, of whom about 20,000 are children. This industry is an unorganized sector and the workers are not protected by the legislation made for the welfare of workers applicable to the organized sectors. The workers are also not covered by any health service schemes. Secondly, these industries employ a considerable proportion of child workers, even though it is prohibited under the Constitution of India. In the gem polishing industry of Jaipur the raw semiprecious stones are mostly imported from African nations. These raw stones are then cut with the help of a rotating saw to remove those parts that contain some impurities. This is followed by separating the raw stones on the basis of their colours. After sorting, the stones are preshaped with the help of a rotating wheel into the desired shape and then to the desired size and measured with calipers. This is followed by faceting the stone so that the multiple facets using the principle of refraction give a shine to the stone. Finally, these stones are polished with chromic oxide powder and quartz powder to increase the shine and lustre. Some of these finished materials are used for preparing neck jewelleries and are converted into beads with a drill. The schematic flow chart of the process is shown in Fig. 1. The processes which are likely to result in injuries include the cutting process which causes cuts, the faceting process that causes abrasions and the drilling process which causes piercing type of injuries (Fig. 1). Except for the making of jewellery, sorting and marketing, the children work in almost all the processes and therefore are prone to injury. The occurrence of injuries at the workplace depends upon a number of factors including the age of workers, familiarity with the hazardous processes, amount of precision required, daily working duration, etc. Similarly, the complication of the wound in the form of contamination and sepsis will depend upon the knowledge regarding first aid and proper wound care, but neither this sector of unorganized child labour nor this issue of minor injuries and knowledge regarding wound care has been studied. Therefore we have carried out the present study to find out the prevalence of injuries, factors associated with the occurrence of injuries and knowledge regarding wound care and first aid.

Asthenopia (eyestrain) in working children of gem-polishing industries.

Working children of gem-polishing units are exposed to poor illumination and improper workstations. Also processes require lot of visual and mental concentration for precision. This may result in eyestrain. The study included 432 exposed and 569 comparison group subjects. Self-reported eyestrain was recorded through personal interview. Eyestrain included symptoms like itching, burning, or irritated eyes; tired or heavy eyes; difficulty seeing clearly (including blurred or double vision); and headache. The study variables included age, gender, daily working hours, and duration of exposure. The prevalence of eyestrain in child labourers was 32.2%, which was significantly more than the comparison group subjects. Also, the working children of gem-polishing units were at 1.4 times higher risk of developing eyestrain. Age 314 years and female gender were significantly associated with the eyestrain. The prevalence of eyestrain in child labourers was 32.2% and was associated with age 314 years and female gender.