Balram S. Pangtey

Clinical, biochemical and neurobehavioural studies of workers engaged in the manufacture of quinalphos.

59 workers exposed to different chemicals during the manufacture of quinalphos, an organophosphate pesticide (OP) and 17 control subjects were studied. Despite similar blood acetylcholinestarase (AChE) levels in both the exposed and control subjects, a significant number of exposed subjects had altered plantar and ankle reflexes. Higher nervous functions such as memory, learning and vigilance were also found to be affected in these subjects. These findings were attributed to chronic low dose combined exposure to different chemicals used/formed in the manufacture of quinalphos. The study raises the doubt that monitoring of AChE alone among subjects engaged in the manufacture of OP pesticides may not be an adequate safeguard as regards to their health.

Musculoskeletal pain and its associated risk factors in residents of national capital region

Background: Musculoskeletal (MS) pain is responsible for poor quality of life and decreased productivity. Objective information about the burden of musculoskeletal disorders among the general community in India is scanty, and the few reports that exist are based on a small sample size. Materials and Methods: This paper examines the issue of MS pain and its associated risk factors in a cross-sectional study of 2086 subjects from National Capital Region (NCR). Results: Overall prevalence of MS pain was found to be 25.9%. Pain was found to be more frequent among females (31.3%) as compared with males (20.9%). Significant association of pain in joints/limbs/knee/lower legs with obesity (OR = 2.1, P < 0.001) and high body fat (OR = 2.2, P < 0.001) was established. More than 50% of the subjects complained of backache. Conclusions: Our findings confirm that MS pain is a significant burden of disease among the residents of NCR. Women and subjects doing heavy work load, like agriculture and dairy farming, constitute the chief demographic groups. It is high time that a policy is framed to reduce this load of sickness.

Biological monitoring of chlorinated pesticides among exposed workers of mango orchards: a case study in tropical climate.

Organochlorine, organophosphorus and carbamate compounds are widely used pesticides in India for controlling disease carrying vectors and agricultural pests. Organochlorine compounds being persistent and lipophilic in nature, accumulate in the human body through food chain and environmental exposure. Accumulation of DDT, BHC and endosulfan has been implicated in the pathogenesis of cardiovascular disorders, hypertension and other health related problems. Earlier, the authors have observed respiratory impairment (36.5%) among workers engaged in spraying of organochlorine pesticides on mango trees at Malihabad. In the present investigation, the levels of chlorinated present investigation, the levels of chlorinated pesticides among exposed workers have been monitored to study the distribution pattern in blood and their excretion in urine of human subjects.

A STUDY OF RESPIRATORY MORBIDITY AND PULMONARY FUNCTION AMONG SOLDERERS IN THE ELECTRONICS INDUSTRY

Pulmonary function assessment of 197 solderers engaged in soldering printed circuit boards and other electronic components using lead-tin alloy impregnated solder in five major electronics workplaces in India was compared with the findings observed in 143 unexposed controls. Spirometry showed a significant impairment in the values of vital capacity (VC) and forced expiratory volume/forced vital capacity (FEV1/FVC) percent ratio in 47.2% of the solderers in comparison to 1.3% in the reference group (P<0.001). In the exposed group, female solderers particularly showed significantly higher (55.0%) prevalence of overall respiratory impairment in comparison to the 32.3% observed in their male counterparts (p<0.001). Bronchial obstruction was recorded in 7.6% of the solderers compared with 1.3% of the unexposed controls (p<0.01). The prevalence of restrictive and mixed ventilatory impairment was found to be 28.9 and 10.6%, respectively, among the exposed workers, while there was none among the control group. Th...

Respiratory symptoms and ventilatory capacity in metal polishers

To evaluate the long-term effects of metal dusts on the bronchopulmonary system and the synergistic effect of cigarette smoke, a comparative study of spirometric measurements in 104 polishers and 90 unexposed controls was carried out in 25 brass and steelware polishing industries at Moradabad in northern India. The two groups were comparable in terms of age, height, smoking habit and socio-economic status. A total of 58.6% of the polishers had one or more respiratory symptoms, compared to only 25.5% of the controls (P<0.05). Chronic cough was present in 21 polishers (20.2%) as compared to 11.1% of the controls. However, this difference was insignificant. Chronic phlegm was nearly three times as frequent among the polishers as among the controls (17.5% vs 4.4%) (P<0.005). The prevalence of dyspnoea of varying grades was also significantly higher (16.3% as opposed to 4.4%) among the exposed groups. Chronic bronchitis (6.7%) and occupational asthma (4.8%) were found to be confined to polishers. The polishers also experienced acute respiratory symptoms during the work shift. The prevalence of acute respiratory symptoms was recorded for cough in 19 workers (44.1%) followed by dyspnoea in 14 workers (32.5%) and throat irritation in 11 workers (25.5%). Comparison of the mean values of pulmonary function parameters in the polishers and the controls showed significant differences in the smoking and non-smoking groups (P<0.001 ). The polishers exhibited significantly greater acute reductions in various lung functions over the work shift, particularly for forced expiratory flow over the 25-75% portion of the spirogram (FEF25_75%) FEF25% and FEF 50%, than did the controls. Among the exposed group, the acute changes in lung function were found to be significantly larger in the smoking than in the non-smoking polishers. The duration of exposure showed a direct correlation with the acute fall in lung function. Polishers who were exposed to dusts of various metals for more than 10 years showed a significantly greater acute reduction in all the pulmonary functions (P<0.001) thereby indicating that occupational exposure to multimetals in the work environment of the polishing industry had deleterious respiratory effects.

Mathematically derived body volume and risk of musculoskeletal pain among housewives in North India.

Background Global Burden of Disease Study 2010 demonstrates the impact of musculoskeletal diseases as the second greatest cause of disability globally in all regions of the world. The study was conducted to determine the role of mathematically derived body volume (BV), body volume index (BVI), body mass index (BMI), body surface area (BSA) and body fat % (BF %) on musculoskeletal pain (MSP) among housewives in National Capital Region (NCR). Methods A cross sectional study was undertaken among 495 housewives from Gurgaon and New Okhla Industrial Development Area (NOIDA) in National Capital Region (NCR), New Delhi, India. The study includes questionnaire survey, clinical examination and body composition monitoring among housewives. Results A significantly higher BMI, BVI, BV and BSA were observed in subjects with MSP as compared to those who had no MSP. This was also true for subjects with pain in knee for BMI category for overweight. Subjects with pain in limbs had significantly high BMI and BVI as compared to subjects with no MSP. A significant positive correlation of age with BMI, BVI, BV and BSA was observed among subjects having no MSP denoting a direct relationship of age and these body factors. Conclusions The prevalence of MSP among housewives is associated with increasing age, BMI and BVI. This can possibly be used for formulating a strategy for prevention of MSP.

Gender Disparity in Lung Function Abnormalities among a Population Exposed to Particulate Matter Concentration in Ambient Air in the National Capital Region, India

Background The World Health Organization (WHO) global air quality study shows that 27 Indian cities, including New Delhi, are among the one hundred cities with the worst air quality globally. The scope of airway obstruction cases among residents in locations with critical air pollution levels like particulate matter (PM) pollutants PM2.5 and PM1 has not been addressed in the National Capital region, India. Objectives The present cross-sectional study was undertaken to assess the forced expiratory volume in one second (FEV1) % predicted abnormalities among residents living in the National Capital Region, India with respect to their exposure to particulate matter pollutants (PM1, PM2.5) in ambient air. Methods Eight hundred and fifty-four residents, including 433 men and 421 women ranging in age from 18-70 years, living in the National Capital Region (NCR) of India participated in the study. Particulate matter concentrations in ambient air (PM2.5 and PM1) were monitored at 10 residential locations in the National Capital Region, India (New Okhla Industrial Development Authority (NOIDA) and Gurgaon). The lung function test (FEV1) was conducted using a spirometer. Results The Indian Air Quality Index showed either very poor or severe levels for PM2.5 at all study locations. A significant negative linear relationship was found between higher concentrations of PM1 and reduced FEV1% predicted values (r = -0.8, p < 0.05). The prevalence of airway obstruction cases (79.6%, odds ratio 1.96, confidence interval 1.42-2.71) was higher (p<0.001) among female subjects compared to their male counterparts. Even though there was a significant decline in FEV1% predicted among 80% of cases in women, only 19.24% cases were in the moderate category and 6.18% cases in the severe category. The severe category of FEV1% predicted cases showed greater respiratory symptoms than the other two categories, which denotes higher risk among those in the severe category. The present study shows that obstruction cases increased from 1.97 to 7.40% and 2.73 to 14.93% in women, with a corresponding increase in PM1 and PM2.5 from the minimum to maximum concentration. Conclusions Since the women in this study were non-smokers, the PM in ambient air can be considered to be the major reason for the decline in lung function. The sources of PM pollutants in the study locations are large scale infrastructural development activities such as building and road construction activities. Narrowed lung airways can alter the airway caliber or resistance and flow rates proportional to the airway radius, especially in smaller airways. The present study suggests the need for policy makers and stake holders to take the necessary steps to identify PM sources and reduce the emissions of PM concentrations in ambient air.