Showing papers in "Indian Journal of Occupational and Environmental Medicine in 2008"

The sick building syndrome.

Abstract: The sick building syndrome comprises of various nonspecific symptoms that occur in the occupants of a building. This feeling of ill health increases sickness absenteeism and causes a decrease in productivity of the workers. As this syndrome is increasingly becoming a major occupational hazard, the cause, management and prevention of this condition have been discussed in this article.

E-waste hazard: The impending challenge.

Abstract: Electronic waste or e-waste is one of the rapidly growing problems of the world. E-waste comprises of a multitude of components, some containing toxic substances that can have an adverse impact on human health and the environment if not handled properly. In India, e-waste management assumes greater significance not only due to the generation of its own e-waste but also because of the dumping of e-waste from developed countries. This is coupled with India's lack of appropriate infrastructure and procedures for its disposal and recycling. This review article provides a concise overview of India's current e-waste scenario, namely magnitude of the problem, environmental and health hazards, current disposal and recycling operations, existing legal framework, organizations working on this issue and recommendations for action.

Occupational noise-induced hearing loss in India.

Abstract: Noise is the insidious of all industrial pollutants, involving every industry and causing severe hearing loss in every country in the world. Exposure to excessive noise is the major avoidable cause of permanent hearing impairment. Worldwide, 16% of the disabling hearing loss in adults is attributed to occupational noise, ranging from 7 to 21% in the various subregions. The estimated cost of noise to developed countries ranges from 0.2 to 2% of the gross domestic product (GDP). Noise-induced hearing loss (NIHL) is bilateral and symmetrical, usually affecting the higher frequencies (3k, 4k or 6k Hz) and then spreading to the lower frequencies (0.5k, 1k or 2k Hz). Other major health effects are lack of concentration, irritation, fatigue, headache, sleep disturbances, etc. The major industries responsible for excessive noise and exposing workers to hazardous levels of noise are textile, printing, saw mills, mining, etc. Hearing protectors should be used when engineering controls and work practices are not feasible for reducing noise exposure to safe levels. Earmuffs, ear plugs and ear canal caps are the main types of hearing protectors. In India, NIHL has been a compensable disease since 1948. It is only in 1996 that the first case got compensation. Awareness should be created among workers about the harmful effects of noise on hearing and other body systems by implementing compulsory education and training programs. There are very few published studies of NIHL in India. More extensive studies are needed to know the exact prevalence of NIHL among the various industries in India.

Renal effects of environmental and occupational lead exposure.

Abstract: Lead is one of the most useful elements in industry, but serves no useful function in the human body. Environmental and industrial lead exposures continue to pose major public health problems in the exposed population.[1] Over the years, it has become increasingly evident that low-level lead exposure resulting in blood lead levels between 10 and 15 μg/dL can lead to deleterious effects like cognitive impairment and behavioral deficits, high blood pressure (BP) and impaired renal function.[2,3] Lancereaux[4] provided the first description of kidney disease and interstitial nephritis by postmortem examination of a lead-poisoned artist. It was not until the late 1920s when an epidemic of chronic nephritis in Queensland, Australia, was linked to childhood lead poisoning that the full spectrum of lead-induced nephropathy became apparent.[5,6] This was followed by cases of renal diseases from the US in individuals consuming lead-contaminated illegally distilled moonshine whisky.[7]

Occupational health hazards in sewage and sanitary workers

Abstract: An estimated 1.2 million scavengers in the country are involved in the sanitation of our surroundings. The working conditions of these sanitary workers have remained virtually unchanged for over a century. Apart from the social atrocities that these workers face, they are exposed to certain health problems by virtue of their occupation. These health hazards include exposure to harmful gases such as methane and hydrogen sulfide, cardiovascular degeneration, musculoskeletal disorders like osteoarthritic changes and intervertebral disc herniation, infections like hepatitis, leptospirosis and helicobacter, skin problems, respiratory system problems and altered pulmonary function parameters. This can be prevented through engineering, medical and legislative measures. While the engineering measures will help in protecting against exposures, the medical measures will help in early detection of the effects of these exposures. This can be partly achieved by developing an effective occupational health service for this group of workers. Also, regular awareness programs should be conducted to impart education regarding safer work procedures and use of personal protective devices.

Occupational health risks among the workers employed in leather tanneries at Kanpur.

Abstract: In a cross-sectional study, a random sample of 197 male workers drawn from different sections of 10 leather tanneries in Kanpur were selected for the assessment of health risks. A control group comprising of 117 male subjects belonging to a similar age group and socioeconomic strata, who never had any occupational exposure in the leather tanneries, were also examined for the comparison purpose. The findings revealed a significantly higher prevalence of morbidity among the exposed workers in contrast to that observed in the controls (40.1% vs. 19.6%). The respiratory diseases (16.7%) were mainly responsible for a higher morbidity among the exposed workers whereas the gastrointestinal tract problems were predominant in the control group. The urinary and blood samples collected from the exposed group showed significantly higher levels of chromium, thereby reflecting the body burden of Cr in the exposed workers as a result of a high concentration of environmental Cr at the work place.

An ergonomic study of women workers in a woolen textile factory for identification of health-related problems

Abstract: The observational cross-sectional study conducted on a sample of 100 women workers who volunteered, outlines their cardio-respiratory and musculo-skeletal profile before, during and at end of work. In addition, information on their health status in general was collected in advance. Contrary to expectation, there was no significant change in respiratory function. However, the musculo-skeletal problems were found to be abundantly present with pain in 91% of the subjects. Region-wise mapping of pain revealed that postural pain in low back was present in 47% while in neck was 19%. Scapular muscles on the right side were involved in stabilizing shoulder, which never went overhead. On the contrary, left shoulder was raised as high (>90 degrees) in spinning action, while pulling thread. This muscle work involved trapezius, deltoid and triceps action concentrically in lifting and while coming to starting position slowly, eccentrically. There was no pause since the wheel continued to spin the thread continuously, unless a worker opted to stop the work. Accordingly, left wrist and hand were in holding contraction while the right wrist and hand holding the handle were also in a fixed position with wrist in flexion with supinated forearm. Though the overall job was light as per peak HR, there was pain due to fatigue and grip strength weakened by around 10%, at the end of the day's work. In conclusion, pain and fatigue were found to be the main problems for women in the spinning section of the small-scale industry under this study. Women have to take up dual responsibility of a full-time job as well as the domestic work. It was considered that ergonomic factors such as provision of a backrest and frequent rest periods could remediate the musculo-skeletal symptoms.

Zinc toxicology following particulate inhalation

Abstract: The current mini-review describes the toxic effects of zinc inhalation principally in the workplace and associated complications with breathing and respiration. The International Classification of Functioning, Disability and Health Criteria were used to specifically select articles. Most of the commercial production of zinc involves the galvanizing of iron and the manufacture of brass. The recommended daily allowance for adults is 15 mg zinc/day. Metal fume fever associated with inhalation of fumes of ZnO is characterized by fatigue, chills, fever, myalgias, cough, dyspnea, leukocytosis, thirst, metallic taste and salivation. ZnCl(2) inhalation results in edema in the alveolar surface and the protein therein the lavage fluid is elevated. Particular pathological changes associated with zinc intoxication include: pale mucous membranes; jaundice; numerous Heinz bodies; and marked anemia. Adequate ambient air monitors for permissible exposure limits, excellent ventilation and extraction systems, and approved respirators are all important in providing adequate protection.

Monitoring of plasma butyrylcholinesterase activity and hematological parameters in pesticide sprayers.

Abstract: To evaluate the health impact of spraying organophosphorus insecticides (OPs), 34 male sprayers in the mango belt of Malihabad, a small town located 27 km from Lucknow in North India was selected Plasma butyryl cholinesterase (PBChE) and complete blood count were assessed among sprayers after spraying pesticides and the findings obtained were compared with those determined in a reference group (n = 18) The most common symptoms observed were burning sensation in the eyes (882%), itching/skin irritation (2352%) and chest symptoms (3235%) in the exposed workers Plasma butyrylcholinesterase (PBChE) was significantly decreased in workers The results indicated significant decrease in the mean value of hemoglobin, hematocrit and platelets count; however, significantly higher count of leukocytes was also observed in the exposed group (sprayers) compared to that observed in the control group (P < 005) Monitoring of PBChE in pesticide sprayers could be useful to predict and prevent health hazards of OPs

Neopterin: Biomarker of cell-mediated immunity and potent usage as biomarker in silicosis and other occupational diseases.

Abstract: Neopterin is regarded as an early biomarker of the cellular immune response. This low molecular mass compound belongs to the class of pteridine and is a metabolite of guanosine triphosphate, which is produced by the activated macrophages and dendritic cells after stimulation with gamma-interferon. An international group acknowledges the fact that the levels of serum neopterin can be used as a marker of the effect of exposure to silica and other occupational diseases. The determination of neopterin is an innovative tool for monitoring diseases associated with the activation of cell-mediated immunity.

Solid-waste management in Jalandhar city and its impact on community health.

Abstract: In this study, solid-waste management practices were evaluated in order to find out its link with occurrence of vector-borne disease. Strategies for solid-waste management were employed as practical model to solve the problems regarding pollution which is originated by solid-waste.

Noise exposure in oil mills

Abstract: Context: Noise of machines in various agro-based industries was found to be the major occupational hazard for the workers of industries. The predominant noise sources need to be identified and the causes of high noise need to be studied to undertake the appropriate measures to reduce the noise level in one of the major agro-based industries, oil mills. Aims: To identify the predominant noise sources in the workrooms of oil mills. To study the causes of noise in oil mills. To measure the extent of noise exposure of oil mill workers. To examine the response of workers towards noise, so that appropriate measures can be undertaken to minimize the noise exposure. Settings and Design: A noise survey was conducted in the three renowned oil mills of north-eastern region of India. Materials and Methods: Information like output capacity, size of power source, maintenance condition of the machines and workroom configurations of the oil mills was collected by personal observations and enquiry with the owner of the mill. Using a Sound Level Meter (SLM) (Model-824, Larson and Davis, USA), equivalent SPL was measured at operator's ear level in the working zone of the workers near each machine of the mills. In order to study the variation of SPL in the workrooms of the oil mill throughout its operation, equivalent SPL was measured at two appropriate locations of working zone of the workers in each mill. For conducting the noise survey, the guidelines of Canadian Centre for Occupational Health and Safety (CCOHS) were followed. Grid points were marked on the floor of the workroom of the oil mill at a spacing of 1 m x 1 m. SPL at grid points were measured at about 1.5 m above the floor. The direction of the SLM was towards the nearby noisy source. To increase accuracy, two replications were taken at each grid point. All the data were recorded for 30 sec. At the end of the experiment, data were downloaded to a personal computer. With the help of utility software of Larson and Davis, USA, equivalent SPL and noise spectrum at each reading was obtained. Noise survey map of equivalent SPL was drawn for each oil mill by drawing contour lines on the sketch of the oil mill between the points of equal SPL. The floor area in the oil mill where SPL exceeded 85 dBA was identified from the noise survey map of each oil mill to determine the causes of high level of noise. Subjective assessment was done during the rest period of workers and it was assessed with personal interview with each worker separately. Demographic information, nature of work, working hours, rest period, experience of working in the mill, degree of noise annoyance, activity interference, and psychological and physiological effects of machine noise on the worker were asked during the interview. These details were noted in a structured form. Statistical Analysis Used: Nil. Results: The noise survey conducted in three renowned oil mills of north-eastern region of India revealed that about 26% of the total workers were exposed to noise level of more than 85 dBA. Further, 10% to 30% floor areas of workrooms, where oil expellers are provided have the SPL of more than 85 dBA. The noise in the oil mills was dominated by low frequency noise. The predominant noise sources in the oil mills were seed cleaner and power transmission system to oil expellers. Poor maintenance of machines and use of bamboo stick to prevent the fall of belt from misaligned pulleys were the main reason of high noise. Noise emitted by the electric motor, table ghani and oil expellers in all the oil mills was well within 85 dBA. Subjective response indicated that about 63% of the total workers felt that noise interfered with their conversation. About 16% each were of the opinion that noise interfered in their work and harmed their hearing. About 5% of workers stated that the workroom noise gave them headaches. Conclusions: The workers engaged in the workrooms of the oil mills are exposed to high noise, which will have detrimental effect on their health. The poor maintenance of drive system was found to be the main reason for high noise level.

A study on health status of women engaged in a home-based "Papad-making" industry in a slum area of Kolkata.

Abstract: Background: The 'papad-making' industries of India have provided ample opportunity of employment for the women workers of low socio-economic class although their problems are not much explored. In this study an attempt had been made for the same. Aims: 1.To find out the health status of the women. 2. To find out the factors, in the working conditions, influencing their health status. 3. To assess their felt needs. Settings: A slum area of Kolkata. Design: A cross-sectional, descriptive type of observational study. Methods and Materials: The slum was chosen by random sampling method. Following this, complete enumeration method was adopted. Data were collected by interview and clinical examination of the women engaged in this occupation with a pre-designed and pretested schedule. Statistical Analysis: Proportions and Chi-square test. Results: 77.5% were in the reproductive age group and none were below 14 years. Most of them belonged to poor socioeconomic status. Sixty per cent were in this occupation for more than 10 years and they spent 5 hours for this work daily over and above their household job. Musculoskeletal problem was their commonest health problem. Pallor, angular stomatitis, pedal edema, chronic energy deficiency were found on examination. Personal hygienic measures taken were far from satisfactory. A focus group discussion revealed their health and family problems, dissatisfaction about their working conditions and wage. Other needs identified were home visits for their health care, free medicines and health education. Conclusion: Need exists for a participatory occupational health programme for this working population.

The role of exhaust ventilation systems in reducing occupational exposure to organic solvents in a paint manufacturing factory

Abstract: This paper presents the successful design and implementation of several exhaust ventilation systems in a paint manufacturing factory. The ventilation systems were designed based on American Conference of Governmental Industrial Hygienists recommendations. The duct works, fans, and other parts were made and mounted by local manufacturers. The concentrations of toluene and xylene as the common solvents used in paint mixing factories were measured to evaluate the role of ventilation systems in controlling the organic solvents. Occupational exposure to toluene and xylene as the major pollutants was assessed with and without applying ventilation systems. For this purpose, samples were taken from breathing zone of exposed workers using personal samples. The samples were analyzed using Occupational Safety and Health Administration analytical method No.12. The samples were quantified using gas chromatography. The results showed that the ventilation systems successfully controlled toluene and xylene vapors in workplace, air well below the recommended threshold limit value of Iran (44.49 and 97.73 ppm, respectively). It was also discovered that benzene concentration in workplace air was higher than its allowable concentrations. This could be from solvents impurities that require more investigations.

Environmental sanitation: An ignored issue in India

Abstract: Dear sir, In general, environmental sanitation covers arrangements for drainage of rainwater and effluents, collection and disposal of garbage and removal of human excreta. The World Health organization (WHO) defines environmental sanitation as “the control of all those factors in man′s physical environment, which exercise or may exercise a deleterious effect on his physical development, health and survival."[1] The Millennium Development Goals (MDG) is also insuring the environmental sustainability. Important indicators of the Millennium Development Goals are to reduce by half the proportion of people without sustainable access to safe drinking water and to achieve significant improvement in lives of at least 100 million slum dwellers, by 2020.[2] India is still lagging far behind many countries in the field of environmental sanitation. Most cities and towns India are characterized by over-crowding, congestion, inadequate water supply and inadequate facilities of disposal of human excreta, wastewater and solid wastes.[3] Most of the problems in the country are due to defective environment, which in turn rob people of their health, destroy their livelihoods and undermine their overall development potential.[4] The environmental sanitation is still an ignored issue in India. To raise the overall of standard of living the issue of environmental sanitation must be tackled seriously. It is essential to take some stricter steps to raise the current state of environmental sanitation in India. For an example in Nigeria, the state government of Lagos has set up a sanitation court, which will prosecute offenders arrested for violating the state environmental sanitation exercise. The state is also planning to set up five additional mobile courts in this connection. Offenders could be any form of environmental pollution such as those concerning noise, water, air, littering or erecting posters and billboards without necessary approval.[5] Such steps taken by the governmental authorities certainly create an impact in the attitude of the community. In India, similar type of arrangements will be helpful in raising the current state of environmental sanitation. To conclude, environmental sanitation involves both facilities provided by the governmental authorities as well as attitude of the community that work together to create a better environment.

Counseling at work place: A proactive human resource initiative.

Abstract: Peter Drucker one of the greatest management thinkers of our time says “In a few hundred years, when the history of our time is written from a long term perspective, it is likely that the most important event the historians will see is not technology, not the Internet, nor e commerce. It is the unprecedented change in the human condition. For the first time – literally – substantial and rapidly growing number of people have choices. For the first time they will have to manage themselves, and society is totally unprepared for it”. The following statements reinforce the above statement: “With the recent restructuring and the faster cycle of business, My staff is finding work pressure difficult to cope with. I am finding it hard to coach them to cope with the transition.” Concerned Line Manager “I have become very anxious lately due to my heavy workload and family responsibilities. I start taking medicine to calm myself, but it doesn't seem to help.” Worried Employee “Findings from our employee survey show a worrying trend of loss of work-life balance. We need to do something before this starts harmpering Productivity and staff well-being.” Human Resources Director Counseling is definitely one service that can help people learn to manage themselves. Different people since the beginning of mankind e.g. Parents, teachers, friends, elders, etc have used counseling in some way or the other. It was to the family doctor that people went most frequently. Today of course it is a very specialized service and a profession in itself. Pressure at work place and at home, lack of support system such as elders and the mismatch of expectations are the reasons for disharmony between couples & there is alienation. Tata Consultancy Services (TCS) has set up a network “Maitree” in 2005 to counsel its 30,000 employees. Under the initiative, 90% of TCS offices organize family get-togethers and activities such as ball dancing and yoga classes and theatre workshop, helping employees working long hours keep healthy. “At Wipro, to reduce employee stress after long working hours, HR initiated “Mitr”, an in house counseling service, in 2003, the set up trains employees in counseling to help out colleagues in distress,” said a senior HR manager with Wipro Technologies” Recent tragic death of young couple made headlines in the print media were not so fortunate, Only if they had called the 24x7 helpline Infosys set up two years ago the out come would not have been tragic. Professional counselors who can stimulate personal growth in others; offer help in addressing many situations that cause emotional stress, including, but not limited to: Anxiety, depression, and other mental and emotional problems and disorders Family and relationship issues Substance abuse and other addictions Sexual abuse and domestic violence Absenteeism Career change and job stress Social and emotional difficulties related to disability and illness Adopting to life transitions The death of a loved one Appropriate referrals after assessment. Good indicators of when you should seek counseling are when you're having difficulties at work, your ability to concentrate is diminished or when your level of pain becomes uncomfortable. Dimensions that can be added to workplace counseling: - Managers could be trained in some basic counseling skills. - Some growth and development workshops can be conducted in emotional Intelligence, Transactional Analysis, Marriage enrichment etc can also be conducted by the counselor. A counselor in a work place can work with designated personnel as a thinking partner, a revealing mirror, and a pacesetter among others. A counselor can help in leveraging core capacities of employees. Can help create a culture for greater synergy in organizational learning and development. Can help employees increase their self-awareness regarding their thinking patterns and behavioral tendencies so as to make them more effective as an individual and in turn effective in their job also. Managers know that many problems at work often stem from an employee's personal life rather than just the work situation. What we do from 9 to 5 at job is directly related to what we do between 5 to 9 outside the work place. Counseling is an effective and preventive people management strategy for organizations to help employees better managing stress, personal issues or work related problems. Benefits to the organization: Decrease costs related to turnover, burnouts, absenteeism & accident-related disability. Improvement in employee performance & therefore increase in productivity. Counselor can play the role of a business partner to manage behavioral Problems brought about by organizational changes. Unfortunately our educational system does not equip us with living skills. A counselor can train people in managing themselves and thus enhancing Personal growth.

Minor heavy metal: A review on occupational and environmental intoxication.

Abstract: Heavy metal is widely used in industries and presents as a problematic environmental pollution. Some heavy metals, especially lead and mercury, are well described for their occupational and environmental intoxication whereas the other minor heavy metals are less concerned. In this article, the author will present the details of occupational and environmental minor heavy metal intoxication. This review focuses mainly on aluminum, tin, copper, manganese, chromium, cadmium and nickel.

Cost-benefit analysis of installing dust control devices in the agate industry, Khambhat (Gujarat).

Abstract: It is well known that an exposure to crystalline silica gives rise to silicosis and silico-tuberculosis (TB) In the agate industry of Khambhat (Gujarat) not only workers but also people staying in the vicinity of the agate-grinding facilities are exposed to crystalline silica To reduce their dust exposure, dust control devices were developed There are approximately 500 grinding machines located in Khambhat A cost-benefit analysis of installing dust control devices on all agate-grinding machines was carried out by adding all positive factors and benefits and subtracting the negatives and costs It was concluded that by installing dust control devices not only could the prevalence of silicosis and TB be reduced but also, in the long run, there could be financial benefits

Susceptibility and resistance in the genesis of asbestos-related mesothelioma

Abstract: Asbestos is the principal agent in the etiology of malignant mesothelioma. However, a small proportion of people exposed to asbestos develop mesothelioma. This suggests the role of host factors in the genesis of the tumor. A genetic susceptibility is suggested by the occurrence of more mesothelioma cases among blood-related members of a single family. Such an occurrence reached about 4% in a large mesothelioma series. In some studies, mesothelioma patients showed higher prevalences of additional malignancies when compared with controls. This indicates a particular vulnerability to cancer in people with mesothelioma. Not rarely, very old persons heavily exposed to asbestos remain free from asbestos-related cancer, a fact indicating an absolute resistance to the oncogenic effects of asbestos. A relative resistance may be recognized in people severely exposed to asbestos who develop mesothelioma only after 60 years or more since the onset of the exposure. The long survivals, rarely observed among mesothelioma patients, have been attributed to a high efficiency of immune mechanisms. Mesotheliomas have been reported among people with severe immune impairment, such as acquired immunodeficiency syndrome patients or organ transplant recipients. The natural history of mesothelioma shows that a resistance to the oncogenic effects of asbestos does exist. Probably, such a resistance is due to the efficient immune mechanisms. To strengthen the defence mechanisms may represent a way for preventing mesothelioma among people exposed to asbestos.

Safety in nuclear power plants in India

Abstract: Safety in nuclear power plants (NPPs) in India is a very important topic and it is necessary to dissipate correct information to all the readers and the public at large. In this article, I have briefly described how the safety in our NPPs is maintained. Safety is accorded overriding priority in all the activities. NPPs in India are not only safe but are also well regulated, have proper radiological protection of workers and the public, regular surveillance, dosimetry, approved standard operating and maintenance procedures, a well-defined waste management methodology, proper well documented and periodically rehearsed emergency preparedness and disaster management plans. The NPPs have occupational health policies covering periodic medical examinations, dosimetry and bioassay and are backed-up by fully equipped Personnel Decontamination Centers manned by doctors qualified in Occupational and Industrial Health. All the operating plants are ISO 14001 and IS 18001 certified plants. The Nuclear Power Corporation of India Limited today has 17 operating plants and five plants under construction, and our scientists and engineers are fully geared to take up many more in order to meet the national requirements.

Global initiatives to prevent climate change.

Abstract: Dear Sir, Climate change is one of the most critical global challenges of our times. Recent events have emphatically demonstrated our growing vulnerability to climate change. Climate change impacts will range from affecting agriculture – further endangering food security – to sea-level rise and the accelerated erosion of coastal zones, increasing intensity of natural disasters, species extinction, and the spread of vector-borne diseases.[1] This issue is of immense importance for every global citizen. That is why it requires an initiative against it globally. Fortunately, a few of the global initiatives to prevent climate change are started by various sectors. The United Nations Environment Programme (UNEP) stimulates worldwide awareness of the environment and enhances political attention and action through World Environment Day, commemorated each year on 5th June. The World Environment Day slogan for 2008 is “Kick the Habit! Towards a Low Carbon Economy”. Recognizing that climate change is becoming the defining issue of our era, UNEP is asking countries, companies, and communities to focus on greenhouse gas emissions and how to reduce them. The World Environment Day will highlight resources and initiatives that promote low carbon economies and lifestyles, such as improved energy efficiency, alternative energy sources, forest conservation, and eco-friendly consumption.[2] In 2007, The World Environment Day slogan selected was “Melting Ice – a Hot Topic?” In support of International Polar Year, the theme selected for 2007 focuses on the effects that climate change is having on polar ecosystems and communities, and the ensuing consequences around the world.[3] In the past also, UNEP tried to raise voice against climate change. In 1989, the World Environment Day slogan was “Global Warming; Global Warning”; and in 1991, the World Environment Day slogan was “Climate Change. Need for Global Partnership”.[4] World Health Organization (WHO) is also initiating a campaign against climate change. In 2008, World Health Day focuses on the need to protect health from the adverse effects of climate change. The theme “Protecting Health from Climate Change” puts health at the center of the global dialog about climate change. WHO selected this theme in recognition that climate change is posing ever-growing threats to global public health safety. Through increased collaboration, the global community will be better prepared to cope with climate-related health challenges worldwide.[5] Other global initiatives include: on October 29, 2007, leaders of more than 15 governments met in Lisbon, Portugal to launch the establishment of the International Carbon Action Partnership (ICAP). Climate change is a global problem that requires global solutions. ICAP was formed to contribute to the establishment of a well-functioning global cap and trade carbon market. ICAP provides the opportunity for member countries and regions to share best practices and learn from each other's experiences.[6] Since the severe land and forest fires and the transboundary haze pollution incidents of 1997–1998, ASEAN has taken many initiatives and actions on-the-ground to address land and forest fires and the resulting transboundary haze pollution. ASEAN Member Countries, guided by the ASEAN Agreement on Transboundary Haze Pollution, activated bilateral and regional mechanisms to facilitate the timely exchange of information and offer assistance as necessary to deal with the situation expeditiously.[7] Rainforest Action Network (RAN) is made up of 43 staff members in San Francisco, CA and in Tokyo, Japan, plus thousands of volunteer scientists, teachers, parents, students, and other concerned citizens around the world. RAN is working to curb the global warming crisis.[8] The Cooler Heads Coalition was formed on May 6, 1997 under the auspices of the National Consumer Coalition out of concern that the American people were not being informed about the economic impact of proposals to drastically reduce greenhouse gas emissions. Nor was the American public being provided with balanced information about the science of global warming. The Cooler Heads Coalition has a website solely dealing with global warming issues, www.globalwarming.org. This site, designed and maintained by Consumer Alert, pools together information from experts, both inside and outside, of the coalition and serves as a clearinghouse for information on global warming science and policy proposals.[9] Apart from these initiatives, the prominent personalities and organizations working in the field of climate change are also recognized at international level by the most prestigious organizations and institutes. The Nobel Peace Prize for 2007 was awarded to the Intergovernmental Panel on Climate Change (IPCC) and the former United States Vice President Al Gore for their efforts to build up and disseminate greater knowledge about man-made climate change, and to lay the foundations for the measures that are needed to counteract such change.[10] Another prestigious recognition, the Oscar Award for the Best documentary feature film was given to “An Inconvenient Truth”, a documentary film about global warming, presented by the former United States Vice President Al Gore and directed by Davis Guggenheim.[11] Definitely, such kind of recognition will inspire many workers, especially the youth, to contribute in the initiative to prevent climate change. To conclude, it is now clear that initiatives to prevent climate change are started, but most importantly these initiatives must be continuous, sustainable, and every individual of all countries will need to contribute to prevent climate change.

India needs a great sanitary awakening.

Abstract: Dear sir, I read the article titled “Environmental sanitation: An ignored issue in India” published in the April 2008 issue of your esteemed journal with keen interest. The author has chosen a vital subject that needs to be addressed urgently. Environmental sanitation is indeed still an ignored issue in India. This is evident from the facts available from the report of the National Family Health Survey-3 (NFHS-3), which throws light on some of the household characteristics like the type of house, safe drinking water and sanitation, cooking fuel and overcrowding.[1] It is reported that more than half of the households in India live in kachha/semipucca (14% kachha, 40% semipucca) houses. The proportion of households living in pucca houses is lowest in Manipur (10.7%). In 34% of the households, three to four persons and in 29% of the households, five or more persons share a single room for sleeping. Ninety percent of the rural households and 31% of the urban households use solid fuels for cooking, which generate smoke and unhealthy conditions when inhaled. About 90% of the households that use solid fuels cook on an open fire without diverting the smoke through a chimney. Although 88% of the households have access to an improved source of drinking water, only half the households reported having drinking water on their premises (51% urban, 28% rural). For 37% of the households, it takes up to 30 min and for the remaining 12% more than half an hour to fetch drinking water. Transportation and storage is known to cause contamination of water, but only 33%of the households treat their drinking water to improve its potability. More than half (55%) of the households (74% rural, 17% urban) have no toilet facility, the figure varying from 2% for Mizoram to 81.3% for Chhatisgarh. Only 29% of the households have toilet facilities that are improved and not shared with any other household. The survey about disposal of household (solid and liquid) and animal waste, which form a significant source of illness, is silent. Control of these factors has been responsible for a considerable improvement in the health of people during the past century in the developed countries. On the other hand much of the illness in India is due to poor environmental sanitation, i.e., unsafe drinking water, polluted soil, unhygienic disposal of human excreta and refuse, poor housing, insects and rodents.[2] The National Water Supply and Sanitation Programme was launched as early as 1954 and was supported by the Accelerated Rural Water Supply Programme (1971-72), the International Drinking Water Supply and Sanitation Decade (1981-90), the Rajiv Gandhi National Drinking Water Mission (1986), the Central Rural Sanitation Programme, the Total Sanitation Campaign and the Millennium Development Goals(2000) and similar programs. But, it is evident from facts reported by the NFHS-3 that the sanitary conditions have not changed much. The unsanitary conditions are appalling in India and[3] perhaps India also needs a great sanitary awakening like that which took place in London in the mid-nineteenth century.

Retinal damages in turner workers of a factory exposed to intraocular foreign bodies.

Abstract: Damages caused by an intraocular foreign body (IOFB) to the visual system, mainly the retina, mostly occur during certain occupational activities. Turners are among the laborers who are mostly exposed to IOFB. The aim of the present work is to survey the effect of an IOFB on the visual system, mainly the retina. Fifty laborers of a turner factory who were exposed to IOFB were selected. Electroretinography (ERG) was recorded in all the laborers. Beside these workers, 50 laborers with no incidence of IOFB were also selected. They were also tested using ERG. The results obtained in the two groups were compared together to search for the possible changes in the two groups. The ERG patterns of the case groups were found to be changed in comparison to the control group. The changes were observed in the area under the b-wave of the ERG pattern in the early stage of damage and in the late stages, the latency and amplitude of the ERG b-wave were also affected. Finally, from the result of the present study, one can conclude that ERG is a suitable technique to search for the retinal changes in the laborers exposed to IOFB.

Morbidity profile of steel pipe production workers

Abstract: Objective: To study the different morbid conditions among steel pipe producing workers. Methods: The present cross-sectional study has been carried out among the workers of one of the steel pipes and tubes manufacturing factory of Gujarat. Hundred workers from the four major departments of the steel pipe production plant, namely welding, pressing machine, X-ray welding and loading/transportation department were covered. The information regarding demographic, occupational, clinical characteristics and diagnosis were recorded on a pre-designed proforma. Statistical analysis included calculation of percentages and proportions and was carried out using the statistical software Epi Info Version 3.3.2. Results: The mean age of the study subjects was found to be 38.7±7.1 years. The mean duration of exposure was found to be 9.0±3.4 years. Forty-four percent of the subjects had an upper respiratory tract infection, as evidenced by symptoms like dry cough, cough with rhinitis and cough with fever. Symptoms suggestive of allergic bronchitis were observed in 12% of the subjects while symptoms suggestive of heat stress such as prickly heat, dehydration, perspiration and pyrexia were observed in 13% of the subjects.

Mental stress in the workers exposed to humidity in a cheese processing factory

Abstract: Certain inevitable physical factors in working environment can damage the workers in related fields. Sea sickness and white finger due to ship movement and vibration respectively are two examples in this regard. Humidity in working area can also bring discomfort of the workers in humid area. Cheese processing factories are such places where there is high humidity in the working space. Mental stress is a psychological complication which can arise due to some physical factors in certain occupational activities, therefore an attempt was made to have a search on mental stress in the laborers working in a cheese factory in Orumieheh, a city in north of Iran, with a cold climate throughout the year. For the purpose of the present study, a cheese processing factory with 100 workers was selected. The workers were divided in to two groups. One group was exposed to high humidity and the other exposed to normal humidity level. A standard questionnaire was given to two groups to check the mental stress. The results obtained from both groups were compared.. The result showed severe mental stress in workers exposed to high humidity whereas moderate stress level in other workers. The conclusion of the present work is a proof of the adverse effect of humidity in working environments which reflect in mental stress in workers which will be discussed in detail in full paper.

Investigation of respirable particulate matter pollutants on air-breathing zone workers in the Beam Rolling Mills Factory (Iran National Steel Industrial Group), Ahvaz, Iran

Abstract: Workers of iron and steel factories are exposed to a wide range of pollutants depending on the particular process, the materials involved, the effectiveness of monitoring and the control measures. Adverse effects are determined by the physical state and propensities of the pollutant involved, the intensity and duration of the exposure, the extent of pollutant accumulation in the body and the sensitivity of the individual to its effects. The main aim of this study is to assess the levels of the indoor respirable particulate matter (RPM) and to compare the health condition of exposed workers, with nonexposed employees group. Line 630 has only one furnace of 40 tons and line 650 has two furnaces of 20 and 40 tons capacity due to which the mean of the RPM concentrations in the breathing zone was significantly different (P < 0.05) in line 650 but not in line 630 as compared with National Institute for Occupational Safety and Hygiene's (3 mg/m3). The average of the RPM concentrations in production line 650 is higher than that of production line 630, with the 95% confidence interval in saw cabin station number 1 of production line 650.

Implementation of occupational health legislation at work place, issues and concerns

Abstract: In the last fifty years Indian industry has grown rapidly and more so in the last two decades. This has resulted in increased manufacturing activities, technological advancements and change in work practices. This change in business environment has profound effect on the health of working population. Thus the onus is on Occupational Health Physician to protect and promote health of working population. This can only be achieved by comprehensively implementing Occupational Health Legislations pertaining to work place. The Occupational Health Legislation has been amended only twice in the last fifty years, one central act related to Building and other Construction workers of 1996 and The Biomedical waste (management and handling) rules of 2003 under Environment protection act of 1986 have seen the daylight, whereas in the field of Public health more than 36 different Health Legislations have come with changing time. It is only after the Bhopal disaster that legislations in the area of safety. Health and environment were forced to be reframed and notified. The concern is whether only change in legislation would result in improved Occupational health care at work place or benefits of legislation remain only on the paper is the issue. The expectation from Occupational Health Legislation would be: Occupational health legislation Prohibit conduct injurious to workers Health Aims at protecting from disease and promoting positive health Defines resourses for occupational Health care Carry out medical screening, surveillance and rehabilitation Concerning ethical issues in occupational health care Current occupational health care service is because of Governmental legislation for Industry, Mines, Docksand Ports and others Demand from the Trade Union Management concerns for compliance of legislation and Employee health care Action groups NGO like Indian Association of Occupational Health, NSC and others. Current factories acts – Occupational health care (Factories Act and Maharashtra factories rules as illustrative reference) FA – 45- First aid appliances: Under this act and MFR- 76,77 and 78 describe First- aid facilities at work place, ambulance room. Trained First-Aiders and contents of the first-aid Box. MFR – 43: Drinking water certification by Health Officer for Human consumption. FA – 87 – MFR – 114: Medical examinations for persons employed in “25 Dangerous Operations”. FA – 89: Notification of Occupational diseases(29 as per Third schedule) MFR – 73L: Declaration of Health and safety Policy. MFR – 73 V: Deals with fitness for employment in form No. 6, pre-placement and Periodic Medical examinations. Maintaining Health Register in form No. 7. MFR – 73 W: Describes size, equipment, manpower, qualifications and facilities at Occupational health Centre MFR – 73X: Deals with ambulance van, emergency medicines and equipments. MFR – 73Z: Making available Health records to Workers. MFR – 116: Notice of poisoning or disease (Form no.25) A survey was conducted amongst randomly selected 26 Industries in and around Mumbai to assess the problems faced by Occupational health Physicians in implementing legislations pertaining to Occupational health. Findings of the survey are being shared here.

Emerging public health issues due to climate change.

Abstract: Dear sir, Climate change has emerged as one of the most devastating environmental threat. The United Nation's Intergovernmental Panel on Climate Change stated that there is overwhelming evidence that humans are affecting the global climate and highlighted a wide range of implications for human health.[1] In a news release by the World Health organization on World Health Day (April 7, 2008), it stated that human beings are already exposed to the effects of climate-sensitive diseases and that these diseases today kill millions. They include malnutrition, which causes over 3.5 million deaths per year, diarrhoeal diseases, which kill over 1.8 million, and malaria, which kills almost 1 million. The following examples already provide us with images of the future: European heat wave, 2003: Estimates suggest that approximately 70,000 more people died in that summer than would have been expected. Rift Valley fever in Africa: Major outbreaks are usually associated with rains, which are expected to become more frequent as the climate changes. Hurricane Katrina, 2005: More than 1800 people died and thousands more were displaced. Additionally, health facilities throughout the region were destroyed, critically affecting the health infrastructure. Malaria in the East African highlands: In the last 30 years, warmer temperatures have also created more favorable conditions for mosquito populations in the region and therefore for the transmission of malaria. Epidemics of cholera in Bangladesh: They are closely linked to flooding and unsafe water. These trends and events cannot be attributed solely to climate change but they are the types of challenges we expect to become more frequent and intense with climate changes. They will further strain health resources that, in many regions, are already under severe stress.[2] To conclude, climate change already contributes to the global burden of disease and this contribution is expected to grow in the future. Direct as well as indirect effects of climate change are alarming to the public health authorities. It is essential for the health policy planners and administrators to consider climate change as a major public health problem in the near future. The intersectoral coordination is a key in dealing with the climate change. Health planning as well as budget allocations should not be carried out in the traditional manner. Rather, the prime importance should be given to areas where the climate change is affecting the most. Sensitization of general population about climate change and its effects is also an essential aspect.[3] Planning today for the public health issues of tomorrow is the need of the hour.