Indian Journal of Occupational and Environmental Medicine最新文献

Malignant mesothelioma is an aggressive cancer primarily associated with asbestos exposure, affecting the mesothelial lining of the lungs, abdomen, or heart. Despite global awareness, it remains relatively rare, with an age-standardized incidence of mesothelioma around 3 per million individuals, with Northern Europe exhibiting the highest rates. The occurrence is significantly higher in males compared to females. Malignant pleural mesothelioma (MPM) affects the pleura and often develops after years of asbestos exposure, silently progressing until symptoms appear. MPM predominantly affects men, with cases being more common in industries such as asbestos product manufacturing, construction, demolition, shipbreaking, and mining. In exposed populations, about 7-13 men per million develop the disease annually, while in those without asbestos exposure, it is rarer at 1-2 cases per million. In India, despite widespread asbestos use, mesothelioma cases remain underdiagnosed and underreported, highlighting the importance of a smart occupational health surveillance system.

Background: Work-related musculoskeletal disorders (WMSDs) are a leading cause of occupational morbidity among healthcare professionals globally. In India, the high patient load, resource constraints, and demanding work conditions expose doctors and nurses to significant ergonomic risks.

Objective: To determine the prevalence and risk factors associated with WMSDs among healthcare workers (HCWs) in a tertiary care setting in South India.

Methods: A cross-sectional study was conducted among 290 HCWs, including doctors and nurses, using a stratified random sampling method. Data were collected using the Standardized Nordic Musculoskeletal Questionnaire and a structured work profile assessment. Descriptive statistics, Chi-square tests, and multivariate logistic regression were used to analyze the prevalence and identify risk factors.

Results: The overall prevalence of WMSDs was 82.1%, with the lower back (68.3%), neck (54.8%), and shoulders (48.6%) being the most commonly affected regions. Nurses reported significantly higher prevalence compared to doctors (88.4% vs. 73.9%, P < 0.01). Prolonged standing, repetitive movements, and poor ergonomics were identified as major risk factors. Multivariate analysis revealed that work experience > 10 years (AOR = 2.65; 95% CI: 1.21-5.83) and lack of ergonomic training (AOR = 3.12; 95% CI: 1.48-6.58) were independently associated with WMSDs.

Conclusion: WMSDs are alarmingly prevalent among HCWs in India, especially among nurses. There is an urgent need for workplace ergonomic interventions, regular training, and policy-level initiatives to safeguard the occupational health of frontline medical staff.

Background: Indian coffee cultivation relies on a substantial labor force, notably women and children, who are exposed to significant occupational health and safety risks due to physical strain, agrochemical application, and adverse environmental conditions. This study aimed to evaluate their working conditions, lifestyle factors, occupational health hazards, injuries, and associated health implications.

Methodology: This cross-sectional study comprised coffee processing workers (n = 80) and administrative staff (n = 50) associated with coffee plantations in Karnataka. Information includes occupational health risks, injuries, and acute and chronic health complaints, which were collected from them using a predesigned standard questionnaire. Chi-square tests were used to assess associations between categorical variables, such as job category and health outcomes using SPSS tool.

Findings: The study revealed that 36.3% of the participants lacked personal protective equipment (PPE) at work, and 24% of the subjects were illiterate. Heavy lifting, bad weather, falls, and physical strain were among the risks. Coffee processing workers faced occupational injuries (40%), leech bites (66%), and palm discoloration (51%). There was higher prevalence of musculoskeletal disorders (P < 0.05), including low back pain (59%), joint pain (52.5%), and neck pain (30%). Other reported issues included headaches (26.3%), fatigue (31.3%), eye problems (18%), gastrointestinal issues (20%), and skin complaints (20%). Respiratory symptoms including cough (14%), wheezing (8%), breathlessness (6%), and asthma (1.3%) were also noted.

Conclusion: Improving occupational health in coffee plantations is crucial to reducing high morbidity rates among workers, and PPE and training can significantly mitigate risks in them. Implementing regular health interventions may be significantly reduced health burden in them.

Background: The widespread use of smartphones among healthcare students raises concerns about cognitive and occupational safety impacts. This study aimed to examine the relationships between smartphone addiction, attention difficulties, and susceptibility to occupational accidents among university students in health science internships.

Methods: A cross-sectional study was conducted in 2023 with 553 volunteer university students enrolled in the health sciences programs at Yozgat Bozok University Hospital. Participants were selected using a convenience sampling method. The study site was a university hospital in central Türkiye, where students were completing clinical internships. Data were collected using validated scales, and the analysis plan included descriptive statistics, Pearson correlation, and multivariate linear regression to examine associations between variables.

Results: Significant positive correlations were found between smartphone addiction and attention difficulties (r = 0.510), accident susceptibility (r = 0.504), and daily smartphone use (r = 0.314). Regression analysis showed that attention difficulties were primarily influenced by smartphone addiction. Susceptibility to accidents was mainly predicted by attention difficulties, smartphone addiction, and being a student in nursing, midwifery, or medicine (Adj. R² =0.473). Occupational accident risk was associated with susceptibility to accidents, higher risk perception, off-campus work, lack of occupational health and safety training, attention difficulties, nursing education, and previous accident experience (Adj. R² =0.238).

Conclusion: The study found that smartphone addiction is significantly associated with increased attention difficulties, which in turn elevate students' susceptibility to occupational accidents. Smartphone use may thus indirectly increase accident risk in clinical settings.

Objective: The present study aims at evaluating the influence of whole-body vibration (WBV) exposure and its contributing factors on musculoskeletal disorders (MSDs) of equipment operators in coal mines.

Methodology: In this paper, WBV measurement was conducted for 100 equipment operators exposed to vibration, followed by a questionnaire survey. This questionnaire survey was also extended to 104 workers with limited exposure to vibration.

Results: The daily average frequency-weighted acceleration A(8), when compared with health guidance caution zone (HGCZ) of ISO 2631-1, reveals that 15% operators are exposed to likely health risk and 82% to potential health risk. The relative risk of MSDs of vibration-exposed operators was 2.63 times more than the control group. Moreover, when mines were compared, Mine B showed a 3.27 times higher likelihood of vibration hazards compared to Mine A.

Conclusion: Equipment operators in mines are exposed to vibration as a part of their occupation. The company management may take preventive measures through design of workplace and work environment for minimizing vibration exposure on operators to reduce MSDs.

Background: The occupational health scenario is undergoing a paradigm shift in India due to rapid industrialization. Occupational health services are important to develop healthy and productive work forces. This is to be delivered through occupational health team of which the occupational health nurse is an important member. The gap in demand and supply of this specialist's service is very significant.

Aim: To assess the knowledge about occupational health among the nursing students and find their attitude about the occupational health nurse as a job opportunity.

Settings and design: A cross-sectional study among fourth-year nursing students of a Nursing College using an anonymous, self-administered, structured questionnaire.

Methods and materials: A total of 124 nursing students responded and were asked to provide demographic details, knowledge about occupational health, and their views on occupational health nursing as a job opportunity.

Results: The respondents had a mean age of 21.5 years. Students had good knowledge about occupational health problems in India and among nurses. About 68% had heard about the occupational health nurse, but only 51% knew that there was a specialized course for it. About 43% felt that a job opportunity was in private sector and 90% felt the need of such course while 63% were willing to enroll, but none of them knew about any institute where the course of occupational health nursing was available.

Conclusion: There is a need to create awareness among students regarding occupational health nursing as a course and how to fast-forward their career by choosing occupational health nursing as a job opportunity.

Background: Teachers are among the professionals most affected by voice disorders. The VHI-30 is a psychometrically valid tool used to measure the psychosocial handicapping of voice disorders.

Aims: To translate (to the Sinhala language), culturally adapt and validate the VHI-30 questionnaire, and to develop a cutoff to screen for voice disorders among primary school teachers in the Colombo District in Sri Lanka.

Methods: Standard forward-backward translation, cultural adaptation, and assessment of judgmental validity by a panel of six experts were conducted. The calculated sample size of 215 primary school teachers was gathered from 11 schools by purposive sampling. Construct validity using confirmatory factor analysis (CFA) on LISREL software version 8.8, and convergent validity, discriminant validity, and composite reliability were assessed. Criterion validity was assessed by a speech-language therapist (SLT) and confirmed by acoustic measurements using PRAAT software 6.1.16. A cutoff value to screen for voice disorders was determined from the ROC curve. The assessment of reliability was by Cronbach's alpha, and test-retest reliability by Spearman correlation.

Results: The three-factor model assessed for CFA demonstrated a medium fit. Factor loadings exceeded the desired value of 0.4, except for item 10. Convergent and discriminant validity were medium. Reliability was satisfactory with values above 0.7 for composite reliability, Cronbach's alpha, and test-retest reliability. The cutoff value for screening voice disorders, determined from the ROC curve, was 14 (sensitivity 84%, specificity 72.5%).

Conclusion: The Sinhala version of the VHI-30 is a reliable tool with medium validity. It is recommended for use among primary school teachers for screening voice disorders in the Colombo District in Sri Lanka.

Background: Bharatanatyam, a classical Indian dance form, involves dynamic lower limb movements often performed in extreme joint positions. This study aims to biomechanically evaluate one of the basic movement units (adavu) of Bharatanatyam called Paichal adavu and its three variations, denoted for this study as Simple Paichal (SP), Paichal Variation (PV), and Paichal Mandi (PM), using 3D motion capture and musculoskeletal modeling.

Methods and materials: A trained male Bharatanatyam dancer performed the three variations of the Paichal movement in a motion capture lab equipped with a Qualisys motion capture system and an AMTI force plate. Kinematics, joint contact forces, muscle activations, and muscle forces were analyzed using a musculoskeletal model.

Results: The PM showed the highest compressive knee joint force (16 BW) and maximum muscle force (10 BW in the vastus lateralis), indicating high stabilizing demands. The PV exhibited the highest hip flexion (112.4°) and ankle dorsiflexion (-33°), along with substantial joint forces, reflecting dynamic loading. The SP had the lowest overall joint and muscle loads but showed short bursts of muscle activation, especially in the rectus femoris and tensor fasciae latae (TFL).

Conclusion: Among the analyzed movements, PM imposed the greatest muscular and joint stabilization demands, while the PV, with body turn, involved the highest mobility and dynamic loading. These biomechanical insights can support the development of safer techniques and, thus, injury prevention for Bharatanatyam dancers.

Background: Posterior load carriage (PLC) on inclined agricultural surfaces challenges postural stability. Traditional aids like fabric shawls are commonly used, but their biomechanical impacts are not well understood.

Aims: This study examined how surface inclinations and different carrying aids affect postural stability and lower extremity posture during PLC.

Methods and materials: Twelve participants performed static PLC tasks using two carrying aids (i.e., a traditional fabric shawl and a custom-designed frame backpack) across three inclinations (-25º, 0º, 25º). Center of pressure (COP), joint angles, and subjective ratings of steadiness and discomfort were measured and analyzed using repeated measures ANOVA.

Results: Uphill PLC significantly reduced stability and increased postural deviations. The frame backpacks improved stability but caused greater ankle and knee deviations. The fabric shawls minimized postural deviation but were less effective uphill.

Conclusions: Frame backpacks enhance incline stability but may increase joint strain, highlighting the need for ergonomic design improvements.