Universal occupational health care – the need of the hour Bobby Joseph Indian Journal of Occupational and Environmental Medicine 2019 23(2):59-60

Obituary - Dr. G K Kulkarni, Editor, Indian journal of occupational and environmental medicine T Rajgopal Indian Journal of Occupational and Environmental Medicine 2019 23(2):61-62

Electric field exposure assessments and a novel control method for buildings installed nearby high-voltage lines A Shemshadi, AK Maleki Indian Journal of Occupational and Environmental Medicine 2019 23(2):63-67 This essay presents a review of new methods for electric field value assessment in high-voltage areas. For buildings that are placed near high-voltage transmission line corridor, two main scenarios are modeled using finite element method. A new approach to reduce electric field value is also simulated and the results are discussed in detail. The results are compared to related standards values. In some cases the improvement rate exceeds 65%.

Association of musculoskeletal disorders and inflammation markers in workers exposed to lead (Pb) from Pb-battery manufacturing plant Kalahasthi Ravibabu, Bhavani Shankara Bagepally, Tapu Barman Indian Journal of Occupational and Environmental Medicine 2019 23(2):68-72 Background: Lead (Pb) deposits in the skeletal system on chronic exposure and releases to circulation over a period. The musculoskeletal disorders (MSDs) are associated with enhanced expression of inflammation. The combination of Pb-exposure and MSDs induced inflammation was not attempted. Objective: This study was conducted to examine the association between MSDs and inflammatory markers in workers exposed to Pb from Pb-battery plant. Material and Methods: In a case-control study design, the study enrolled 176 male Pb-exposed workers as study subjects and 80 healthy workers with no occupational exposure to Pb as control subjects. The Nordic musculoskeletal questionnaire was used to assess the MSDs. From the blood sample, blood lead level (BLL) and High Sensitivity C-reactive protein (Hs-CRP) were estimated as markers of Pb-exposure and Inflammatory marker respectively. The BLL was estimated by flame atomic absorption spectrometric method and the Hs-CRP by using a diagnostic kit method. Results: Significantly high proportions of MSDs were noted in study subjects as compared to controls. The MSDs identified in the study subjects were at low back (33%) followed by knee (26%), shoulders (16%), neck (14%), ankle/foot (11%), wrist/hand (10%), elbows (8%), upper back (7%), and hips/thighs (5%). The significant association between Pb-exposure and MSDs among study subjects was mainly noted in low back and ankle/foot. Also, significantly high serum Hs-CRP levels were noted among study subjects with ankle/foot MSDs. Conclusion: Pb-exposure and inflammatory markers were significantly associated with lower limbs of MSDs.

A Study of stress, coping, social support, and mental health in police personnel of Uttar Pradesh Shweta Singh, Bandna Gupta, Divya Sharma, Prem Chandra Mishra Indian Journal of Occupational and Environmental Medicine 2019 23(2):73-78 Background: Presence of enormous stress gives birth to a higher prevalence of mental health difficulties. Globally, the job of police personnel is full of stress. Coping strategies and social support have a crucial role to play in the management of stress and mental health. Objective: The objective of this study was to study stress, social support, coping, and mental health in the police personnel of Uttar Pradesh. Methodology: The sample comprised 300 male police personnel including 100 constables, 100 inspectors, and 100 officers being incidentally selected from six districts of Uttar Pradesh viz. Lucknow, Varanasi, Meerut, Raibareilly, Ghazipur, and Noida. The mean age of the sample was 40 years and average experience of 15 years of police service. They were assessed by using Occupational Stress Questionnaire (OSQ, Gmelch and Chan, 1994), Brief COPE Scale (Carver, 1997), Social Support Scale (Cohen et al. 1985), and Mental Health Inventory (Jagdish and Srivastava, 1983). The results obtained were analyzed statistically, the mean score was calculated, and the independent t-test was applied. Results: Among the police personnel, inspectors scored highest mean occupational stress score (39.89 ± 13.17) with the lowest mean score of active coping (17.40 ± 7.37), adaptive coping (23.81 ± 8.59), and the highest mean score in maladaptive coping (21.43 ± 7.89). Mental health of inspectors was most adversely affected with highest mean score (97.81 ± 24.49). Conclusion: The study concludes that the amount of stress experienced by all echelons of police is extremely high and almost of similar level except for inspectors showing highest among the three groups, thus emphasizing the use of healthy coping mechanisms and modification in work environment promoting health and well-being.

Hand-arm vibration syndrome in farmers and its correlation with degenerative triangular fibrocartilage complex injury Javid Hussain Sagar, Soniya T Lohana Indian Journal of Occupational and Environmental Medicine 2019 23(2):79-82 Context: Hand-arm vibration syndrome (HAVS) is an occupational disease that affects workers who are exposed to vibrations. Farmers are prone to various musculoskeletal and cumulative trauma disorders. These occur owing to overuse, degeneration, and excess physical efforts along with whole-body vibrations- owing to the use of farming equipment such as tractors and harvesters. Aims: Aims of the study were to find out the prevalence of various symptoms of HAVS among farmers using tractors, harvesters, etc., and to find out the correlation of triangular fibrocartilage complex (TFCC) injury with HAVS. Subjects and Methods: A prevalence study was conducted among farmers. Farmers were selected by random sampling method and were asked to fill-up a HAVS surveillance questionnaire. The handgrip strength was recorded with a hand dynamometer. Assessment of carpal tunnel syndrome was done, and correlation of HAVS with TFCC injury was assessed. Results: Data from 100 farmers was obtained and analyzed. The musculoskeletal symptoms of HAVS, more specifically pain was prevalent (n = 65), followed by sensorineural symptoms (n = 70), and the vascular symptoms were less common (n = 43). HAVS accounts for a prevalence of 64% with 39% of farmers having TFCC injury along with HAVS (P value = <0.0001). Conclusions: These findings reported in the study provide a better understanding of the impact and extent of HAVS in farmers. There is a significant prevalence of HAVS with mild symptoms of vascular component, mild to moderate symptoms of sensorineural component, and significant involvement of the musculoskeletal component. In addition, TFCC injury is correlated with HAVS.

Risk of tuberculosis infection among healthcare workers in a tertiary care hospital in Bengaluru City Melvin G Kumar, Bobby Joseph, B Ramakrishna Goud, Merlyn Joseph, M Rajitha Indian Journal of Occupational and Environmental Medicine 2019 23(2):83-89 Introduction: Tuberculosis (TB) is an airborne communicable disease caused by Mycobacterium tuberculosis. Infection is most likely to occur when an individual is exposed to someone with pulmonary TB on a day-to-day basis, such as by living or working in close quarters with someone who has an active disease. This study was undertaken using reliable screening and investigation tools for assessing the incident latent tuberculosis infection (LTBI) among healthcare workers (HCWs). Methodology: This descriptive longitudinal study was conducted among 600 HCWs at a tertiary care hospital in Bengaluru city for a period of 1 year 4 months (March 2016–June 2017). All HCWs were stratified according to their work profile as doctors, nurses, laboratory technicians, nursing aides, pharmacists, laundry workers (only those who come in contact with patients), dietary workers (only those who come in contact with patients), and workers from housekeeping department. Study subjects were enrolled in proportion to their population size. The data were collected by administering TB screening questionnaire and performing tuberculin skin test (TST). All the subjects who had negative TST reaction were followed up after 1 year from March 2017 to June 2017. Results: The study subjects consisted of 600 HCWs with a mean age of 27.8 ± 7.1 years. Initially, 600 study subjects underwent TST, 2 of whom were not contactable between 48 and 72 h of test administration. Of the remaining 598 subjects, 120 (20.1%) had a positive TST reaction. After 1 year, of the 478 subjects who tested negative, 345 study subjects underwent the repeat TST and 67 (19.4%) of the study subjects had a positive TST reaction. Conclusion: The prevalence of LTBI was 20.1% and it was significantly associated with age, place of residence, education, work commute time, and mode of transport. The incidence of LTBI was 19.4% and it was significantly associated with gender, place of residence, education, work commute time, and marital status.

Blowing balloons and pulmonary talcosis: An uncommon hazard Mahismita Patro, Dipti Gothi, Umesh Ojha, Ram B Sah, Sameer Vaidya Indian Journal of Occupational and Environmental Medicine 2019 23(2):90-92 A 65-year-old nonsmoker man presented with bilateral upper lobe conglomerated calcific opacities with basal reticulations. The patient denied any significant occupational exposure. Repeated and persistent enquiry revealed an intense exposure to talc 20 years back, from blowing balloons stained with talc powder for a period of 1 year. To the best of our knowledge, only one case has been reported in the past with talcosis due to balloon blowing.

Malignant mesothelioma – Report of two cases with different presentations Mahavir N Munot, Ketaki V Utpat, Unnati D Desai, Jyotsna M Joshi Indian Journal of Occupational and Environmental Medicine 2019 23(2):93-96 Malignant pleural mesothelioma (MPM) is a rare and aggressive neoplasm that stems from the mesothelial cells lining the visceral cavities, namely, the pleura, peritoneum, pericardium, and tunica vaginalis of the testes. MPM is the most common variant of these and constitutes up to 80% of all malignant mesotheliomas. It is usually associated with asbestos exposure and is a locally invasive neoplasm that spreads along pleura and can involve lungs with locoregional metastasis. Diagnosis remains challenging due to the latency between asbestos exposure and clinical presentation and the variable clinicoradiological manifestations. Meticulous history taking, high index of, suspicion and multimodality approach toward diagnosis are the keys to better prognosis. We hereby present two interesting cases of MPM with different presentations.

Strategies to deal with publication misconduct among medical students and teaching faculty: An Indian perspective Saurabh R Shrivastava, Prateek S Shrivastava Indian Journal of Occupational and Environmental Medicine 2019 23(2):97-98