Occupational health in small scale and household industries in Nepal: a situation analysis.

INTRODUCTION: Making working conditions safe and healthy is the interest of workers, employers and the Government.Although it seems simple and obvious, this idea has not yet gained meaningful recognition in Nepal. MATERIALS AND METHODS: The study was conducted in ten small scale industries of Kathmandu valley. Altogether 545 questionnaires on socioeconomic and occupational history were filled up. Similarly, Workplace Occupational Health Assessment was done in all ten industries. A thorough medical examination of 135 child workers was done using a structured questionnaire to find out the health effects due to occupational hazards. RESULTS: Out of the total 545 workers present in the industries under study, 135 (24.8%) were child workers. Higher proportion of child workers (97%) was illiterate compared to 3% of children with primary level education. Among the child workers, 23 (17%) were girls. The majority of the child labourers were suffering from conditions like otitis externa, otitis media, scabies, anaemia, upper respiratory diseases, nasal problems, abdominal pain etc. CONCLUSION: The occupational health and safety practices in small scale industries in Kathmandu have been found to be unsatisfactory. Child labour is a serious problem. Out of ten industries, six have employed child workers and the working conditions range from bad to terrible. Health and welfare of the child workers was also not satisfactory.

Environmental health effects of brick kilns in Kathmandu valley.

INTRODUCTION: Brick kilns operating in Kathmandu valley are known to be a leading cause of air pollution. The main objective of this study was to assess the effect of brick kilns on environment and human health. This study has been done at Duwakot VDC in Bhaktapur. METHODS: This study was conducted during brick kilns operating and not operating periods. Different methods were used for data collection, such as household environmental health survey, school health examination, and air quality measurement for total suspend particles, particulate matter of size less than 10 microns, Sulphur Dioxide, Oxides of Nitrogen, and Carbon Monoxide. RESULTS: A total of 330 individuals were interviewed during household environmental survey and majority of them expressed about smoke related respiratory discomfort at home and surrounding. Out of 141 school children who underwent thorough physical health examination, 79 students were from Ganesh Public School (located near to brick kilns) and 62 were from Nabin English School (far away from brick kilns). Statistically significant high odds ratios for respiratory problems like tonsillitis (4.17 95% CI 2.05, 8.45) and acute pharyngitis (4.08 95% CI 2.01, 8.33) were observed among the students from Ganesh Public School. Average value of particulate matter of size less than 10 microns and total suspend particles for the pre operation time was 0.029 mg/m3 and 0.033 mg/m3 respectively whereas, it reached 0.050 mg/m3 and 0.056 mg/m3 respectively during the brick kiln operation time. CONCLUSION: The concentration of various air pollutants was higher during the operation of brick kilns at Duwakot. Similarly, the health status of the school children attending the school close to the vicinity of the brick kilns was worse compared to the students attending the school away from the brick kilns.

Acquaintance with the actuality: community diagnosis programme of Kathmandu Medical College at Gundu village, Bhaktapur, Nepal.

INTRODUCTION: In Nepal, various field programs such as community diagnosis programmes (CDP) have been initiated to make the education of doctors, nurses and dentists more community oriented and relevant and suited to the health care scenario. Community diagnosis refers to the identification and quantification of the health problems in a community and identification of their correlates for the purpose of defining those individuals or groups at risk or those in need of health care. The article presents the main activities of community diagnosis as a core component of community-based education for the medical students at Kathmandu Medical College, Kathmandu, Nepal. METHODOLOGY: A 4 weeks' Community Diagnosis Programme was conducted by MBBS II students (9th Batch) of the Kathmandu Medical College under the supervision of the Department of Community Medicine in November 2006 in the rural community of Gundu VDC (village development committee). The tools used included pre-tested questionnaires, weighing machines, measuring tapes, stethoscopes and sphygmomanometers. After the data collection and compilation, the students presented their findings in oral presentations, accompanied by a written report, including essential recommendations for improving the health status of these communities. RESULTS: The students benefited from the necessary process of integrating clinical skills and a public health approach, so as to enhance their epidemiological thinking and be of greater use to the communities where they will practice. The community also benefited by achievement of behavioral changes leading to healthier lifestyles and increased awareness of health-related matters and their role in quality of life. CONCLUSIONS: CDP is a way to practically demonstrate that the link between a medical college and society is possible. That is, a medical college can serve the community and thus society, with specific activities to improve health and the skills of students who will serve as future health professionals.

Environmental noise induced hearing loss in Nepal.

INTRODUCTION: Noise pollution in urban cities is a serious problem and steadily increasing over the years. This has direct and indirect affect to the people that can lead to the health hazard. OBJECTIVES: To find out environmental noise induced health effect on people residing in an urban community and to predict the risk of the environmental noise induced hearing loss. MATERIAL AND METHODS: One hundred fifty questionnaires were filled up for the environmental noise pollution survey. For the case control study, 36 exposed and 25 non-exposed residents of Kupondole were included. Based on the place of residence (main road and 20 min. walking distance from the main road), subjects were divided into exposed and non-exposed group concerning environmental noise. Demographic data and information about health problems was obtained by a structured interview. Audiometric test was performed using manual audiometer. Odds ratios (OR) and their 95% confidence intervals (95% CI) for noise induced hearing loss were estimated using logistic regression. Adjustment for occupational noise was done. RESULTS: The major health effect induced by the environmental noise was observed as lack of concentration followed by irritation, fatigue and headache. The crude OR and 95% CI for the exposed subjects was 4.2 (1.4, 12). After adjustment for occupational noise, the OR (95% CI) was 4.0 (1.2, 13). CONCLUSION: This study shows that exposure to noise causes wide range of health effects. For the exposed subjects there was an increased risk of noise induced hearing loss. The risk was significantly increased also after adjusting for occupational noise.

Occupational cancer in Nepal--an update.

This article is a discussion of occupational cancer in Nepal. The knowledge of specific problems of occupational cancer in Nepal is very scarce. Few researches on occupational cancer have been done in Nepal. A case-control study done recently has revealed a high risk (OR 4.2 95% CI: 1.4, 12) for lung cancer among the workers, who have worked in the exposed occupations. The incidence of cancer is thought to be rising every year. In this article an attempt has been made to establish the probable occurrence of carcinogens in the middle and large scale manufacturing industries in Nepal and the approximate number of workers exposed to different hazardous substances at the work places.

Peak expiratory flow rate of carpet weaving children.

OBJECTIVE: To assess the adverse influence of carpet weaving on lung functions and the nurtritional status of children employed in such factories. DESIGN: Comparison of the peak expiratory flow rate (PEFR) of the study group with controls of similar socio-economic status and correlate it with anthropometric values. SETTING: Field study. SUBJECTS: One hundred and ten boys, 6-15 years of age engaged in 23 carpet weaving factories of Jaipur city. OUTCOME MEASURES: Linear regression analysis using age, height and weight as independent variables and PEFR as the dependent variable. RESULTS: PEFR of carpet weaving children were significantly lower (p < 0.05) than controls for all except 6-7 years group. The height, weight and chest circumference of these children were also lower (p < 0.05). PEFR did not show significant difference when children were grouped according to their height. CONCLUSIONS: Children working in carpet weaving factories are shorter and lighter compared to normal school going children. As a consequence of the growth retardation, their PEFR values were also lower as compared to normal children.

Health status of carpet weaving children.

A cross-sectional study was undertaken to determine the health status of children engaged in carpet weaving factories of Jaipur City. Two hundred and ninety school going boys of similar socio-economic status served as controls. A higher prevalence of signs of nutritional deficiencies was observed in carpet weaving children. Analysis of the presenting complaints and the illness suffered in the past six months also revealed a significantly higher morbidity in these children. A statistically significant difference was also observed in anthropometric measurements of the two groups.