Risk factors and cost of low back pain in a paper industry

Low back pain [LBP] is a serious occupational problem in terms of human sufferings and social cost. The human, public health and economic consequences of LBP make its prevention one of the most worthwhile priority areas for occupational health and safety. This study was formulated to reveal the demographic features of LBP as well as to identify administered medical care and calculate the direct total medical cost of LBP in the paper industry. A cross-sectional study was conducted in a paper factory in Alexandria, Egypt, all workers' in the factory [n= 454] were included in the study. Data collected covered personal characteristics of workers, work circumstances, occupational history and medical history of LBP. Height and weight were measured for all workers and their personal health records were reviewed to collect data concerning duration and cost of sickness absence attributed to LBP, during the last 12 months prior to the study. The results of the study revealed that the prevalence of LBP in the studied factory was 78.6%. Smoking was found to be a significant risk factor for the occurrence of LBP. On the other hand, increase in age, height, weight and level of education showed no significant association with the development of LBP. Regarding the type of job performed, forklift drivers, operators and maintenance workers reported a significantly higher prevalence of LBP [90.2, 80.7 and 77.6% respectively] compared with office and security workers [70% and 64.3% respectively]. Considering the relation between awkward postures adopted by the studied workers during their working day and risk of LBP; all awkward postures [bending, twisting, kneeling and squatting] were found to be significantly associated with LBP; moreover, LBP was significantly associated with manual material carrying and pushing / pulling tasks. The mean total direct cost of LBP in the studied year was 111, 821.7 L.E. and the main bulk was found to be spent on sickness absence, hospitalization and x-ray imaging. LBP is a prevalent health problem in the paper industry. Some personal and work-related factors can predispose to occurrence of LBP, such as; smoking, awkward postures, manual material carrying and pushing / pulling tasks. The estimated mean total direct cost for LBP was 111, 821.7 +/- 46700.29 LE. in the studied rear

Effect of exposure to X-ray radiation on the hematological system and immunoglobulin concentration of customs clearance workers in Alexandria port

Based on scientific evidence, any exposure to radiation can be harmful; there is no safe dose, i.e. no threshold-dose. This study was conducted to reveal the effect of low dose radiation on the haematological system, as the blood cells are classified as the most radiosensitive tissue in the human body. The inference population included 40 male Customs Clearance Workers [CCWs] from Alexandria seaport; they were exposed to low doses of ionizing radiation while using various types of electronic and imaging machines for security purposes. .The comparative population included 40 male workers; they were not exposed to ionizing radiation or radioactive hazardous materials in their work environment. All CCWs and unexposed workers were subjected to an interviewing schedule, physical examination, and haematological investigations, which included a complete blood count and IgG, IgA and IgM concentrations. In the present study the prevalence of general manifestations such as pallor, hair loss, repeated infections and bouts of fever were higher among CCWs compared with unexposed workers. Neurological manifestations namely, headache and fatigue were prevailing among CCWs. Haematological investigations revealed that the mean total leucocytic count was significantly decreased among CCWs. On the other hand the mean values of RBC and platelet counts were not significantly lowered among CCWs. Moreover, the differential picture showed a significant depression in the mean percent of circulating lymphocytes among CCWs. Regarding the immunoglobulin concentrations, the present study revealed no significant difference between CCWs and unexposed workers regarding their serum IgG, IgM and IgA concentrations, Furthermore, there were significant negative correlations between the total leucocytic count and both the duration of occupation and smoking index, and between the mean percent of circulating lymphocytes and duration of occupation. CCWs at Alexandria seaport although assumed to be exposed to low doses of ionizing radiation, yet significant affection of some basic blood parameters was evident. Thus, personal monitoring for X-ray radiation and increasing the level of protection for CCWs is of utmost importance

Respiratory system assessment of marine spray painting workers

Workers at the Marine Spray Painting Workshop [MSPW] are exposed to respiratory hazards durig ship surface preparation and spray painting. To identify hazards at the Marine Spray Painting Workshop [MSPW] and assess the impact of these hazards on the respiratory system of Marine Spray Painters [MSPs]. The study included 80 workers, of these were 40 MSPs from the Alexandria Shipyard Company. The rest were control workers, not exposed to respiratory hazards in their work environment. All MSPs and unexposed workers were subjected to an interviewing schedule; to collect data on personal characteristics, occupational, and medical history. The Medical Research Council [MRC] questionnaire was used, it included questions on respiratory symptoms, and diseases. All workers underwent a general clinical examination, a local chest examination, pulmonary function tests, and lung imaging by conventional chest radiographs [CCR]. The present study demonstrated that breathlessness grade IV, wheeze, and bronchial asthma, were significantly more encountered among MSPs compared with unexposed workers. On assessing lung functions, mean percent predicted values of lung function indices [LFI] reflecting large and small-airway functions were lowered among MSPs compared with unexposed workers, but the lowering was not statistically significant. Furthermore, it was found that 47.5% of MSPs had no radiological abnormalities [0/0 ILO profusion grade], while 52.5% of MSPs were either with suspicious radiological abnormalities of [0/1 or 1/0 ILO profusion, glade] [10.00%] or with definite radiological abnormalities whose ILO profusion grade was of [2/1, 2/2, or 2/3 ILO profusion grade] [10.00%, 17.5%, or 15.0% respectively]. A comparison between silicotic and non-silicotic MSPs was conducted, where no significant differences were found between them regarding respiratory symptoms, diseases, and spirometric measurements, thus, the significant increase in bronchial asiluna among MSPs in the present study can be attributed to exposure to HDI during spray painting. The study revealed a significant positive correlation between grade of profusion and age, duration of exposure and breathlessness, especially those with profusion grade >/= 1/1, but no significant correlations between the grade of profusion and mean values of spirometric measurements were recorded. A potential respiratory health hazard exists at the [MSPW] in Alexandria Shipyard Company and the level of protection for workers should be increased

Effects of occupational exposure to lead and noise on hearing

Noise induced hearing loss is one of the most common and expensive sources of compensated work related health problems in modern industrialized countries. This study was conducted to detect the combined effect of occupational exposure to noise and lead on hearing. An observational analytic comparative approach was selected for this study. The inference population comprised 208 production workers from the Egyptian Copper Works Company in Alexandria, of these workers 51 were exposed to both noise and lead, 54 workers were exposed to noise, 53 workers were exposed to lead, and the rest, 50 workers were not exposed to neither noise or lead. All workers were subjected to a detailed interview, physical examination, otological examination, and auditory evaluation through a pure-tone audiometry, speech audiometry [Speech Reception Threshold [SRT] and Speech Discrimination Score [SDS]%], tympanometry, and auditory brain-stem response audiometry. Moreover, the blood lead level of workers, and workplace noise intensity were measured. Clinical evaluation of workers revealed a significant increase in mean systolic blood pressure among lead exposed and noise exposed workers. Neurological manifestations [tremors, tingling/numbness, reduced visual acuity and headache], urinary troubles, and oral manifestations gingivitis and bleeding gum], were significantly more encountered among lead exposed workers and workers with combined exposure. On assessing the workers' mean hearing threshold of the right ear, it was evident that at low frequencies [250 Hz and 500 Hz] the maximum significant drop was recorded among the workers with combined exposure [30.2 +/- 9.8 dB, 30.2 +/- 9.74 dB respectively], compared to lead exposed workers [29.15 +/- 8.42 dB, 28.49 +/- 6.97 dB respectively], and noise exposed workers [27.68 +/- 6.98 dB, 28.43 +/- 7.57 dB]. On the contrary, at higher frequencies [1 KHz - 8 KHz] the maximum drop was recorded by noise exposed worker. Regarding the left ear, the maximum impairment at low frequencies was observed among lead exposed workers [28.3 +/- 8.08 dB, 28.49 +/- 9.38 dB respectively], but at the higher frequencies a similar pattern to that observed at the right ear was obtained. Noise exposed workers had the most impaired mean SRT [31.48 +/- 8.22 dB], while workers with combined exposure recorded the worst mean SDS% [91.67 +/- 6.06%]. No significant delay was observed in the Auditory Brainstem Response [ABR] audiometry recorded at the latencies I, III, and V and inter-peak latencies; I-III, I-V, and III-V for the studied workers. On calculating the total hearing impairment percent, noise exposure imposed the worst effect on hearing, where both noise exposed workers and workers with combined exposure had the highest mean hearing impairment percent [15.25 +/- 13.61%, 13.22 +/- 13,49% respectively]. Among noise exposed workers, the significant predictors of hearing impairment were the duration of employment and smoking. While, blood lead level and aging were the significant predictors for hearing impairment among workers with combined exposure. Cochlear affection is the main site of lesion in noise and/or lead exposed workers, and the risk of combined exposure to noise and lead imposed on the auditory system sensitivity at the studied levels of exposure is nearly similar to that encountered by noise exposure alone

Combined effect of smoking and occupational noise exposure on hearing

Although noise and smoking are frequently encountered hazards in the occupational settings, and they may act in common causal pathways for hearing loss, yet, the combined effects involving smoking and noise have rarely been assessed. To study the combined effect of smoking and noise on hearing loss. A cross sectional comparative study was adopted. The study included 196 male smokers, and 154 male non smokers from a wood processing factory, where workers were exposed to noise levels exceeding 85 dBA. All workers were subjected to: a] an interviewing schedule to collect data about personal characteristics, smoking habit, duration of military service, current working conditions, and manifestations related to noise exposure, b] physical examination, and c] audiometric measurements for assessing hearing acuity. It was observed that noise exposed smokers had a significant high prevalence of hypertension, Raynaud's phenomenon and self reported hearing loss compared with non-smokers exposed to the same noise intensity. Moreover, noise exposed smokers had a significantly higher mean hearing loss [%] and a higher mean hearing threshold at the frequency 4000Hz compared with non smokers. When age groups and smoking index were studied in relation to hearing loss, noise exposed smokers above the age of 40 years had a significant increase in the mean hearing loss percent compared with non- smokers in the same age group, and heavy smokers had a significant increased prevalence of hearing loss compared with mild and moderate smokers. Furthermore, after allowing for the effects of age and duration of noise exposure, current smokers were 4.16 times at a higher risk of developing hearing loss compared with non smokers. Smoking aggravates noise induced hearing loss specialy after the age of forty, and accurate follow up of smokers who are exposed to hazardous noise is suggested

Assessment of memory status among workers exposed to mercury

Mercury [Hg] has well established toxic effects on the central nervous system. To study the memory status of workers exposed to mercury. A comparative cross-sectional epidemiological study was carried out among 100 workers exposed to mercury vapour in a fluorescent lamp factory in Alexandria, Egypt. The comparative group comprised 100 workers not exposed to Hg or any other occupational hazard or systemic disease that may affect the memory status. All workers included in this study were interviewed to collect data on personal characteristics, medical and occupational histories, recent and remote memory status. Urine samples were collected to asses the level of mercury in urine in micro g/liter. The results of this study indicated that the mean age of workers was 40 +/- 8.46 years, their mean duration of exposure was 17.21 +/- 8.4 years and their mean urine mercury level was 32 micro g/L. Hg exposed workers showed a significant deficit in the ability to remember remote events and events that happened 10 years ago. Moreover the mean percentage of story events recalled was significantly lowered in mercury exposed workers. On the other hand there was no significant difference between Hg exposed workers and their controls in forward and backward repetition of numbers and in the mean percentage of pictures recalled. After allowing for the effects of age, and smoking, mercury exposed workers were at a higher risk of developing recent and remote memory disorders than unexposed workers. This study highlights the potential for deterioration of memory status among workers exposed to mercury in the fluorescent lamp industry, where deficits in both recent and remote memory were significantly associated with the level of mercury in urine

Respiratory disorders in workers exposed to tobacco dust

Tobacco dust when inhaled as an aerosol, may exert a variety of harmful effects on the airways and lungs. To study the prevalence of respiratory symptoms, lung function impairment and parenchymal changes in chest x-rays among tobacco exposed workers. This study was conducted, in a tobacco processing plant that manufactures cigarettes in Alexandria, Egypt. One hundred and forty eight tobacco workers and an equal number of unexposed referents were interviewed by a questionnaire based on the Standard Medical Research Council questionnaire. Immediately after the interview workers underwent measurements of lung functions, and chest X rays were performed and interpreted, according to the classification of pneumoconiosis. This study clearly demonstrates that exposure to tobacco dust has led to significant increase in the prevalence of chronic respiratory symptoms as cough, phlegm production, wheeze, and breathlessness, also respiratory diseases as chronic bronchitis and asthma were significantly more encountered among tobacco workers compared with unexposed workers. After adjusting for age and smoking still exposure to tobacco dust was a significant risk factor for chronic respiratory symptoms and chromic bronchitis. Significant decrements were also observed in the spirometry data for tobacco workers, where the mean parentages of predicted values of lung function indices reflecting large and small airway functions [VC, FVC, FEV1, FEV[1%], PEFR, FEF[75%], FEF[50%] and FEF[25%]] were all significantly lower in tobacco workers compared with unexposed workers even after allowing for the effects of age, height, weight and smoking; with a marked significant decrease in FEF[25%] suggesting a constrictor effect of tobacco dust on small airways. No findings suggestive of pneumoconiosis were observed in this study. Tobacco dust had deleterious effects on the respiratory system of tobacco exposed workers and the level of protection for exposed workers should be increased