ABSTRACT
In India, rice is the staple food for most people and many people are employed in rice mills. With lack of specific guidelines for rice mills’ establishment and operation, workers face a lot of problems especially from respiratory illness. We wanted to determine the pattern of respiratory symptoms and pulmonary function disorders among rice mill workers and provide health education to reduce respiratory morbidity. METHODSA cross-sectional study was conducted during the period October 2016 – 2018. A total of 50 rice mill workers and 50 normal individuals were assigned to the exposure and control groups respectively. Each individual was interviewed using the British Medical Research Council questionnaire and was later subjected to physical examination, routine laboratory investigations, and pulmonary function tests (PFT). Data was statistically analysed and presented. RESULTSThere was a higher prevalence of respiratory symptoms among the rice mill workers when compared to their control counterparts. Cough (28 %) was the predominant symptom and was high in those involved in sweeping and cleaning activities (80 %). There was a statistically significant difference (p < 0.05) among all the spirometric parameters tested like FEV1, FVC, FEV1 / FVC and PEFR except for FEF. About 74 % had respiratory morbidity and obstructive lung diseases (36 %) were predominant as compared to restrictive lung diseases (26 %) and mixed lung disorders (12 %) in the exposure group. Obstructive pattern was predominantly seen in those with a working history of < 10 years and restrictive and mixed patterns were predominantly seen in those with a working history of >10 years. With increase in duration of work, prevalence of respiratory symptoms as well as the severity increased. CONCLUSIONSIt can be concluded that rice mill workers are at a higher risk of acquiring respiratory symptoms and lung impairments. Therefore, it is necessary to implement preventive measures by means of controlling dust emission, educating the workers, etc. Workers should also have periodical clinical and spirometric evaluation and those showing significant impairment should be readjusted in other sections of the industry.
ABSTRACT
COPD has considerable effects on cardiac functions. Most of the increased mortality and morbidity associated with COPD is due to cardiac involvement. We wanted to assess the electrocardiographic and echocardiographic findings in COPD, correlate these findings in assessing the severity and duration of the disease, analyse these findings in assessing right ventricular dysfunction and compare the results of clinical, electrocardiographic and echocardiographic findings in detecting right ventricular dysfunction in COPD. METHODS50 COPD patients fulfilling the inclusion criteria were recruited. They were staged by PFT and evaluated by ECG and echocardiography. Statistical analysis of correlation was done, and statistical significance was taken as p < 0.05. RESULTSAmong the total of 50 cases selected for study 80 % were males, 20 % were females. On the basis of GOLD guidelines there were 8 %, 44 %, 36 %, 12 % mild, moderate, severe and very severe COPD cases respectively. Symptoms at presentation were cough with sputum (92 %), breathlessness (96 %), swelling of feet (24 %), fever (16 %), and decreased urine output (4 %). Physical signs at presentation were tachypnoea (68 %), loud P2 (24 %), parasternal heave (20 %), raised JVP (24 %), pedal oedema (16 %) and ascites (4 %). ECG findings analysis were P-pulmonale (46 %), RAD (38 %), RVH (34 %), low voltage complexes (30 %), poor progression of r-wave (30 %) and incomplete RBBB (12 %). Correlation of all the above ECG findings showed statistical significance (p < 0.05) with disease severity and disease duration (p < 0.05). Echocardiographic findings were pulmonary hypertension (50 %), Cor pulmonale (44 %), RV dilatation (44 %), RA dilatation (32 %), RVH (24 %), interventricular septal motion abnormality (14 %), LVDD (16 %), LVSD (4 %) and RVSD (4 %). All the above echocardiographic findings of RV dysfunction i.e. PAH, Cor pulmonale, RA dilatation, RVD, RVH and RVSD were statistically significant with disease severity and duration (p < 0.05) along with LVDD, LVSD. CONCLUSIONSThis study emphasises on early cardiac screening of all COPD patients which will be helpful in the assessment of the prognosis and will further assist in identifying the individuals likely to suffer increased morbidity and mortality.