Household Expenditure on Tobacco Consumption in a Poverty-Stricken Rural District in Sri Lanka.

Tobacco is a determinant of poverty and a barrier for development. Monaragala, a rural, agricultural district, reports the highest poverty-related indicators in southern Sri Lanka. A cross-sectional study was used to describe the household expenditure on tobacco and its association with food- and education-related expenditures at household level. This study used a 4-stage cluster sampling method to recruit a representative sample of 1160 households. Response rate was 98.6%. Median monthly household income was LKR 20 000 (interquartile range [IQR] = LKR 12 000-30 000). The median monthly expenditure on tobacco was LKR 1000 (IQR = LKR 400-2000) with the highest spending tertile reporting a median of LKR 2700 (IQR = LKR 2000-3600).The proportionate expenditure from the monthly income ranged from 0.0% to 50% with a median of 5.0% (IQR = 2.0-10.0) and a mean of 7.4% (7.6). The poorest reported the highest mean proportionate expenditure (9.8%, SD = 10) from the household income. Household expenditure on tobacco negatively associated with expenditure on education.

Ill-health retirement at a health agency between 1991 and 1994.

AIM: To describe factors related to the process of ill-health retirement (IHR) among employees of three hospital trusts. METHODS: A descriptive study was carried out at a health agency on retirements recorded by the management due to ill-health between 1991 and 1994. Relevant data were extracted from records maintained in the occupational health department. RESULTS: Among the 339 retirements recorded by the management as due to ill-health, 100 (29.5%) records could not be retrieved. Of the 239 records available for analysis, information regarding full- or part-time work was available for 164 (69%) employees. Further information from the individual's general practitioner or specialist was obtained for 106 (44%) employees and redeployment considered for 52 (22%) employees. The total number of employees who were recommended IHR was 125 (52%). One hundred and forty of the cases reported 220 disease conditions at pre-employment while 170 (71%) cases reported 229 disease conditions at retirement. In 37 (15.5%) the disease condition that led to retirement was the same as that at pre-employment. The commonest of these were musculoskeletal (46%; 17/37) and psychiatric (11%; 4/37) disorders. Twenty-one percent of all the retirements were due to work-related conditions. The time taken to arrive at the decision of IHR was more than 1 year for 20 (8%) employees. CONCLUSIONS: This study found that many aspects of the IHR process did not meet the current suggested standards.

Non-specific occupational health conditions among brass workers at Gadaladeniya, Sri Lanka.

OBJECTIVE: To determine the effect of exposure to metal dusts, fumes and high temperature levels among brass workers in comparison to a control group. STUDY DESIGN: Analytical cross-sectional study. METHODOLOGY: One hundred and fifty four brass workers were matched for age with 154 controls selected from the local population. An interviewer-administered questionnaire was used to determine the presence of acute and chronic symptoms and metal fume fever. Haemoglobin and blood zinc and copper levels were measured using the cyanmethaemoglobin technique and atomic absorption spectrophotometry respectively. Thermal environmental measurements were carried out by determining wet bulb and globe temperature (WBGT) levels and air velocity. RESULTS: Among the chronic symptoms anorexia (OR = 3.3), distaste (OR = 8.3), and aches and pains (OR = 4.0) were significantly higher in the study group. Among the acute symptoms at work, cough (OR = 4.2), dry nose (OR = 6.8), tearing (OR = 6.3), and itchy eyes (OR = 6.3) were significantly higher in the study group. Sweating was significantly higher in the control group. Metal fume fever was significantly higher among the study group with an OR of 7.6. Levels of both copper and zinc were significantly higher in the study group, although both median and mean values were lower than the normal reference ranges. The recommended WBGT level of 26.1 degrees C for an air velocity of less than 1.53 m/s for heavy work was exceeded only in two workshops. CONCLUSIONS: Prevalence of non-specific symptoms was higher among brass workers. It is necessary to take preventive measures.