Self-reported musculoskeletal complaints among garment workers

One hundred forty-four sewing machine operators answered questionnaires concerning occupational history and musculoskeletal symptoms adapted from the National Health and Nutrition Examination Survey. They were matched for age within 5 years, race, and sex with persons completing the HANES I Augmentation Survey, and the prevalence of self-reported musculoskeletal morbidity was compared. Operators complained significantly more often of knee pain (prevalence odds ratio [POR] = 1.84, p = .0001) and knee swelling (POR = 9.98, p less than .00001), although they were no more likely to have had knee surgery. Similar increases were reported for upper-back pain (POR = 2.13, p = .002) joint ache, and joint swelling (both were significant for fingers, wrists, elbows, and shoulders at p less than .05 levels). No differences in low-back pain or in hospitalization for joint conditions were noted. Ergonomic redesign of sewing machines needs to address knee and upper-back movements as well as the arm, wrist, and finger movements.     

Mortality among a cohort of garment workers exposed to formaldehyde: an update

Aims: To evaluate the mortality experience of 11 039 workers exposed to formaldehyde for three months or more in three garment plants. The mean time weighted average formaldehyde exposure at the plants in the early 1980s was 0.15 ppm but past exposures may have been substantially higher.

Methods: Vital status was updated through 1998, and life table analyses were conducted.

Results: Mortality from all causes (2206 deaths, standardised mortality ratio (SMR) 0.92, 95% CI 0.88 to 0.96) and all cancers (SMR 0.89, 95% CI 0.82 to 0.97) was less than expected based on US mortality rates. A non-significant increase in mortality from myeloid leukaemia (15 deaths, SMR 1.44, 95% CI 0.80 to 2.37) was observed. Mortality from myeloid leukaemia was greatest among workers first exposed in the earliest years when exposures were presumably higher, among workers with 10 or more years of exposure, and among workers with 20 or more years since first exposure. No nasal or nasopharyngeal cancers were observed. Mortality from trachea, bronchus, and lung cancer (147 deaths, SMR 0.98, 95% CI 0.82 to 1.15) was not increased. Multiple cause mortality from leukaemia was increased almost twofold among workers with both 10 or more years of exposure and 20 years or more since first exposure (15 deaths, SMR 1.92, 95% CI 1.08 to 3.17). Multiple cause mortality from myeloid leukaemia among this group of workers was also significantly increased (8 deaths, SMR 2.55, 95% CI 1.10 to 5.03).

Conclusions: Results support a possible relation between formaldehyde exposure and myeloid leukaemia mortality. Previous epidemiological studies supporting a relation between formaldehyde exposure and leukaemia mortality have been primarily of formaldehyde exposed professional groups, not formaldehyde exposed industrial workers. Limitations include limited power to detect an excess for rare cancers such as nasal and nasopharyngeal cancers and lack of individual exposure estimates.

     

Tuberculosis among health care workers

To assess the annual risk for latent tuberculosis infection (LTBI) among health care workers (HCWs), the incidence rate ratio for tuberculosis (TB) among HCWs worldwide, and the population-attributable fraction of TB to exposure of HCWs in their work settings, we reviewed the literature. Stratified pooled estimates for the LTBI rate for countries with low (<50 cases/100,000 population), intermediate (50-100/100,000 population), and high (>100/100,000 population) TB incidence were 3.8% (95% confidence interval [CI] 3.0%-4.6%), 6.9% (95% CI 3.4%-10.3%), and 8.4% (95% CI 2.7%-14.0%), respectively. For TB, estimated incident rate ratios were 2.4 (95% CI 1.2-3.6), 2.4 (95% CI 1.0-3.8), and 3.7 (95% CI 2.9-4.5), respectively. Median estimated population-attributable fraction for TB was as high as 0.4%. HCWs are at higher than average risk for TB. Sound TB infection control measures should be implemented in all health care facilities with patients suspected of having infectious TB.     

Occupational exposure and respiratory illness symptoms among textile industry workers in a developing country

This study investigates the respiratory health profile of textile mill workers in Bangladesh, aiming to develop workers' awareness and public attention, and to ensure a proper implementation of health and safety measures. Forced vital capacity was measured by peak expiratory flow rate instrument among 210 subjects. The personal history, the occupational history, and the state of health were also determined using a questionnaire and checklists. The subjects who had a considerably low peak expiratory flow rate (< 290 liters/min), and had symptoms of chronic respiratory illness, underwent X-ray examination. A statistically significant low peak expiratory flow rate was identified among 52.9 percent of workers. Among them, 42.9 percent had symptoms of cough with or without phlegm; 5.7 percent had a history of chronic bronchitis and/or asthma, and 4.3 percent experienced chest tightness or breathlessness. This study showed a high degree (p < .001) of respiratory-related illness symptoms present among the workers in the blow/card rooms and the workers in the spinning section. Irrespective of variation of age as well as work pattern, non-smokers were less likely to be affected. Whether worker were occupationally exposed to other incidences was also investigated. The results of these investigations are presented and the findings discussed in light of other studies carried among similar occupational groups.     

Determinants of healthcare utilisation by migrant workers in the State of Qatar

BackgroundLabour migration enables populations to adjust to changing economic and social conditions, yet often precipitates increased health risks. Few previous studies examined healthcare utilisation by migrant workers. This study aimed to examine the healthcare utilisation by migrant workers in Qatar.MethodsIn 2011, Qatar launched National Health Strategy 2011–2016, phasing in Universal Health Care accessible to both Qataris and non-Qataris. Qatar’s high proportion of foreign migrant workers to Qatari citizens is unique, estimated at 5:1. Multivariate analysis on Household Utilization and Expenditure Survey (HUES) 2014 data yielded determinant factors for healthcare utilisation by migrant workers in Qatar.ResultsIn nationally-representative sampling, the proportion of migrant labourers accessing outpatient care was only half of expatriates and Qataris, with inpatient care utilisation even less. Results suggest all forms of health insurance coverage had protective effects for expatriate and labourer healthcare utilisation. Specifically, such protective impact on all migrant groups’ inpatient care use was much greater than outpatient.ConclusionsThis study highlights differences in the pattern of care-seeking and total health expenditure across migrant worker groups in Qatar. Improving health insurance coverage to migrant worker groups can promote higher utilisation of care, and thereby reduce health disparities of migrant workers to better protect their health and productivity.     

Tuberculosis among Pennsylvania migrant farm workers

The purpose of this study was to determine the tuberculin positivity rates and the incidence of sexually transmitted diseases (STDs) among a population of seasonal, nonmigrating farm workers. Participants were tested for tuberculosis (TB) sensitivity, syphilis, gonorrhea, and chlamydia. Patients were afforded follow-up even if they returned home to Mexico during the course of their treatment. We found that the TB rate (15%) and the incidence of STDs to be significantly lower than in other studies of migrant populations. We hypothesize that exposure to urban commercial sex workers who frequent many migrant camps may be involved in the transmission of TB. Further research is needed to determine the incidence of TB among commercial sex workers and the extent to which transmission occurs between these two populations. We also describe our follow-up program and recommend a closer adherence to the Centers for Disease Control and Prevention guidelines with respect to adequate health education and disease prevention.     

Knowledge and use of folic acid among pregnant Arabian women residing in Qatar and Oman

The objective of this study was to assess the knowledge and use of folic acid among pregnant Arabian women in Qatar and Oman. Three hundred pregnant women were interviewed during their second trimester based on a questionnaire developed for the study. Results of the survey indicated that 94% of the women knew about folic acid, 41.3% knew it should be taken periconceptionally, 58.5% knew that it prevents birth defects and 34.4% were able to identify five or more food sources of folic acid. The majority (88.7%) of women was taking the supplement, 85.0% were taking it regularly and 13.2% took it before getting pregnant. Knowledge and use were significantly influenced by ethnicity, age, education level, employment and family income. Periconceptional use of supplement was lowest among younger women (4.9%) and illiterate and least educated women (5.3%). It was concluded that high level of knowledge of folic acid was not reflected as successful use of the folic acid supplement.     

Knowledge and use of folic acid among pregnant Arabian women residing in Qatar and Oman

The objective of this study was to assess the knowledge and use of folic acid among pregnant Arabian women in Qatar and Oman. Three hundred pregnant women were interviewed during their second trimester based on a questionnaire developed for the study. Results of the survey indicated that 94% of the women knew about folic acid, 41.3% knew it should be taken periconceptionally, 58.5% knew that it prevents birth defects and 34.4% were able to identify five or more food sources of folic acid. The majority (88.7%) of women was taking the supplement, 85.0% were taking it regularly and 13.2% took it before getting pregnant. Knowledge and use were significantly influenced by ethnicity, age, education level, employment and family income. Periconceptional use of supplement was lowest among younger women (4.9%) and illiterate and least educated women (5.3%). It was concluded that high level of knowledge of folic acid was not reflected as successful use of the folic acid supplement.     

Respiratory illnesses and ventilatory function among workers at a cement factory in a rapidly developing country

Chronic exposure to Portland cement dust has been reported to lead to a greater prevalence of chronic respiratory symptoms and a reduction of ventilatory capacity. The seriousness of pulmonary function impairment and respiratory disease has not been consistently associated with the degree of exposure. Regular use of appropriate personal protective equipment, if available at the worksite, could protect cement workers from adverse respiratory health effects. For a variety of reasons, industrial workers in rapidly developing countries do not adequately protect themselves through personal protective equipment. This study explores the prevalence of chronic respiratory symptoms and ventilatory function among cement workers and the practice of use of personal protective equipment at work. An interviewer-administered questionnaire was used to collect information on sociodemographic characteristics, smoking profile and history of respiratory health among workers at a Portland cement plant (exposed) and workers occupationally unexposed to dust, fumes and gases (unexposed). Pulmonary function was assessed and pulmonary function impairment was calculated for the exposed and the unexposed workers. A higher percentage of the exposed workers reported recurrent and prolonged cough (30%), phlegm (25%), wheeze (8%), dyspnoea (21%), bronchitis (13%), sinusitis (27%), shortness of breath (8%) and bronchial asthma (6%). Among the unexposed, prevalences of these symptoms were 10, 5, 3, 5, 4, 11, 4 and 3%, respectively. Ventilatory function (VC, FVC, FEV(1), FEV(1)/VC, FEV(1)/FVC and PEF) was significantly lower in the exposed workers compared with unexposed workers. These differences could not be explained by age, body mass index (BMI) or pack-years smoked. Ventilatory function impairment, as measured by FEV(1)/FVC, showed that 36% of the exposed workers had some ventilatory function impairment compared with 10% of those unexposed. Certain jobs with greater exposure to cement dust had lower ventilatory function compared with others among the exposed workers. It was concluded that adverse respiratory health effects (increased frequency of respiratory symptoms and decreased ventilatory function) observed among cement workers could not be explained by age, BMI and smoking, and were probably caused by exposure to cement dust.     

Screening for tuberculosis among orphans in a developing country

BACKGROUND: There has been a recent resurgence of tuberculosis (TB) as a worldwide public health concern. It is a well-documented health problem in Haiti, where the reported prevalence is 123.9 per 100,000 population. While the Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) policy papers for the eradication of TB recommend screening in shelters, prisons, and other congregate-living facilities, screening in institutional orphanages is not specifically mentioned. METHODS: A total of 445 orphans with no documentation of Bacillus Calmette-Guerin (BCG) vaccine at six orphanages representing urban, suburban, and rural Haiti were screened for TB using standardized purified protein derivative (PPD). An inoculum of 0.1 cc was introduced intradermally, with site checks for induration at 48-72 hours after inoculation. Induration >5 mm was recorded as positive. Active cases of TB were defined by symptoms such as fever, night sweats, cough greater than 1 month, or signs of extrapulmonary TB (like scrofula or Pott's disease). RESULTS: The number of positive PPD tests was 170 of the 445 children tested, or 38,202 per 100,000; there were 10 active cases. The overall prevalence of tuberculin positivity in the three orphanages with one or more active cases was 44%, compared to 13% in the three with no identified active cases. CONCLUSIONS: The data indicate that TB prevalence among the orphans screened was 1123 per 100,000. This is substantially greater than that reported for the general Haitian population. These data thus suggest children living in orphanages as a previously unidentified high-risk group for TB infection. Further investigation of TB is recommended for orphans in developing countries.     

Malignant mesothelioma in garment sewing-machine workers

BACKGROUND: Due to poor information collected through patient interviews, a considerable number of malignant mesothelioma (MM) cases still remain classified as "unknown" asbestos exposure in the Italian Mesotelioma Registry (Re.Na.M). At the same time, some occupational asbestos exposures, which were previously unknown, have been demonstrated in certain types of work, i.e., in agriculture and in the textile industry. OBJECTIVES: The aim of this research was to investigate the possible past occupational exposure to asbestos in clothing workers using sewing-machines. METHODS: The MM cases were collected from the Mesothelioma Registry of Brescia. Work histories were obtained via a standardized questionnaire. Investigations were conducted in sewing-machine maintenance workshop in order to collect information regarding the possible use of asbestos parts. In addition, the use of asbestos friction materials and the use of insulated asbestos materials was checked in the clothing divisions by interviewing the management and maintenance workers of two companies where cases of MM were observed. RESULTS: The Mesothelioma Registry of Brescia identified and collected 10 MM cases with past work in the clothing industry: 6 used sewing-machines and 4 were self-employed tailors. The search for asbestos materials gave positive results as the use of friction materials had been widespread since the 1950's in all types of sewing-machines; in addition, asbestos materials were used to insulate some parts of the ironing equipment and the steam pipelines. CONCLUSION: The results of this investigation suggest assigning at least "possible occupational asbestos exposure" to those cases employed in clothing manufacture since the 1950's, who used sewing-machines or pressing machines, according to the Re.Na.M guidelines. Other possible occupational exposures to asbestos in this working sector cannot be excluded; when the simple interview of patients does not reveal such exposures further investigations are needed in order to demonstrate all the possible circumstances of exposure.     

Effect of duration of employment in piecework on severe disability among female garment workers

This study measured the association between duration of employment in piecework and the prevalence of severe disability among 533 Quebec female garment workers who left employment between 1976 and 1985. Yearly information regarding occupational characteristics was available from a public agency for the 30-year period 1956-1985. Information on disability status was collected in a personal interview. Duration of employment in piecework was associated with the prevalence of severe disability. A multivariate analysis found that the association was independent of age, smoking habits, education, type of task and total length of employment. Workers who spent 5-9, 10-14, 15-19, and greater than or equal to 20 years in piecework had an increased prevalence of severe disability in comparison with the base-line category of 0-4 years. The adjusted risk ratios were 2.2 [95% confidence interval (95% CI) 1.0-4.6], 3.3 (95% CI 1.5-6.9), 3.6 (95% CI 1.5-8.4), and 2.3 (95% CI 0.8-6.6), respectively. The association was particularly strong for disability due to musculoskeletal problems and disability due to cardiovascular disorders although small numbers were involved.     

Disability among female garment workers. A comparison with a national sample

An indicator of permanent disability was used to measure the chronic health problems associated with garment work. The study population comprised 800 female sewing-machine operators employed in the Quebec garment industry between 1976 and 1985. The workers were identified from public agency records. Their disability status was obtained in a personal interview. The disability prevalence of these workers was compared to national disability data of women employed in clerical work, services, and manufacturing industries. The garment workers who had left employment had an increased prevalence of severe disability (in comparison with that of workers who had left other types of employment) and an increased prevalence of moderate and slight disability. Currently employed garment workers had an increased prevalence of moderate and slight disability when compared with workers currently employed in other occupations. The risk ratios remained similarly elevated when the data were adjusted for age and smoking status.     

Tuberculosis among healthcare workers in a tertiary-care hospital in South India

It is possible that tuberculosis is transmitted from patients to healthcare workers (HCWs). However, there are few data on this from developing countries. The object of this study was to document the incidence of tuberculosis among HCWs in the Christian Medical College (CMC), Vellore, India during a 10-year period (January 1992-December 2001). Data were collected from records maintained in the staff and students health services of CMC. A total of 125 cases were diagnosed during the period of study. The overall incidence of sputum positive cases was similar to that observed in the general population, during most years. However, it appears that focal outbreaks occur with transmission between HCWs. The chance of developing extra-pulmonary tuberculosis was higher in HCWs compared with the general population.     

Knowledge and communication needs assessment of community health workers in a developing country: a qualitative study

Background  

Primary health care is a set of health services that can meet the needs of the developing world. Community health workers act as a bridge between health system and community in providing this care. Appropriate knowledge and communication skills of the workers are key to their confidence and elementary for the success of the system. We conducted this study to document the perceptions of these workers on their knowledge and communication needs, image building through mass media and mechanisms for continued education.     

Early occupational hearing loss of workers in a stone crushing industry: our experience in a developing country

Noise-induced hearing loss (NIHL) is an irreversible sensorineural hearing loss associated with exposure to high levels of excessive noise. This paper aims to assess the prevalence of early NIHL and the awareness of the effects of noise on health among stone crushing industry workers. This was a comparative cross-sectional study in Ghana of 140 workers from the stone crushing industry compared with a control group of 150 health workers. The stone workers and controls were evaluated using a structured questionnaire, which assessed symptoms of hearing loss, tinnitus, knowledge on the health hazards associated with work in noisy environment and the use of hearing protective device. Pure tone audiometric assessment was carried out for stone workers and controls. Noise levels at the work stations of the stone workers and of the controls were measured. Statistical Analysis of data was carried out using SPSS package version 16. The mean age of stone workers and controls was 42.58±7.85 and 42.19±12 years, respectively. Subjective hearing loss occurred in 21.5% of the workers and in 2.8% of the controls. Tinnitus occurred in 26.9% of stone workers and 21.5% of controls, while 87.5% stone workers had sound knowledge on the health hazards of a noisy environment. Early NIHL in the left ear occurred in 19.3% of the stone workers compared with 0.7% in controls and in the right ear, it occurred in 14.3% of the stone workers and in 1.3% of the controls; P<0.005. In conclusion, the prevalence rate of early NIHL among stone crushing workers is about 19.3% for the left ear and 14.3% for the right ear.     

宁波市2家制衣企业女工宫颈癌筛查意愿相关因素调查

目的分析影响制衣企业女工参与宫颈癌筛查的影响因素。方法对宁波市2家制衣企业510名女工进行现场问卷调查,分析受调查者的相关因素与筛查意愿的关系,分析影响女工参与宫颈癌筛查的障碍因素。结果 459名入选的被调查者中,共324名（71.2%）女工有筛查意愿,对宫颈癌的认知度、文化程度和个人月收入是影响宫颈癌筛查意愿的相关因素,宫颈癌筛查障碍的原因依次为：没必要（33.3%）、没有医生建议（27.4%）、对检查感到尴尬（19.3%）、担心费用（16.3%）、害怕得癌（3.7%）。结论开展宫颈癌相关知识和筛查的健康教育,提高女工对宫颈癌的认知度,有助于提高她们的筛查意愿。     

High prevalence of respiratory symptoms among workers in the development section of a manually operated coal mine in a developing country: A cross sectional study

Background  

Few studies of miners have been carried out in African countries; most are from South Africa, where the working conditions are assumed to be better than in the rest of Africa. Several studies have focused on respiratory disorders among miners, but development workers responsible for creating underground road ways have not been studied explicitly. This is the first study assessing the associations between exposure to dust and quartz and respiratory symptoms among coal mine workers in a manually operated coal mine in Tanzania, focusing on development workers, as they have the highest exposure to coal dust.