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PubMed2003

The Kariapatti pediatric eye evaluation project: baseline ophthalmic data of children aged 15 years or younger in Southern India.

PURPOSE: To estimate the prevalence of ocular morbidity among children of rural southern India before developing a service delivery model for community-based pediatric eye care. DESIGN: Population-based cross sectional study. METHODS: Trained field-workers performed door-to-door enumeration in 74 randomly selected villages of the Kariapatti block in southern India to identify children aged 15 years or younger and performed visual acuity measurements using Cambridge crowded cards and external eye examination with torchlight. Pediatric ophthalmologists further examined subjects with ocular problems identified by the field-worker. The clinical team performed repeat visual acuity measurements with Cambridge crowded cards, refraction, slit-lamp anterior segment examinations, and dilated posterior segment examinations at the screening site. The ophthalmologist identified and recorded one major cause for each visually impaired eye. RESULTS: Field-workers screened 10605 (94.6%) of 11206 children enumerated, and identified 1441 (13.6%) children as requiring further clinical examination. An additional 449 children identified as normal by the field-worker were randomly chosen for repeat examinations at the screening sites. In all, 1578 (83.5%) of these 1890 children were examined at the screening site. According to World Health Organization criteria, 6.2 of 10000 children were blind; 42.9% of this blindness was potentially avoidable. Refractive errors (0.55%, 95% confidence interval: 0.41, 0.69) and strabismus (0.43%, 95% confidence interval: 0.30, 0.55) were the major ocular morbidity in this population. CONCLUSIONS: Developing an appropriate service delivery model for this region will require a balance between the relatively low prevalence of morbidity and blindness and the need for service in this population.

Adolescent↗
PubMedDate not supplied

[Occupational exposure to 50 Hz magnetic fields in workers employed in various jobs].

BACKGROUND: Information on occupational exposure to ELF magnetic fields (MF) in workers is largely insufficient, and is mostly based on results obtained in Scandinavian countries and North America. Accordingly, the collection of further data is needed, especially in workers exposed in other countries, including in Italy. METHODS: One hundred and fifty workers (84 males and 66 females) employed in 28 different jobs in the Emilia-Romagna Region of Italy were examined. Individual exposure was measured using personal monitors worn on the hip in a belted pouch during three whole work-shifts (8 hours each) of a normal working week. A sampling interval of 10 seconds was adopted, resulting in the collection of more than 8600 measurements for each worker. The individual Time-Weighted Average (TWA) occupational exposure of workers was calculated as the arithmetic mean of all measurements during each work-shift. Environmental non-occupational exposure was also measured. RESULTS: The 50 degrees percentile of individual TWA in the whole group was 0.15 microT, and the 5 degrees - 95 degrees percentile was respectively 0.02-1.45 microT. Job-related exposure (expressed as the mean of the TWA measured in all workers engaged in that job) was highest in substation electric power plant workers (1.12 microT) and in sewing machine workers (0.84 microT), but was lower than 0.2 microT in more than the 70% of the examined jobs. Considering the geometric mean of individual TWA are 27 out of 28 the jobs inducing an exposure lower than 0.2 microT. The lowest exposure was observed in infant school teachers. A high variability was observed among different workers engaged in the same occupation, mainly in substation electric power plant workers, machine testers and grinders in the engineering industry and in sewing machine workers and quality control in garment production. A marked variability of the pattern of exposure during the work-shift was also observed The overall environmental (non-occupational) exposure was 0.044 microT, and individual exposure was lower than 0.2 microT in about 97% of the examined subjects. Occupational exposure was usually higher and was not correlated with environmental exposure. CONCLUSIONS: The results show that the occupational component of overall exposure must be considered in studies on the biological effects of ELF-MF in populations. The high variability observed among workers engaged in the same occupation and the variability of the pattern of exposure certainly constitute major problems and could be a cause of the scarce coherence of the results of epidemiological studies on biological effects of ELF-MF to date. An improvement in protocols for the evaluation of exposure in workers, including the use of personal monitoring, is certainly needed.

Electromagnetic Fields↗
PubMed2004

Training and field methods in the WorldSAFE collaboration to study family violence.

INTRODUCTION: This paper describes the collaborative efforts of research teams from medical schools in India, Chile, Egypt, the Philippines, Brazil, and the United States to develop and implement a core protocol for household surveys on family violence and to conduct standardized training for field workers. Our objectives are to share successes and difficulties encountered in training and field work and to offer recommendations for similar undertakings. METHODS: Study methods, developed by a multidisciplinary group of international investigators, were documented in a procedures manual. On-site standardized training was conducted and field workers were monitored for adherence to protocol. Special attention was given to safety and ethical issues. RESULTS: Overall, the training protocol and field methods were successful with relatively few problems encountered. Study participants were receptive to the interview and cooperated in safety procedures. The most common problem in the field was interruptions of the interview, mostly by children. Community advisory boards were actively involved in some of the sites, providing guidance on the safety and logistical aspects of the study, facilitating access to study communities, and providing community service information that could be shared with all study participants. CONCLUSIONS: WorldSAFE successes were attributed to rigorous standardized training and monitoring of field work; meticulous protocol implementation; unflagging attention to the ethical issues and to safeguarding study participants, field workers, and data; and openness and trust developed among the collaborators during the extended developmental phase.

Brazil↗
PubMed2002

Reconsidering the doorstep-delivery system in the Bangladesh Family Planning Program.

The government of Bangladesh is currently testing and implementing strategies to change its family planning program from a reliance on field-workers who conduct home visits to a conventional fixed-site delivery system. Researchers have made two suggestions: First, the program should encourage women to switch from nonclinical methods delivered by family planning workers to more cost-effective clinical methods such as sterilization, and second, field-workers should not be resupplying nonclinical methods, but should focus their attention on motivating nonusers to practice contraception. Longitudinal data from the Maternal and Child Health-Family Planning Extension Project of the International Centre for Diarrhoeal Disease Research, Bangladesh, are analyzed to show that a better strategy might be to target visits to women according to their educational level and area of residence. For uneducated women living far from clinics, access to contraceptives is likely to be a problem, and home visits for resupply might have a larger impact on the contraceptive prevalence rate than would field-workers' visits to motivate nonusers.

Bangladesh↗
PubMed2001

[Exposure to VHF and UHF electromagnetic fields among workers employed in radio and TV broadcast centers. I. Assessment of exposure].

Nowadays, radio and television have become one of the areas of the human technical activity that develops most rapidly. Also ultra-short waves of VHF (30-300 MHz) and UHF (0.3-3 GHz) bands have proved to be the most important carriers of radio and TV-programs. In Poland, a network of radio and TV broadcast centers (RTCN) with high (over 200 m) masts was set up in the 1960s and 1970s. These centers concentrate the majority of stations broadcasting national and local programs (for areas within the RTCN range). At present, the RTCN established several decades ago are equally important. The assessment of the exposure to electromagnetic fields among workers of multi-program broadcast stations is complicated and feasible only to a certain degree of approximation because of changing conditions of exposure in individual stations during their long history, resulting from the changing numbers and types of transmitters installed. In this work, the method of retrospective estimation of exposure dose is described, and the results of the assessment carried out at three kinds of typical RTCN are discussed. The results of the analysis indicate that the workers of RTCN are exposed primarily to electromagnetic fields of VHF and UHF bands, but this exposure may be considered as admissible, hence it should not exert an adverse effect on the workers' health.

Electromagnetic Fields↗
PubMed1992

Acute pesticide morbidity and mortality: California.

The California Pesticide Illness Surveillance Program collects, investigates, abstracts, and records reports received from physicians. A minority of the reports are received through the county health officers who are notified by physicians under a state requirement for reporting pesticide-caused conditions. Most of the cases are identified by review of workers' compensation records. All the cases identified are investigated by the agricultural commissioners of the counties where exposure occurred. The investigation reports are reviewed and abstracted by staff of the Worker Health and Safety Branch of the California Department of Pesticide Regulation, California Environmental Protection Agency (Cal/EPA). The crucial determination is assessment of the degree of relationship between the exposure and subsequent disease: definite, probable, possible, unlikely, or unrelated. In most years, the number of cases investigated has been between 2,500 and 3,000. Excluding antimicrobials, the number of cases found after investigation to have a definite, probable, or possible relationship with pesticide exposure has ranged from 970 (in 1989) to 1,372 (in 1988). Cases involving antimicrobials rarely were reported prior to 1987. In that year, surveillance staff began reviewing workers' compensation records personally, with the specific goal of identifying antimicrobial cases. Since then, antimicrobials have been found to account for 746-813 cases annually, primarily involving splashes and squirts to the eye and inhalation of fumes or vapors. Numbers of case reports from agricultural situations have varied irregularly, driven by small numbers of episodes concerning multiple individuals. Variability in numbers of cases involving the skin has depended almost entirely on variation in numbers of field worker dermatitis. The most common situation for field worker dermatitis has been summer work in table grapes grown in the southern San Joaquin valley. In the two years since reentry intervals for the acaricide propargite were lengthened, there have been no more major clusters of field worker dermatitis. Although the cases collected by the surveillance program are predominantly occupational, because of dependence on workers' compensation for case identification, most recorded deaths are nonoccupational. Nonoccupational fatalities include suicides, mistaken ingestion of pesticides (especially if stored in food containers), and entry into structures being fumigated. Occupational deaths are less common and more varied. The circumstances of each reported occupational death are summarized above.

California↗
PubMed2003

Overweight and obesity among Kuwait Oil Company employees: a cross-sectional study.

BACKGROUND: Overweight and obesity are considered major risk factors for many diseases, and their prevalence is known to be high in Kuwait from previous studies. AIM: To assess the prevalence of overweight and obesity and related risk factors among Kuwait Oil Company (KOC) employees. METHOD: A cross-sectional study of full-time KOC employees was carried out using a structured questionnaire that was completed during periodic medical examinations. The questionnaire included demographic details, frequency and duration of physical activity, history of chronic diseases and medication. All participants were counselled and examined. Blood pressure, body mass index and fasting glucose were recorded. RESULTS: Some 3282 out of 3900 employees completed the study; 85% of participants were male, 62%were field workers and 38%were office workers. The overall prevalence of overweight and obesity among KOC employees was 75%. Males showed a higher level of overweight and obesity (79%) than females (56%). Field workers had a higher level of overweight and obesity (78%) and higher inactivity (65%) than office workers (72% and 56%, respectively). CONCLUSION: Overweight and obesity, together with inactivity, are highly prevalent among KOC employees, and more so among field workers than office workers. Encouraging an active lifestyle, healthy eating habits and weight control programmes are all possible interventions to reduce the prevalence of overweight and obesity.

Adult↗
PubMed1995

Lung health in sawmill workers exposed to pine and spruce.

Workers exposed to a variety of wood dusts have been shown to exhibit occupational asthma, lung function deficits, and elevated levels of respiratory symptoms. Despite the popularity of pine and spruce, the health effects of exposures to these woods have not been extensively investigated. A study was undertaken to investigate the respiratory health of a group of sawmill workers processing pine and spruce (n = 94). Data collection included a respiratory symptom questionnaire, spirometry, and allergy skin testing. The sawmill workers were compared with a group of oil field workers from the same geographic area who underwent the same study protocol (n = 165). The results showed that the sawmill workers had significantly lower average values for FEV1 and FEV1/FVC (%), adjusted for age, height, and smoking. The largest differences were for current smokers. Significantly elevated age and smoking-adjusted odds ratios (OR) were detected for shortness of breath (2.83; 95% confidence interval [CI], 1.47 to 5.46) and wheeze with chest tightness (2.58; 95% CI, 1.18 to 5.62). Nonsignificant elevations were also seen for usual cough (1.47; 95% CI, 0.68 to 3.16), usual phlegm (1.94; 95% CI, 0.98 to 3.87), shortness of breath with exercise (1.45; 95% CI, 0.66 to 3.20), chest tightness (1.43; 95% CI, 0.80 to 2.57), and attacks of wheeze (1.70; 95% CI, 0.79 to 3.68). Sawmill workers were 2.5 times as likely as oil field workers to report current asthma (95% CI, 0.76 to 8.32). Workers employed more than 3 years showed significantly more asthma (OR = 3.67; 95% CI, 1.00 to 13.5) and bronchitis (OR = 2.14; 95% CI, 1.02 to 4.52). Sawmill workers were only 43% as likely to report a history of hay fever (95% CI, 0.20 to 0.94). These health effects were noted despite an average concentration of respirable dust of 1.35 mg/m3 (range, 0.1 to 2.2 mg/m3). These levels are below the present occupational standard.

Adult↗
PubMed1980

A methodology for intensive case-finding and monitoring of drug use in Mexican community.

An intensive case-finding model of drug use is presented with respect to its advantages and limitations. Two approaches were used: (a) direct, in which the questions concerning drug use were asked openly by the field-workers, and (b) indirect, where the field-workers obtained information about drug use from general conversation with interviewees. The indirect approach was found to be very useful in contacting new drug users and in assessing the psycho-social context of drug use. This research suggests that the intensive case-finding method is suitable for a community where the majority of drug users form cohesive groups, while it was found to be less effective for the study of isolated cases.

Adolescent↗
PubMed1997

[History and dilemmas in the development of the worker's health field]

This article reflects on the theoretical and practical foundations impacting and shaping the field of workers' health in Brazil, as part of the overall field of collective health. By analyzing the various forms of approaching the relationship between work and health, the paper emphasizes its complex and conflicting nature as a central reference for the work process, in keeping with the premises of social medicine in Latin America. This focus underscores the need for interdisciplinary approaches contemplating and even extrapolating the links between areas of knowledge generally ascribed to the field of health. Finally, the paper gives a brief diagnosis of the current situation in this field, where pending questions join those resulting from globalization of the economy and particularly industrial restructuring, in light of which the challenge is raised to broaden the objects of study and intervention to include the implications of outsourcing, increasingly precarious labor conditions, informal labor, and unemployment on the population's health and living conditions.

Journal Article↗
PubMedDate not supplied

[Personal exposure to ELF magnetic fields in workers engaged in various occupations].

Using personal dosimeters worn during two complete work-shifts, we measured occupational exposure to Extremely Low Frequency-Magnetic Fields (ELF-MF) in 290 workers employed in 56 jobs, representative of the main occupational activities in the area of Modena and Reggio Emilia (Italy). Environmental nonoccupational exposure was also monitored. In the whole sample, the mean Time-Weighted Average (TWA) exposure during work resulted 0.59 microT (SD 3.2), while the median was 0.13 microT. Exposure was lower than 1 microT in more than 90% of the workers. In one job only exposure was greater than 1 microT (job-related median TWA); in other 8 exposure was between 1 and 0.4 microT, while about 84% of the jobs presented a median TWA lower than 0.4 microT. A high variability among workers engaged in the same job resulted in various occupational tasks. Non-occupational exposure was lower than 0.4 microT in more than 98% of the examined workers. Our results show a low to moderate occupational exposure to ELF-MF in the greatest part of the workers and working activities. Also the non-occupational exposure resulted low in the large majority of the subjects. The high variability observed among workers engaged in some occupations may represent a problem in exposure evaluation. Personal monitoring is particularly useful in such a situations.

Electromagnetic Phenomena↗
PubMed1990

[Measurement of oil mists by a portable sampler and subjective symptoms among machine workers: a field investigation of machine workshops].

Machine oils are widely used in metal processing and many workers are exposed to oil mists in the work environment. Some investigators have pointed out such health hazards due to prolonged exposure to oil mist as respiratory disorders, dermatitis, and possible carcinogenesis. In Japan, a permissible limit of oil mists of 3 mg/m3 was recommended in 1977 by the Japan Association of Industrial Health (JAIH) mainly based on the hazardous effects on the respiratory system. After this recommendation was made, only a few studies have been made on the measurement of oil mists and on the health effects in machine workers to determine whether the permissible limit is justifiable or not. In the present study, the levels of oil mists in the air of machine workshops were measured together with personal exposure levels by personal samplers. Oil mists were collected by a sampler head with 2 stages which enabled differentiation of distribution of particulates between larger than 10 microns and 2-10 microns in size. Oil components collected on the stainless steel stages were washed out by sonication in CCl4 solution and measured by an oil meter with infra-red spectrometry against a standard solution of heavy oil class B according to procedures reported elsewhere by the authors. Questionnaire surveys were also conducted on 308 male machine workers composed of 221 workers exposed to oil mists and 87 nonexposed controls. The questions were composed of five items about air quality in the work environment and 18 subjective symptoms during work and daily lives. The symptoms included nasopharyngeal, muco-dermal, gastrointestinal and neuro-muscular symptoms. Statistical analysis was made by the Manthel-Haenszel method for a comparison of "yes" rates of complaints between the exposed and the non-exposed by adjusting the underlying confounding factor of age distribution. 1. The levels of oil mists measured here ranged from 94 to 813 micrograms/m3 in the ambient air and from 107 to 483 micrograms/m3 of personal exposure. There was no obvious difference between the level in the ambient air and that of personal exposure. All these measured levels were under the permissible limit (3 mg/m3) recommended by JAIH in 1977. 2. The observed distribution of particulate size of oil mists from 2 to 10 microns referred to as respirable size was 32.8 +/- 16.1% generated from the grinding machines using water-soluble type of machine oils and 50.0 +/- 12.4% from those using insoluble type.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1986

[Obesity index and blood pressure of workers in Kitakyushu].

Relation between obesity index and blood pressure of male, 40-49 years old, workers (11,526 persons) were observed, classified by industry (total industry, construction, manufacturing, transport & communication) and by occupation (total occupation, field workers, office workers) from a source of periodic health examination (April to September in 1982) of establishments in Kitakyushu. In results, the followings were noted. Proportion of number of subjects with hypertension in office workers was higher than that in field workers, except transport & communication. Hypertension depended on abnormal diastolic blood pressure was more than abnormal systolic blood pressure. Proportion of the number of subjects with abnormal blood pressure was high in construction, in transport & communication and in manufacturing, in order. Classified by obesity index, proportion of number of subjects with hypertension was high in construction and in manufacturing, in order. There were significant positive correlations between obesity index and blood pressure (both of diastolic and systolic) in all industries and in all occupations. Both distributions of obesity index by the KATO method and the MINOWA method had high positive skewness. Proportion of the number of subjects with hypertension, classified by obesity index, increased with obesity index. Obesity indices by the KATO method and the MINOWA method were seemed to be appropriate for the observation of relations between obesity index and blood pressure.

Adult↗
PubMed1994

Data management for large community trials in Nepal.

The current accessibility and sophistication of hardware and software has made it possible to design high-quality data management systems for community-based trials in resource-poor environments. We designed, implemented, and operated an effective data management system for the Nepal Nutrition Intervention Project Sarlahi (NNIPS), a placebo-controlled community trial to assess the impact of vitamin A supplementation on the preschool mortality of 38,000 children in the Sarlahi district of Nepal. A data center was established in Kathmandu, approximately 8 hr drive from the study area. The trial is now completed and over 200,000 forms have been processed. The majority of potential data discrepancies were identified and corrected by field workers during the interviews. Supervisors and forms editors located at the field office corrected most data errors. Once forms reach Kathmandu, the average number of data entry errors was 3.1 per 10,000 keystrokes for the eight data entry operators employed during the study. Extensive computerized checking of data during data entry found out-of-range, missing, or inconsistent data in only 1% of forms. Timely analysis of field worker performance provided ongoing feedback to supervisors and analysis for the Data Safety and Monitoring Committee, and for publication of results.

Bias↗
PubMedDate not supplied

[Levels of occupational exposure to extremely low frequency magnetic fields among workers in different jobs].

Using personal dosimeters, occupational exposure to ELF-MF was measured in 150 workers employed in 28 different occupations. The main results are presented. The overall arithmetical mean in the whole sample was 0.36 microT, the overall geometric mean 0.21 microT. A high variability among workers engaged in the same occupation, and among different days in the same worker, was observed. The results suggest a relatively low exposure to ELF-MF in the large part of workers. Nevertheless, the higher levels measured in some workers, and the high variability, show the need of adequate measurements of ELF-MF exposure in workers.

Electromagnetic Fields↗
PubMedDate not supplied

Treatment compliance by leprosy out-patients and its monitoring under field condition.

The widely experienced poor treatment compliance by leprosy out-patients has interfered with effective leprosy control and contributed to the problem of drug (dapsone) resistance. This paper summarises (1) the pattern of treatment compliance by rural and urban patients in a leprosy hyperendemic area, and (2) various methods to monitor the treatment compliance, especially under field conditions. Two simple methods of monitoring the dapsone intake by patients viz. "Physical verification of DDS tablets with patients" and "paper spot test", when applied together, by a field worker in the field, were found to be operationally very feasible, economical and acceptable; and had good correlation with each other. Thus these methods are recommended to be used on large scale in leprosy control programme. The paper spot test was found to be 98% reliable, when compared with DDS/Cr. ratio estimation. In addition, communities and patients be continuously educated about leprosy and its control; and for the optimal utilization of medical care services by patients, they should be organized in background of the consumers.

Aged↗
PubMed1999

Biochemical effects of high intensity constant magnetic fields on worker honey bees.

Hemolymph samples from adult bees that had completed their pupal development and emergence in a 7 Tesla field contained a lower percentage of glucose than controls, indicating that trehalase enzyme activity in honey bees is reduced in strong magnetic fields. Significantly more phospholipids were found in the intestines of magnetic field-exposed bees than in controls. No significant differences were found for fatty acids, triacylglycerols, or steroids.

Animals↗