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Accepted for next issue
Accepted articles for the IJOSH, Volume 14, No 1, 2024:
1. Knowledge, Perception and Practices Regarding COVID-19 among frontline Nurses at Selected hospitals in Sri Lanka during COVID-19 Pandemic
Introduction: The World Health Organization confirmed the COVID-19 epidemic situation as a public health emergency and is an emerging public health problem that has threatened millions of lives worldwide. Since COVID-19 has significantly affected the healthcare system globally, it is essential to update healthcare workers especially frontline nurses on the best practices for the proper management of the disease. The study aimed to assess Knowledge, Perceptions, and Practices regarding COVID-19 among frontline nurses at the National Institute of Infectious Diseases, National Hospital of Sri Lanka, and Base Hospital Mawanella in Sri Lanka.
Methods: This cross-sectional study was conducted among 257 frontline nurses from main three hospitals in Sri Lanka from June 2020 to December 2021. A validated, pre-tested self-administered questionnaire was used for data collection. Kruskal Wallis test and Chi-square test were applied to find significant factors associated with good knowledge, using SPSS version 25.
Results: The average age of the 257 participants was (31.8 ± 6.6) years and most (95%) of them were female. Of them, 79.4% had good knowledge, and the knowledge level of the nurses was significantly associated with their marital status (p=0.04) and their participation in the COVID-19 management workshop or lecture (p ≤0.001). There was a statistically significant median score difference between participants’ knowledge, and three hospitals (p<0.05).
Conclusion: The findings demonstrated that the nurses had overall good knowledge, positive perception, and good practice on COVID-19. This study highlighted the factors influencing knowledge about COVID-19 that must be addressed in future education, awareness, and preparing the programs.
2. Ergonomic Risk Assessment and Fatigue Analysis During Manual Lifting Tasks in Farming Activities
Introduction: Farming is a physically demanding occupation that puts farmers at risk of musculoskeletal disorders, particularly when frequently performing activities like heavy lifting, which strains the lower back muscles. The present study aimed to assess the ergonomic risk and fatigue during manual lifting tasks pertaining to farming activities.
Methods: A study was performed on 20 farmers to analyze the ergonomic risks associated with load lifting through the estimation of the Recommended Weight Limit and Lifting Index using the revised NIOSH lifting equation. The low back compression forces of the participants were estimated using the 3DSSPP software. Surface electromyography was employed to analyze the onset of muscle fatigue during the lifting activity.
Results: The results of the study showed a 111.12% increase in the recommended weight limit, a 52.77% reduction in lifting index, and a 28.15% reduction in the low back compression forces for the redesigned lifting technique. The average low-back compression force for the redesigned technique was observed to be well below the back compression design limit of 770 lb. A reduction in the slope of the RMS voltage regression line by 60% and a reduction of 50.23% in the peak spectral power of the sEMG signal, accompanied by a shift in the peak spectral power towards higher frequency region indicated delayed onset of fatigue for the redesigned technique.
Conclusion: The outcomes of the study indicated that the ergonomic redesign of the lifting task could significantly reduce the lifting index and alleviate the spinal compression forces well within the back-compression design limit. The redesign was also found to delay the onset of fatigue in the erector spinae muscles.
3. Prevalence and Determinants of Sickness Absenteeism among Healthcare Workers in a Tertiary Hospital in Southwestern Nigeria
Introduction: Sickness absenteeism is a global problem that affects almost all forms of workers, especially healthcare workers. This study assessed the prevalence and determinants of sickness absenteeism among healthcare workers in a tertiary hospital in Southwest, Nigeria.
Methods: An institutional-based, cross-sectional study was conducted among 360 healthcare workers in a Tertiary Hospital in Southwest, Nigeria from October to December 2022. A pre-tested interviewer-administered, semi-structured questionnaire was used to elicit information from the respondents who were selected using a stratified sampling technique. Bivariate analysis and binary logistic regression analysis were performed to identify the predictors of sickness absenteeism using SPSS version 25.0. The significance of associations was determined at p-value < 0.05.
Results: The mean age ± SD of the respondents was 34 ± 7.15 years. The prevalence of sickness absenteeism among the health workers was 21.0%, while the causes of sickness absenteeism were malaria (51%), body pain (18%), and diarrhea (5%). Family obligation (AOR: 2.1, 95% CI: (1.20, 3.53), P=0.009) and the job type (AOR: 2.7, 95% CI: (1.05, 6.83), P=0.038) were the only predictors of sickness absenteeism.
Conclusion: About one-fifth of the respondents had one spell of sickness keeping them away from work due to illnesses such as malaria, diarrhea, and body pain. Preventive interventions should be instituted by stakeholders based on the identified factors to reduce the prevalence of sickness absenteeism among these populations.
4. Assessment of Knowledge, Attitude, and Practices of Biomedical Waste Management among Health Care Workers in a Tertiary Care Hospital, Chengalpattu, Tamil Nadu, India
Introduction: Bio-medical waste (BMW) means any solid and/or liquid waste including its container and any intermediate product, which is generated during the diagnosis, treatment, or immunization of human beings or animals. Inadequate and inappropriate knowledge of handling healthcare waste may have serious health consequences and a significant impact on the environment. Thus, the study aims to assess the knowledge, attitude, and practice of biomedical waste management among healthcare workers from different strata in the hospital.
Methods: This was a cross-sectional study involving 383 participants conducted between June 2022 to October 2022, A structured, close-ended, self-administrated questionnaire was used to collect the data. The data were analyzed using R studio and presented as frequencies and percentages. The association between different variables was analyzed by the chi-square test.
Results: Most of the doctors (41.3%) and nurses (41.5%) had very good knowledge of Bio-Medical Waste Management (BMWM) but only 23.1% of laboratory technicians and housekeeping staff 18.2% showed very good knowledge. All the participants had a very good attitude (69.2% to 82.6%) towards BMWM but it needs some improvement concerning reporting needle stick injuries and taking Post-exposure prophylaxis (PEP). More than 80 % of participants were immunized against Hepatitis B and followed the appropriate practice of BMWM except for wearing adequate personal protective equipment (PPE) while handling BMW. Knowledge and good attitude were observed to increase with experience.
Conclusion: From the study, it is identified that knowledge regarding BMWM is inadequate among the healthcare professions. It is concluded that there should be adequate training among the HCWs about BMWM like video lectures, symposiums, quiz programs, and role play that can help them update their knowledge.
5. Prevalence of work-related musculoskeletal disorders and ergonomic risk assessment among production workers of pig slaughterhouse in the town municipality of Ang Thong, Thailand
Introduction: Work-related musculoskeletal disorders (WMSDs) are a significant health concern among workers, especially in the meat processing industry. Their impacts have been well documented and reported on numerous occasions. The study aimed to determine the prevalence of WMSDs and the ergonomic assessment of exposure to their risk factors.
Methods: This cross-sectional study was conducted in a pig slaughterhouse in the town municipality of Ang Thong, Thailand. Data were collected from April to July 2021 from 108 participants who answered a questionnaire. The descriptive questionnaire for WMSDs was adapted from the Standardized Nordic Questionnaire in Thai and the Bureau of Occupational and Environmental Diseases, Department of Disease Control of Thailand. Ten individuals received an ergonomic assessment of their exposure to risk factors using the Rapid Entire Body Assessment (REBA) method.
Results: According to the study, 94.4% of participants working in pig slaughterhouse production reported experiencing the prevalence of WMSDs in the last seven days. Additionally, 93.5% of workers reported experiencing the prevalence of these disorders within the past 12 months. It has been observed that 29.6% of participants experience higher pain levels in their hands, while 25.9% experience it in their wrists, respectively. Based on the results of an ergonomic risk assessment using the REBA method, the half-cutting operator position presents a moderate level of risk.
Conclusion: The study revealed that most of the workers at the pig slaughterhouse had to use their hands and arms to apply repeated pressure consistently. The occurrence rates of WMSDs within the last seven days and 12 months were highest in the hands or wrists, followed by the upper arms and shoulders. Therefore, it is crucial to implement ergonomic measures to minimize the risk factors for WMSDs among production workers in pig slaughterhouses.
6. The impact of safety culture dimensions on workplace accidents: an application in the Moroccan automotive industry
Introduction: There is a general accord that safety culture is multidimensional. but limited research and publications are there about those dimensions. Almost one-third of the publications presenting safety culture definitions do not discuss the safety culture dimension nor the relationship between the safety culture dimensions and workplace accidents. To further understand the factors influencing this correlation. it appeared appropriate in this situation to investigate the relationship between the safety culture dimensions and occupational accidents. This study aims to identify the safety culture dimensions in the automotive industry in Morocco and its relations with occupational accidents.
Methods: A study was done with 35 of the largest automotive companies in Morocco. the effects of Safety Culture dimensions on workplace accidents in the automotive industry were examined based on the literature review. and a measurement questionnaire that was created with a sample of numerous automotive workers for 2 months in the winter semester of November and December 2022.
Results: The results highlight that the safety culture dimensions have a strong influence on avoiding accidents especially the safety culture's dimensions which present 40%. In addition, the COVID-19 period had a big impact on the number of occupational accidents in the automotive sector. 40.54% of these occupational accidents occurred between 2020 and 2022.
Conclusion: Based on the results gained from the Questionnaire the common safety culture dimensions are employees’ attitudes or unsafe behaviors, lack of staff participation, and inadequate supervision.
7. Resumption of dental practice after COVID-19 lockdown: perspectives of dental professionals in Karachi, Pakistan
Introduction: In the COVID-19 pandemic, the implementation of the lockdown led to the closure of dental practices. Restricting treatment to emergency patients, having to use Personal Protective Equipment and the fear of contracting the virus led to modifications in the techniques and methods used to provide efficient dental care to the patients. However, it caused a significant psychological and financial impact on the dental community. The purpose of this research was to evaluate dentists’ perceptions regarding the psychological, financial, and general impact of the COVID-19 pandemic on the reopening of their dental practices.
Methods: This cross-sectional analytical study was conducted using a validated questionnaire, which was distributed among 257 dental practitioners working in Karachi through the social media app (WhatsApp®) from May 2021 to May 2022. The questionnaire included four sections and 26 items, recording data for demographics, psychological effects on resumption of dental practices, workplace disinfection, and precautionary measures along financial impacts. Data were analyzed using SPSS, version 21.0. p-value ≤ 0.05 was taken as statistically significant
Results: A total of 200 filled questionnaires were received, making the response rate 77%. The majority of respondents were females (67%). More than half of the respondents (55.5%) were working in dental OPDs. Most participants affirmed that they did not have a COVID-19 screening area nor patient triage was being done in dental OPDs. Closure of dental practices caused financial problems for all dental practitioners, more specifically for those that were associated with both public and private types of practices (84.9%). The majority of the dentists in private practice (94.4%) declared that their workplaces were being disinfected, while 47.7% of dental practitioners working in the dental OPD affirmed that they had enough financial stability to keep using Personal Protective Equipment. Approximately 64.9% of professionals practicing in dental OPDs and 33.3% in private practice believed that the reopening of dental practices was responsible for the re-spread of the coronavirus
Conclusion: Significant anxiety and stress related to COVID-19 were seen among dental practitioners. Some CDC-recommended guidelines such as the use of Personal Protective Equipment were being implemented whereas COVID-19 screening and patient triage were found deficient.
8. “Vaai Ganam” - a screening program for early detection of oral potentially malignant disorders and oral cancer among truck drivers in Chennai – a cross-sectional survey
Introduction: Truck drivers, though forming an integral part of a vital trade link for the Indian population, lack basic life insurance and health care benefits offered by other organized sectors in Indian Industries. This paper aims to present the initial findings of the “VaaiGanam” program which proposes to identify tobacco use and the prevalence of Oral potentially malignant disorders (OPMDs) among truck drivers who are stationed or passing via Chennai and provide cessation services by behavioral therapy.
Methods: This cross-sectional study was conducted by a dental screening team who were involved in data collection and screening of the 747 truck drivers who fulfilled the inclusion and exclusion criteria between Jan to Oct 2022. After data collection, oral examinations were done and suspicious lesions were sought for expert opinion. A standard punch biopsy was taken from those lesions requiring confirmation.
Results: Among the 747 subjects who participated in this program, 704 (94.2%) were current users of various tobacco products, with 235 (31.4%) preferring smoking and the rest 469(62.8%) using smokeless tobacco products. Oral mucosal lesions were recorded in 49 (6.5%) of the study population, mostly among tobacco users. Punch/incisional biopsies were taken among 17 of the 49 subjects and oral dysplasia was histopathologically confirmed in 9 (mild epithelial dysplasia = 5; moderate epithelial dysplasia = 4) subjects.
Conclusion: Truck drivers with tobacco and substance abuse are at high risk of developing oral cancer and hence this study emphasizes the importance of periodic oral cancer screening programs for this vulnerable population to identify potentially malignant oral lesions at an early stage.
9. Biosafety knowledge and perception among medical laboratory students: a cross-sectional study at a medical university in Vietnam
Introduction: Medical students have to deal with biohazards in laboratories during undergraduate studies and intensive practice in hospitals. Unsafe operators can result in an outbreak of biohazardous pathogens to healthcare workers, the community, and the environment. However, the most common risk factors for laboratory accidents are a lack of perception and knowledge of biosafety and laboratory safety management. This study aimed to assess knowledge and factors influencing the biosafety practices of medical students at Hanoi Public Health University, Vietnam
Methods: A cross-sectional study was conducted to assess the biosafety knowledge of all 286 students majoring in a medical laboratory at HUPH from December 2021 to February 2022. Ethical clearance was obtained from the Ethics Committee of Hanoi University of Public Health. The questionnaire has been created based on WHO biosafety guidelines with some modifications according to the local context. The data were collected by face-to-face interviews
Results:: Out of the 286 students invited to complete a biosafety questionnaire, 68.6% of students recognized the fundamental principles of biosafety. Additionally, 76.2% and 91% of students correctly identified risk factors and danger signs in the laboratory, respectively. Furthermore, 79.8% of students provided accurate answers to biosafety laboratory troubleshooting questions. Notably, academic performance, students’ year of study, and average scores in biosafety courses had significantly related to the biosafety knowledge. Gender factors and academic performance were related to the rate of obtaining precise knowledge about incident handling and preventing risk factors in the laboratory.
Conclusion: The passed rate of biosafety knowledge among medical laboratory students at the University of Public Health was 68.6%. Factors such as the student's school year, academic performance, average score in the biosafety course number of internships in hospitals significantly affected their biosafety and troubleshooting knowledge in the laboratory.
10. Assessment of self-perceived risk and risk rating among chemical sprayers in selected tea plantations in South India
Introduction: Chemical sprayers of the tea plantation industry perceive various degrees of risk involved in their daily work. The objective of the study was to assess self-perceived risk and to rate these risks among the pesticide sprayers working in selected tea plantations in South India.
Methods: A cross-sectional study was conducted among 290 chemical sprayers in six selected tea plantations in South India from September to October 2018 after approval from the Institutional Ethics Committee and permission from the plantations. Data was collected by structured interview schedule with the chemical sprayers and key informant interviews were conducted with their supervisors. The risks perceived by the sprayers were rated and expressed using the Risk Rating Matrix.
Results: The mean age of the participants was 45.6±8.5 years and all of them were males. The most common risks encountered were leech bites (76%), other insect bites (58%) and bruises (46%). Chemical spills, splashes, slips, falls and backaches were considered as minor hazards in risk rating. Animal attacks and falls from trees were assigned the highest risk rating scores.
Conclusion: Insect bite was the most common risk perceived and animal attacks attained the highest risk score. Regular supervision and monitoring of work-related risk factors can help in the reduction of common injuries thereby ensuring safety at the workplace.
11. Musculoskeletal Pain and its Ergonomics Risk Factors among School Teachers from Tamil Nadu, India: a Cross-Sectional Study
Introduction: Teachers are often exposed to occupational hazards like musculoskeletal pain which may force them to early retirement from their jobs, affecting their quality of life. This study aimed to estimate the prevalence of musculoskeletal pain among government school teachers and to assess its ergonomic risk factors.
Methods: A cross-sectional study was conducted among government school teachers in Kundrathur Block, Kancheepuram District, Tamil Nadu, India. The Nordic Musculoskeletal Questionnaire was used to estimate the prevalence of musculoskeletal pain. The study was conducted from June to November 2019 for 6 months. In total, 400 participants were included in the study. Descriptive statistics like frequency and percentage were used for different variables and the various risk factors as well as inferential statistics like prevalence, confidence interval, odds ratio, and chi-square test were used for finding the association between the dependent and independent variables.
Results: The prevalence of musculoskeletal pain among school teachers was 69.8%. Binary logistic regression analysis showed that the factors such as sex (adjusted odds ratio [aOR] = 2.47; 95% confidence interval [CI]: 1.47-4.15) with p-value = <0.01* and number of students in each class (aOR= 1.86; 95% CI: 1.12-3.08) with p-value = <0.01* were identified to be significant risk factors associated with musculoskeletal pain.
Conclusion: The prevalence of musculoskeletal pain among school teachers was found to be high. This clearly shows the significant burden of this occupational hazard on the teacher’s community, which should be addressed to focus on its prevention.
12. Statistical Data Analysis in Emergency Management Elements of Indian State of Tamil Nadu Manufacturing Industries Utilising LPG
Introduction: Process safety is becoming more difficult as requirements increase. When balancing quality, volume, and safety on a budget, major accidents are unavoidable. The inability of organizations to absorb unwelcome and unanticipated disruptions is a major contributor to complacency and a decline in safety attitudes. The inability of industries to interpret standards impedes self-regulation.
Methods: A total of 50 emergency management element questionnaires were developed to evaluate the state of an industry. These questionnaires were categorized as first aid, personal protective equipment (PPE), communication systems used in plants, safety education and training, occupational hygiene and health, management systems on accident reporting, safety and health, analysis and investigation, and procedures and protocols. From 32 LPG industries in Tamil Nadu districts, information for all 50 questions was gathered and the statistical tool "Analysis ToolPak" in Excel 2010 was used to analyze the data.
Results: This study conducted a comprehensive statistical analysis of various aspects of industrial on-site emergency planning. The questionnaire's reliability was determined using Cronbach's alpha test. Utilizing descriptive statistics, t-tests for means, one-way ANOVA, and histograms, statistical evaluation was conducted. Encouragingly, all the results were favorable, providing compelling evidence that the LPG-utilizing industries in various regions of Tamil Nadu, India, are exceeding safety requirements.
Conclusion: In conclusion, the findings suggest that improved legal frameworks, laws, and implementation of EME in communication systems can greatly enhance the development of safety in plants, fire protection, and emergency health services. These measures can significantly reduce the occurrence of accidents and improve the response time to emergencies, ultimately saving lives and reducing property damage.
13. Impact of High-Heeled Footwear on the health of the young female students of selected colleges of Mangalore, India
Introduction: High-heeled shoes are a leading cause of foot problems and chronic lower limbs, as well as discomfort, fatigue, and an increased risk of injury. The research aimed to analyze the influence of wearing high-heeled shoes on the foot health of young females. The study emphasizes the need to create awareness among females about the detrimental impacts of utilizing heeled footwear over the long term on discomfort, BMI, and functional capacity. A slight change in footwear choices could significantly reduce discomfort and disability experiences.
Methods: Purposive sampling was used to select 50 young female students studying in Mangalore's undergraduate college for the cross-sectional study. A pre-designed and pre-tested structured Google Form questionnaire was used to examine the socio-demographic characteristics and outcome measures, including the location of pain, the intensity of the pain, and functional ability. Data was collected in the second half of 2020. Descriptive and inferential statistics were used to analyze the data.
Results: According to the survey, 46% of young female students exhibited poor functional activities while wearing high heels. It was found that 12% of students had pain in their toes all of the time, 8% had pain in the arch of their foot, and 25% had discomfort in their lower back occasionally. About two-thirds (64%) felt averagely manageable discomfort.
Conclusion: The study found that wearing heeled shoes has a significant influence on women's musculoskeletal systems. Young females will be better able to resist pain from the deforming effects of footwear if they condition their feet properly and choose the appropriate footwear.
14. Exploring Risk of Posture and Musculoskeletal Disorders among Smartphone Addicted Youth: a Protocol Paper
Introduction: Smartphones with rapid advancement in telecommunication technology causing high usage leads to addiction, especially among youth. Concerning health, smartphone addiction influences posture causing neck-shoulder pain. However, the mechanism of how smartphone addiction causes pain related to posture control is still doubtful. Anticipatory feed-forward motor control mechanism has proposed that smartphone usage is a static low-level activity influenced by muscle fatigue and discomfort. Therefore, this study aimed to explore neck-shoulder muscle fatigue, particularly at the upper trapezius about smartphone addiction behaviors and adopted posture while using smartphones among youth. This study aims to investigate the relationship between smartphone addiction, risk of posture and the relationship between trapezius muscle fatigue, and neck-shoulder pain among youth.
Methods: A cross-sectional study design will be conducted through convenient sampling among students at secondary schools in Malaysia. The Smartphone Addiction Scale, Rapid Assessment Upper Limb, Nordic Musculoskeletal Questionnaire and Electromyogram will be used as outcomes tools.
Discussion: This study investigates the risk of smartphones in terms of duration usage among adults. Fatigue over the upper trapezius muscle has not yet been investigated among youth which will provide fundamental
15. Study on Causal Effects of Occupational Stress on Healthcare Workers at a selected Healthcare Facility in Oman
Introduction: Occupational stress (OS) can be described as any physical or psychological change in an individual due to immediate or long-term reactions to workplace conditions that pose perceived threats or challenges to that employee. Typically, since work environments differ worldwide, scientists posit that the nature, sources, and causes of OS and the solutions proffered to address its impacts among healthcare workers (HCWs), differ markedly. The study aims to identify and examine the causal effects of OS on HCWs at the selected health facility in Oman.
Methods: The study adopted a quantitative design that utilized questionnaires to examine the causes and effects of OS on selected health workers. Data was collected from December 2021 to January 2022 from 150 health facility employees to obtain their opinions on the causes and effects of OS on their health, work life, and productivity.
Results: Findings revealed that 47% of the respondents were male and 53% were female. Further, the results also revealed that HCWs at the selected health facility have experienced a high prevalence of OS due to various factors ranging from staff shortages, as revealed by 56.2% of the participants, to work duration and loads, as revealed by 69.0% of the participants, and staff working conditions.
Conclusion: As a panacea, recommend management of healthcare facilities engage more highly qualified staff and create highly conducive work environments and training. Likewise, the management can provide modern-day facilities and amenities. It is envisaged that such measures will also reduce workloads, which will help the HCWs to rest, resuscitate, re-energize, and nurture effective stress. Furthermore, the measures will help create a stress-free, healthy, and conducive environment for the HCWs and greatly improve quality healthcare delivery services.
16. Health status of police personnel in a selected subdivision of Bengaluru District, Karnataka, India
Introduction: Police personnel perform untiring duties to maintain law and order. The objectives of this study were to assess the physical and mental health status of police personnel in a selected rural subdivision of Bengaluru District.
Methods: A cross-sectional study was conducted among 142 police personnel in 7 police stations of the selected rural subdivision using a universal sampling technique. A structured interview schedule was used, which included socio-demographic details, occupational details, anthropometry, blood pressure and blood sugar measurements, Patient Health Questionnaire-9 (PHQ-9) to screen for depression and Perceived Stress Scale (PSS) to identify stress.
Results: The mean age of the police personnel was 40.28±10.97 years. Most of the workforce were males (83%). About 68.3% of the studied group were obese. High random blood sugar and high blood pressure values were observed in 5.6% and 48.6% of the personnel who had no previous history of diabetes mellitus and hypertension. The prevalence of mild to severe depression was found to be 36% and that of high stress was 83.1%.
Conclusion: The high prevalence of increased blood pressure, obesity, depression and perceived stress warrants the need for routine screening and application of various levels of prevention. Health promotion and improved working conditions can improve their health status.