Prevalence of hepatitis B virus infection among barbers and their knowledge, attitude and practices in the district of Sukkur, Sindh .

Abstract OBJECTIVES: Several occupations in developing countries lag behind in ensuring the safety of their workers in occupational settings. Lack of implementation of safety guidelines at workplaces can expose workers to health risks. In Pakistan, barbers are one of the un-regulated occupational groups. Low literacy, increased frequency of direct skin contact and blade/razors use can expose barbers to body fluids including blood of the customers. We conducted this study in order to determine hepatitis B virus (HBV) prevalence among barbers and their knowledge, attitude and practices in a peri-urban district of Sindh. MATERIAL AND METHODS: Three hundred eighty-five barbers from the Sukkur district were interviewed using a structured questionnaire. Blood samples were collected and tested for HBsAg. A scale was built to determine the proportions of responses to knowledge, attitude and practice items. RESULTS: The prevalence of HBV among barbers was 2.1%. The barbers\u27 knowledge on HBV and its transmission routes was poor. The response to attitude items was good, except that only 35.1% of the participants agreed to have vaccination against HBV. The overall performance on the knowledge and practice scales was poor compared to the attitude scale on which 80% of the barbers performed well. CONCLUSION: The prevalence of HBV among barbers was lower compared to the available national figures for the prevalence among the general population

Chronic bronchitis and chronic obstructive pulmonary disease (COPD) among textile workers in Karachi, Pakistan

Objective: To determine the frequency and predictors of chronic bronchitis and COPD among textile workers in Karachi, Pakistan.Study design: Cross-sectional survey.Place and duration of study: Karachi, Pakistan, from October to December 2009.Methodology: Male textile workers from 15 mills of Karachi were inducted. Data was collected using American Thoracic Society respiratory questionnaire (ATS-DLD-78-a) and spirometry.Results: Out of 372 participants, 29 (7.8%) workers had chronic bronchitis (4, 9.1% aged ≥40 years) and 25 (6.7%) had COPD (12, 27.2% aged ≥40 years). Workers with chronic bronchitis had significantly decreased lung function compared to the healthy workers. Those reporting severe self-perceived dust exposure at work, ≥ 10 pack years of smoking, uneducated, longer duration of work (≥11 years), and ever smokers were more likely to have chronic bronchitis or COPD. In the multivariate analyses, severe self-perceived dust exposure at work (AOR = 7.4; 95% CI: 1.9, 28.0), family history of respiratory illness/symptoms (AOR = 4.8; 95% CI: 1.1, 20.9) and lack of education (AOR = 4.2; 95% CI: 1.1, 16.9) were significant predictors of chronic bronchitis. Duration of work ≥11 years (AOR = 5.5; 95% CI: 1.5, 19.7) and pack years of smoking ≥10 years (AOR = 3.5; 95% CI: 1.1, 11.7) were strong predictors for COPD.Conclusion: There is a high frequency of chronic bronchitis and COPD among textile workers. Multiple important predictors for prevention are identified

The Effect of Uncertainty in Exposure Estimation on the Exposure-Response Relation between 1,3-Butadiene and Leukemia

In a follow-up study of mortality among North American synthetic rubber industry workers, cumulative exposure to 1,3-butadiene was positively associated with leukemia. Problems with historical exposure estimation, however, may have distorted the association. To evaluate the impact of potential inaccuracies in exposure estimation, we conducted uncertainty analyses of the relation between cumulative exposure to butadiene and leukemia. We created the 1,000 sets of butadiene estimates using job-exposure matrices consisting of exposure values that corresponded to randomly selected percentiles of the approximate probability distribution of plant-, work area/job group-, and year specific butadiene ppm. We then analyzed the relation between cumulative exposure to butadiene and leukemia for each of the 1,000 sets of butadiene estimates. In the uncertainty analysis, the point estimate of the RR for the first non zero exposure category (>0–<37.5 ppm-years) was most likely to be about 1.5. The rate ratio for the second exposure category (37.5–<184.7 ppm-years) was most likely to range from 1.5 to 1.8. The RR for category 3 of exposure (184.7–<425.0 ppm-years) was most likely between 2.1 and 3.0. The RR for the highest exposure category (425.0+ ppm-years) was likely to be between 2.9 and 3.7. This range off RR point estimates can best be interpreted as a probability distribution that describes our uncertainty in RR point estimates due to uncertainty in exposure estimation. After considering the complete probability distributions of butadiene exposure estimates, the exposure-response association of butadiene and leukemia was maintained. This exercise was a unique example of how uncertainty analyses can be used to investigate and support an observed measure of effect when occupational exposure estimates are employed in the absence of direct exposure measurements

Environmental and Socio-Demographic Determinants of Dengue Fever in Colombo City, Sri Lanka

Dengue fever has increased exponentially in Sri Lanka, from 24.4 cases per 100,000 in 2003 to 165.3 per 100,000 population in 2013. Although early warning systems using predictor models have been previously developed in other settings, it is important to develop such models in each local setting. Further, the ability of these models to be applicable at smaller geographic units will enhance current vector control and disease surveillance measures. The aim of this paper was to identify environmental and socio-economic status (SES) risk factors that may predict dengue fever at the Gram Niladhari Divisions (GND) level (smallest administrative unit) in Colombo city, Sri Lanka. These factors included landcover classes, amount of vegetation, population density, water access and neighborhood SES as determined by roof type. A geographically weighted regression (GWR) was used to develop the prediction model. A total 55 GND units covering an area of 37 sq km were investigated. We found that GND units with decreased vegetation, higher built-up area, higher population density and poor access to tap-water supply were associated with high risk of dengue; the pertinent GND units were concentrated in the center of the city. This is the first study in Sri Lanka to include both environmental and socio-demographic factors in prediction models for dengue fever. The methodology may be useful in enhancing ongoing dengue fever control measures in the country, and to be extended to other countries in the region that have an increasing incidence of dengue fever

Determinants of low birth weight in urban Pakistan

Objective: To identify determinants of low birth weight (LBW) in Karachi, Pakistan, including environmental exposures and nutritional status of the mother during pregnancy. Design: Cross-sectional study. Participants: Five hundred and forty mother-infant pairs. We interviewed mothers about obstetric history, diet and exposure to Pb. We measured birth weight and blood lead level (BLL). We performed multiple log binomial regression analysis to identify factors related to LBW.Results: Of 540 infants, 100 (18.5%) weighed 208.7 mg/d), infants of mothers with MUAC less than or equal to the median and dietary vitamin C intake \u3e 208-7 mg/d (adjPR = 10.80, 95 % CI 1.46, 79.76), mothers with MUAC above the median and vitamin C intak

Effect of sunlight exposure on cognitive function among depressed and non-depressed participants: a REGARDS cross-sectional study

<p>Abstract</p> <p>Background</p> <p>Possible physiological causes for the effect of sunlight on mood are through the suprachiasmatic nuclei and evidenced by serotonin and melatonin regulation and its associations with depression. Cognitive function involved in these same pathways may potentially be affected by sunlight exposure. We evaluated whether the amount of sunlight exposure (i.e. insolation) affects cognitive function and examined the effect of season on this relationship.</p> <p>Methods</p> <p>We obtained insolation data for residential regions of 16,800 participants from a national cohort study of blacks and whites, aged 45+. Cognitive impairment was assessed using a validated six-item screener questionnaire and depression status was assessed using the Center for Epidemiologic Studies Depression Scale. Logistic regression was used to find whether same-day or two-week average sunlight exposure was related to cognitive function and whether this relationship differed by depression status.</p> <p>Results</p> <p>Among depressed participants, a dose-response relationship was found between sunlight exposure and cognitive function, with lower levels of sunlight associated with impaired cognitive status (odds ratio = 2.58; 95% CI 1.43–6.69). While both season and sunlight were correlated with cognitive function, a significant relation remained between each of them and cognitive impairment after controlling for their joint effects.</p> <p>Conclusion</p> <p>The study found an association between decreased exposure to sunlight and increased probability of cognitive impairment using a novel data source. We are the first to examine the effects of two-week exposure to sunlight on cognition, as well as the first to look at sunlight's effects on cognition in a large cohort study.</p

Situational Analysis of Household Energy and Biomass Use and Associated Health Burden of Indoor Air Pollution and Mitigation Efforts in Pakistan

Biomass fuel burning leads to high levels of suspended particulate matter and hazardous chemicals in the indoor environment in countries where it is in common use, contributing significantly to indoor air pollution (IAP). A situational analysis of household energy and biomass use and associated health effects of IAP was conducted by reviewing published and un-published literature about the situation in Pakistan. In addition to attempt to quantify the burden of ill health due to IAP, this paper also appraises the mitigation measures undertaken to avert the problem in Pakistan. Unfortunately, IAP is still not a recognized environmental hazard in Pakistan and there are no policies and standards to control it at the household level. Only a few original studies related to health effects of IAP have been conducted, mainly on women’s health and birth outcome, and only a few governmental, non-governmental and academic institutions are working to improve the IAP situation by introducing improved stoves and renewable energy technology at a small scale. Control of IAP health hazards in Pakistan requires an initial meeting of the stakeholders to define a policy and an action agenda. Simultaneously, studies gathering evidence of impact of intervention through available technologies such as improved stoves would have favorable impact on the health, especially of women and children in Pakistan

Acute health effects of the Tasman Spirit oil spill on residents of Karachi, Pakistan

BACKGROUND: On July 27 2003, a ship carrying crude oil run aground near Karachi and after two weeks released 37,000 tons of its cargo into the sea. Oil on the coastal areas and fumes in air raised health concerns among people. We assessed the immediate health impact of oil spill from the tanker Tasman Spirit on residents of the affected coastline in Karachi, Pakistan. METHODS: We conducted a study consisting of an exposed group including adults living in houses on the affected shoreline and two control groups (A and B) who lived at the distance of 2 km and 20 km away from the sea, respectively. We selected households through systematic sampling and interviewed an adult male and female in each household about symptoms relating to eyes, respiratory tract, skin and nervous system, smoking, allergies, beliefs about the effect on their health and anxiety about the health effects. We used logistic regression procedures to model each symptom as an outcome and the exposure status as an independent variable while adjusting for confounders. We also used linear regression procedure to assess the relationship exposure status with symptoms score; calculated by summation of all symptoms. RESULTS: Overall 400 subjects were interviewed (exposed, n = 216; group A, n = 83; and group B, n = 101). The exposed group reported a higher occurrence of one or more symptoms compared to either of the control groups (exposed, 96% vs. group A, 70%, group B 85%; P < 0.001). Mean summary symptom scores were higher among the exposed group (14.5) than control group A (4.5) and control group B (3.8, P < 0.001). Logistic regression models indicated that there were statistically significant, moderate-to-strong associations (Prevalence ORs (POR) ranging from 2.3 to 37.0) between the exposed group and the symptoms. There was a trend of decreasing symptom-specific PORs with increase in distance from the spill site. Multiple linear regression model revealed strong relationship of exposure status with the symptoms score (β = 8.24, 95% CI: 6.37 – 10.12). CONCLUSION: Results suggest that the occurrence of increased symptoms among the exposed group is more likely to be due to exposure to the crude oil spill

Descriptive epidemiology of somatising tendency: findings from the CUPID study.

Somatising tendency, defined as a predisposition to worry about common somatic symptoms, is importantly associated with various aspects of health and health-related behaviour, including musculoskeletal pain and associated disability. To explore its epidemiological characteristics, and how it can be specified most efficiently, we analysed data from an international longitudinal study. A baseline questionnaire, which included questions from the Brief Symptom Inventory about seven common symptoms, was completed by 12,072 participants aged 20-59 from 46 occupational groups in 18 countries (response rate 70%). The seven symptoms were all mutually associated (odds ratios for pairwise associations 3.4 to 9.3), and each contributed to a measure of somatising tendency that exhibited an exposure-response relationship both with multi-site pain (prevalence rate ratios up to six), and also with sickness absence for non-musculoskeletal reasons. In most participants, the level of somatising tendency was little changed when reassessed after a mean interval of 14 months (75% having a change of 0 or 1 in their symptom count), although the specific symptoms reported at follow-up often differed from those at baseline. Somatising tendency was more common in women than men, especially at older ages, and varied markedly across the 46 occupational groups studied, with higher rates in South and Central America. It was weakly associated with smoking, but not with level of education. Our study supports the use of questions from the Brief Symptom Inventory as a method for measuring somatising tendency, and suggests that in adults of working age, it is a fairly stable trait