BackgroundWe assessed the health effects of hexavalent chromium groundwater contamination (from tanneries and chrome sulfate manufacturing) in Kanpur, India.MethodsThe health status of residents living in areas with high Cr (VI) groundwater contamination (N = 186) were compared to residents with similar social and demographic features living in communities having no elevated Cr (VI) levels (N = 230). Subjects were recruited at health camps in both the areas. Health status was evaluated with health questionnaires, spirometry and blood hematology measures. Cr (VI) was measured in groundwater samples by diphenylcarbazide reagent method.ResultsResidents from communities with known Cr (VI) contamination had more self-reports of digestive and dermatological disorders and hematological abnormalities. GI distress was reported in 39.2% vs. 17.2% males (AOR = 3.1) and 39.3% vs. 21% females (AOR = 2.44); skin abnormalities in 24.5% vs. 9.2% males (AOR = 3.48) and 25% vs. 4.9% females (AOR = 6.57). Residents from affected communities had greater RBCs (among 30.7% males and 46.1% females), lower MCVs (among 62.8% males) and less platelets (among 68% males and 72% females) than matched controls. There were no differences in leucocytes count and spirometry parameters.ConclusionsLiving in communities with Cr (VI) groundwater is associated with gastrointestinal and dermatological complaints and abnormal hematological function. Limitations of this study include small sample size and the lack of long term follow-up.

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Background:Musculoskeletal (MS) pain is responsible for poor quality of life and decreased productivity. Objective information about the burden of musculoskeletal disorders among the general community in India is scanty, and the few reports that exist are based on a small sample size.Materials and Methods:This paper examines the issue of MS pain and its associated risk factors in a cross-sectional study of 2086 subjects from National Capital Region (NCR).Results:Overall prevalence of MS pain was found to be 25.9%. Pain was found to be more frequent among females (31.3%) as compared with males (20.9%). Significant association of pain in joints/limbs/knee/lower legs with obesity (OR = 2.1, P < 0.001) and high body fat (OR = 2.2, P < 0.001) was established. More than 50% of the subjects complained of backache.Conclusions:Our findings confirm that MS pain is a significant burden of disease among the residents of NCR. Women and subjects doing heavy work load, like agriculture and dairy farming, constitute the chief demographic groups. It is high time that a policy is framed to reduce this load of sickness.

Pesticide spraying operation is associated with the increased risk of adverse health effects among sprayers who do not follow safe farm work practices. A study was conducted among pesticide sprayers in North India to evaluate the clinical and subclinical variations in their vital health parameters before and after the pesticide spraying season. Blood cholinesterase levels, pulmonary function test, nerve conduction velocity and self-reported symptoms were studied among 18 eligible and consenting male sprayers. Mean acetylcholinesterase activity was reduced by 55 % in the post-exposure assessment (P<0.001) as compared to pre-exposure levels. Mean forced expiratory volume in 1 s was 20 % lower in the post-exposure assessment as compared to the pre-exposure level (P<0.05). No significant change was observed in the motor and sensory nerve conduction velocity in the median nerve of sprayers before and after the spraying activity. Also, no significant variation was observed with respect to self-reported symptoms except weakness in arms and legs (P<0.05). The significant decline in lung function and acetylcholinesterase level after pesticide exposure reflects the strongly negative effect of exposure to pesticides during spraying activity. More longitudinal studies among pesticide sprayers must be undertaken to further substantiate the cause-effect relationship between pesticide exposure and its subclinical effects. There is a strong necessity to minimise the exposure through the use of personal protective equipment in pesticide sprayers.

The World Health Organization has estimated that air pollution is responsible for 1.4 % of all deaths and 0.8 % of disability-adjusted life years. NOIDA, located at the National Capital Region, India, was declared as one of the critically air-polluted areas by the Central Pollution Control Board of the Government of India. Studies on the relationship of reduction in lung functions of residents living in areas with higher concentrations of particulate matter (PM) in ambient air were inconclusive since the subjects of most of the studies are hospital admission cases. Very few studies, including one from India, have shown the relationship of PM concentration and its effects of lung functions in the same location. Hence, a cross-sectional study was undertaken to study the effect of particulate matter concentration in ambient air on the lung functions of residents living in a critically air-polluted area in India. PM concentrations in ambient air (PM(1,) PM(2.5)) were monitored at residential locations and identified locations with higher (NOIDA) and lower concentrations (Gurgaon). Lung function tests (FEV(1), PEFR) were conducted using a spirometer in 757 residents. Both air monitoring and lung function tests were conducted on the same day. Significant negative linear relationship exists between higher concentrations of PM(1) with reduced FEV(1) and increased concentrations of PM(2.5) with reduced PEFR and FEV(1). The study shows that reductions in lung functions (PEFR and FEV(1)) can be attributed to higher particulate matter concentrations in ambient air. Decline in airflow obstruction in subjects exposed to high PM concentrations can be attributed to the fibrogenic response and associated airway wall remodeling. The study suggests the intervention of policy makers and stake holders to take necessary steps to reduce the emissions of PM concentrations, especially PM(1,) PM(2.5), which can lead to serious respiratory health concerns in residents.

Spirometric lung functions were evaluated in 220 asymptomatic glass bangle workers exposed to the salts of various heavy metals, such as arsenic, lead, zinc, copper, manganese, cobalt, cadmium, and selenium, which are used as coloring agents in the manufacture of glass bangles. The mean values of various spirometric variables (viz. FVC, FEV1, IMBC, and PEFR) were within normal range (more than 80% of the predicted values) in both smoking and nonsmoking glass bangle workers and did not reveal any significant differences in comparison with those observed in the unexposed controls. However, variables such as FEV1/FVC% ratio, FEF25-75 and FEF75-85 were reduced significantly (p less than 0.001) in the exposed group. The reduction was more marked in the smoking glass bangle workers indicating additive effect of cigarette smoking on the small airways. The exposed group showed a significantly higher prevalence (16.3%) of respiratory impairment in comparison to that observed in the controls (7.9%) as a result of exposure to various metals in the work environment (p less than 0.01). The respiratory impairment observed in the exposed group indicated primarily restrictive pattern of pulmonary abnormality (10.4%), while the controls revealed only 1.1% prevalence of this disease (p less than 0.001). The effect of the duration of exposure on the prevalence of respiratory impairment in the glass bangle industry revealed significantly higher prevalence (p less than 0.05) in those who worked for more than 10 years (23.0%) than in those who worked for less than 10 years (10.8%) thereby indicating that the duration of exposure is directly related to the prevalence of respiratory impairment.

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To evaluate the long-term effects of metal dusts on the bronchopulmonary system and the synergistic effect of cigarette smoke, a comparative study of spirometric measurements in 104 polishers and 90 unexposed controls was carried out in 25 brass and steelware polishing industries at Moradabad in northern India. The two groups were comparable in terms of age, height, smoking habit and socio-economic status. A total of 58.6% of the polishers had one or more respiratory symptoms, compared to only 25.5% of the controls (P<0.05). Chronic cough was present in 21 polishers (20.2%) as compared to 11.1% of the controls. However, this difference was insignificant. Chronic phlegm was nearly three times as frequent among the polishers as among the controls (17.5% vs 4.4%) (P<0.005). The prevalence of dyspnoea of varying grades was also significantly higher (16.3% as opposed to 4.4%) among the exposed groups. Chronic bronchitis (6.7%) and occupational asthma (4.8%) were found to be confined to polishers. The polishers also experienced acute respiratory symptoms during the work shift. The prevalence of acute respiratory symptoms was recorded for cough in 19 workers (44.1%) followed by dyspnoea in 14 workers (32.5%) and throat irritation in 11 workers (25.5%). Comparison of the mean values of pulmonary function parameters in the polishers and the controls showed significant differences in the smoking and non-smoking groups (P<0.001 ). The polishers exhibited significantly greater acute reductions in various lung functions over the work shift, particularly for forced expiratory flow over the 25-75% portion of the spirogram (FEF25_75%) FEF25% and FEF 50%, than did the controls. Among the exposed group, the acute changes in lung function were found to be significantly larger in the smoking than in the non-smoking polishers. The duration of exposure showed a direct correlation with the acute fall in lung function. Polishers who were exposed to dusts of various metals for more than 10 years showed a significantly greater acute reduction in all the pulmonary functions (P<0.001) thereby indicating that occupational exposure to multimetals in the work environment of the polishing industry had deleterious respiratory effects.