Workplace accident has a devastating and long term effect on the lives of people who are affected. Globally, workplace accidents are estimated at 317 million annually and 6300 workers die daily of occupational diseases and accidents. This study determines the characteristic of workplace injuries, accident frequency rate (AFR), accident severity rate (ASR) and leading causes across six ferroalloy industries in Bhutan. From the total numbers of 1366 workers, a sample size of 300 was considered and distributed proportionately among the companies and the departments within the companies. Information was gathered through face-to-face interview, observation, and secondary data maintained by each company. This study found that the workplace injury rate was 200 (20%) per 1000 workers, with over all AFR 62.45 and ASR 583.20 per million hours of work annually among the six ferroalloy industries. Out of 561 lost working days, 516 days were lost due to major injury with AFR 11.45 and ASR 540.20 per million hours work annually. This study found that AFR alone cannot be used as an exclusive indicator for predicting the occurrence of severe events at workplace. Contact with object and equipment (44.2%), fall from height (20.9%) and contact with the hot substance (26.7%) were three main leading causes of workplace accidents among ferroalloy industries. Comparing between the survey data and accident record maintained by each company, though it showed a similar nature, the frequency was found to be higher in survey data.

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Introduction: Exposure to any type of noise has a potential risk. Higher the level of noise and longer duration of exposure, the more the risk for the hearing sensitivity and health as a whole. The objective of the study is to determine the prevalence of Occupational Noise Induced Hearing Loss (ONIHL) among the industrial workers in Bhutan and to ascertain high risk establishment and vulnerable occupations. Methods: The hearing assessment was conducted among 1638 workers considering different types of industries and occupations to ascertain the prevalence of occupational noise induced hearing loss and vulnerable group amongdifferent industries and occupations. Descriptive statistics and binary logistic regression were performed to test the significance of ONIHL among the various independent variables. Results: The study found that the prevalence of ONIHL stands at 27.9% among industrial workers in Bhutan. 42.45% of candidates who had ONIHL reported with tinnitus in either or both ears. This study founda significant association between the exposure duration and the severity of ONIHL among the industrial workers. Considering the type of industry, wood based industry, hydro services, cement and polymer were found to have a higher prevalence of ONIHL and similarly, higher prevalence of ONIHL were found among occupations such as blaster, chipper, carpenters, dryer (knife grinder) and crusher operators. Conclusions: This study conduces that prevalence of ONIHL among industrial workers is found to be at the higher side and some of the occupations and industries impose higher risk. The study suggests that there is need for intervention such as strict enforcement of the permissible exposure limit, monitor and evaluate hearing conservation programs, and providing advice and recommendation to address such issues by the relevant agencies and industries

Background Hearing impairment due to ototoxicity is one common cause adding to global burden of disability. Amikacin and kanamycin are two common Aminoglycosides used to treat multidrug resistant tuberculosis which results in ototoxicity. The mean prevalence rate of multidrug resistant tuberculosis in Bhutan stood at 16%. Objective The study is aimed to establish prevalence rate of hearing impairment due to ototoxicity and secondary side effects which may ascertain specific early intervention. Method A total of 42 Patients undergoing multidrug resistant tuberculosis treatment participated in the study conducted at Jigme Dorji Wangchuk National Referral Hospital and Gidakom Hospital over a period of one year. Audiological tests were conducted once every month. The severity of ototoxicity was being graded using Brock's hearing loss grades. Result The study found 45.23% participants with some degree of hearing loss consequent to multidrug resistant tuberculosis treatment. Around 9.5% of the total participants developed potential disabling hearing loss. Around 30.09% of participants had experienced subjective tinnitus during the course of treatment. Study found no significant association (p-value 0.88, 95%CI 0.93–1.00) between referred test result of DPOAE (distortion product Otoacoustic emission) screener and the ototoxicity. Conclusion Study showed with significant prevalence of ototoxicity. Since hearing impairment have negative impact on psychosocial wellbeing and communication abilities, it is paramount importance to put in place the various preventative measures. With current guidelines by World Health Organisation on replacement of second-line injectable by oral regimens while treating patients with MDR-TB, it is expected to address ototoxicity and related issues.

Introduction: Workplace plays an important role in the lives of not only workers but also their dependents and families. Therefore, it is very important to consider safety and health in every workplace. However, the health and safety standards in Bhutan is still at a premature stage.Objective: The objective of this study is to assess the overall occupational health and safety situation in the country to better understand the level of occupational safety and health standards in the country.Methods: All the enterprises in Bhutan, who had constituted a health and safety committee in 2016 to 2017 were considered. Structured questioners were used for assessing and evaluating the health and safety standards at the workplace. Results:The study found that the health and safety standards have improved however, improved marginally with the higher percentage of improvement falling in the fair practice of health and safety at their workplace. Conclusion:The Department of Labour plays a pivotal role in taking leadership and educating employers, employees, the general public on workplace safety and health. Therefore, it is important for the Department to rigorously enforce the safety and health standards in the companies. Further, the management of the companies also needs to ensure commitment and leadership for implementation of workplace safety and health.

Introduction: Poor indoor air quality (IAQ) in Bhutan remains a concern, as firewood and biomass combustion are the fuels generally used for cooking and heating. The adverse impact of indoor air pollution (AIP) on health is inevitable and requires further evidence to be acquainted with strategic modifications. This study aimed to determine IAQ in the rural communities of Bhutan. Method: Air sampling equipment DUSTTRA DRX Aerosol Monitor was used to collect samples from 161 rural households with randomised sampling from February to June 2021. An hourly survey included data extraction regarding particulate matter (PM1, PM2.5, and PM10 ) and common health problems among household members. Results: IAQ worsened during the cooking hours, where PM10, PM2.5, and PM1 increased by 118%, 112.2%, and 111.6%, respectively. Overall, 77% of households used firewood for cooking, 96.3% used it for room heating, and 100% used fodder for cooking. The main source of higher indoor air pollution was associated with the combustion of sawdust, firewood, and biogas. Similarly, traditional mud stoves generated more IAP than gas and modified mud stoves. It is found that there is a significant association of longer hours of window-opening (p < 0.05) and more numbers of rooms (p < 0.001), with IAP. Common health-related complaints comprised eye irritation (22%), headache (22%), coughing (19%), and skin irritation (11%). Conclusion: This study recorded high concentrations of PM during biomass combustion in rural houses in Bhutan. The Study demonstrated the importance of modified stoves with efficient venting systems as alternatives to counter the long-term burden of IAP.

The construction industry is one of the most hazardous industrial fields, wherein the construction workers are prone to work related accidents resulting in disabilities and/or deaths. The probability of fatality in the construction industry is five times more likely than in the manufacturing industry.In developing countries, construction work is ten times more dangerous than in industrialized countries. ILO (2016) estimated that of all workplace accidents, about 30% of fatal accidents occur at construction sites. Similarly, the construction industry in Bhutan accounts for 60% of total workplace accidents in the country. This paper will evaluate the existing Occupational Health and Safety (OHS) practices in the construction industry of Bhutan. It will also identify the challenges and problems faced by both the contractors and those attempting to implement OHS policies and procedures.A study was conducted involving 119 participants from several construction companies and government regulatory organizations relevant to the construction industry in Bhutan. Data was collected through questionnaire surveys, interviews and discussions. The study identified a number of OHS problems in the construction industry, including: i) Low priority given to safety; ii) Poor attitude of contractors and laborers towards OHS; iii) lack of competent manpower to enforce regulations; iv) lack of safety promotion; and v) poor health and safety management systems.

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