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Indian Journal of Community Medicine

Morbidity Profile of Cotton Textile Workers

Author(s): Rajnarayan R Tiwari, Mrinalini C Pathak, Sanjay P Zodpey*, Vijay Y Babar

Vol. 26, No. 1 (2001-01 - 2001-03)

Department of Community Medicine, Jawaharlal Nehru Medical College, Sawangi (M), Wardha *Department of Preventive and Social Medicine, Government Medical College, Nagpur

Abstract:

Research question: What are the common morbid conditions among cotton textile workers?

Objective: To study the morbidity pattern and prevalence among cotton textile workers.

Study design: Cross-sectional study.

Setting: Shri Bapurao Deshmukh Sut Girni, Wardha.

Participants: 514 cotton textile workers employed in the Sut Girni.

Results: All the study subjects were males. Majority of the workers belonged to age group 25-35 years (68.1%) and lower socio-economic strata (78.4%) according to modified Kuppuswamy's scale. Majority of the workers had an educational attainment upto primary school level (42.2%). Most of the workers were working in Ring frame (39.3%) and majority (65.2%) were working for last 5-10 years. Mean height of subjects was 164.8 13.7 cm and mean weight was 57.3 7.8 kg. The common morbid conditions included, amoebiasis (4.1%), grade 1/2 byssinosis (2.3%), chronic bronchitis (4.5%), dental stains (5.6%), dental calculus (11.7%), dental caries (8.2%), eosinophilia (19.8%), iron deficiency anaemia (52.7%), refractive errors (8.8%) and upper respiratory infection (7.2%).

Keywords : Morbidity profile, Cotton textile workers

Introduction:

Occupational health is branch of community medicine which deals with the effects of occupation or workplace on human health1. Every occupation is associated with one or other ill effects on health. One such occupational group is cotton textile workers. Cotton textile workers are susceptible to various morbid conditions by virtue of workplace and working conditions. These morbid conditions may range from chronic respiratory diseases due to cotton dust inhalation2 to anaemia because of nutritional deficiency and varicose veins to low backache due to working postures3. Though many studies on chronic respiratory diseases among cotton textile workers have been carried out4-6, a study including complete health profile of cotton textile workers is lacking. With this background the present study was undertaken to study the morbidity profile among cotton textile workers.

Material and Methods:

The present cross-sectional study was carried out among cotton textile workers of Shri Bapurao Deshmukh Sut Girni, Wardha during December 1996 to April 1997. Out of total 730 workers employed in the Sut Girni, 514 workers participated in the current study. Interview technique was used to collect information on a predesigned proforma regarding demographic data, occupational history and history of present or past complaints. This was followed by complete clinical examination, laboratory investigations such as haemoglobin estimation, peripheral smear examination and chest radiograph of each study subject. Opinion of specialists was sought for wherever felt necessary. Standard diagnostic criteria were used for diagnosis of various morbid conditions7-9.

For grading byssinosis Roach and Schilling criteria2 was used which is as follows:

Grade 0 - No symptoms of chest tightness or breathlessness on Monday.
Grade1/2 -  
Grade 1 - Occasional chest tightness on Mondays or mild symptoms such as irritation of the respiratory tract on Monday.
Grade 2 - Chest tightness and/or breathlessness on Mondays only.
Grade 3 - Chest tightness and/or breathlessness on Mondays and other days. Grade 2 symptoms accompanied by evidence of permanent respiratory disability from reduced ventilatory capacity.

Statistical analysis included calculation of percentages, proportions and use of test of significance.

Results:

Table I: Distribution of study subjects according to demographic characterstics.

Characteristics Number of subjects (n=514) Percentage
Age (in years)
<25 73 14.2
25-30 176 34.2
30-35 174 33.9
35-40 73 14.2
40-45 15 2.9
>45 3 0.6
Education
Illiterate 47 9.2
Primary 217 42.2
Middle school 168 32.7
Secondary 35 6.8
Higher secondary 30 5.8
Graduate & above 17 3.3
Socio-economic strata*
Lower middle 111 21.6
Upper lower 173 33.7
Lower 230 44.7
*According to modified Kuppuswamy's socio-economic status scale.

Distribution of study subjects according to demographic characteristics is shown in Table I. Majority of the subjects belonged to 25-30 years (34.2%) and 30-35 years (33.9%) age group. 217(42.2%) workers had primary level of education while 168(32.7%) workers had educational attainment upto middle school level. Majority of the subjects belonged to upper lower (33.7%) and lower (44.7%) socio-economic strata according to Modified Kuppuswamy's socio-economic status scale10.

Table II: Distribution of study subjects according to occupational and personal characterstics.

Characteristics Subjects (n=514)
No. (%)
Duration of exposure (yrs)
<5 107 (20.8)
5-10 335 (65.2)
>10 72 (14.0)
Department
RJK winding 147 (28.6)
Speed frame 43 (8.4)
Ring frame 202 (39.3)
Blow room 5 (0.9)
Carding 20 (3.9)
Others 97 (18.9)
Smoking
Smokers 112 (21.8)
Non-smokers 402 (78.2)

Table II shows the distribution of study subjects according to occupational and personal characteristics. Majority (65.2%) of the workers had considerable duration of exposure i.e. 5-10 years and that too in dusty departments such as winding, ring frame, speed frame and carding. Of the total 514 study subjects only 21.8% were smokers.

Table III: Distribution of study subjects according to anthropometric characteristics.

Characteristics Subjects (n=514)
No. (%)
Height (cm)
<150 5 (0.9)
150-155 17 (3.3)
155-160 83 (16.1)
160-165 202 (39.3)
165-170 135 (26.3)
>170 72 (14.0)
Weight (kg)
<45 10 (1.9)
45-55 173 (33.7)
55-65 206 (40.1)
65-75 77 (15.0)
>75 48 (9.3)
BMI (kg/m2)
<25 315 (61.3)
25.0-29.9 97 (18.9)
30.0-39.9 90 (17.5)
>40 12 (2.3)

Distribution of study subjects according to anthropometric characteristics is shown in Table III. The mean height of study subjects was 164.8 13.7 cm. Majority (39.3%) of the subjects had height between 160-165 cms. Similarly, the mean weight of study subjects was 57.3 7.8 kg with majority (40.1%) of study subjects having body weight between 55-65 kg. Using body mass index as a parameter for obesity, 38.7% subjects were found to have obesity of varying degrees.

Table IV: Distribution of study subjects according to morbid conditions.

ICD No. Morbid conditions No. (%) ICD No. Morbid conditions No. (%)
T30.4 Acid peptic disease 6( (1.2) K05.1 Gingivitis 2 (0.4)
A06.9 Amoebiasis 21 (4.1) A07.1 Giardiasis 2 (0.4)
M45 Ankylosing spondylitis 1 (0.2) I84.9 Haemorrhoids 1 (0.2)
J30.4 Allergic rhinitis 2 (0.4) R23.8 Hypopigmented patch 1 (0.2)
K12.0 Aphthous ulcers 14 (2.7) K46.9 Hernia 1 (0.2)
L70.0 Acne vulgaris 1 (0.2) I10 Hypertension 10 (1.9)
J66.0 Byssinosis 12 (2.3) L30.4 Intertrigo 2 (0.4)
J45.9 Bronchial asthma 5 (1.0) T14.9 Injury 1 (0.2)
J44.8 Chronic bronchitis 23 (4.5) D50.9 Iron deficiency 271 (52.7)
H53.5 Colour blindness 1 (0.2) N48.0 anaemia 1 (0.2)
K36.0 Chronic recurrent appendicitis 1 (0.2) M47.8 Leukoplakia 11 (2.1)
H66.3 Chr. suppurative otitis media 1 (0.2) D17.9 Lumbar spondylosis 1 (0.2)
K03.6 Dental stains 29 (5.6) M79.1 Lipoma 5 (1.0)
K03.6 Dental calculus 60 (11.7) K13.5 Myalgia 1 (0.2)
K02.9 Dental caries 42 (8.2) H52.7 Oral submucous fibrosis 45 (8.8)
L30.9 Dermatitis 2 (0.4) K62.3 Refractive errors 2 (0.4)
J34.2 Deviated nasal septum 1 (0.2) T14.3 Rectal prolapse 1 (0.2)
N45.9 Epididymitis 1 (0.2) L72.1 Sprain 1 (0.2)
J30.9 Eczema 2 (0.4) I49.5 Sebaceous cyst 1 (0.2)
D72.1 Eosinophilia 102 (19.8) B36.0 Sick sinus syndrome 3 (0.6)
B74.9 Filariasis 1 (0.2) J03.9 Taenia versicolor 1 (0.2)
M75.0 Frozen shoulder 1 (0.2) A16.2 Tonsillitis 3 (0.6)
J01.1 Frontal sinusitis 1 (0.2) J06.9 Tuberculosis 37 (7.2)
K60.2 Fissure in ano 1 (0.2) E54 Upper respiratory infections 1 (0.2)
B49.0 Fungal infection 6 (1.2) N43.3 Vitamin C deficiency 9 (1.8)
K14.0 Glossitis 1 (0.2) B88.9 Vaginal hydrocele 1 (0.2)
M67.4 Ganglion 1 (0.2)   Worm infestation    

Table IV depicts the various morbid conditions among cotton textile workers. Most common morbid conditions included amoebiasis (4.1%), grade 1/2 byssinosis (2.3%), chronic bronchitis (4.5%), dental stains (5.6%), eosinophilia (19.8%), hypertension (1.9%), iron deficiency anaemia (52.7%), refractive errors (8.8%) and upper respiratory infection (7.2%).

Discussion:

In the present study, a total of 754 morbid conditions were found among cotton textile workers giving an average of 1.5 morbid conditions per study subject. High prevalence of respiratory morbidity is due to the inflammatory and allergic response to inhaled cotton dust particles resulting in chronic bronchitis, bronchial asthma, upper respiratory infections and byssinosis. Other studies have also reported similar findings4-6. Allergic response to inhaled cotton dust particles may have been responsible for eosinophilia in 102 study subjects. High prevalence of dental problems suggests a poor oral hygiene among study subjects. Similarly, a considerably higher prevalence of amoebiasis indicates a substandard personal hygiene. As most of the subjects belonged to upper lower and lower socio-economic class, they have poor purchasing capacity, which may be responsible for a high prevalence of iron deficiency anaemia and other morbid conditions because of nutritional deficiency.

To conclude, the findings of present study indicate a need of health education regarding use of personal protective devices such as mask and other respiratory devices and maintaining a higher standard of oral, personal and community hygiene1. Tobacco smoking and chewing should be dissuaded. Efforts should be made to improve the overall health status of cotton textile workers.

References:

  1. Park K. Park's text book of Preventive and Social Medicine. 15th edition. Jabalpur: Banarsidas Bhanot Publishers; 1997. p.542-56.
  2. Raffle PAB, Lee WR, Murray R, McCallum RI. Hunter's Diseases of Occupations. 6th edition. London: Hodder and Stoughton; 1987. p.690-705.
  3. Mekky S, Schilling RSF, Walford J. Varicose veins in women cotton workers. An epidemiological study in England and Egypt. British Medical Journal 1969; ii: 591-5.
  4. Parikh JR, Bhagia LJ, Majumdar PK, Shah AR, Kashyap SK. Prevalence of byssinosis in textile mills at Ahmedabad, India. British Journal of Industrial Medicine 1989; 46: 787-90.
  5. Gupta S, Gupta BK. A study of byssinosis and associated respiratory disorders in cotton mills workers. Indian Journal of Chest Diseases and Allied Sciences 1986; 28(4): 183-8.
  6. Parikh JR, Bhagia LJ, Shah AR, Majumdar PK, Rao N Mohan, Kashyap SK. Chronic bronchitis in textile workers. Indian Journal of Industrial Medicine 1994; 40(2): 62-5.
  7. Edwards RW, Bouchier IAD. Davidson's Principles and Practice of Medicine. London: ELBS with Churchill Livingstone; 1991. p.1-503.
  8. World Health Organisation. Nutritional anaemia. Technical Report Series No. 409, Geneva, 1968: 9-10.
  9. World Health Organisation. Hypertension Control. Techinical Report Series No. 862, Geneva, 1996: 2-10.
  10. Mahajan BK, Gupta MC. Textbook of Preventive and Social Medicine. Second edition. New Delhi: Jaypee Brothers
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