Epidemiological Correlates of Well Being at Work Place and Hazards Identification and Risk assessment Amongst Saw Mill Workers in Anand, Gujarat.

CONTEXT: The nature of the work in saw mills carries a huge risk as the workers are exposed to various life-threatening hazards. AIMS: This study was conducted to know the "Work place Wellbeing" of the saw mill workers, occupational Hazards identification and Risk assessment (HIRA) including hazard communication, occupational accidents, injuries and diseases. SETTINGS AND
DESIGN: The study was a cross sectional study amongst workers of saw mills. METHODS AND MATERIAL: A total of 219 saw mill workers were interviewed. "Work place wellbeing", was studied by using the "Workplace Wellbeing Questionnaire - Black Dog Institute" which includes four areas of workplace wellbeing viz. (1) Work satisfaction, (2) Organizational respect for the employee, (3) Employer care, and (4) Intrusion of work into private life. Reliability analysis was done and Cronbach's alpha was found. Association was found between the work place wellbeing and other demographic and occupational variables. STATISTICAL ANALYSIS USED: Proportions and Mann-Whitney U test.
RESULTS: Scores of all the participants fall in the medium scale for "work satisfaction". For "respect", 93.6% fall in the medium scale. In "employer care" 97.7% fall in medium category. All the workers scored in the medium scale for the "intrusion in private life". None of the scores were in low scale for any domain. Injury as an event was reported by 8.22%. Specific disease prevalence was highest for back ache as 72.1%. Hazard communication was done in 40% workers.
CONCLUSIONS: We found poor working positions at work place and they did suffer from various medical morbidities at the work place. Copyright:

INTRODUCTION

A sawmill industry involves cutting of logs into lumber and now motorized saw is used in modern sawmills to cut logs in different shapes.[1] The sawmill workers are exposed to moving machine parts, ocular injuries by flying objects and high-voltage current. Occupational exposure to wood dust has been shown to cause several respiratory disorders resulting in decreased work output and increased respiratory morbidity.[2] The main risk factors in wood processing industry are hazardous tools, heavy physical load, noise, and wood dust.[3] In sawmills, there is wide possibility of improvement in ergonomic demands.[4] In Indian sawmill yards difficult environmental conditions, heavy works, and dangerous machineries expose workers to Musculo-skeletal disorders (MSD).[5] Wood dust generated in different types of processing are reasons of occupational respiratory and skin problems.[6] To assess “Workplace Wellbeing” of saw mill workers and other associated occupational variables, the current study was undertaken.

SUBJECTS AND METHODS

The cross-sectional analytical study was conducted with the 219 sawmill workers in Anand district, Gujarat. To study Workplace wellbeing, “Workplace wellbeing” questionnaire[7] from Black Dog Institute was used. Reliability analysis was done. Cronbach's alpha was more than 0.70 for all four domains of workplace well-being.

IEC permission was taken from the institute. Verbal consent was taken from all the participants and permission was taken from the owner of the factories.

RESULTS

Mean age of workers was 33.95 years with SD 10.807. Scores of all the participants fall in the medium scale for work satisfaction. For respect, 93.6% fall in the medium scale. In employer care 97.7% fall in medium category. All the workers scored in the medium scale for the intrusion in private life. 72.1% workers were having backache problem and 54.33% were having hearing problems. 23.28% were not having any problems. In 91.78% workers, no injuries were reported. Risk rating is quite high for injuries because of saw machines and high voltage current [Table 1].

Table 1

Risk Matrix for saw mill workers[8]

	Impact
	Legends	Negligible 1	Minor 2	Moderate 3	Significant 4	Severe 5
L	Very Likely 5			l.Working Position- Ergonomic issues		Injuries because of
I				2.Vibration		Saw Machines
K	Likely 4			Dust	Noise	High Voltage Current
E	Possible 3		Psycho		1. Ocular Injuries
L			Social Effects		2. Injuries because of Piles of Log
I	Unlikely 2
H	Very Unlikely 1
O
D

Risk rating is highest for injuries because of saw machines and high voltage current

DISCUSSION

In our study, mean age of workers was 33.95 years and all the workers were male. 35.6% workers were from the age group 20–30 years. 49.3% workers had primary education and 18.7% were illiterate. Agu AP et al. found mean age of workers as 29.3 years and majority of the workers were males.[9] In the study by Awosan KJ et al. most of the respondents were of the age between 20-39 years and all were male. Majority of respondents were married and had primary education.[10] According to Onowhakpor AO et al. the mean age of respondents was 34.6 years and 98.3% were males.[11] Ugheoke AJ et al.found that all the workers were males and aged between 18 and 50 years.[12] Polek Duraj K in his research found that mostly the workers were with basic education level and were male.[13] Agu AP et al. mentioned that more than two-third workers had worked in the sawmill for 2–5 years and working hours were 8-10 hours.[9] Rahman MS et al. stated the mean working time as 11 hours.[14] This is in contrast to our study where we found effective working hours as 8 hours. In the study by Sutcu A and Semerci NT, they found female employees as 3.6% only and more than half of the employees were from 30 to 40 years and three fourth employees had primary education.[15]

In our study, 73% workers were having the addiction of tobacco. 26.48% were not having any addictions.

In our study, 72.1% workers were having backache problem. Awkward working positions for long duration and extensive mechanical handling of Logs of wood was found. Qutubuddin SM et al. in their study observed musculoskeletal disorders (MSD) were present in a good number of workers.[16] Ali A et al. mentioned that MSDs are amongst the most common work-related problems in India.[5] Rahman MS et al. found musculoskeletal problems in almost three-fourth workers.[14] Mitchual S et al. mentioned commonly reported problems as respiratory, cuts, and body aches.[17] Chandra AM et al. noticed musculoskeletal disorders as a major problem in which lower back was involved in all.[18] Jagtap A and Deshmukh J in their study found that MSDs were the commonest morbidity among sawmill workers.[19] Ergonomically poor working conditions leads to occupational health problems because heavy loggers were handled manually.[15] Lack of ergonomics related knowledge was cited as the reason for MSD.[14]

Independent association of noise exposure and hypertension was found in the study by De Souza et al.[20] In our study, hypertension was reported by 1.3%. Gomez ME et al. mentioned that lighting was found below 500 lux in half of the workshops.[21] We found the presence of sufficient daylight during the visits in all the workshops.

In our study, 54.33% were having hearing problems. Gomez ME et al. observed that permissible maximum limit value for noise (85 dBA) was exceeded in all the workshops.[21] Rahman MS et al. mentioned high-level noise reporting by 70% of the workers.[14] Ramzan MR et al. stated that permanent hearing impairment because of excessive noise is avoidable.[22] Qutubuddin SM et al. noticed that the noise produced was above the desired limits.[16] Agbana BE et al. found that noise was experienced as an occupational hazard by many workers.[23]

In our study, breathing problem was reported by 1.3%. Respiratory problems reported were coughing, breathlessness, chest tightness and heaviness. Respiratory symptoms particularly sputum production and chest pain was common and smoking further aggravated their respiratory symptoms.[12] Azmi U and Azmi T found that saw-dust exposure makes workers more vulnerable to respiratory impairment in the workplace environment.[24] Tobin EA et al. stated that half of the workers were having various respiratory symptoms.[25] Study by Fatusi A and Erhabor G found a high prevalence of respiratory symptoms and duration of exposure was found to be having an inverse relationship with different pulmonary function test parameters.[26] Sakariya K et al. in their study found that workers exposed to wood dust caused restrictive lung disease.[27] Kulkarni CM et al. found various respiratory parameters to be significantly reduced in the workers due to long exposure.[28] Ige OM and Onadeko OB found running nose, sneezing, and productive cough the most frequent pulmonary symptoms.[29] Exposed workers had more respiratory symptoms and greater risk of airflow obstruction corresponding to the Number of years of employment.[30]

Exposure to wood dust is a risk factor for nasal and sinonasal cancers.[31] Risk of cancers as well as work place injuries increases by working in wood industries.[32] Wood dust is classified as a Group 1 agent carcinogenic to humans.[33] Hardwood dusts has also been classified as carcinogenic by the Council of European Union (EU), based on their Directive (1999/38/EC).[34]

In our study, injuries to upper limb, lower limb and ophthalmic injuries were reported by 8.22% workers. 91.78% didn't report any injury. Workers negligence and irresponsibility can cause accidents apart from other reasons.[13] Majority of the respondents had experienced workplace related accidents/injuries and other medical conditions.[10] Injuries from falling of object from height, missile objects, cut injuries, crush injuries and electric shock were reported in study by Ali A et al.[5] Musculoskeletal injuries were the most common and the upper extremity was the most frequently injured.[35] Injuries were very common in saw mills and occurred to different body parts mostly the upper limb including head and neck.[36]

Association between Nativity and different “Workplace Wellbeing” domains revealed that “respect for employees” and “employer care” domains were found to be significant with nativity. Migrant labourers were not having any financial and social support at the work place other than the employer. Polek Duraj K mentioned that workers took up the job because of nearness of work place to the residence.[13] The poor education limits the horizon of good job prospects and we did find that many workers in this study were primarily educated. Nearness was a factor which was not applicable in true sense in our study, as we found many migrant workers from Nepal in our study, who took up the job because of limited job options. Polek Duraj K mentioned that 75% employees were dissatisfied and were not satisfied with salary. Interpersonal relations were found to be low in the study.[13] This is in contrast to our study where scores of all the participants fell in the medium scale for work satisfaction.

In our study, 19.17% workers were not using any PPE and rest were using different forms of Personal protective equipment (PPE).

Workers found hand gloves as cumbersome and interfering with the grip. This finding was similar to finding by Top Y et al.[37] A considerable proportion of respondents were not aware of necessity of using personal protective equipment. Attention in training used to be poor with poor regards.[13] Qutubuddin SM et al. have mentioned about the inadequate use of personal protection devices.[16] Ugheoke AJ found less than 5% wearing protective wears.[12] Health and safety standards were not practiced and not enforced as well.[1211] Only one-fifth workers were wearing protective masks in spite of that almost all the workers were aware of potential hazards to exposure to saw dust.[26] Rahman MS et al. found that one should use safety aids in a regular manner.[14] Awosan KJ et al. mentioned that the various preventive measures were known to the respondents which included switching off the electric supply and use of PPE amongst various others.[10] Agu AP et al. found that majority were aware of PPE. The commonest reasons for non-use were unawareness of PPE, non-availability and cost.[9]

We did not find any hazard communication in 40% workers. Agbana BE et al. found that almost two third sawmill workers' knowledge was poor on occupational hazards.[23] Polek Duraj K stated that the employees and their supervisors were provided with the induction trainings. Only half of the participants felt that training was not a time waste and it can reduce the number of accidents.[13] Awosan KJ et al. mentioned that less than half of the workers had attended any official training in occupational safety.[10] Onowhakpor AO et al. found that in spite of a fair knowledge of occupational hazards and positive attitudes towards occupational hazards, safety practices were poor.[11] There is a training programme, Hazard Communication Standard (HCS) by OSHA,[38] based on a concept to know the hazards at work place.

A Risk Rating table can help to assess the likelihood and consequence of injury or harm.[39] Hazard exposure put the people's health and safety at risk and risk management is not limited to hazard identification only and goes beyond this.[40] In our study, we found risk rating as quite high for injuries because of saw machines and high voltage current, followed by ergonomic issues, dust exposure, noise and injuries because of piles of log. Agu AP et al. also identified occupational hazard in the workplace risk assessment.[9] Fatushi A and Erbahor G stressed the need for workplace safety regulation.[26] Mitchual S et al. suggested to enforce practice of safety including the use of personal protective equipment to reduce hazards and injuries.[17] Rus R M et al. from their study stressed on the importance of an education program to raise workers' awareness.[41] Rahman MS et al. mentioned about the joint responsibility of both management and workers to reduce the work-related problems. Mechanization if possible, should be done.[14] Chandra AM et al. emphasized proper ergonomic measures should be taken.[18] Training is important to train about the correct positions at work place.[16]

CONCLUSION

We found poor working positions at workplace. Hazard communication was done in a very informal way by the senior employees and issue of training at workplace was seen. Interpersonal relationship was good, but interference in employee's life was seen.

RECOMMENDATIONS

Ergonomic issues should be solved by adopting proper working methods and adopting right postures which should be taught by keeping some training sessions. Hazard communication, identification and risk assessment should be done.

Key Messages: Ergonomic issues should be solved by adopting proper working methods and adopting right postures which should be taught by keeping some training sessions. For injury prevention, First Aid training should be given.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.