A STUDY OF THE MORBIDITY PROFILE OF CONSTRUCTION WORKERS IN BANGALORE URBAN DISTRICT

SYNOPSIS OF DISSERTATION SUBMITTED TO RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE

In partial fulfillment of the regulations for the award of

M.D Degree in Community Medicine

Submitted by

DR.SANDEEP.H, MBBS

POST GRADUATE STUDENT IN

COMMUNITY MEDICINE (M.D.)

Under the guidance of

DR.SHASHIKALA MANJUNATHA, MBBS, MD

PROFESSOR AND HEAD,

DEPARTMENT OF COMMUNITY MEDICINE,

RAJARAJESWARI MEDICAL COLLEGE AND HOSPITAL,

KAMBIPURA, BANGALORE - 560074

DEPARTMENT OF COMMUNITY MEDICINE,

RAJARAJESWARI MEDICAL COLLEGE AND HOSPITAL, KAMBIPURA, BANGALORE - 560074

2012

Rajiv gandhi university of health sciences, Karnataka,

Bangalore.

annexure - ii

Proforma for registration of subject for dissertation

1. / NAME OF THE CANDIDATE AND ADDRESS (in block letters) / DR.SANDEEP.H
“SREEVARI”, NO. 1031,
9TH MAIN, 10TH ‘C’ CROSS,
WEST OF CHORD ROAD 2ND STAGE, BANGALORE - 560086, KARNATAKA.
2. / NAME OF THE INSTITUTION / RAJA RAJESWARI MEDICAL college AND hospitaL, MYSORE ROAD,
BANGALORE – 560074, KARNATAKA.
3. / COURSE OF STUDY AND SUBJECT / M.D IN community medicine.
4. / DATE OF ADMISSION TO THE COURSE / 30 – 05 – 2012
5. / TITLE OF THE TOPIC
A STUDY OF THE MORBIDITY PROFILE OF CONSTRUCTION WORKERS IN BANGALORE URBAN DISTRICT.
6. / BRIEF RESUME OF THE INTENDED WORK
6.1 INTRODUCTION
Workers represent half the world’s population and are major contributors to economic and social development. [1]
In India, nearly two-thirds of the contribution to the net domestic product is by the unorganized sector. [2]
Construction is one of the important industries employing a large number of people on its workforce. A wide range of activities are involved in it. Due to the advent of industrialization and recent developments, this industry is taking a pivotal role for the construction of buildings, roads, bridges and so forth. The workers engaged in this industry are victims of different occupational disorders and psychosocial stresses. In India, the workers belong to the organized and unorganized sectors. It is true that a sizable number of the workforce is from the unorganized sectors – the working hours are more than the stipulated hours of work – the work place is not proper – the working conditions are non-congenial in most of the cases and involve risk factors. The hazards include handling of different materials required for construction, exposure to harsh environmental conditions like sun, rain and so on. On account of this, in adverse conditions, it results in accidents. Adverse health conditions cause psychosocial strain and the like. The repetitive nature of the work causes boredom and the disproportionate earning compared to the requirements puts the workers under psychological stress and strain and other abnormal behavioral disorders. Social security for the unorganized sector workers is very meagre. The workers are victims of headache, backache, joint pains, other muscular skeletal disorders, skin diseases, lung disorders like silicosis and so on. The workers might go through different occupational diseases due to exposure to work. They are less educated and are not cautious about the different preventive measures. [3]
Construction industry has been broadly classified into-
Building works: involving projects like houses, schools, colleges, offices, factories, shops, hospitals, flats and apartments.
Civil engineering works: involving projects like roads, tunnels, bridges, dams, canals, docks, etc. [4]
Hence, construction workers of both organized and unorganized sectors are more prone to physical, mental, economic and psychosocial problems in their daily routine life.
6.2 NEED FOR THE STUDY
·  Building and construction industry is recognized as the unorganized sector with vast labour intensity and economic activity after agriculture in India. The construction workers face an inherent risk to life / vital body parts due to occupational hazards. However, these labourers’ work is temporary and casual natured with lack of basic amenities and inadequate welfare facilities. [4]
·  The performance of a worker is usually accounted by the output. It is true that sound health is essential for proper functioning of the body. [5]
·  About 340 million (roughly 92%) of the workforce is engaged in the unorganized sector, of which, half of them are from construction industry. [5,6,7,8]
·  In a study done by National Sample Survey Organization [NSSO], Fernandes.D and Paul.B, it has been stated that 22.68 million of the workforce in India is engaged in the construction industry and out of this, 18.25 million are casual workers. [9,10]
·  The maximum stipulated hours of work by Factories Act 1948 is 8 hours per day [11], but the construction workers are working 10-12 hours per day. [12]
·  This affects their health and they are prone to accidents. The rate of incidence of accidents is higher in the construction industry than manufacturing industry. [13]
·  Various health hazards are associated with the construction industry. [14,15]
Hence, it is important to know the occupational health hazards of construction workers and their current prevalence, so that further implementations can be made towards health education of the workers as well as prevention and management of their health problems.
6.3 REVIEW OF LITERATURE
In India, 22.68 million of the workforce is engaged in the construction industry, out of this 18.25 million are casual workers. About 19% of the construction workers in the urban area and 38% in the rural area were not eligible for paid leave. The workers had to work 10-12 hours daily. Very often it happened that they worked day and night to finish a particular construction due to the time constraint. This rigorous work led to many diseases and hazards. They fell sick and were not paid for sick leave. They are exposed to all types of weather conditions. This causes health disorders and they may fall sick. Respiratory, eye and skin disorders, noise-induced hearing loss, cancer and so on are found to be prevalent among workers exposed to hazards like dust, noise, heat and cold, non-ionizing radiation, cement, glass, adhesives, tar and paint. Psychological ill-health is also common with high rates of alcohol and drug abuse. The workers misuse their money on alcohol as they do not have any other recreation. Too much intake of alcohol affects their mental state. This results in them beating their wives and children and scolding them for not being able to fulfill their basic needs. [3]
In a study done by Shah CK et al., the prevalence rate of injury due to all causes was found out to be 25.42% (61 / 240 workers). The most leading cause of injury was a particle in the eye with a prevalence rate of 7.08% (17 / 240 workers) followed by being struck by a hammer / instrument with a prevalence rate of 6.25% (15 / 240). The remaining causes that contributed were 12 workers falling from a height (5%), 7 workers being struck by a falling object (2.92%), 6 workers sustaining electrical injury (2.5%) and 4 workers being struck by a vehicle (1.67%). [16]
In a study done by D.Rothenbacher et al., the crude prevalence rate was 7.6% for pathological findings on lung auscultation, 8.8% for a reduced FEV1 (<70% of predicted value) and 6.1% for a recorded diagnosis of chronic respiratory disease among construction workers. Male employees in the German construction industry aged 40-64 years were the study subjects. [17]
In a study done by Balkrishna.B.Adsul et al., the highest morbidity at the construction site was acute febrile illness (23.11%) followed by various respiratory infections (12.6%), injuries (7.9%), musculoskeletal problems (5.4%), skin problems such as fungal infection, contact dermatitis and eczematous rash (4.71%), gastrointestinal problems such as abdominal pain, loose motions, constipation and loss of appetite (4.41%) and hypertension (3.4%). [18]
6.4 AIM OF THE STUDY :
To find out the morbidity profile among workers of building construction industry.
OBJECTIVES OF THE STUDY:
1.  To study the morbidity profile of construction workers.
2.  To study the socio-demographic profile of construction workers.
7. / MATERIALS & METHODS:
STUDY SET-UP: This study will be conducted at the building construction sites in the organized sector of Bangalore Urban district managed by private authorities. [Catchment area of Raja Rajeswari Medical College & Hospital].
STUDY DESIGN: A cross-sectional study.
STUDY DURATION: One year.
STUDY POPULATION: Construction workers belonging to the building construction sites in the organized sector.
STUDY INSTRUMENTS:
·  Pre-tested, semi-structured questionnaire by interview method
·  Medical examination – General physical examination and Systemic examination clinically.
SAMPLE SIZE:
The sample size for this study is calculated according to the prevalence rate of highest morbidity among construction workers. Hence, prevalence rate of injury due to all causes (25.42%) is considered. [16] According to this prevalence rate, considering an allowable error of 20% and confidence interval of 95%, the sample size is calculated by using the formula N = 4pq/L2 where p = prevalence, q = 1-p and L = allowable error of p (20% of p).
Sample size (N) = 4pq/L2
= [(4 x 25.42 x 74.58) / (5.08 x 5.08)] = 7583.2944 / 25.8064 = 293.85
Hence, N = 294 construction workers.
7.1 SOURCE OF DATA
·  All construction workers belonging to the building construction sites in the organized sector.
·  Primary data obtained from the questionnaires after interviewing the workers.
INCLUSION CRITERIA:
All construction workers who give informed written consent to participate in this study.
EXCLUSION CRITERIA:
1.  All construction workers who do not give their consent to participate in this study.
2.  Construction workers who are less than 14 years of age [child labourers].
7.2 METHOD OF DATA COLLECTION
All construction workers belonging to the building construction sites in the organized sector are explained about the purpose of the study. Informed written consent is obtained from them before administering the pre-tested, semi-structured questionnaire. The questionnaire includes socio-demographic profile, morbidity profile and parameters of general physical examination and systemic examination.
PLAN FOR DATA ANALYSIS
The data collected from the study will be compiled in MS Excel worksheet, analyzed using SPSS package version 19 and results will be expressed as various morbidities and the percentage of their prevalence rate.
7.3DOES THE STUDY REQUIRE ANY INVESTIGATION / INTERVENTION TO BE CONDUCTED ON OTHER HUMANS OR ANIMALS? IF SO, PLEASE DESCRIBE BRIEFLY.
NO
7.4 HAS ETHICAL CLEARENCE BEEN OBTAINED FROM YOUR INSTITUITION IN CASE OF 7.3?
YES
8. / LIST OF REFERENCES
1.  World Health Organization [Internet]. Workers’ health: Global plan of action [last accessed on 2010 May 15]. Available from: http://apps.who.int/gb/ebwha/pdf_files/WHA60/A60_R26-en.pdf
2.  Labour.nic.in [Internet]. Informal sector in India: Approaches for social security [last accessed on 2010 May 15]. Available from: http://labour.nic.in/ss/INFORMALSECTORININDIA-ApproachesforSocialSecurity.pdf
3.  A review on the occupational health and social security of unorganized workers in the construction industry – Indian Journal of Occupational and Environmental Medicine, Vol. 15, No. 1, January-April 2011, pp 18-24.
4.  Study on building and other construction workers welfare schemes / amenities in Karnataka by R.S.Nithin Prasad [MBA student], K.Vittal Rao [Professor] and H.N.Nagesha [Head of the Department] – Department of MS, M.S.Ramaiah School of Advanced Studies, Bangalore.
5.  NCEUS. Report on Social Security for Unorganized Workers, National Commission for Enterprises in the Unorganized Sector, Government of India, New Delhi, 2006.
6.  Das S. Workers in unorganized sector lack security, Down to Earth, 2007.
7.  Ramesh PB. Rethinking social protection for India’s working poor in the unorganized sector, Cross National Policy Exchange: Asia Social Protection Papers; 2009, p 1-18.
8.  Rajasekhar D, Suchitra JY, Madheswaran S, Karanath GK. At times when limbs may fail: Social security for unorganized workers in Karnataka. Karmayoga; 2009, p 1-32.
9.  National Sample Survey Organization [NSSO]: Employment and unemployment situation in India 2005-06, NSS 62nd Round, Ministry of Statistics and Programme implementation, Government of India, 2008.
10.  Fernandes.D D, Paul B: Social network of migrant workers in construction industry: Evidence from Goa, Tata Institute of Social Sciences; 2009, p 1-24.
11.  Sarkar P. Working hours of adults; Factories Act, 1948 with Short Notes; 2008, p:A35.
12.  Lakhani R. Occupational Health of Women Construction Workers in the unorganized sector. Sage Journals Online; Journal of Health Management 2004; p:187-200.
13.  Jinadu MK. Occupational health and safety in a newly industrializing country. Journal of Social Health 1987; 107:8-10.
14.  Kulkarni GK. Construction Industry: More needs to be done. Indian Journal of Occupational and Environmental Medicine 2007; 11:1-2.
15.  Roto P. Preventive health services in construction. Encyclopedia of Occupational Health and Safety-I 1998; 93:10-1.
16.  Study of injuries among construction workers in Ahmedabad city, Gujarat – by Dr.Chintu.K.Shah, Assistant Professor, Department of Community Medicine, PDU Medical College, Rajkot, Gujarat and Dr.Harshvardhan Mehta, Assistant Professor, Department of Community Medicine, BJ Medical College, New Civil Hospital Campus, Ahmedabad, Gujarat – Indian Journal for the Practising Doctor [IndMedica], Vol. 5, No. 6
17.  Chronic respiratory disease morbidity in construction workers: patterns and prognostic significance for permanent disability and overall mortality – D Rothenbacher, V Arndt, H Brenner [Dept. of Epidemiology, University of Ulm, Ulm, Germany]; T M Fliedner, V Arndt, E Fraisse [Institute of Occupational and Social Medicine, University of Ulm, Ulm, Germany] and U Daniel [Occupational Health Service of the Workmen’s Compensation Board for construction workers, Wuerttemberg, Boeblingen, Germany.
18.  Health problems among migrant construction workers: A unique public-private partnership project – Balkrishna.B.Adsul, Payal.S.Laad, Prashant.V.Howal and Ramesh.M.Chaturvedi – Indian Journal of Occupational and Environmental Medicine. 2011; Jan-Apr; 15(1): 29 – 32.
9. / SIGNATURE OF THE CANDIDATE
10. / REMARKS OF THE GUIDE
11. / NAME AND DESIGNATION (in block letters)
11.1  GUIDE
11.2  SIGNATURE
11.3 CO-GUIDE (if any)
11.4  SIGNATURE
11.5  HEAD OF THE DEPARTMENT
11.6 SIGNATURE / DR.SHASHIKALA MANJUNATHA
------
DR.SHASHIKALA MANJUNATHA
12. / 12.1 REMARKS OF THE CHAIRMAN
AND PRINCIPAL
12.2 SIGNATURE