CHAPTER- I
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INTRODUCTION
“Working may be an occupational hazard to you. Not working is an occupational hazard to the country.”
(12 Eustace 8:5)
Work is considered as a basic part of human existence. Most of the adults spend approximately one-third to one-fourth of their life time at work and often perceives work as a part of their self identity, self-expression and self-fulfilment. Many people believe that work is worship, equally important is the place of work because the workplace has significant influence on individual’s health and is a primary site for the delivery of preventive health care. (Rogers, 2006)
The level of occupational health and safety, socioeconomic development of a country, quality of life and wellbeing of working people are not only closely linked with each other but also influence each other. This suggests that intellectual and economic inputs on occupational health care are not burdens but have a positive and productive impact on the company and national economy. Some industries and countries have demonstrated that it is technically feasible and economically productive to prevent and minimize hazards at work. This occupational health is an important factor for sustainable socio-economic development that enables workers to enjoy a healthy and productive life both throughout their active working years and beyond, especially after their retirement. (WHO, 2005)
Textile industry is one of the leading industries both in India and in the world at large. Nearly 14% of the total industrial production comes from textile industry and it forms around 3% of GNP in India. After Indian railways, Indian textile industry seems to generate more employment. (India Business Directory, 2010)
The current global labour force stands at about 2600 million and is growing continuously. Approximately 75% of these working people are in developing countries. The officially registered population constitutes 60-70% of the world’s adult male and 30-60% of the world’s adult female population. Each year another 40 million people join the labour force and most of them are in developing countries. It is imperative therefore to realize that workplace environmental hazards are a threat to a large proportion of the world population.
Occupational health is a branch of Community Medicine which deals with the effects of occupation of workplace on human health (Park. JE, 2009). Every occupation is associated with one or other ill effects on health. One such occupational group is cotton textile workers. (Hunter’s Disease of Occupation, 2008)
The major health problems associated with cotton dust are respiratory problems, which include Byssinosis, pneumonitis and Emphysema. The problems are highly prevalent in the mills of developing countries. (Fantahumand Adebe, 2009)
Byssinosis is an occupational lung disease often observed among workers exposed to cotton dust. Despite the fact that byssinosis has been recognized for over 100 years, the etiology and pathogenesis remain obscure. The ability of textile fibres to produce byssinosis is determined by fibre type-cotton being the most potent, followed by flax, hemp. Harvested cotton consists of a mixture of plant materials including leaves, bracts and stems, fibre, bacteria, fungi, and other contaminants. Very importantly, the compounds which cause byssinosis are water soluble. The biological activity of cotton can be greatly reduced by either steaming or washing the cotton before processing the textile work. (David, 2006)
The occurrence of respiratory symptoms represents the earliest response to cotton dust exposure, followed by lung function changes. Early respiratory symptoms may be a risk factor for subsequent loss of pulmonary function in cotton textile workers. (David, 2006)
The severity and extent of problem are well recognized in the developed countries and control measures have been implemented to prevent the disease. This is not true, however, for developing countries where the severity and extent of the problem are not well studied and preventive measure are far from adequate. (J.R.Parikh, 2007)
The occupational health nurse plays an important role in maintaining health and safety of employees by assessing the work site for hazards and reducing risk that could lead to disastrous situations. More effort could be directed at integrating promotion of health and health protection activities to provide with an environment more conducive especially to general health of the workers, so that the work site offers an excellent setting to focus on both health protection and health promotion. (Blix, 2009)
Need for the Study:
Occupational health is concerned with health in its relation to work and the working environment. Occupational health implies not only health protection but also health promotion, emergency care, wide range of preventive, curative services, rehabilitative services, a concept which includes everything that can apply to promote health and working capacity of the workers.
Occupation health is a branch of community medicine which deals with the effects of occupation or workplace on human health. We have already seen that every occupation is associated with one or the other ill effects on health and cotton mill workers are not an exception to this fact. These 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 inhalation to anaemia because of nutritional deficiency. Although many studies on chronic respiratory disease among cotton mill workers have been carried out, a study including complete health profile of cotton mill workers is limited and is need of further research. (Indian Journal of Occupational and Environmental Medicine, 2010)
An occupation is something in which persons not only earn their daily bread but also spend one-third of average adult life. The Bureau of Labour Statistics reports that every 5 seconds a worker is injured in the world and every one second a worker is temporarily or permanently disabled in India. The Centre for disease control and prevention reported in 2006 that every day and average of 137 persons die from injuries on the job. Each year 74000 require treatment in hospital emergency departments for work related injuries. (Girijakumari, 2009)
According to a recent estimate, the cost of work related to heat loss and associated productivity loss may amount to several percent of the total gross national product of a country. In India there are about 20 million workers who are involved in textile industry, among them 1.07 million workers are engaged in the manufacture of cotton textile. Byssinosis, hypertension, noise induced hearing loss, dermatitis and risk of cancer due to various chemicals and dyes are common occupational diseases found among weavers. In a study done by NGO in 2008, byssinotic condition was first recorded in Indian history in the last 150 years. A maximum number of Byssinosis is a respiratory syndrome that occurs as a result of inhaling dust that is produced when cotton is inhaled. The occupational nurse should realize that the primary concern to protect the health of working population.
A longitudinal study was conducted to assess the prevalence of byssinosis and to find out the association between smoking and byssinosis. 344 samples were taken among the textile workers. The synergistic effect of smoking on cotton dust exposure was evaluated. Indeed, smoking had significantly higher frequency than non-smoking. In the survey conducted, it was observed that the frequency of respiratory symptoms and prevalence of severe byssinosis were 14.9% and 12.6% respectively. The reduction of symptoms was due to the old cotton mill. The reality is lower in the case of non-smokers. The result indicated that smoking potenitates’ byssinosis and smoking was found to show an additive effect of cotton dust exposure. (Maunder, LR, 2007)
A study was conducted to determine the effect of past cotton dust exposure on the respiratory tract; a total of 223 persons working in textile mills were included in this study. A questionnaire was used to enquire about respiratory problems, the participants underwent using several spirometric measurement. The most common respiratory problem was pneumonitis 14.3%, the prevalence of byssinosis was only 20.2% and emphysema was 11% in cotton processing workers. (Basel, K.A, 2008)
The jobs and tasks in textile mills varied according to the product, process and operations since the subjects were selected from four sections, such as the blow and card room, spinning mills, finishing section and general section. The symptoms of respiratory illness were identified as highest among the workers in the blow and card room, and in the spinning section. In all, 53% of the workers have had such symptoms that had a low peak expiratory flow rate (< 290 litres/minute). The differences of mean peak expiratory flow rate were highly significant (409 litres/minute) between those who had respiratory problems, and who had no such symptoms (504 litres/ minute). The occurrences of such problems were also significant in the production section compared with the subjects in the general section because no one had the symptoms of chest tightness or breathlessness from the general section. However, many of them had symptoms of cough with or without phlegm (e.g. 43%), symptoms of pneumonitis (6%) and also chest tightness and /or breathlessness (4%). (Taylor, et.al, 2010)
Regular smoking was significantly associated with the occurrence of respiratory related illness and its symptoms. A number of ‘beedi’ (the name of a local cigarette stick that contains more nicotine than usual cigarettes) smokers worked in the production section. They smoked 2 to 25 sticks (a mean of 13 sticks) per day. Non- smokers were less likely to be affected, but many of them suffered from casual fever (20%) and also morning headaches (8%).
Prevalence of other health problems were also identified as restlessness at night (24%), daytime sleepiness (11%), snoring (19%), impotence (31%), and feeling physically weak (10%). The prevalence of hypertension (14%) was also noted among some workers. Only 16% of the workers in the production section had been using masks for more than 5-7 years, and no significant association was found between the symptoms of respiratory illness and the length of their service. However, some evidence from their health record (personally kept at home and from doctor’s prescription) proved that symptoms of respiratory illness were suspected among those who were working for more than six-year duration. (Jackson, 2008)
Prevention of occupational hazards as an essential component of health aims at training and educating these workers in order to promote good health. It is extremely important to make people aware of the concerns of workplace. One of the major responsibilities of community health nurse is to impart knowledge related to specific measure in preventing occupational hazards. It is the Community health nurse who can play a vital role in preventing and controlling occupational hazards. Therefore, she/he should function independently and carry out this particular responsibility for better health of the workers. (Pyuish Gupta, 2010)
Statement of the Problem:
A Study to assess the Effectiveness of Video Assisted Teaching Programme on Knowledge Regarding Occupational Hazards and its Prevention among Cotton Mill Workers at Selected Industries, Salem.
Objectives:
To assess the knowledge regarding occupational hazards and its prevention among cotton mill workers in experimental group and control group.
To determine the effectiveness of video assisted teaching programme regarding occupational hazards and its prevention among cotton mill workers in experimental group.
To associate between the pre test scores on knowledge regarding occupational hazards and its prevention among cotton mill workers and their selected demographic variables in experimental group and control group.
Operational Definitions:
Effectiveness:
Effectiveness is a measure of the ability of video assisted teaching programme regarding occupational hazards and its prevention among cotton mill workers to produce a specific desired effect or result that can be quantitatively measured.
Video Assisted Teaching Programme:
It is a systematically planned teaching programme on occupational hazards and its prevention and imparted through video film based lecture cum discussion.
Knowledge:
It is the correct response given by the cotton mill workers regarding occupational hazards and its prevention which can be assessed through structured interview schedule.
Occupational Hazards:
It is a state of deviation from normal status of health to illness while working in cotton mill industry. In this study it includes physical hazards, chemical hazards, and mechanical hazards, psychosocial hazards of Byssinosis, pneumonitis, and emphysema.
Prevention:
It refers to precautionary measures to be followed by cotton mill workers to protect their health from occupational hazards.
Cotton Mill Workers:
They are the adult employees working at selected cotton industries, Salem.
Assumptions:
The cotton mill workers may have knowledge regarding occupational hazards and its prevention.
Video assisted teaching programme may improve their knowledge regarding occupational hazards and its prevention among cotton mill workers.
Increased level of knowledge among cotton mill workers regarding occupational hazards and its prevention may help them to improve their quality of life.
Hypotheses:
H1:There will be significant differences in pre test and post test scores on knowledge before and after video assisted teaching programme regarding occupational hazards and its prevention among cotton mill workers in experimental group at p? 0.05 level.
H2:There will be significant difference in post test scores on knowledge after video assisted teaching programme regarding occupational hazards and its prevention among cotton mill workers in experimental group and control group at p ?0.05 level.
H3:There will be significant association between the pre test scores on knowledge regarding occupational hazards and its prevention among cotton mill workers and their selected demographic variables at p? 0.05 level.
Delimitations:
The study was limited to only 60 samples.
Study was limited to cotton mill workers who were available during the study period.
Study period was limited to 4 weeks.
Projected Outcome:
This study would reveal the existing knowledge on occupational hazards and its prevention among cotton mill workers.
This study would motivate the cotton mill workers to update their knowledge regarding occupational hazards and its prevention.
This study would evaluate the effectiveness of video assisted teaching programme on knowledge regarding occupational hazards and its prevention among cotton mill workers.
Conceptual Framework:
This study is to assess the effectiveness of video assisted teaching programme on knowledge regarding occupational hazards and its prevention among cotton mill workers. The conceptual framework for this study was based on J.W.KENNY’s open system model.
According to Kenny, all the living systems are open and they are in continuous exchange of matters, energy and information.
The system receives input and gives back output in the form of information or knowledge.
System model consist of 3 phases input, throughput, and output. These 3 phases also known as classical element of the system.
Input:
It is the first phase in open system. Based on Kenny, input can be a matter of information. In this study, it is testing the knowledge on occupational hazards and its prevention among cotton mill workers by using structured interview schedule.
Throughput:
According to theorist, information is continuous process through the system. This is the activity phase, which allows the input to be changed. In the present study, providing video assisted teaching programme regarding occupational hazards and its prevention among cotton mill workers, only to the experimental group.
Output:
According to Kenny after processing the input, the system gives output (Information/ knowledge). It is the third element of the system, where alteration can be expected because of the throughput.
In this study, majority of the cotton mill workers had gained adequate and moderately adequate knowledge regarding occupational hazards and its prevention in experimental group. There was no significant change in the knowledge regarding occupational hazards and its prevention among cotton mill workers in control group. Feedback:
According to throughput, feedback is the improvement of knowledge among cotton mill workers. In this study, improved knowledge regarding occupational hazards and its prevention among cotton mill workers in experimental group was assessed by the investigator.
If there is no significant changes in the output, feedback will return to input and the process will continue which is not included in the study.
(Pretest)(Post test)
(Feedback)
Not included in this study
Cotton mill industry
Fig-1.1 : Conceptual Framework Based On Modified J.W. Kenny’s Open System Model On Effectiveness Of Video Assisted Teaching Programme On Knowledge Regarding Occupational Hazards And Its Prevention Among Cotton Mill Workers.
Summary:
This chapter dealt with introduction, need for the study, and statement of the problem, objectives, operational definition, assumptions, delimitations, projected outcome and the conceptual frame work.
CHAPTER-II
