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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 15  |  Issue : 1  |  Page : 29-32

Study of general health and haematological status of automobile garage workers exposed to toxicants: Comparison with office workers


1 Department of Community Medicine, Father Muller Medical College, Kankanady, Mangaluru, Karnataka, India
2 Father Muller Research Centre, Kankanady, Mangaluru, Karnataka, India

Date of Submission03-Aug-2021
Date of Decision08-Dec-2021
Date of Acceptance12-Dec-2021
Date of Web Publication25-Mar-2022

Correspondence Address:
Manjeshwar Shrinath Baliga
Mangalore Institute of Oncology, Pumpwell, Mangaluru - 575 001, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/hmj.hmj_53_21

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  Abstract 


Background: Automobile Garage Workers are exposed to a range of toxicants and depending on the level and duration of exposure various health effects are observed. The current study was undertaken to understand the haematological status and general health among garage workers when compared with occupationally nonexposed participants in Mangalore, India. Objectives: In this study, an attempt is made at understanding the general health and haematological status of garage workers by comparing them with age-matched controls (office workers) from the same area. Materials and Methods: This was a purposive, comparative cross-sectional study, and a camp-based approach was done with willing volunteers. The socio-demographic details were collected in a structured questionnaire, while a detailed clinical examination was carried out by senior clinicians and blood collected was analysed for haematological parameters. Knowledge of occupational safety and health insurance was also collected from the garage workers. The data were subjected to frequency and percentage and analysed using X2 and t-test, P < 0.05 was considered statistically significant. Results: In this study, most of the garage workers (58.6%) were involved in mechanical work and 91.3% of them did not use any kind of protective measures. Joint pain (13.04%) was the most common ailment, whereas in the office workers, back pain was common (6.52%). In the garage workers, awareness of health-related problems due to their occupation was less. In addition, none of the garage workers had any kind of employees' state insurance benefits. When compared with the controls, there was a significant difference in haematological parameters and eosinophilia was more in garage workers. Conclusions: The results of the study indicate that garage workers have occupation-related health issues and that appropriate and effective safety measures need to be taken by the workers to prevent possible chemical exposure during routine tasks.

Keywords: Eosinophilia, garage workers, general health, haematological status, office workers


How to cite this article:
Haladi SP, Kalekhan F, Simon P, Baliga MS. Study of general health and haematological status of automobile garage workers exposed to toxicants: Comparison with office workers. Hamdan Med J 2022;15:29-32

How to cite this URL:
Haladi SP, Kalekhan F, Simon P, Baliga MS. Study of general health and haematological status of automobile garage workers exposed to toxicants: Comparison with office workers. Hamdan Med J [serial online] 2022 [cited 2022 May 28];15:29-32. Available from: http://www.hamdanjournal.org/text.asp?2022/15/1/29/340822




  Introduction Top


Garage workers are exposed to myriad toxic hazardous chemicals that affect their general health.[1] Auto-garage workers in India are involved in car painting, soldering and welding and other repair activities.[1] The garage compound in which the workers carry out their daily activities are usually filled with fuel exhaust from automobiles entering or leaving the garage compound.[1] Most of the workers have no idea about the toxic metals they might be exposed to or the impact they may have on the body; as a result, they pay little attention to protecting themselves from the possible inhalation or ingestion of such toxic substances, nor are they given awareness on the issue or advised to take the necessary protective measures.[2] The study proposed to understand the general health (through clinical evaluation) and haematological changes (TC, DC, Hb and peripheral smear) in garage workers and compare it with age-matched controls (office workers) from the same area.


  Materials and Methods Top


Study design

This was a purposive study done among garage workers of Mangalore, Karnataka, India in accordance with the Helsinki declarations after taking sanction from the Institutional Ethics committee.[3] The inclusion criteria for the study included men who worked in garages full-time, were above the age of 18 years and were residents of Mangalore city for more than 10 years. The exclusion criteria included people from other professions, garage workers with a mental health disorder, tuberculosis, cancer, HIV, who have had an acute illness (such as malaria, dengue, leptospirosis and scrub typhus), were on any medication, and from other parts of the country. For controls, the investigators collected the haematological values from age-matched healthy individuals who were working as office assistants in the adjoining area to avoid area bias. The whole study was done in a span of 10 days to avoid possible seasonal variation.

Sample size selection

The sample size was selected using the following formula; where p1 = 0.2; p2 = 0.5; α = 0.05; β = 0.2 and ratio of Group 1 by Group 2 is 1, to give a sample size of 39 in each group. Considering possible attrition, we rounded up the number to 46 in each cohort. The formula and calculations were done as prescribed in an earlier study.[4]



Methodology

A camp-based approach was done and garage workers included. During the health-care program, the volunteers were informed about the research objective and written informed consent was taken from all the willing volunteers. A self-structured questionnaire was filled along with the clinical examination of each of the garage and office workers in the study group. The questionnaire was filled by personally interviewing each garage worker by the student investigators. Clinical examination included history taking and general physical and systemic examination was carried out by senior clinicians.

Blood analysis

From all willing volunteers, 5 ml of the blood was collected from each volunteer by trained phlebotomists in premarked ethylenediaminetetraacetic acid vacutainer and analysed as per the standard procedures using Beckhman Coulter LH 750. A senior pathologist unaware of the origin of the blood sample scored for haematological changes.

Statistical analysis

The accrued data were analysed using the SPSS (IBM version 16; Chicago, IL, USA). The demographic and clinical details were subjected to frequency and percentage, whereas the haematological values were subjected to the unpaired t-test. A statistical value of P < 0.05 was considered to be significant.


  Results Top


A total of 92 (46 each of office and garage workers) were available for the data analysis, and the results are represented in [Table 1] and [Table 2]. Most of the garage workers (58.6%) of them were involved in the mechanical type of work, whereas 26.08% were involved in the chemical type of work and 6.52% in other work [Table 1]. Majority of the workers did not use any protective measures as it interfered with their work. With regard to health issues, joint pain (13.04%) was the most common ailment [Figure 1], whereas in the office workers, the only ailment expressed was pain in the back in 6.52% of the volunteers. All garage workers were aware of at least one type of the risks related to their work and that most were aware of the accidental injuries which can take place during the work and is represented in [Table 1].
Table 1: Sociodemographic details, habits and job details of garage workers and control

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Table 2: The hematological details between the two groups

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Figure 1: Health issues expressed by the garage workers

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In addition, none of the garage workers had any kind of employees' state insurance (ESI) benefits. A total of 18 garage workers had at least 1 health complaint [Figure 1]. Among the 46 garage workers, 1 was anaemic. The results from the peripheral smear indicated that 17 out of 46 garage workers had eosinophilia (36.95%), whereas in the control group, it was 15.21% and significant (P < 0.02). Accordingly, there were 10 workers with eosinophilia who worked for more than 10 years, whereas there were only 2 workers with eosinophilia who worked for less than a year [Table 2]. With regard to the controls, a statistically significant difference was seen in the levels of neutrophils, lymphocytes and eosinophils in the garage workers (P = 0.04–0.001) [Table 2].


  Discussion Top


Majority of the garage workers in our study were involved in either mechanical or chemical work and were in regular contact with the toxic substances. A substantial amount (36.95%) of them had eosinophilia as compared to 15.21% in controls and was statistically significant (P < 0.02). Eosinophilia was more in people who had worked for a longer period of time indicating that the duration of employment plays a significant role in its development and may be due to exposure to toxicants.[5],[6],[7] Another interesting finding of elevated neutrophils was seen in garage workers as compared to normal controls. This highly significant change most likely indicates that the garage workers are exposed to unhealthy toxins and pollutants which cause subclinical levels of inflammation, putting them at risk for major diseases in the long run.

Despite their knowledge, only 9% of the garage workers routinely used protective measures and majority of the workers although having knowledge about the protective measures still did not use it because of the interference of these measures in their work. They also thought that the protective measures were not of much use. There were no ESI benefits given to any of the garage workers as these garages were small scale private garages which are not included under the ESI scheme. Thus, the garage workers are devoid of various social and economic benefits covered under the ESI benefit. The awareness about the health-related risks was also noted in the study. Health-related risks were categorised into accidental injuries, physical injuries, chemical injuries, biological problems and others. Other problems included psychosocial and organizational factors.[1] The clinical evaluation revealed that the garage workers have variety of health complaints [Figure 1]. These workers develop joint pain because the majority of work involved in garage is mechanical in nature.[1],[6] Allergy was also one of the complaints possibly due to exposure to particular matters and chemical substances generated during the repair of automobiles.[1],[6],[7]

Accidental injuries included fall from the ladder, elevated platforms, injuries due to equipment and eye injuries such as flying objects during welding.[5] Physical injuries included injuries related to radiations, exposure to excessive noise, excessive heat or cold, especially in open garages or during road work. Chemical hazards included skin diseases and conditions, breathing difficulties, chest tightness, eye irradiation due to irritating chemicals and fumes,[1],[6],[7] inhalation of diesel, fumes and heavy metals like lead causing an increased risk of cancer.[1],[6],[7] It also included gastrointestinal disturbances as a result of accidental or chronic ingestion of adhesives. Every one of the garage workers was aware of at least one of the hazards. Garage workers continue to work even after the awareness of significant hazards in their routine work; this can be attributed to the socioeconomic reasons, as most of them had a low monthly income.


  Conclusions Top


The results suggest that garage workers are aware of health-related risks and also about the protective measures, but still do not use them as it interferes with their work. The authors recommended that proper education about the risks and protective measures should be given so that appropriate use of these measures can decrease the health-related complaints. It is also suggested that the garage workers should inculcate good working practices by adopting appropriate and effective safety measures to mitigate the chemical exposure during their routine work. Furthermore, strict regulations and guidelines for occupational health and safety should be implemented by the garage owners and the local health authorities. Furthermore, when compared to the office workers (controls), there was a statistically significant difference in the levels of neutrophils, lymphocytes and eosinophils in the garage workers. The greatest drawback of this study is that it focused on the haematological parameters and did not focus on other health issues. Garage workers are known to develop occupational lung diseases due to inhaling of particulate organic and inorganic matters emitting from the vehicles. It is suggestive that radiological studies with lung like chest X-ray or computed tomography scan as well as pulmonary function tests should be incorporated to ascertain any damages. Furthermore, long-term prospective studies of garage workers would help to gain a more comprehensive picture of long-term effects of chemical exposure and identify the specific types of chemicals to which the workers are exposed. It is also suggested that regular screening and monitoring of the health of garage workers are important to reduce the long-term adverse effects of occupational chemical exposure, especially of cardiac, pulmonary complications and cancer.

Consent to participate

Written informed consent was obtained from all the study participants.

Acknowledgement

The authors are grateful to Father Muller Medical College Administration for providing facilities to conduct the research.

Ethical clearance

The study was approved by the institutional Ethics Committee of Father Muller Institutional Ethics committee of Father Muller Medical College, Mangalore. (Approval number: FMMC/FMIEC/1099/2013 dated 22-01-2013).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Ataro Z, Geremew A, Urgessa F. Occupational health risk of working in garages: Comparative study on blood pressure and hematological parameters between garage workers and Haramaya University community, Harar, eastern Ethiopia. Risk Manag Health Policy 2018;11:35-44.  Back to cited text no. 1
    
2.
Adela Y, Ambelu A, Tessema DA. Occupational lead exposure among automotive garage workers – A case study for Jimma town, Ethiopia. J Occup Med Toxicol 2012;7:15.  Back to cited text no. 2
    
3.
Anonymous. Ethical Guidelines for Biomedical Research on Human Participants; 2006. Available from: http://icmr.nic.in/ethical_guidelines.pdf. [Last accessed on 2021 Jul 12].  Back to cited text no. 3
    
4.
Whitley E, Ball J. Statistics review 4: Sample size calculations. Crit Care 2002;6:335-41.  Back to cited text no. 4
    
5.
Kamal A, Malik RN. Hematological evidence of occupational exposure to chemicals and other factors among auto-repair workers in Rawalpindi, Pakistan. Osong Public Health Res Perspect 2012;3:229-38.  Back to cited text no. 5
    
6.
Landrigan PJ. Lead. In: Rosenstock L, Cullen MR, editors. Textbook of Clinical Occupational and Environmental Medicine. Philadelphia: Saunders; 1994. p. 745-54.  Back to cited text no. 6
    
7.
AlMahmoud T, Elkonaisi I, Grivna M, Abu-Zidan FM. Personal protective eyewear usage among industrial workers in small-scale enterprises. Inj Epidemiol 2020;7:54.  Back to cited text no. 7
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]



 

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