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Background Work-related musculoskeletal disorders (WRMSDs) are significant concern in intensive care units (ICUs) due to distinct work environment. This study aims to comprehensively investigate determinants of WRMSDs and ergonomic challenges, specific to ICU nurses, providing valuable insights for targeted interventions. Methods In this six-month convergent mixed methods study, 200 consenting nurses with over one year of experience from seven ICUs across three public tertiary hospitals of Ahmedabad participated. Structured questionnaires were used to collect data on socio-demographics, occupation, physical and workplace factors, risk perception, and musculoskeletal pain (through modified Nordic Musculoskeletal Questionnaire) and ergonomic issues using REBA (Rapid Entire Body Assessment) scale. Qualitative insights were obtained through in-depth interviews until saturation of responses. Statistical analysis involved chi-square, t-test and logistic regression, with a significance level set at p  < 0.05. Thematic analysis was used to interpret the findings of qualitative study. Results The study included predominantly female ICU nurses (78%) with a mean age of 34 years. A high prevalence of WRMSDs (84%) was observed, with the lower back and neck being the most affected regions. Nurses with WRMSDs reported significantly higher mean scores for physical factors (15.1 vs. 11.1, p  = 0.00), physical workload (12.8 vs. 10.7, p  = 0.001), work environment (13.1 vs. 10.1, p  = 0.00), and risk perception (11.8 vs. 8.9, p  = 0.00) compared to those without WRMSDs. Logistic regression identified key risk factors for WRMSDs, including longer ICU tenure [OR = 1.4 (1.13–1.66)], high shift frequency [OR = 2.7 (1.27–5.95)], higher physical factor score [OR = 1.2 (1.05–1.42)], higher physical workload score [OR = 1.2 (1.09–1.49)], higher risk perception [OR = 1.3 (1.10–1.78)], and lack of exercise [OR = 0.5 (0.27–0.93)]. The qualitative findings highlighted key ergonomic challenges, including inadequate equipment, heavy patient loads, poor posture during tasks, and insufficient breaks, contributing to WRMSDs among ICU nurses. Conclusion The findings underscore urgent need for targeted interventions to address risk factors associated with WRMSDs, including ergonomic training, workplace modifications, and education programs to enhance risk awareness and preventive behaviours. Future research should focus on developing and evaluating comprehensive interventions that integrate both physical and work environment factors to effectively mitigate WRMSDs among ICU nurses.

Background Women in India’s informal economy face significant occupational health risks that remain largely undocumented and unaddressed. With limited labour protections and inadequate access to health services, informal women workers (IWWs) experience overlapping vulnerabilities related to gender, work conditions, and environmental exposures. This study explored the multi-level determinants of health among IWWs in Ahmedabad, India, to inform gender-responsive integration of occupational health within primary health care systems. Methods A qualitative study was conducted using focus group discussions (FGDs) guided by the Socioecological Model (SEM). Five FGDs were held with 41 women representing key occupational groups—agricultural workers, construction workers, street vendors, home-based workers, and waste recyclers. Discussions were recorded, transcribed, translated, and thematically analysed. Themes were organized across SEM domains: intrapersonal, interpersonal, organizational, community, and policy levels. Findings Participants reported multiple, intersecting health risks such as musculoskeletal disorders, respiratory problems, skin irritation, and heat-related illnesses. Psychological stress, economic insecurity, and work-family conflict were pervasive, compounded by gendered expectations and absence of social protection. Poor workplace infrastructure, including lack of sanitation and shade exacerbated illness and fatigue. Many women avoided drinking water due to lack of toilets, leading to dehydration and urinary problems. Health-seeking behaviour was shaped by trust and convenience; private clinics were preferred over public facilities despite higher costs. Awareness of government schemes such as Ayushman Bharat and e-Shram was limited. Participants expressed demand for pensions, maternity protection, and home-based livelihood support. Conclusion Findings underscore the urgent need for gender-responsive occupational health integration into primary health care system. The study informed a national policy roundtable that convened key stakeholders to co-develop actionable recommendations to improve occupational health coverage for women in India’s informal economy.

Background Flour dust, with an inherent allergic nature, increases vulnerability to various respiratory ailments. We systemically reviewed and compared literature-reported pulmonary function parameters to quantify pulmonary dysfunction among individuals with high flour dust exposure (among flour mill workers) and relatively un-exposed groups. Methods Studies that compared pulmonary function parameters for flour dust exposed and unexposed control groups were systemically searched in PubMed, Scopus and Embase from inception to June 2024. The Newcastle Ottawa scale was used to assess the risk of bias among included studies. With the random effect model, we pooled (along with 95% CI) the mean difference for forced expiratory volume in the first second (FEV 1 ), forced vital capacity (FVC), the ratio of FEV 1 & FVC, mid-expiratory flow (FEF25-75%), peak expiratory flow rate (PEFR) and other pulmonary function parameters. Cochran-Q test and I 2 statistics were applied to determine heterogeneity. Results This quantitative synthesis included twenty-two studies involving 2,482 flour dust exposed and 1,925 control participants. The pooled mean difference for FEV 1 , FVC, FEV 1 /FVC, PEFR and FEF 25 − 75% were − 0.43 L (-0.57, -0.29; I 2  = 88.7), -0.49 L (-0.64, -0.33; I 2  = 89.3), -3.5% (-6.49, -0.5; I 2  = 89.7), -1.36 L/s (-1.70, -1.03; I 2  = 90.4) and − 0.34 L/s (-0.63, -0.06; I 2  = 77.3). The pooled odds ratio for obstructive [12.9 (3.41, 49.2); I 2  = 82.4)] and restrictive changes [5.11 (0.55, 47.4); I 2  = 81.6] were significantly higher among the exposed than controls. As per the bias assessment majority of studies rated with moderate to severe risk of bias. Conclusion Study observed pulmonary function deficits associated with exposure to flour dust. However, considering the quality of primary studies and higher heterogeneity, high-quality larger studies with longitudinal design are required to affirm the effects of flour dust on lung function.

Objectives: Work-related musculoskeletal disorders (WMSDs) are among the most common occupational diseases, affecting various sectors such as agriculture, small-scale industries, handicrafts, construction, and banking. These disorders, caused by overexertion and repetitive motion, lead to work absenteeism, productivity loss, and economic impacts. The aim of the study was to determine the magnitude of musculoskeletal disorders among different occupational workers in India.Methods: We identified studies reporting the prevalence of WMSDs using the Nordic Musculoskeletal Questionnaire in different databases between 2005 and 2023 through searches on SCOPUS, PubMed Central, and Google Scholar. The required information was then extracted. A random effects model was used to pool estimates of prevalence with 95% CIs. Publication bias was assessed by applying funnel plots.Results: The 12-month prevalence of WMSDs was reported across several occupational groups, and the meta or the pooled prevalence was estimated as 0.76 (95% CI, 0.70 to 0.82) along with substantial variability in the prevalence estimates between different industries and studies. The meta-prevalence for low back pain was estimated as 0.60 (95% CI, 0.54 to 0.66). The meta-prevalence for neck pain was estimated as 0.40 (95% CI, 0.34 to 0.47) whereas for shoulder pain it was estimated as 0.36 (95% CI, 0.30 to 0.42), respectively. The risk of bias was statistically nonsignificant, and overall publication bias was low as per visual inspections from funnel plots.Conclusions: WMSDs are prevalent across various Indian industries in significant proportions, particularly in agriculture, health care, and mining, leading to significant productivity loss and economic impact. The variation in prevalence highlights the need for sector-specific interventions. Addressing WMSDs requires comprehensive ergonomic and policy measures. Effective strategies are essential to mitigate these disorders’ widespread impact.

Background: Air pollution is a significant contributor to respiratory illness globally, and in India, evidence is scarce on whether smoking exacerbates this problem. Objective and Methods: We aimed at assessing if being a smoker among public transit drivers increased risk for respiratory illnesses and affected performance of pulmonary function tests in a cross-sectional study in a metropolitan city of Gujarat, western state of India. We conducted a cross-sectional study among public transit drivers (those who were smoking and not smoking). Administration staff who were not smoking were considered as control group. We collected socio-demographic and medical history including occupational history (N = 296). We collected details of respiratory symptoms with standard tools and assessed pulmonary function tests (PFT) using spirometry. Group differences and regression analyses were conducted in R software. Results: We found that respiratory symptoms among public transit drivers who smoked were higher than those who did not smoke and healthy controls. In PFT diagnosis, drivers who smoke displayed two times higher prevalence of obstructive pattern compared to drivers who did not smoke. There was a significant reduction in the larger as well as the smaller airway functions, reflected in reduction of FEV1/FVC ratio (p < 0.001) and FEF25-75% (p < 0.001), respectively, among drivers who smoked compared to controls. Our results indicate that being a driver with a smoking history leads to a 3.1% greater decrease in the FEV1/FVC ratio and about half a litre reduction in FEF25-75% compared to the drivers who did not smoke. Conclusion: We suggest there is a high need for smoking cessation programmes for public transit drivers as they are at higher risk for respiratory illnesses and reduced pulmonary functions when smoking is added to the existing vehicular exposure.

The prevalence of depression among elderly people varies across different setups such as old age homes (OAHs), community, and medical clinics. The aim of this study was to compare the epidemiological factors pertaining to depression among elderly residents of OAHs and community, using a new Gujarati version of the Geriatric Depression Scale-Short Form (GDS-G). A cross-sectional, epidemiological study conducted in an urban setup of Western India. All the eligible 88 elderly residents of all the six OAHs and 180 elderly residents from the same city were administered a pretested semistructured questionnaire having the GDS-G form. Descriptive statistics, odds ratio, Spearman's rank correlation test. The elderly of OAHs were more depressed compared to those of community (odds ratio = 1.84; 95% confidence interval = 1.09-3.06). Older age, females, weaker family ties, economic maladies, poorer self-perception of health status, presence of chronic ailments, absence of recreational activity, lack of prayers, impaired sleep, history of addiction emerged as the predictors of depression in both the setups. More health complaints and a later self-perception of visit to a doctor were found among the depressed than the nondepressed in both the setups. Depressive symptoms were quite high among the elderly in both the setups. Special attention should be given toward health checkups of depressed persons in the OAH and improvement of family ties among depressed persons of the community.

Urban Social Health Activists (USHAs) are the grass root health care workers of urban areas. There are 290 USHAs distributed in various Urban Health Centers (UHCs) of Rajkot city. To compare the (i) effectiveness of the training received by the USHAs on their knowledge and counseling skills (ii) knowledge and counseling skills of USHAs on the awareness and utilization of Maternal and Child Health (MCH) care services by their beneficiaries. This cross-sectional study involved 32 USHAs and 416 beneficiaries served by the same USHAs. 32 USHAs serving in the same field practice area for more than two years were randomly selected. The beneficiaries were those mothers who had a child between 1-2 years age, and who had availed their antenatal and postnatal services in the same area. A scoring system was used to assess the knowledge and counseling skills of the USHAs and the knowledge and utilization of services by their beneficiaries. The utilization of health services was significantly more in the beneficiaries who were serviced by USHAs having comparatively better knowledge (72.7% vs. 35.3%) and counseling skills (62.2% vs. 30.6%). The median score for knowledge (41 vs. 30) and counseling skills (20 vs. 16) of the USHAs was found to be more ( < 0.05) in those who had undertaken induction training. Induction training helped the USHAs to improve their knowledge and counseling skills. Utilization of MCH services was more in those areas served by USHAs having better knowledge and counseling skills.

BackgroundAir pollution, a significant global health concern, notably impacts human well-being. Children, owing to their distinctive physiology and behavior, are particularly susceptible to its adverse effects. This prospective study examines air quality variations and respiratory risks in children residing in critically polluted areas (CPA) compared to relatively non-polluted areas (NPA), utilizing a prospective design to understand the impacts of air pollution on children’s respiratory health, including measures like relative risk (RR) and attributable risk (AR).MethodsThis prospective study tracked 739 students of 5th– 7th grade residing in CPA and NPA for one year, and measured the ambient and indoor air quality levels in both these areas. Throughout the study, based on the observed respiratory symptoms new episodes of upper and lower respiratory tract illnesses were recorded for each child on a weekly basis. Incidence rate, RR and AR for both the illnesses were compared. Statistical analysis was performed with SPSS 26.0.ResultsThe study observes higher concentration for particulate matter and gaseous pollutants at CPA in comparison to NPA. Children living in CPA exhibited a notably greater weekly occurrence of both upper and lower respiratory tract illnesses compared to those in NPA, with RR of 1.26 (95% CI: 1.16–1.37) and 1.74 (95% CI: 1.34–2.27), respectively. The AR associated with air pollution for upper and lower respiratory tract illnesses among CPA students was found to be 20.7% and 42.7%, respectively.ConclusionThis research underscores the pressing need to address air pollution in critically polluted areas and its profound effects on children’s respiratory health. Public health interventions, such as reducing emissions from industries and creating green spaces, should be prioritized. Furthermore, early respiratory health screening in schools within polluted areas could aid in the timely diagnosis and management of respiratory issues in children.What this study adds• By employing a prospective study design, this research offers a better understanding of the trends of children’s respiratory health in critically polluted areas compared to non-polluted areas, which is often missing in cross-sectional studies.• The study quantifies the attributable risk of air pollution, revealing that a substantial proportion of childhood respiratory illnesses can be attributed to industrial air pollution, emphasizing the need for environmental and public health interventions.• This research uniquely addresses the gap in the existing literature by focusing on critically polluted areas with high industrial emissions, shedding light on the specific health risks faced by children in these settings and emphasizing the necessity of targeted interventions.

IntroductionWorkers in different sections of ceramic tile industry are continuously exposed to dust of varying micron size and are at risk to develop occupational respiratory diseases. We conducted this study to quantify and characterize the workplace respirable dust exposure (PM4 – particulate matter < 4 microns) and to estimate the prevalence of abnormal lung function among ceramic tile workers of Gujarat, India.Materials and MethodsThis cross-sectional study was conducted in industrial zone of Morbi with a sample of 128 workers to achieve 5% alpha and 20% beta. The subjects included ceramic tile workers of different sections exposed to dust and administrative employees of industry as comparator group. Particulate sampling was done near breathing zone of representative subject from each section using personal environmental monitor (SKC, USA). We evaluated lung functions of all workers using pneumotach sensor based Spirovit SP-1 (Schiller). Statistical analysis was performed with SPSS v26.0. The study was approved by Institutional Ethics Committee and funded by the Institute.ResultsCompared to respective international recommended limits, average personal exposure to PM4 was relatively high in spray drying (8 hour time weighted average – 28.9 mg/m3) and ball milling (8 hour TWA – 7.12 mg/m3) sections; whereas average respirable crystalline silica was higher in spray drying section only (0.08 mg/m3 TWA). We observed abnormal lung functions (obstructive/restrictive) in 17% workers. We found significant deteriorated spirometry measurements in workers as compared to administrative staff. Duration of job was associated with compromised spirometry measurements.ConclusionIt is evident that ceramic tile workers have higher than recommended exposure to PM4 and crystalline silica at workplace and high prevalence of abnormal lung functions. Proper implementation of industrial hygiene for containing workplace dust and periodic screening programmes of workers for early detection of pulmonary compromise is recommended in ceramic tile industry.