Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore s7
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. AMIT KUMAR SINHA, MBBS
POST GRADUATE STUDENT IN COMMUNITY MEDICINE (M.D.)
Under the guidance of
DR. SHASHIKALA MANJUNATHA, MBBS., MD.,D.I.H.,
PROFESSOR AND HEAD,
DEPARTMENT OF COMMUNITY MEDICINE
RRMC&H, KAMBIPURA, BANGALORE
DEPARTMENT OF COMMUNITY MEDICINE
RAJARAJESWARI MEDICAL COLLEGE AND HOSPITAL,
KAMBIPURA,BANGALORE-560074
2013
Rajiv gandhi university of health sciences, Karnataka, Bangalore
annexure - ii
Proforma for registration of subjects for dissertation
1. / Name of the Candidate and Address (in block letters) / dr. amit kumar sinha#7, 7th main, 1st floor, papaiah garden, banashankari 3rd stage, bangalore-70
2. / Name of the Institution / rajarajeswari medical college and hospital,
kambipura, KENGERI HOBLI, mysore road, bangalore -560074
3. / Course of Study and Subject / m.d community medicine
4. / Date of Admission to Course / 29 may 2013
5. / Title of the Topic
“morbidity profile ofauto-rickshaw drivers from RANDOMLY selected drivers unions in BANGALORE CITY”
6. / Brief resume of the intended work
6.1 INTRODUCTION:
Occupational disorders are important because they affect a large number of workers.1 There is no internationally accepted definition for the term occupational disease or disorders. However, occupational disease or disorders are usually defined as disease/disorders arising out of or in the course of employment.2 Professional drivers have a higher prevalence of occupational disorders than other groups.3 Several studies have shown that musculoskeletal disorders are more prevalent among bus drivers.4 Driving as a task involves prolonged sitting, a fixed posture and vibration, any of which could directly lead to musculoskeletal trouble.5
Studies have shown that when a vehicle is in motion the body is subjected to different forces: accelerations and decelerations lateral swaying from side to side, and whole-body up and down vibrations. Also, when the feet is active [i.e. when they are actively being used -the right foot on the gas (accelerator) pedal, the left on the brake, and in a stick shift also on the clutch], they cannot be used to support and stabilize the lower body as it normally happens when they are placed on the floor during normal sitting in a chair. Exposure to vibration is the cause of some occupational injuries and diseases.6
The environment in which drivers spend majority of their time is polluted, noisy and dangerous7. Drivers are exposed to harmful environment like pollutant gases, continuous noise and whole-body vibration as well as harmful lifestyle like irregularity of meals, bad posture while driving and stressful occupational conditions due to their working conditions7. These work-related harmful factors may be associated with various gastro-intestinal, musculo – skeletal, Cardio-vascular, respiratory, hearing and other problems which can have driving safety implications 7,8
NEED FOR THE STUDY
A lot of studies had been conducted worldwide on the prevalence of various Cardio-vascular disease risk factors among truck, bus and taxi drivers9 , Respiratory and Reproductive health problem in Auto-rickshaw drivers10,11 but no such study is ever done collectively in auto-rickshaw drivers of India. So this study will be conducted with objectives of finding the prevalence of morbidity profile of Auto-rickshaw drivers among randomly selected Auto-rickshaw drivers unions in Bangalore city and to make suitable recommendations based on the study findings.
6.2 RESEARCH QUESTION
What are the common morbidities among auto-rickshaw drivers in Bangalore City?
6.3 REVIEW OF LITERATURE
A study conducted by Rajkumar10 on “Effect of air pollution on respiratory system of auto rickshaw drivers in Delhi” revealed that the main symptoms observed were cough (77%), eye irritation (80%), breathlessness(54%), 25(80%) shows mild-moderate-severe obstruction.(Chronic Obstructive Pulmonary Disease)
A study conducted by S S Chaudhary, M M Nagargoge, S S Kubde, S C Gupta, S K Misra11 on “Prevalence of cardiovascular diseases risk factors among auto-rickshaw drivers” in Nagpur revealed that mean age of Acute Respiratory Distress syndroms was 41.70+ 9.05 years, 27.36% subjects had moderate or severe self reported stress, 37.16% subjects had pre-hypertensive, while 35.14 subjects had hypertension.
A Study conducted by Gaikwad VS, Murthy TSM, Sudeepa D12 “A Qualitative study on men’s involvement in reproductive health of women among Auto-rickshaw drivers in Bangalore rural” revealed that 62.50% of men did not help their wives seek antenatal care. Only 7.29% were aware of parameters of antenatal care. There were 45.83% men who reported the symptoms of Reproductive Tract Infections,35.42% were not aware of HIV/AIDS.
6.4 OBJECTIVE OF THE STUDY:
To assess the Morbidity Profile of Auto-rickshaw Drivers from randomly selected Drivers Union in Bangalore City.
7. / MATERIALS & METHODS
7.1 SOURCE OF DATA
Auto-rickshaw Drivers among Randomly selected Auto-rickshaw Drivers
Union in Bangalore city
· STUDY DESIGN: Cross-sectional study
· STUDY DURATION: One year study
· PLACE OF STUDY: Auto-rickshaw Drivers Unions - Bangalore City
· SAMPLE SIZE:
Sample size is based on the prevalence of morbidity of:
o Rajkumar10. Effect of air pollution on respiratory system of auto rickshaw drivers in - Delhi - COPD - 80%.
o Gaikwad VS11, Murthy TSM, Sudeepa D A Qualitative Study on Men’s Involment in Reproductive Health of Women among Auto-rickshaw Drivers in Bangalore Rural.OJHAS- Reproductive tract infection15 - 45.83%.,
o S S Chaudhary12,M M Nagargoge, S S Kubde, S C Gupta, S K Misra on Prevalence of cardiovascular diseases risk factors among auto-rickshaw drivers. Indian Journal of Community Health Vol. 22, Vol. 23 No. 1 July 2010-June 2011 Nagpur hypertension-35.14%
Hence Sample Size is considered based on a study conducted by S S Chaudhary13 by taking prevalence of Hypertension as 35.14%.
Using formula n= 4 pq / L2
p(Prevalence) = 35.14%, q= 100 – p= 64.86
Considering allowable error of 10%
L = 10% of p
L=10 x 35.14/100
L = 3.51
n= 4 x 35.14 x 64.86 /3.51 x 3.51
=9116.72/12.33
= 739.39
Sample size(n) – 740 subjects
o List of Auto-rickshaw Drivers Union in Bangalore is obtained and allotted serial numbers & selected randomly &
o Study subjects – Auto–rickshaw drivers are selected from Auto-rickshaw Drivers Union, till sample size is reached.
o The Study Subjects (Auto-rickshaw Drivers)- 740 will be considered from Randomly selected Auto-rickshaw Drivers Union.
INCLUSION CRITERIA: All the registered Auto-rickshaw drivers from
Randomly selected Auto-rickshaw drivers union.
EXCLUSION CRITERIA: Those who are not willing to participate in the study.
7.2 METHOD OF DATA COLLECTION
o Permission for conducting the study from the Auto-rickshaw Drivers Union, Bangalore City will be obtained.
o Informed written consent will be obtained from each Study subject before starting the Interview and clinical Examination (General Physical & Systemic examination and Random Blood Sugar estimation)
o Pretested, semi-structured questionnaire will be used to collect the data.
o Blood pressure will be measured by using the sphygmomanometer, in sitting position, two times over a period of ten minutes and the lowest reading recorded. BP >140/90 considered as hypertensive13
o Study subject will be categorized into low risk, medium risk and high risk based on The Indian Diabetes Risk Score (IDRS)14 and for the high risk category Random blood sugar estimation will be done using Glucometer (Accu check active)
PLAN FOR DATA ANALYSIS
The data will be entered and compiled using Microsoft Excel and analyzed using SPSS version 20.0 Descriptive statistics will be used as necessary. All qualitative variables will be presented as frequency and percentages. All quantitative variables will be presented as mean and standard deviation. Chi square test and other relevant tests of significance will be applied.
7.3Does the study requires any investigations or intervention to be conducted on other humans or animals? If so, please describe briefly.
YES, Random blood sugar estimation will be done using Glucometer (Accu check active)
7.4 Has ethical clearence been obtained from your instituition in case of 7.3?
YES
8. / LIST OF REFERENCES:
1) Bildt C, Alfredsson L, Punnett L, et al. Effects of drop out in a longitudinal study of musculoskeletal disorders. Occp Environ Med. 2001; 58: 194 – 9.
2) Park K.Park’s Text book of Preventive and Social Medicine.22nd ed. Jabalpur: M/s Banarsidas Bhanot Publishers;2013. 750
3) Bylund P, Biornstig U, Lasson T. Occupational road trauma and permanent medical Impairment. SafetyScience.1997; 26: 203 – 6.
4) Magnusson ML, Pope MH, Wilder DG, et al. Are occupational drivers at an increased risk for developing musculoskeletal disorders? Spine.1996; 15: 710 – 17.
5) Gyi D. E. and J. M. Porter. Musculoskeletal problems and driving in police officers Occup. Med.1998; 48, 153-160,
6) Doodebiyi, Dcogwezi, Boa Adegoke .The Prevalence of Low Back Pain in commercial motor drivers and private automobile drivers. Nigerian Journal of Medical Rehabilitation (NJMR).2007 DEC; Vol.12,No.1 &2,(Issue No.20).
7) John Whitelegg. Health of professional drivers. A report for transport & general workers union. Eco-Logica Ltd, White cross, Lancaster, LA1 4XQ. 1995.
8) Saltzman GM, and Belzer MH (ed.). Truck Driver Occupational Safety and Health: 2003 Conference Report and Selective Literature Review .DHHS(NIOSH) Publication No. 2007-120. Cincinnati,OH.
9) Kartikeyan S, Gurav R B, Joshi S D, Wayal R. Health and socio-demographic profile of transport workers. Indian Journal of Occupational and Environmental Medicine (IJOEM). 2004; Vol 8, No. 2:1-5.
10) Rajkumar. Effect of air pollution on respiratory system of auto rickshaw drivers in delhi. Indian Journal of Occupational and Environmental Medicine (IJOAM).. 1999 Oct-Dec.;3(4): 171-3
11) Chaudhary S S, Nagargoge M M, Kubde S S, Gupta S C, Misra S K. Prevalence of cardiovascular diseases risk factors among auto-rickshaw drivers. Indian Journal of Community Health (IJMS). Vol. 22, Vol. 23 No. 1 July 2010-June 2011:32-34
12) Gaikwad VS, Murthy TSM, Sudeepa D A Qualitative Study on Men’s Involment in Reproductive Health of Women among Auto-rickshaw Drivers in Bangalore Rural. Online J Health Allied Sec. 2012;11(1):3
13) Reference Card from the seventh report of Joint National Committee on prevention, detection, evaluation & Treatment of High Blood Pressure(JNC 7) NIH Publication No. 03-5231, may 2003. accessed on 8th oct 2013
14) Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects.J Assoc Physicians India.Sep 2005;53:759-763.
9. / SIGNATURE OF THE CANDIDATE
10. / REMARKS OF THE GUIDE / This Study reflects on the Morbidity Profile, of Auto-Rickshaw Drivers. As Auto – rickshaw is an important means of Public Transport, in Bangalore, this Study suggests for frequent Periodic Medical Examination of Auto-rickshaw Drivers & Follow – up, to maintain Conducive Health status of Auto-rickshaw Drivers.
11. / NAME AND DESIGNATION
(in block letters)
11.1GUIDE
11.2 SIGNATURE
11.3 CO-GUIDE (if any)
11.4 SIGNATURE
11.5 HEAD OF THE
DEPARTMENT
11.6 SIGNATURE / dr shashikala manjunathA
proffessor and head
dept of community medicine
rajarajeswari medical collEge and hospital, kambipurA, bangalore-74
dr shashikala manjunathA
proffessor and head
dept of community medicine
rajarajeswari medical collEge and hospital, kambipurA, bangalore-74
12. / 12.1 REMARKS OF THE
CHAIRMAN AND PRINCIPAL
12.2 SIGNATURE
Certificate
The dissertation topic “morbidity profile of auto-rickshaw drivers from RANDOMLY selected drivers unions in BANGALORE CITY” by Dr. Amit kumar sinha, Post-Graduate student in the Department of Community Medicine has been approved by the Institutional ethical committee RAJARAJESWARI MEDICAL COLLEGE, BANGALORE.