Health Watch

National Safety week:

Equipping the workforce against hazards

Ishara JAYAWARDANE

Around 1750 - 2000 occupational accidents have taken place annually
Our workforce is about 8 million - 1/3 of our population.

“We work with the working people” is an apt slogan for the National Safety Week that was celebrated last week from October 6 to 12. Unfortunately occupational hazards are an area of life that is not paid adequate attention in this country.

This is where the National Institute of Occupational Safety and Health comes in, as an organization intent on raising awareness on this subject. Daily News met up with National Institute of Occupational Safety and Health Director General Dr. Champika Amarasinghe to discuss the workman's woe.

“We want to prevent the occupational accidents and occupational diseases. The week is designated by the Cabinet of Ministers to prevent the occupation diseases and occupation related injuries. All of us work but we never think of our health. Sometimes the work can affect our health in negative ways. It can cause certain diseases. There can be a variety of diseases, sometimes eyes can get affected, muscular skeleton disorders - there can be fractures and injuries even fatalities a range of diseases and injuries,” said Amarasinghe.

For this week the Institute has organized many programmes. “ This subject is not basically a subject area where we are dealing with one category of people - there are many stakeholders: employers and employees- all these people are responsible for their health while they are working. So we are working with the employers and employees during this week with a strategy, mostly our mandate is to create awareness and research on safety and health. We had a press conference on October 5 and we had an employer- employee commitment programme at

Finlays group of factories at Welisara.

It was like a sports meet with the employees showing their commitment towards safety and health, it was a programme with quizzes and lots of activities. There was also another programme for the construction industry.

The construction industry is also identified as a hazardous industry for employees because a great deal of hazardous work is carried out - welding and underground working, they are dealing with chemicals they are exposed to dusty environments, noise places.

We cater their needs and we identify there are a lot of Occupation related eye injuries. Eye injuries can happen while you are working.

Hence we did an awareness programme for those in the construction industry, we did an eye injury detection campaign and we provided them with spectacles if they required and provided them knowledge on protectiveness for example how are you going to protect your eyes from eye injuries. The main seminar was held on October 10.

Hazard is a cause for health injury. That is what we find. You deal with noise, you work for long years with noise and you might undergo hearing losses. The noise is the hazard.

* Chemical hazards - people who deal with chemicals (Agriculture and plantation sector , Paint industry)

* Physical Hazards - the Noise, the temperature, working in the hot sun, some people work in very cold climates, sometimes they work with radio active material (cancer hospital, X ray machines)

* Biological Hazards - Small germs in a hospital environment and in terms doctors and nurses are also exposed to germs.

Bad news stories ‘alter women's stress response’

James Gallagher

Bad news stories, such as those about murder, seem to alter the way women respond to stressful situations, according to a small study.

Women produced more stress hormones in tests if they had read negative newspaper stories.

The study on 60 people, published in the journal PLoS One, showed there was no equivalent effect in men.

Experts said the findings showed “fascinating” differences between the sexes.

Researchers in Canada compiled newspaper clippings of negative stories, including accidents and murders, as well as neutral stories such as film premieres.

Men and women read either negative or neutral stories and then did a scientific stress test. Levels of the stress hormone, cortisol, were measured throughout the study.

One of the researchers, Marie-France Marin, from the University of Montreal, said: “Although the news stories alone did not increase stress levels, they did make the women more reactive, affecting their physiological responses to later stressful situations.”

Men's cortisol levels were not affected.

She added: “It's difficult to avoid the news, considering the multitude of news sources out there.

“And what if all that news was bad for us? It certainly looks like that could be the case.”

‘Gender puzzle’

The scientists suggested that women may be naturally better at identifying threats to their children, which affects the way they respond to stress.

Professor Terrie Moffitt, from the institute of psychiatry at King's College London, said: “According to self-report studies, women say they are more ‘stress reactive’ on average than men.

“This study adds fascinating new evidence of change in a stress hormone after an experimental... challenge.

“Stress researchers confront a real gender puzzle: As a group, women seem more reactive to stressors, but then they go on to outlive men by quite a few years.

“How do women manage to neutralise the effects of stress on their cardiovascular systems? An answer to that question would improve health for all of us.”

Other experts warned that the study was small so the reported effect would need further testing.

-BBC

World Egg Day was on October 12:

Why eggs are healthier than ever

Dr Allagamuthu Nandakumar Veterinary Surgeon

It is a common belief that eggs are high in cholesterol, which would lead to hyper cholestrolemia and then Coronary Heart Disease (CHD). But the real fact is that eggs have several health benefits including cholesterol lowering factors.

Sherwood Anderson in 1921, in a celebrate story titled “The Egg” wrote: “One hopes for so much from a chicken and is so dreadfully disillusioned”. Anderson's views were proved right in the early 70's when clinical nutritionists condemned eggs for the fear of cholesterol. Over the years eggs have become the visual icon of high cholesterol and many consumers have responded positively by limiting or eliminating eggs from their daily diet.

Between 1970's and 1980's when people started hearing the dietary cholesterol message, eggs consumption reduced by 25% all over the world. The “Avoid eggs” message was so effective that most consumers even today believed dietary cholesterol is a demon and avoids eggs, as doctors tell the same nutritional message to avoid eggs to keep the daily consumption of cholesterol to less than 300 mg in normal person and 183 mg for heart patients, as recommended by the American Heart Association.

An egg contains 210mg of cholesterol at an average. During the past thirty years over 200 studies have been conducted by researchers and have proved that dietary cholesterol has a weak link, at best to blood cholesterol levels because there is only a relatively small chance in blood cholesterol level in response to changes in dietary cholesterol intake.

Perceptions against eggs and dietary cholesterol in this millennium is becoming under increasing scrutiny, as new research and documentary evidence that the old beliefs hold up well to the rigorous scrutiny. As such the dietary guidelines revised in the year 2000 by the American Heart Association (AHA) no longer make recommendations in eating number of eggs per week. In the past the AHA recommended limiting eggs to 3-4 per week as a way to help people limit their average daily cholesterol intake to less than 300 mg. (JAMA; 1999:281:1387-1394)

Issues regarding the effects of menopause

Dr M D P Goonaratne

Consultant Obstetrician and Gynaecologist

President Elect – South Asian Federation of Menopause Societies

The demographic transformation in the world during the latter part of the last century has a major impact on the population structure in this 21st century. More than half of the six billion people in the world live in Asia. By 2030 India will be the most populated country of the world overtaking China. With three of the ten largest populations in it SAARC region would account for over one quarter of the estimated 9.5 billion population of the world in 2050. Except for Sri Lanka and Maldives, the other countries in South Asia have a high population growth. Life expectancy of the female is higher than that of the male, and ranges from 45 years in Afghanistan to 75 years in Sri Lanka. These changes result in an increase in the female population beyond menopause in South Asia.

Menopause is the cessation of the menstrual cycle in the female, during which period there is transition from reproductive to post reproductive period. In Sri Lanka this usually occurs at the age of 50 years as in the developed countries, but at a younger age in many countries in South Asia. Around menopause formation and release of ova stops and there is a marked reduction of the hormones produced by the ovary, which results in estrogen deficiency, which is the main female hormone.

Estrogen deficiency cause many symptoms like hot flushes, sweating, irritability, and effects on genito-urinary, cardiovascular systems, bone and brain among many others. These effects were not a problem for women about a hundred years ago as many did not live beyond the age of menopause. But today with higher life expectancy of the female, one-third of their lives are spent in the postmenopausal age. Total number of menopausal women in the South Asian region is bout 126 million which would increase up to 413 million by 2050. Thus the impact of effects of menopause on the health of this large female population and the burden on the respective governments will be enormous, and this would be modified by the health standards, socio economic status, culture and the outlooks of the county.

World Menopause Day which was on October 18 is instituted by International Menopause Society and World Health Organization and it is an occasion for people to be aware and the governments to address the various issues regarding the effects of menopause.

Women around menopause commonly report many symptoms, like hot flushes, night sweats, fatigue, headache, irritability, inability to sleep, and mood changes. In many, these symptoms last for a few months or years, but in some they continue for many years. These symptoms may be severe enough to disrupt the day to day activities of some women. In the west about 80 percent of women experience these symptoms, but in Asian women they are less common. Which may be related to their dietary habits, culture and religion.

Lifetime risk

The major complications in the postmenopausal women involves heart, bone, and brain. Coronary heart disease is the leading cause of death among postmenopausal women. Women are ten years older than men at the first manifestation of coronary heart disease. But women have a higher chance of dying from it than men. Among women, lifetime risk of death from heart disease is 10 fold greater than that from breast cancer. It has been shown that women with heart disease take longer to present at hospital, to diagnose, and to treat, than men. Further women have higher incidence of post heart attack complications than men, and higher complications after heart surgery. Prevalence of coronary heart disease in rural India is half that of urban India, but still twice that of US and many times that of China.

South Asian women living in US have the highest death rates from heart disease, 30 percent higher than that of whites and many times higher than that of Chinese women living in US.

This is in spite of the fact that smoking is rare among South Asian women. There seems to be a genetic predisposition for an increase risk of heart disease in these postmenopausal women in the South Asian region. Some lipid factors that predispose to heart disease are high in South Asian woman. Further, metabolic syndrome is prevalent in the South Asian women after menopause and central obesity is a major risk factor for heart disease. Other risk factors like diabetes, higher honocysteine levels are common among women in our region. All these evidence leads to an impending epidemic of coronary heart disease among postmenopausal women in South Asia.

Estrogen deficiency results in marked reduction of bone strength in the vertebral as well as in the long bones in the female. Osteoporosis where the bone mineral density is reduced lead to fractures of the vertebra, hip, long bones of the legs and the arms. 75% of these fractures occur in women are postmenopausal and 25 percent of women with hip fractures die within first year. Hip fractures in South Asia are under-diagnosed and under-treated. Many surveys in the region have shown that 60-75 percent of postmenopausal women are osteoporotic. It is estimated that this silent epidemic would lead to about one million hip fractures in this region in 2050. Economic burden fo treating them would amount to 80 billion US dollars.

Difficulties

Many women experience, at surgical or natural menopause, difficulty in remembering names and other information important for daily life as well as deficits in fine motor coordination and reaction times and feelings of depression and anxiety. Inability to learn and consciously recall new information can be a very early sign of Alzheimer disease, which is the commonest cause of dementia or loss of memory in postmenopausal women.

It has been shown by research on animals as well as humans that estrogen has neurotrophic and neuroprotective effects on brain and estrogen seems to have a major influence on the hippocampal area which is involved in memory. Genetic and many non genetic factors play a role in the formation of Alzheimer's disease which is commoner in female than in male. Studies on estrogen receptors and neurotransmitter systems indicate a relationship between estrogen and late onset Alzheimer's disease.

Alzheimer's disease has a devastating effect on the individual and the family. There are about 35 million persons with Alzheimer's disease in the world today. It is estimated that there are about three million postmenopausal women with the disease in the South Asia and this number will be at least three times by 2050. Economic burden on caring for these women will be enormous.

There are many factors in the region that influence the above complications. Vegetarian diet provides natural plant estrogens. Recently it was known that a phenolic compound in turmeric can prevent Alzheimers disease and even useful in treating it. But many South Asians move away from their healthy diet by overboiling or frying and also preferring refined carbohydrates. With urbanization there is increased consumption of fast foods, and lack of exercise which will lead to increased incidence of metabolic syndrome and heart disease.

Extended families common in early days are seen less and less. Older women are sent to day care centres, homes for the aged and nursing homes. Eastern culture and religions which help to ameliorate some problems of menopause are less cared for. Western culture, diet and habits which worsen them are embraced with open arms.

There are many common factors the women of menopausal age in South Asia have to face. Therefore a common front is needed to make people aware of these problems and prevent them.

The respective governments which are in the low income group need to address these problems and reduce the economic burden in the future. Targeting these objectives, Menopause Societies in the SAARC region joined together and established South Asian Federation of Menopause Socialites. (SAFOMS). SAFOMS, in addition to promoting research on post reproductive health, would endeavour to achieve and maintain a better quality of life among women in the region with liaising with the respective governments.

Prize winners of Medical Crossword

No 54

Following are the prize winners in Healthwatch Medical Crossword No 54 held last week (Saturday October 6) at the Dev Siri Sevana Elders Home in Welisara.

Housewives category

1st Prize Entry No 24 Mrs Cadiramanpulle, Colombo 15

2nd Prize Entry No 2 Mrs Srima Wijesinghe, Katugastota

3rd Prize Entry No 26 F C Coomarawel, Nawala

Pensioners Category

1st Prize Entry No 7 S P G C Siriwardena, Colombo 1

2nd Prize Entry No 4 G L Wijesinghe, Kandy

3rd Prize Entry No 6 Alien Peris, Matale

Professionals category

1st Prize Entry No 14 L Mack (Executive), Orugodawatta

2nd Prize Entry No 13 A Mendis (Executive), Moratuwa

3rd Prize Entry No 30 S N Mass (Nurse), Colombo 2

The prizes offered by the sponsors Wish Institute to the winners are gift vouchers of Rs 6000, Rs 4000 and Rs 3000 to the winners, 1st 2nd and 3rd.

Daily News and the Wish Institute thank the Dev Siri Sevana Elders Home Management, specially the Director Chamil Fernando, Sister Manjula for all the arrangements made for the draw.

Prizes were picked by Home's Centenarian 102 year old Manikam, and other inmates including S E Kern (86 yrs) Miss Cronenberg (77 yrs) Christopher Gomez (76 yrs) and Marimattu (86 yrs).

Daily News Editorial and the Crossword sponsors Wish Institute, congratulate all the winners.

Wish Institute also carried out hearing and eye tests of all the inmates.