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RGUHS Nat. J. Pub. Heal. Sci Vol No: 9  Issue No: 3 eISSN: 2584-0460

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Original Article

Nirmala.C. J1 , Prasad Dharaneesh S2 

1 : Associate Professor, 2: Associate Professor, Department of Community Medicine, Sri Siddhartha Institute of Medical Sciences and Research Institute, Begur

Address for correspondence:

Nirmala C J

Associate professor,

Department of Community Medicine,

BGS Global Institute of Medical Sciences, Bengaluru

Email: nirmalacj@gmail.com

Year: 2018, Volume: 3, Issue: 1, Page no. 16-19,
Views: 919, Downloads: 5
Licensing Information:
CC BY NC 4.0 ICON
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0.
Abstract

Background: Construction sector is a booming industry and an important sector which contributes significantly to GDP. Construction labour form 7.5% of the world labour force. In India, nearly two thirds of the contribution to the net domestic product is by the unorganized sector. The Substance Abuse and Mental Health Services Administration study shows that Substance abuse among workers poses major health risks and productivity of workers.

Objective: To understand the health problems and addiction pattern among the construction workers and to enable appropriate interventions.

Methods: A cross sectional study conducted at two construction sites in a metropolitan city during 2015.The construction sites were selected in southern Bangalore and all workers were enrolled as study subjects. A pretested semi structured questionnaire was used to collect the data. Descriptive statistics like percentages were calculated and Chi square test was done to check the significance of difference.

Results: Majority of them, 87.3% belonged to 15-45-year age group, 40.3% to class IVsocioeconomic status, 40% were Hindu by religion. Around 40% of them were Illiterates and 68% of them were unskilled workers. The prevalence of Tobacco smoking, Tobacco chewing and Alcohol consumption were 26.98%, 47.62% and 32.28% respectively. There was a statistically significant association (P < 0.05) between Tobacco smoking, Tobacco chewing and morbidity status.

Conclusion: The prevalence of Tobacco use and alcohol consumption is high among the construction workers. There is need for intervention programmes like regular health education sessions, behaviour change communication programmes, screening camps for cancers and counselling for de addiction therapies.

<p><strong>Background:</strong> Construction sector is a booming industry and an important sector which contributes significantly to GDP. Construction labour form 7.5% of the world labour force. In India, nearly two thirds of the contribution to the net domestic product is by the unorganized sector. The Substance Abuse and Mental Health Services Administration study shows that Substance abuse among workers poses major health risks and productivity of workers.</p> <p><strong>Objective:</strong> To understand the health problems and addiction pattern among the construction workers and to enable appropriate interventions.</p> <p><strong>Methods:</strong> A cross sectional study conducted at two construction sites in a metropolitan city during 2015.The construction sites were selected in southern Bangalore and all workers were enrolled as study subjects. A pretested semi structured questionnaire was used to collect the data. Descriptive statistics like percentages were calculated and Chi square test was done to check the significance of difference.<strong> </strong></p> <p><strong>Results: </strong>Majority of them, 87.3% belonged to 15-45-year age group, 40.3% to class IVsocioeconomic status, 40% were Hindu by religion. Around 40% of them were Illiterates and 68% of them were unskilled workers. The prevalence of Tobacco smoking, Tobacco chewing and Alcohol consumption were 26.98%, 47.62% and 32.28% respectively. There was a statistically significant association (P &lt; 0.05) between Tobacco smoking, Tobacco chewing and morbidity status.</p> <p><strong>Conclusion:</strong> The prevalence of Tobacco use and alcohol consumption is high among the construction workers. There is need for intervention programmes like regular health education sessions, behaviour change communication programmes, screening camps for cancers and counselling for de addiction therapies.</p>
Keywords
Addiction pattern, construction workers, migrants
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Introduction

The construction sector is an important sector of economy and contributes significantly to GDP. In India, it is the largest economic activity after agriculture and since it is a labor-intensive industryconsist 44% of all urban unorganized workers.1-3 World Health Organization (WHO) has estimated the excess premature mortality attributable to tobacco use as 5 million per year which is expected to reach 10 million by 2025. Tobacco related deaths are increasing in India, and account for approximately a sixth of the world’s tobacco related deaths.In India tobacco consumption in various forms is the single most important avoidable factor in the growth of noncommunicable diseases. It has also been observed that the Tobacco demand in India has remained high.4 National Family Health Survey - 3 (NFHS-3) suggests an estimated 120 million Indians smoke, 57% of men and 11% of women aged 15-49 consume some form of tobacco, smoked or non-smoked. After China, India is the second most populous country and the second largest producer and consumer of tobacco in the world.4 Alcohol abuse or other risk-taking behaviour is quite common in any area of this sector.5 Workers in this industry need to do heavy physical work while living in shabby environment. The unhygienic situation, working pattern, absence of any recreational activity and company of friends force them to indulge in various abuse activities. Substance abuse is influenced by a variety of factors including individual attitudes & beliefs, social norms, easy affordability, acceptability, availability, lesser cost and advertising campaigns.6 The Substance Abuse and Mental Health Services Administration study shows that substance use can pose major risks to the health and productivity of workers.4 There are many misconceptions regarding the tobacco and alcohol, that it helps increase concentration, suppresses appetite, reduces anxiety and tension, causes skeletal muscle relaxation and induces feeling of pleasure.7 In the era of globalization construction is a fast-growing industry and very little research has been done on the occupational health and substance abuse of these workers. In this context to understand the health problems and addiction pattern among the construction workers and to enable appropriate interventions, this study was conducted.

Materials and Methods

This is a cross-sectional study carried out at two construction sites in Bangalore south during 2015. Study was started after taking permission from Institutional ethical committee and concerned authorities at construction sites. All the migrant workers who were semiskilled and unskilled were enrolled for the study and included 315 subjects. The skilled, technical and support staffs were excluded.

Data was collected in a pre-tested and semi structured questionnaire. General information, history of habits, addiction pattern was included in the proforma.During medical examination, they were asked about their present health problems and physical examination was done and findings recorded. Those requiring medications were given free drugs and referrals were given.

The following operational definitions were used for the study. A person staying in the study area for 5 yrs or less was considered to be a “Migrant”. A person using any tobacco product on a daily basis for more than 1 year was labelled as “Tobacco user. Alcohol users were considered as those who had consumed alcohol at least once per month.8

Analysis

All the collected data was coded and entered in Excel data sheet and Statistical analysis was performed. Mean and standard deviations were derived for numerical data. Prevalence was reported in percentages. Chi square test was performed to find the statistical significance. Significance level was defined as P < 0.05.

Results

Data was collected from 315 workers. Most of them belonged to 15-45-year age group (87.3%). Majority were Illiterates (38.5%), belonged to class IV(40.3%) and were Hindus (85%) followed by Muslims. Majority of the workers (68%) were unskilled, rest semiskilled workers. Most of them stayed within premises of construction site. Dwelling arrangement was in the form of tin shed and dormitory with temporary public toilets.

The prevalence of tobacco smoking, chewing and alcohol were 26.98%, 47.62% and 32.28% respectively (Table 1). There was a statistically significant association (P < 0.05) between tobacco smoking, tobacco chewing and morbidity status (Table 2).

Discussion

The construction workers are exposed to multiple risks at working and living places. They are exposed to physical, chemical, biological, ergonomic hazards, environmental and psycho social risks.2,8 In most places the workers reside in make shift camps inside the project sites that expose them to health risks even after working hours. Due to poor environmental conditions at work sites chances of diseases from poor sanitation and unsafe drinking water are high.2,8,9

The risk of accidents increases with extremes of temperature, age, male gender, personal habits like use of alcohol, personality traits of risk-taking behaviour and physical and mental state of the worker.10

Since 40% of the workers were illiterate, a lack of awareness about healthy choices and prevalence of addictions were expected to be high. Among the workers 26.98% were tobacco smokers, 47.62% were tobacco chewers. Earlier studies reported prevalence of 50.48%, 60.2% and national prevalence of 57%. 8,11,12 Most of them were using smokeless tobacco products. The current alcohol use was higher (32.3%) than previous studies (14.6%), 18.8% and national estimate of 21%.8,11,12 The absence of recreational facilities, the nature of work, hours of work, low pay, poor housing and separation from family, lack of job security and lack of access to occupational health services cause anxiety in these workers.2,9

There was a statistically significant association between tobacco smoking, tobacco chewing and morbidity status in our study.

Conclusion

The prevalence of high-risk behaviours in the form of tobacco and alcohol addiction was reported to be high among unskilled and semiskilled construction workers. This study will contribute to further development of health promotion strategies. Measures are needed to improve the work environment of construction workers by ensuring availability of protective gears, good living conditions and sanitation facilities at the sites along with an accessible and accountable occupational health services. 

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References

1. Shah KR, Tiwari RR. Occupational skin problems in construction workers. Indian J Dermatol 2010;55:348-51.

2. Kulkarni GK. Construction industry: More needs to be done. Indian J Occup Environ Med 2007;11:1-2.

3. Tiwary G, Gangopadhyay PK. A review on the occupational health and social security of unorganized workers in the construction industry. Indian J Occup Environ Med 2011;15:18

4. John RM, Rao RK, Rao MG, Moore J, Deshpande RS, Sengupta J et al. The Economics of Tobacco and Tobacco Taxation in India. Paris: International Union Against Tuberculosis and Lung Disease; 2010.

5. U.S. Department of Labor Bureau of Labor Statistics; 1996. Career Guide to Industries. Available from: http://www.bls.gov/oco/cg/ cgs003.htm

6. Cook RF, Hersch RK, Back AS, McPherson TL. The Prevention of Substance Abuse among Construction Workers: A Field Test of a SocialCognitive Program. The Journal of Primary Prevention 2010;25(3): 337-57.

7. World Health Organization. Tobacco increases the poverty of individuals and families. World Health Organization 2004. Available from: http://www.who.int/tobacco/ communications/events/wntd/2004/en/ factsindividuals_en.pdf.

8. Adsul BB, Laad PS, Howal PV, Chaturvedi RM. Health problems among migrant construction workers: A unique public-private partnership project. Indian J Occup Environ Med 2011;15:29-32.

9. Gurav RB, Kartikeyan S, Wayal R, Joshi SD. Assessment of daily wage labourers. Indian J Occup Environ Med 2005;9:115-7.

10. Ramsay JD. Effect of workplace thermal conditions on safe work behaviour. J Safety Res 1983;14:105-14.

11. Jayakrishnan T, Thomas B, Rao B, George B. Occupational health problems of construction workers in India. Int J Med Public Health 2013;3:225-29.

12. International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3) 2005-06; India. Vol. 1. Mumbai: IIPS; 2007.

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