Abstracts for IJOEM

Maarthi Raja, Vidhya Venugopal, DC Mathangi, Suvarna Jyothi, Kantipudi K, Mahesh Kumar, Somnath Panda, Latha PK Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Climate change has intensified occupational heat stress in tropical regions, with outdoor workers facing disproportionate health risks. Beyond direct heat-related illnesses, heat exposure may also disrupt sleep quality, which is essential for recovery, workplace safety, and productivity. However, evidence from India is scarce. This study examined. Aims and Objectives: To assess the prevalence of sleep disturbances and their associations with occupational heat exposure among outdoor workers in Tamil Nadu. Materials and Methods: A cross-sectional survey was conducted among 367 outdoor workers from Tiruvallur, Kancheepuram, and Chennai districts between March and May 2025. Heat exposure was measured using wet bulb globe temperature (WBGT) monitors, and sleep quality was assessed with the validated Tamil version of the Pittsburgh Sleep Quality Index (PSQI). Logistic regression models, adjusted for age, sex, occupation type, and work hours, were used to examine associations between heat exposure, sleep quality, and productivity indicators. Results: Among 367 participants (mean age: 39.8 ± 8.2 years; 60.5% male), poor sleep quality was highly prevalent (84.8%, 95% CI: 80.8–88.2%). The mean workplace WBGT was 29.1 ± 2.4 °C, with 93.7% of workers exposed above the ACGIH threshold (≥27.5 °C). Workers exposed to extreme heat (WBGT ≥30 °C) had significantly higher odds of poor sleep compared to those with moderate exposure (<28 °C) (85.8% vs. 69.6%; χ²=4.37, p=0.037; OR: 2.63, 95% CI: 1.03–6.73). Each 1 °C increase in WBGT was linked with an 18% higher likelihood of sleep disturbance (aOR: 1.18, 95% CI: 1.05–1.33). Poor sleep quality was independently associated with productivity loss (aOR: 1.95, 95% CI: 1.03–3.68) and increased heat-related symptoms (aOR: 1.89, 95% CI: 1.06–3.36). Conclusion: Sleep disturbances are common among heat-exposed outdoor workers, increasing with higher heat exposure. Poor sleep independently contributes to productivity loss and greater susceptibility to heat-related symptoms. Integrating sleep-focused interventions and heat mitigation strategies is essential to protect worker health and performance in a warming climate.

Pavan Vasoya Shri MP Shah Medical College, Jamnagar [email protected] Introduction: Workplace-related spine disorders are a growing occupational health challenge, with low back pain ranking as the leading cause of disability worldwide. Industrial hubs like Jamnagar, where workers face prolonged sitting, poor ergonomics, and heavy lifting, show a rising burden. A neurosurgeon’s perspective highlights both prevention and advanced treatment options. Aims and Objectives: to assess occupational and clinical patterns of cervical and lumbar spine disorders; to identify ergonomic and lifestyle risk factors, and to evaluate outcomes of conservative and minimally invasive surgical management. Materials and Methods: A prospective study (June 2023–June 2025) included 100 patients (80 male, 20 female; 25–55 years). Occupational history, risk factors, and clinical presentations were recorded. MRI was performed in all cases. Conservative management included medication, short rest, ergonomic correction, and exercises. Minimally invasive endoscopic spine surgery was performed in refractory cases. Results: Low backache was most common (45%), followed by lumbar radiculopathy (25%), neck pain (20%), and cervical radiculopathy (10%). Major risk factors were prolonged sitting (70%), poor ergonomics (60%), poor posture (55%), sedentary lifestyle (50%), high BMI (40%), and improper lifting (25%). Conservative treatment was effective in 90% of cases. Ten patients underwent surgery (lumbar discectomy 4, lumbar laminectomy 2, cervical laminoforaminotomy 4) with complete symptom resolution and return to work in 2–3 weeks. Conclusion: Spine disorders in industrial and desk-job workers are highly prevalent. While most respond to conservative treatment, minimally invasive surgery ensures rapid recovery for refractory cases. Preventive ergonomic measures, posture correction, and lifestyle changes remain critical for reducing disability.

Poonam Singh Kharwar, Devesh Kumar, Abhishek Kumar Banaras Hindu University, Varanasi [email protected] Introduction: Tribes are different from the general population because of their different way of living and community life. Although Constitution of India has made special provision for welfare of scheduled tribes (ST) but wide gaps still exists in health outcomes with scope for substantial improvement. Given the common suffering of ST population in eastern Uttar Pradesh (U.P.), it is essential to identify the underlying correlates, which place their life to very miserable conditions in spite of welfare measures. Aims & Objectives: The present study aims to assess the health and health determinants of the ST community to identify the key thrust area. It analyzes the health status (nutrition, anaemia, MCH, hypertension) and health determinants (socioeconomic status, family size, medical facility and capability to handle medical expenditure, personal hygiene) of ST in eastern U.P. for improvement of their health and wellbeing. Materials and Methods: Present study was conducted in 5 districts of eastern U.P. namely Sonbhadra, Varanasi, Deoria, Ghazipur and Ballia covering 11416 ST families by using semi-constructed questionnaire related to general health, education and socio-economic status prepared by the authors, BP and BMI measurement and observation techniques. Results: Majority (73.4%) ST families are in poor grade, highest (96.8%) in Sonbhadra and lowest (51.5%) in Ghazipur. Only 33.16% have small family size limiting their children number to 2 or less, lack of awareness being most common reason. More than 50% of pregnant women have their delivery assisted with medical person either at home (48.48%) or in hospital (13.57%), un-assisted home delivery very common (99.29%) in Sonbhadra. Only 58.3% newborn are normal weight, 13.5% being under weight. Adults are underweight (13.5%), overweight (19.1%) and obese (9.1%). Maternal malnutrition is high among those who have many pregnancies too closely spaced. Anaemia is more common in females (91.11%) compared to males (33%).14.25% of male and 13.21% female adults are suffering from hypertension. Conclusion: Majority of ST are in poor grade, highest in Sonbhadra. Medical facility and failure in efforts to keep small family size as well as MCH, nutrition and treatment needs special attention. Protective developmental measures especially in hilly rural have not yielded desired impact on development; special budget provision remains unutilized largely. There is urgent need of robust institutions not only to bridge of wide gaps between ST and general population but also to strengthen social inclusion by incorporating study findings.

Hitesh Khambholja Dhirubhai Ambani Occupational Health and Family Welfare Centre [email protected] Introduction: Appendiceal intussusception is a rare medical condition characterized by the invagination of the appendix into the caecum. It is often overlooked due to its nonspecific clinical presentation and rarity, particularly among elderly patients. Symptoms may overlap with more common gastrointestinal disorders such as peptic disease, colonic pathology, or chronic abdominal complaints, leading to delayed diagnosis. Definitive identification frequently occurs intraoperatively or on histopathological examination rather than through initial clinical assessment. Aims and Objectives: were to report an atypical presentation of appendiceal intussusception in an elderly male; to highlight the diagnostic challenges associated with nonspecific gastrointestinal symptoms; to emphasize the importance of maintaining clinical suspicion in elderly patients with vague or chronic gastrointestinal complaints; and, to underline the role of imaging, surgery, and histopathology in confirming the diagnosis Materials and Methods: This is a single-patient case report involving a 74-year-old Indian male, a retired government schoolteacher, who presented with persistent heartburn, belching, and abdominal bloating for one month, with similar intermittent symptoms for the preceding six months. Clinical evaluation included routine laboratory investigations and abdominal ultrasonography, which revealed only mild prostatomegaly. Due to persistent symptoms, contrast-enhanced computed tomography (CECT) of the abdomen and pelvis was performed, showing features suggestive of non-complicated acute appendicitis. The patient underwent laparoscopic appendectomy. Intraoperative findings were documented, and the resected appendix was sent for histopathological examination. Results: Laparoscopic exploration revealed a very elongated and moderately inflamed appendix with its base deeply buried within the caecum. There was associated thickening of the mesoappendix and peri-appendicular mesentery, raising suspicion of appendiceal intussusception. Histopathological examination confirmed acute on chronic appendicitis with peri-appendicitis. Microscopic findings included mucosal ulceration, dense transmural inflammatory infiltrates, and inflammation extending into the surrounding adipose tissue. No granulomas, atypia, or malignancy were identified. Conclusion: Appendiceal intussusception is a rare and often underdiagnosed condition, especially in elderly patients presenting with atypical or nonspecific gastrointestinal symptoms. This case highlights the importance of considering appendiceal pathology even when symptoms suggest upper gastrointestinal disease. Cross-sectional imaging aids in preoperative evaluation, while surgical exploration and histopathology provide definitive diagnosis. Early recognition and timely surgical management are essential to prevent complications and ensure favorable outcomes.

Neha Singhal, Dipannita Kaushik, Rohan Desai, Ishan Patel, Ashish Bondia Pfizer Healthcare India Private Limited Email: [email protected] Introduction: Migraine is a major global health concern, ranking second worldwide in years lived with disability and first among women aged 15–49 years[1,2,3,4,5]. It has a substantial societal and economic impact[1,2,3,4]. Epidemiological studies report a significant prevalence in India (25–26%), well above the global average (14%)[1,2]. Aim and Objective: This study aimed to identify key challenges to migraine care seeking and management among individuals employed in India’s urban organised private sector, and to explore actionable strategies to enhance workplace support and improve quality of life for affected employees. Materials and Methods: We conducted a mixed-methods study combining literature review, 29 in-depth interviews, and 2 Focused Group Discussions (FGDs) with 19 neurologists, 6 patient advocates, 3 payors, 2 administrators, 2 occupational health (OH), and 6 human resource (HR) leaders across 15 Indian cities. Data collection continued until thematic saturation. An analytical framework synthesised the key challenges and opportunities. Results: Migraine places a substantial burden on the workforce, causing absenteeism, presenteeism, and increased healthcare utilisation[6,7]. Most productivity loss from migraine (89%) is due to presenteeism, since employees work through headaches, costing employers 3-10 times more than absenteeism, confirmed by FGDs[6,7,8]. Around 70% of sufferers manage headaches without medical consultation; among those who do, about 70% are underdiagnosed or misdiagnosed, mostly in primary settings (which see ~70% cases), with limited provider awareness (28%), while delayed appropriate care, medication overuse, and migraine chronification are commonly observed, confirmed by interviews.[1,9,10,11,12,13,14,15,16]. Interviews reveal that stigma and absence of migraine-friendly workplace policies hinder care-seeking, especially in high-stress, frequent-travel, and night-shift jobs[1,9,10,14,17,18,19, 20]. Indian employees with migraine lose ~17 workdays annually, incurring substantial costs for both individuals (INR 8,731/person) and the economy (INR 18,674 crore)[1,6,21]. FGDs found that current HR systems lack documentation of headache-related sick leave and productivity loss in workplaces. Indirect costs like lost productivity and career setbacks outweigh direct medical expenses, particularly in chronic migraine[6,7,22,23]. Stakeholders recommended a three-pronged response: neurologists stressed patient awareness and PCP education; patient advocates called for empathy-driven workplace education, sensitisation, and migraine-friendly workplaces; OH and HR leaders recommended risk assessments and manager training with a top-down approach[1,7,20,21]. Conclusion: Migraine in workplace is hindered by structural, informational, and organisational barriers. Addressing these through awareness campaigns, workplace support systems, and inclusive health interventions can reduce stigma, improve management, and mitigate productivity loss among India’s urban organised workforce. Integrating migraine awareness and management into occupational health frameworks can optimise workforce health and productivity.

Prajoth Kankonkar, Sunayana Sudhir Shet, Naresh Fadte Micro Labs Ltd [email protected] Introduction: Construction work is known to be long term hazardous to the respiratory system. Respiratory abnormalities like pneumoconiosis, pulmonary tuberculosis, bronchiectasis, chronic bronchitis can increase some basic hematological parameters which may reflect a secondary response to some disease process, allergens or toxins. Similarly, the human hematopoietic system is extremely sensitive to some environmental influences because of rapid synthesis and destruction of cells with consequent heavy metabolic demand. Aims and Objectives: To assess the prevalence and pattern of hematological abnormalities, including anemia, eosinophilia, and lymphocytosis, among construction workers. Materials and Methods: The study was conducted in 10 different construction sites in Goa over a period of 10 days starting from 25th November to 4th December 2024. A total of 100 workers were included in the study, their socio-demographic details were recorded and they were examined for Peripheral Blood Smear using Leishman staining technique. Results: Data of 100 workers were analysed of which 85 were male and 15 were female. We observed microcytic hypochromic blood picture in 42 workers out of 100 of which 36 workers were males and 6 were females. Eosinophilia were seen in 20% of the worker and Lymphocytosis was also present in 20% of the workers. Majority of the workers with eosinophilia & lymphocytosis belonged to 18-30 years of age group. No hemoparasites were detected on peripheral blood smear. Conclusion: High prevalence of microcytic hypochromic anemia observed in 42% of the workers, indicating a possible underlying nutritional deficiency, more common among males. Eosinophilia and lymphocytosis were each noted in 20% of the participants, predominantly affecting individuals aged 18–30 years, which may suggest exposure to allergens or parasitic infections, although no hemoparasites were detected.

Malek Ashyaben Aabidbhai, Bharatkumar Gohel, Anupam Banerjee Pandit Dindayal Upadhyay Medical College, Rajkot [email protected] Introduction: Intensive care unit nursing staff, face occupational challenges due to their continuous contact with patients. Exposure to such hazards lead to susceptibility to illness, injuries and psychological consequences. Such an assessment requires reliable and valid tool. Content validity, reliability and construct validity are indicators of any research tool, ensuring that it measures the intended construct accurately and consistently. Aim and Objectives: To formulate and validate a tool for assessing occupational health hazard exposure among ICU nursing staff; to Identify the domains of occupational health hazards relevant to ICU nursing staff; to formulate structured tool (questionnaire) for assessment of occupational health hazard exposure; and to test content validity, reliability and construct validity of the tool for its applicability in assessing occupational health hazards among ICU nursing staff. Methods: Cross-sectional study focused on tool development and its validation. Process involves three key steps. first step, the tool will be formulated by researcher through literature review followed by conceptualization, item identification and domain classification. In second step content validation is to be done by 15 subject experts to ensure the relevance, and appropriateness of the items included in the tool. In the third step, a study with 30 ICU nursing staff is to be done for reliability testing through internal consistency and construct validity thereby establishing the tool’s credibility for further use. Results: Initially, the tool comprised 25 items. Based on expert evaluation, 4 items were excluded due to their sub-threshold (Content validity ratio (CVR) < 0.49 and item level content validity index (I-CVI) 0.75, Fleiss kappa value (for multi raters) of 0.81 and an overall Scale (S-CVI) of >0.80, underscoring its robustness. The Cronbach’s alpha was 0.9, indicating an acceptable internal consistency. Four components were identified through exploratory factor analysis using principal axis with Bartletts’ test of sphericity p value <0.01, kaiser Meyer Olkin 0.82 and cumulative variance of 88% provides suitability of retention Conclusion: This tool identifies key elements of occupational health hazards for nursing staff stationed in the ICU. This tool can be complemented with additional questionnaires for comprehensive assessment of the occupational health hazards of other staff in the health care sector.

Govinda Narke, Sanjay Patil Pimpri Chinchwad Muncipal Corporation [email protected] Introduction: Tuberculosis (TB) remains a major public health challenge in India, particularly among the working population in both organized and unorganized sectors. Workplaces with high-density environments, migrant labour, and employees with comorbidities contribute significantly to ongoing transmission. Under the National Tuberculosis Elimination Program (NTEP), the TB-Free Workplace initiative was implemented in Pune to promote early detection, treatment adherence, and preventive care through structured workplace-based interventions, aligning with India’s goal of TB elimination by 2025. Aims and Objectives: To implement a TB-Free Workplace model under NTEP in Pune; to ensure early detection and prompt treatment of tuberculosis among the working population; to improve treatment adherence and provide tuberculosis preventive treatment (TPT) to high-risk individuals; to reduce TB-related absenteeism, productivity loss, and workplace transmission; and to demonstrate a scalable occupational–public health collaboration model Materials and Methods: The TB-Free Workplace initiative was implemented in Pune across workplaces in both the organized and unorganized sectors during 2024–25. Key activities included sensitization of employers and employees, TB symptom screening, on-site chest X-ray camps, sputum collection, and NAAT testing. All diagnosed and presumptive cases were documented through real-time data entry into the Nikshay portal. Special focus was placed on vulnerable groups, including contract workers, migrant workers, and employees with comorbidities such as diabetes, chronic obstructive pulmonary disease (COPD), and other chronic illnesses. Eligible close contacts and high-risk individuals were provided Tuberculosis Preventive Treatment (TPT) as per NTEP guidelines to interrupt transmission.Descriptive analysis was used to summarize screening coverage, case detection, treatment initiation, preventive therapy uptake, and estimated workdays saved. Results: During 2024–25, more than 10,000 workers were screened for tuberculosis symptoms across participating workplaces – 135 presumptive TB cases were tested, 18 microbiologically confirmed TB cases were initiated on treatment; Approximately 250 high-risk workers received tuberculosis preventive treatment (TPT). Early diagnosis and prompt initiation of treatment resulted in an estimated 540 workdays saved , contributing to reduced absenteeism and productivity loss. Awareness sessions and IEC activities improved employee participation and helped reduce stigma related to tuberculosis in the workplace. Conclusion: The Pune TB-Free Workplace initiative demonstrates that integration of occupational health services with the National Tuberculosis Elimination Program can effectively enhance early case detection, preventive care, and treatment adherence among the working population. This collaborative model reduces productivity loss, addresses stigma, and provides a sustainable and scalable framework for urban industrial areas, supporting India’s vision of achieving a TB-free nation by 2025.

Rajeshwar P Supekar Randack Fasteners India Pvt Ltd [email protected] Introduction: Vitamin D deficiency has emerged as a major public-health issue in India, affecting diverse populations despite abundant sunlight. This observational study aimed to assess the prevalence and severity of Vitamin D deficiency among employees undergoing annual preventive health check-ups over four consecutive years. A total of 444 participants were evaluated from 2021 to 2025. Serum 25-hydroxy-vitamin D [25(OH)D] levels were analyzed and categorized as: Normal (>30 ng/mL), Insufficient (20–30 ng/mL), Deficient (10–20 ng/mL), and Severely Deficient (90%) across all years. Despite periodic health counseling, no significant improvement was observed. These findings emphasize the urgent need for workplace awareness, dietary supplementation, and lifestyle modification programs. Aims and Objectives: Vitamin D plays a vital role in calcium metabolism, bone health, immune regulation, and prevention of chronic diseases. In India, several studies report widespread deficiency due to indoor lifestyle, limited sunlight exposure, and inadequate dietary intake. The present study was conducted among employees of an industrial establishment undergoing regular annual medical check-ups to evaluate the pattern and persistence of Vitamin D deficiency over four years. Materials and Methods: Study Design: Retrospective observational analysis. Study Period: 2021–2025. Participants: Employees undergoing annual preventive health check-ups. Sample Size: Total 444 subjects (100 in 2021, 109 in 2022, 129 in 2023, 106 in 2025). Investigation: Serum 25(OH)D measured using standard chemiluminescent assay. Classification: - Normal: >30 ng/mL - Insufficient: 20–30 ng/mL - Deficient: 10–20 ng/mL - Severely Deficient: <10 ng/mL Data were analyzed year-wise to assess prevalence and trend. Results: The persistently high prevalence of Vitamin D deficiency in this working population is alarming. The majority of employees had serum levels below 20 ng/mL, indicative of deficiency. Possible reasons include limited sun exposure due to indoor or shift work, use of sunscreen, lack of outdoor recreation, and insufficient dietary intake. The data suggest that routine health education alone may not suffice; a structured supplementation or food fortification program may be necessary. Periodic monitoring, dietary counseling, and workplace wellness programs promoting sunlight exposure could help improve Vitamin D status. Conclusion: Over four years of observation, more than 90% of individuals screened had low or deficient Vitamin D levels, with no significant improvement over time. This highlights the need for sustained intervention measures at both individual and organizational levels.

Naresh Fadte, Suhasi Gaonkar, Prajoth Kankonkar Inspectorate of Factories and Boilers, Goa [email protected] Introduction: Computer Vision Syndrome (CVS), also known as digital eye strain, is a group of eye and vision-related problems resulting from prolonged use of computers and digital screens. With increasing screen time due to work, education, and entertainment, CVS has become a common occupational health concern. Symptoms include eye strain, dryness, blurred vision, and headaches. Understanding its prevalence and impact among computer users is essential for promoting eye health and preventive strategies. Aims & Objectives: The objective of this study was to find out the prevalence of Computer Vision Syndrome (CVS) among computer users in administrative offices and assess the level of awareness about Computer Vision Syndrome. Materials & Methods : A cross-sectional study was conducted among 74 computer users in administrative offices in Goa. The study participants included adults aged 21-60 years who regularly used digital devices such as computers/laptops for at least 5 hours per day. A structured questionnaire consisting of sections assessing demographic details, risk factors, computer usage, signs and symptoms, past medical history and awareness about CVS was used to collect data. Results: A total of 74 participants were included in the study, out of which 65 (86.5%) were males and 9 (13.5%) were females. A majority [33 (44.6%)] of the participants complained of dry eye, 28 (37.8%) complained of blurring vision and 21 (28.4%) complained of frequent headaches. 35.1% of the participants were aware about the Computer Vision Syndrome and only 5% were aware of the 20-20-20 rule. Around 12% of the participants were using topical lubricant eye drops and 20.3% were using protective goggles with blue light filters. Conclusion: Prevalence of Computer Vision Syndrome among computer users in administrative offices was 59.5% which suggest the need for periodic vision & eye check-up of such workers. Also there was low awareness about Computer Vision Syndrome indicating need for frequent training sessions on CVS.

Saurav Basu, Arghyadeep Roy, Surada Ravi ESI-PGIMSR ESIC Medical College Joka, Kolkata [email protected] Introduction: Self-medication (SM) is a significant public health risk, particularly among medical undergraduate students who often exhibit high prevalence rates driven by growing knowledge and easy access to drugs. The global rise of Generative Artificial Intelligence (GenAI) introduces a new, powerful, but unreliable tool for health information seeking. This study addresses a critical gap by examining the patterns and determinants of SM and health-seeking using GenAI in this high-risk group, assessing how this technological shift may influence their future professional conduct and public health stewardship. Objectives: The primary objective of this study was to assess the patterns and determinants of self-medication and health-seeking using generative AI among medical undergraduate students in Eastern India. Materials and Methods: This institution-based cross-sectional study was conducted at a government medical college in Kolkata among 340 undergraduate medical students. Data were collected using a structured, self-administered questionnaire covering sociodemographics, self-medication practices, and GenAI awareness and utilization. Multivariate binary logistic regression was employed to identify independent factors associated with self-diagnosis and various self-prescription practices, reporting Adjusted Odds Ratios (AORs) and 95% Confidence Intervals (CIs). Results: The vast majority of MBBS students (92.4%) engaged in online health information seeking, with a high subsequent self-diagnosis rate (65.3%). Self-medication was substantial, with 43.2% self-prescribing biomedicines and 43.5% nutraceuticals. A major concern was the self-prescription of antibiotics by 35.3% of students, primarily for ‘quick relief’ (78.5%). Over half (50.6%) reported using GenAI for health information, including self-medication purposes (24.4%). On adjusted analysis, senior students were significantly more likely to self-diagnose and self-prescribe biomedicines (AOR 2.5-3.0). Formal AI training was paradoxically associated with higher odds of self-prescribing both biomedicines (AOR 4.9) and alternative medicines (AOR 5.16). Exclusive trust in AI was strongly linked to the use of alternative medicines (AOR 19.5). Reassuringly, 87.4% would seek a second human opinion when AI advice conflicted with a doctor’s recommendation. Gender was not significantly associated with self-medication practices. Conclusions: The rapid integration of GenAI into the self-care of future physicians presents a novel challenge to occupational health and education. The high rate of self-medication, especially with antibiotics, combined with the technology-mediated perceived empowerment from availability of GenAI, indicates a need for urgent curricular reform. Medical undergraduate education must now include mandatory, structured training in digital health literacy and the ethical application of AI, moving beyond didactic lectures to embed practical, evidence-based antimicrobial stewardship and critical evaluation skills.

Amala Sankar Chatterjee, Dhirendra Kumar Tata Main Hospital, Noamundi [email protected] Introduction: Ensuring wellness of employees is considered important for overall performance of the organization. The concept of the healthy workplace is changed now, from an exclusive focus on physical, chemical, and biological hazards of workplace to include organization, workplace culture, lifestyle, and the community. Today’s healthy workplace includes both health protection and promotion. Wellness at Workplace (W@W) is an in-house program, started to measure ‘Health Index’ (HI) of an individual worker, divisions and for the whole organization. Everyone is measured in four (4) parameters- Blood Pressure, BMI, Serum Cholesterol and Random Blood Sugar estimation and each parameter are in 0–4-point scale. Aims and Objectives: To know the health status of “High Risk” workers, to find out the epidemiological profile and prevalence of hypertension, diabetes, and obesity among them, to study factors associated with it and recommendations for prevention. Materials and Methods: A cross-sectional study was conducted during annual health check-up of 860 mining workers of an iron ore mine in Jharkhand and 164 high risk workers among them. Study period :- April 2024 to March 2025. HI was measured for whole population and all ‘High Risk’ cases (0 score in any parameter mentioned). High-risk cases were examined initially, at sixth month and at the end of the study. Follow up and “one-to-one” counselling done for all of them. Chi-Square test was used for statistical analysis. Results: The study revealed, mean age of workers was 41.12±10.38 years, 46% were pre-obese or obese (BMI> 25), followed by Hypertension, Diabetes and Hypercholesterolemia -14%, 11% and 3% respectively. Among the 164 (19%) high risk workers, 75% had BMI> 25. Hypertension, Diabetes and Hypercholesterolemia was seen in 44%, 29% and 10% workers respectively. 28% workers had both hypertension and diabetes. BMI was significantly associated (at p< 0.05) with hypertension (x2=6.4702, p=0.0109) and diabetes (x2=5.6552, p=0.0174). Smoking showed statistically significant association (x2=6.9451, p=0.0084, at p< 0.05) with hypertension. Overall HI was 13.45, HI of high-risk cases was improved from 9.1 to 10.6 at the end of the study. Conclusion: A good no of “High Risk” mining workers were identified as hypertensive, diabetic, and obese. Strict follow up and counselling helped to improve health index of workers. This study emphasized the need for implementation of population-based screening programs along with some specific approaches like weight management plan, hypertension and diabetes control plan, de-addiction program, stress management session for prevention.

Amit Pandey Hindalco Industries Limited, Renukoot, Aditya Birla Group [email protected] Introduction: Heat stress is a critical occupational health concern in manufacturing industry where employees are exposed to high environmental temperature and also exposed to processes generating heat such as smelting, casting, metal fabrication etc. Continuous exposure to heat, combined with high humidity, clothing, workload etc leads to health issue, loss of productivity, and sometimes accidents as well. Hindalco Industries Limited, Renukoot – a flagship unit of the Aditya Birla Group – is one of India’s largest integrated aluminium manufacturing complexes, comprising smelter, power plant, and fabrication units. The workforce is frequently exposed to elevated temperatures, particularly during summer months. The heat stress study was aimed at identifying workplaces and/or activities prone to heat stress, implementing effective control measures, and evaluating the impact of interventions. Aims & Objectives: The primary aim of this initiative at Hindalco Renukoot is to significantly reduce heat stress–related illnesses and enhance workforce well-being in high-temperature operational areas. Materials and Methods: Base line data of heat stress illness was collected from Occupational Health Centre (OHC) records between March to August month of year 2024. Implementation of heat stress management program was started in year 2024 with qualitative & quantitative heat stress assessment at all workplaces and/or activities along with physiological monitoring of employees as per 3 stage approach. Program also includes frequent toolbox talks at workplace, implementing controls (as per hierarchy of controls) etc. During year 2024 & 2025, many controls has been implemented such as use of mechanized machines in places of manual working, increasing number of cool rest areas with air cooling system, providing ORS at high and medium risk workplaces, allowing self-paced work etc. Result : 153 heat stress illness was reported in year 2024, which is reduced to 23 in 2025 (YTD), while the manpower strength remained consistent, achieving a significant 85% reduction. Conclusion: The study demonstrates that a structured approach to heat stress management at Hindalco Renukoot significantly reduced heat-related health illness. Integration of engineering, administrative, and educational measures proved highly effective in mitigating occupational heat exposure. Sustained efforts in periodic monitoring, supervisor engagement, and proactive worker education are essential to ensure long-term protection, productivity, and overall well-being of the workforce in high-temperature industrial operations.

Isha Sukhthankar, Naresh Fadte, Pritiben Shaileshbhai Patel Crompton Greaves Consumer Electrical Ltd, [email protected] Introduction: Factory workers are often exposed to various health hazards like dust, smoke, chemicals, noise etc. During medical examination, ear examination is often either neglected or missed out due to unavailability of resources. In order to tackle this, we conducted a study that specifically identifies ear diseases in various factory workers. Aims & Objectives: To find out the prevalence of various ear diseases in factory workers. Materials and Methods: A cross sectional study was conducted on 413 workers working in various factories of Goa over a period of one month, from 1st June 2025 to 30th June 2025. The data such as age, gender, ear complaints were recorded and their ears were examined using otoscope for any abnormality or diseases. Results: Out of 413 factory workers 58 (14.04%) were females and 355 (85.96%) were males. The prevalence of ear disease in factory workers was 28%. Active ear symptoms were reported by 49 (11.86%) factory workers. Conclusion: Most common ear symptom among factory workers was itching in the ear which was reported by (3.87%) of the workers were as the most common ear finding was wax in the ear which was seen in (20.09%) of the factory workers. Exposure to noise at workplace was reported by (18.88%) of the factory workers.

Jeevan Arjun Shelar, Debjani Dhar, Sharad Kumar Tata Steel Limited, Hooghly Met Coke Division, Haldia West Bengal [email protected] Introduction: Working at height (>1.8 meters) is a high-risk industrial activity due to the potential for fall-related fatal injuries. Hence, medical fitness screening is essential before assigning such tasks. Traditionally, the Occupational Health Center (OHC) at HMC, Haldia required workers to undergo vestibular tests such as Craniocorpography (CCG) and Electronystagmography (ENG) at external hospitals in Kolkata, leading to an annual loss of ₹15,00,000 and 350 man-days. To reduce costs and improve efficiency, Tata Steel Haldia implemented a modified “Medical Fitness for Working at Height” protocol based on the Jamshedpur model, with additional physiological and vestibular function assessments. Aims and Objectives: To validate physiological cut-off limits for Blood Pressure (BP) and Heart Rate (HR) in identifying pathological stress responses related to vestibular dysfunction or acrophobia; To enhance the on-site fitness testing protocol for improved accuracy using bedside vestibular tests; and to achieve operational and financial efficiency by eliminating dependence on external laboratory vestibular testing. Materials and Methods: A prospective observational study was conducted from September 2024 to September 2025 on 169 industrial workers undergoing medical fitness evaluations for work at height. Workers walked a 9-meter-high beam with fall protection systems, and BP and HR were recorded pre-test, immediately post-test, and after 2 hours (recovery). Fitness criteria: systolic BP rise <20 mm Hg, diastolic BP rise <10 mm Hg, HR rise <30 beats/min. Haldia’s modified protocol added 2-hours post test BP, HR measuring and Dix-Hallpike Manoeuvre, Head Impulse Test, Romberg’s Test, and Fukuda Stepping Test to clinically confirm vestibular integrity.Descriptive statistics were used for BP and HR parameters. Paired t-tests compared pre- and post-task vitals. The achieved sample size (n = 169) provided 99.9% statistical power for detecting observed post-task BP changes. Vestibular test results were correlated with physiological responses for indirect statistical validation. Results: Out of 169 participants, 160 (94.7%) were fit and 9 (5.3%) unfit—six due to acrophobia and three due to pathological cardiovascular responses (HR rise >30 beats/min or diastolic BP >10 mm Hg). Among the fit workers, post-task vitals normalized within 2 hours, and all had negative vestibular test result. The close correlation between physiological recovery and vestibular normalcy confirmed the test’s specificity and reliability. Conclusion: The modified Haldia protocol is statistically validated, physiologically reliable, and operationally beneficial.

Anand Hinduja, Rajesh Kumar Purushottam Aarti Clinic [email protected] Introduction: Self-reported stress questionnaires frequently underestimate true occupational stress burden within high-pressure professional settings, mainly due to normalization, under-reporting, and limited self-awareness. Heart Rate Variability (HRV) offers an objective, sensitive biomarker of autonomic balance capable of identifying physiological stress that may not be captured through subjective perception. Objective: To determine whether HRV assessment can uncover physiological stress among pharmaceutical professionals whose self-reported scores on the Stress Overload Scale (SOS) suggest low occupational stress. Methods: In this cross-sectional study, 81 pharmaceutical professionals (ages 21–60) were recruited, excluding individuals with cardiovascular or respiratory conditions, diabetes, thyroid dysfunction, psychiatric illness, substance abuse, sleep disorders, or medications affecting autonomic function. All participants completed the validated 30-item SOS questionnaire and underwent a five-minute resting HRV analysis using standard ECG-based measurements. High SOS stress was defined as Personal Vulnerability (PV) > 29.5 and Event Load (EL) > 36.0, based on sample medians, while low HRV was identified as SDNN < 50 ms, RMSSD 3.0 (established clinical thresholds). Descriptive statistics and Venn analysis were used to identify overlap between self-reported and physiological stress indicators. Results: Thirty participants (37%) demonstrated high self-reported stress, whereas 75 (93%) exhibited low HRV based on objective criteria. Importantly, 45 participants (56%) had low HRV despite reporting low SOS scores, constituting a “hidden stressed” cohort. All participants with high SOS scores showed low HRV, and only 6 (7%) displayed both normal HRV and low SOS scores. These findings reveal that relying solely on self-report may significantly underestimate physiological stress burden within pharmaceutical settings. Conclusion: HRV biomarker analysis reveals subclinical occupational stress that traditional self-report tools often overlook. This approach is potent for identifying at-risk, but asymptomatic, healthcare personnel in high-stress environments. Integrating HRV-based screening with psychosocial assessments in workplace wellness programs may enable targeted, early intervention, reducing burnout and enhancing workforce resilience.

Dinesh Prajapati, Bhavin Dave Relinace Industries Limited, VMD [email protected] Introduction: Human exposure to benzene has been associated with a range of acute and long-term adverse health effects and diseases, including cancer and hematological effects1. Petrochemical Industry workers can be exposed to benzene and consequently may have its adverse health effects. Analytics is done to evaluate hematological effect of benzene in workers of a Petrochemical industry of Western India. Aims and Objectives: This study aims to recognize the haematological effects if any on employees working in Benzene and other Toxic Non benzene chemical exposure after 10 years and to evaluate the preventive efforts in reduction of hazard exposure in plants with Benzene and Toxic Non-Benzene chemicals at Reliance Industries Limited, Vadodara Manufacturing Division. Material and Methods: It was a retrospective cohort study analysing data between 1st April 2015 to 30th September 2024.Analytics was done for all employees working and completing yearly PME for at least 10 years at RIL Vadodara Manufacturing Division(n=312). Comparative reduction in HB, WBC, RBC, Platelets from normal to low was compared in Benzene plants, all Toxic Chemical plants and other plant areas along with change in population mean for haematological parameters. Proportions, Mean, SD Chi square Test and paired t test using MS Excel 13.0 and Openepi 3.01. Results: Mean age of Benzene plants, all Toxic Chemical plants and other plant areas was 57.4 ±2.6 years, 56.8 ±3.7 years and 56 ±4.4 years respectively. Red Blood Cells reduction from Normal to low was found in 6.2%, 7.9% and 6.3% respectively in Benzene plants, all Toxic Chemical plants and other plant areas-The difference is not statistically significant(p>0.05, Chi square Test). No significant difference was observed in three groups for platelet as well as WBC reduction (p>0.05, Chi square Test) as well as change in Mean RBCs, WBCs and platelets after 10 years((p>0.05, paired t-Test). Conclusion: No significant hematological parameters reduction observed in employees working in Benzene and other Toxic Non-Benzene chemical’s exposure areas after 10 years as compared to other plants. Effective hazard elimination/reduction strategy found to have helped in eliminating hematological effects of Toxic Chemicals at RIL, Vadodara Manufacturing Division.

Khyati Desai Relinace Industries Limited, VMD [email protected] Introduction: Cardiovascular disease (CVD) remains a major occupational health concern, especially among industrial employees in high-stress environments. While the Treadmill Test (TMT) is a conventional screening method, it is resource-intensive and not feasible for universal use. Leveraging routinely collected Periodic Medical Examination (PME) data offers an opportunity to develop predictive tools for early cardiovascular risk stratification.1 This study aimed to establish and validate a biostatistical framework to predict abnormal TMT outcomes using PME biomarkers, optimizing resource allocation and enabling preventive interventions.2 Aims and Objectives: To develop a dual-model predictive framework—integrating Decision Tree and Logistic Regression—for identifying employees at risk of abnormal TMT outcomes using routine PME parameters. Secondary objectives included identifying modifiable risk factors for targeted workplace health interventions and evaluating the clinical utility and limitations of the models. Materials and Methods: A cross sectional analysis was conducted on PME data from 985 employees aged ≥40 years; done from April ’25 to September ’25; who are employed at a large petrochemical complex. Variables included demographic factors, anthropometric indices, biochemical parameters and personal habits. TMT results were categorized as Normal or Abnormal. Data were split 70/30 for training and validation. Model development utilized a Decision Tree classifier and Multiple Logistic Regression. Model performance was assessed using accuracy, precision, recall, and AUC metrics. Results: The Decision Tree model identified Haemoglobin, Waist-to-Hip Ratio (WHR), and total Cholesterol as the most influential predictors, with 95.3% accuracy. Logistic regression confirmed the significance of Haemoglobin (χ²=10.2, p=0.001), WHR (χ²=4.5, p=0.03), and Age (χ²=6.4, p=0.01), with overall model fit (χ²=31.7, p=0.024) and AUC=0.771. Although specificity reached 100%, sensitivity was 0%, highlighting challenges in clinical applicability. Interestingly, non-modifiable factors (Sex) and traditional predictors (Blood glucose indices) lacked statistical significance, underscoring limitations and biases inherent in cross-sectional, non-randomized datasets. Conclusion: While this study provides a robust, data-driven framework using routine occupational health data, it crucially warns that clinical adoption requires data randomization, non-biased data and methodological rigor to overcome risks of false positives/negatives and ensure safe integration into health programs.

Mumtaz Qazi, Prema K Chande Lotus College of Optometry [email protected] Introduction: Occupational vision screening is essential for ensuring workplace and road safety, especially for drivers and equipment operators. These tasks rely on multiple visual functions beyond simple visual acuity, such as contrast sensitivity, color vision, stereopsis, and peripheral awareness. Occupational Health Centers (OHCs) are often unable to perform comprehensive evaluations, therefore indicating the need for a vision screener (VS). Aims and Objectives: To evaluate the agreement of an all-in-one portable VS compared with standard ophthalmic tests, and to assess its feasibility for use in OHCs and field screening environments. Materials and Method: A cross-sectional study was performed involving drivers. Each participant underwent several visual functions, including distance and near vision, contrast sensitivity (CS), stereopsis, peripheral awareness, and color vision (CV) were assessed using standard tests like LogMAR, Titmus Fly, and Ishihara tests, respectively. All participants repeated the same set of tests using a VS. Statistical Analysis: Data were analyzed using SPSS version 31, following normality tests, receiver operating characteristic (ROC) curves were plotted to determine sensitivity and specificity, while Bland–Altman plots were used to evaluate agreement between the VS and standard clinical tests. Results: Data of 282 drivers with a mean age of 46 ± 9.41 years were analyzed. Mean presenting distance visual acuity (PDVA) was 0.21 ± 0.15 and 0.20 ± 0.19 LogMAR, with standard charts and VS, respectively. Mean values for CS were 2.67 ± 1.85 % and 5.78 ± 10.60 % (p < 0.001), the values for stereopsis were 901 ± 1438.94 and 576.89 ± 872.22 sec of arc with standard charts and VS, respectively. ROC analysis showed excellent diagnostic accuracy for distance visual acuity (AUC = 0.861, SE = 0.037, 95% CI = 0.788–0.933, p < 0.001) and modest discriminative ability for stereopsis (AUC = 0.653, 95% CI = 0.589–0.718, p < 0.001). Bland–Altman analysis indicated good agreement between the standard test and screener for vision, CS, and stereopsis, with no significant systematic bias. Conclusion: The portable vision screener demonstrated high accuracy and strong agreement with standard clinical tests for visual functions. It enables rapid, comprehensive assessment of visual function, making it a practical tool for large-scale vision screening in OHCs and outreach camps.

Komala S, Naveen BEML Medical Centre [email protected] Introduction : HbA1c and Vitamin B12, are important indicators of health among people with Diabetes. Occupational stress and lifestyle patterns among employees may influence these parameters. Aim and Objectives: To identify differences in mean HbA1c and Vitamin B12 levels between Blue-Collar and White-Collar, Diabetic male employees after adjusting for age, and to assess correlations between the two biomarkers. Methodology : A cross-sectional study involving 1,037 male participants was conducted. There are 425 individuals in the cohort who are classified as diabetic. Analysis of Covariance (ANCOVA) tested the effect of Blue-Collar and White-Collar, on HbA1c and Vitamin B12, with age as a covariate. Results: Age was a significant predictor for both HbA1c (p < 0.001) and Vitamin B12 (p = 0.001). HbA1c increased by about 0.06% per year of age. As HbA1c increased, Vitamin B12 levels decreased, showing a significant inverse relationship (p < 0.001). Occupational categories (blue-collar and white-collar) showed no significant effect on HbA1c (p = 0.107) or Vitamin B12 (p = 0.242). Conclusion: Blue-Collar and White-Collar, status did not independently influence HbA1c or Vitamin B12 levels. Variations were primarily age-related and decreased in Vitamin b12 and increase in HbA1c. Preventive screening and health interventions should therefore prioritize age-based risk stratification rather than job category.

Ankit Viramgami, Sarang Dhatrak, Nitish Tank, Rakshit Shah ICMR - National Institute of Occupational [email protected] Introduction: While advanced, restrictive occupational lung diseases resulting from long-term dust exposure in mine workers are well-documented, less is known about the early, subclinical changes in air conduction. Short-term exposure, leading to allergic and inflammatory reactions, can cause initial narrowing of the smaller airways, identifiable only through sensitive pulmonary function testing (PFT). Identifying these early changes is critical for preventive intervention. Aim and Objectives: This study aimed to determine the prevalence, pattern, and key determinants of air conduction abnormality, particularly focusing on small airway dysfunction, among active mine workers. Methods and material: A representative cross-sectional study was conducted enrolling 2,151 male, active, non-smoking mine workers after obtaining written informed consent. Detailed socio-demographic, occupational, and medical histories were collected. Pulmonary Function Testing (PFT) was performed on all participants following standard protocols. Data analysis utilized SPSS 26.0, employing appropriate statistical tests to identify associations with a significance threshold set at p < 0.05. Results: The mean age and job duration of the participants were 48.6 ± 8.1 years and 24.0 ± 9.8 years, respectively. Overall, 17% of the participants exhibited an abnormal PFT pattern (10.3% obstructive, 5.5% restrictive, and 1.3% mixed). Crucially, nearly one-quarter (25%) of the total cohort showed compromised air conduction parameters indicative of small airway dysfunction. Significant associations (p < 0.05) were observed between abnormal PFT patterns and age, total job duration, and type of mining operations. No significant differences were found relative to Personal Protective Equipment (PPE) usage or specific job profiles. Conclusion: The high prevalence of compromised air conduction, especially early small airway dysfunction, demands immediate implementation of a tailored, evidence-based respiratory health screening program for active mine workers.

Nagaraj K, Manigandan, Jayashree, Pradeep Raj Mahindra Research Valley [email protected] Introduction: Deficiencies of vitamin D3 and vitamin B12 are recognized contributors to fatigue and reduced occupational performance. Employees in research and development roles face sustained cognitive and physical demands, potentially intensifying the impact of such deficiencies. This study was conducted to assess the prevalence of vitamin D3 and B12 deficiencies and quantify self-reported fatigue among and employees, with the aim of informing targeted occupational health strategies. Aims and Objectives: To determine the prevalence of vitamin D3 and vitamin B12 deficiency among employees in the & sector. To quantify self-reported fatigue and the prevalence of isolated and combined deficiencies to guide workplace interventions. Materials and Methods: A cross-sectional biochemical screening was conducted among 121 employees in the and division. Each participant underwent laboratory evaluation of serum vitamin D3 and B12 levels and completed a standardized fatigue symptom questionnaire. Laboratory results were categorized as deficient or insufficient based on institutional reference thresholds. Descriptive statistics were used to summarize participant characteristics and laboratory findings. Frequencies and percentages were calculated for categorical variables, including deficiency status and fatigue prevalence. Results: Among the 121 employees screened: Vitamin D3 deficiency was present in 103 individuals (85.1%), with 14 (11.6%) showing insufficiency. Vitamin B12 deficiency was observed in 70 employees (57.9%), and 5 (4.1%) had insufficient levels. Combined deficiency of both vitamins was noted in 67 individuals (55.4%). Fatigue was reported by 104 employees (86.0%). Conclusion: The findings reveal a high prevalence of vitamin D3 and B12 deficiencies among & employees, accompanied by significant fatigue. These results support the need for workplace health measures, including routine screening, nutritional counselling, and supplementation. As the study is cross-sectional, causality cannot be inferred. Prospective studies are recommended to evaluate the impact of correcting deficiencies on fatigue and performance.

Dake Rajesh Reliance Industries Limited, KGD6 [email protected] Introduction: Cardiovascular diseases (CVD) are a major cause of morbidity and mortality in India, with rising prevalence among working-age populations. Industrial employees are particularly vulnerable due to occupational stress, sedentary lifestyle, irregular dietary habits, and substance use. Accurate risk prediction facilitates early preventive interventions. Online 10-year cardiac risk calculators, such as WHO/ISH charts, Framingham Risk Score (FRS), ASCVD, and QRISK3, offer practical tools for stratifying cardiovascular risk. Aim and Objectives: To retrospectively estimate the 10-year cardiac risk among industrial employees attending the Occupational Health Centre (OHC), Kakinada, using validated online calculators, and to compare risk categorization across different tools. Methods: A retrospective study was conducted on health records of 316 industrial employees screened at OHC, Kakinada, between 2023–2025. Data on age, sex, smoking, alcohol use, blood pressure, diabetes status, and lipid profile were extracted. The 10-year cardiac risk was calculated using WHO/ISH charts, FRS, ASCVD, and QRISK3 calculators. Participants were classified into low (20%) risk categories. Comparative analysis was done to identify variations across calculators. Results: Using WHO/ISH charts, 91.7 % of employees were categorized as low risk, 4.11 % moderate, and 1.97 % high risk. With the FRS, the proportions shifted to 94.6 % low, 1.89 % moderate, and 1.53 % high risk. The ASCVD calculator identified 94.6% low, 5.06% moderate, and 0.31 % high-risk individuals. QRISK3 showed the highest proportion of Low risk 89.2 %, high-risk employees 1.89 %, and 8.86 % moderate. Variation was noted particularly in employees aged >45 years with multiple risk factors, who were more frequently reclassified into higher risk categories by ASCVD and QRISK3 compared to WHO/ISH. Conclusion: Online 10-year cardiac risk calculators are practical tools for retrospective assessment of cardiovascular risk in industrial employees. In this cohort, 1.98 % of employees were classified as high-risk, underscoring the urgent need for targeted interventions. Inter-tool variability highlights the importance of context-specific model selection and potential recalibration to the Indian industrial workforce.

Rida Muskaan, Sudha Bala, Rudra Harichandhana, Riya Singh ESIC Medical College and Hospital, Hyderabad [email protected] Introduction: Hypertension and diabetes are major public health challenges globally, with rising prevalence in urban areas of developing countries like India. These chronic conditions necessitate continuous management and regular medical consultations to prevent complications and improve quality of life. Health literacy and healthcare-seeking behavior significantly impact disease prognosis. This study aims to explore these factors among industrial workers with diabetes and hypertension in a Tertiary care hospital setting in Hyderabad, India. Aims and Objectives: The study aims to assess health literacy, determining factors influencing it and healthcare-seeking behavior among industrial workers with diabetes and hypertension at a tertiary care hospital in Hyderabad. Materials and Methods: A cross-sectional study was conducted in the semi-urban field practice area of ESIC Medical College and Hospital, Hyderabad. Two hundred industrial workers aged 18 years and above with diagnosed diabetes or hypertension for at least six months were enrolled through simple random sampling. Data was collected through structured interviews using a pre-tested questionnaire covering socio-demographic variables, health beliefs, access-to-care, and healthcare behaviors. Ethical approval and informed consent was obtained. Descriptive statistics summarized continuous variables by mean and standard deviation, and categorical variables by proportions. Univariate analysis was performed using Chi-square and T tests. Multivariate binomial logistic regression identified predictors of health literacy. Results: Significant associations were observed between health literacy and sex, socioeconomic status, physical activity, dietary habits, BMI, and co-morbidity control. Industrial workers from different sectors (automobile, pharmaceutical, garment industries etc.) demonstrated varied health literacy patterns. Female workers had higher prevalence of insufficient health literacy than males (p=0.04). Lower socioeconomic groups showed higher rates of insufficient literacy (p=0.03). Workers with controlled co-morbidities exhibited better health literacy than those with uncontrolled conditions (p<0.001). Barriers to care included financial constraints and lack of awareness of complications. Conclusion: This study highlights that health literacy among diabetic and hypertensive industrial workers is influenced by socio-demographic and behavioral factors. Lower socioeconomic status and female sex are associated with poorer literacy levels. Health literacy also significantly varies with field of work. Integration of targeted educational programs and multidimensional public health strategies addressing these factors is essential for improving disease management and outcomes in this population.

Fredy Joseph Varghese, Sudha Bala, Surendra Babu ESIC Medical College – Hyderabad [email protected] Introduction: Falls from height (FFH) remain one of the leading causes of fatal and non-fatal injuries in the global construction industry, with developing nations such as India experiencing a disproportionately high burden due to rapid industrial growth and limited safety compliance. Within this context, the use of Personal Protective Equipment (PPE) particularly safety harnesses play a critical preventive role in mitigating the severity and frequency of such incidents. However, inadequate adherence to safety protocols and insufficient training continue to compromise occupational safety standards across construction sites in India, necessitating structured assessment and intervention. Aims and Objectives: This study assessed fall risk among Mumbai construction workers, identifying personal, environmental, and behavioural factors, and evaluating safety harness compliance using FRAT and ASK tools to improve site safety. Materials and Methods: A cross-sectional study of 250 male construction workers in Mumbai assessed PPE risk levels and worker awareness using FRAT and ASK tools, following ethical approval and informed consent. Data were analysed using descriptive statistics and Chi-Square tests to identify fall risk levels, contributing factors, and significant associations (p < 0.05). Results: Out of 250 participants, 98.4% were found to be at moderate to high fall risk levels. The most significant contributing factors included fatigue or poor sleep (p = 0.006), poor lighting or visibility (p = 0.000), medication-induced dizziness (p = 0.000), and alcohol or substance use during work (p = 0.000). PPE noncompliance was common, with workers who did not use safety harnesses showing a significantly higher prevalence of high fall risk (p < 0.05). ASK Tool findings indicated low awareness, inadequate skill, and lack of confidence in inspecting PPE or responding to fall emergencies. Conclusion: The study highlights a critical gap in occupational safety practices among Mumbai’s construction workforces. The high prevalence of moderate to high fall risk emphasizes the urgent need for behaviour-based safety interventions, mandatory PPE training and retraining, and stronger on-site supervision. Improved lighting, fatigue management, and policy-driven enforcement of PPE compliance especially harness use are imperative. The study’s outcomes align with national and international literature, reinforcing that fall risk mitigation requires a multidimensional approach integrating worker education, supervision, and environmental control.

Vishwaraj Mhalshekar, Sweta Mhalshekar Goa Shipyard Limited [email protected] Introduction: Shift work adversely affects worker productivity, performance, health and quality of life and puts others at risk due to workplace or driving accidents. Shift work including night work is known to impact workers’ health along with impairment of social life leading to increased risk of psychosocial hazards. Aims and Objectives: This study examines the differences in morbidity profiles, metabolic health and respiratory function among shift and regular workers in the pig iron industry where pig iron is produced by smelting of iron ore in blast furnaces. Materials and Methods: This cross-sectional study was conducted between August 2024 to January 2025 among workers in the pig iron industry. Following written informed consent the workers were conveniently sampled. A semi-structured interview schedule was administered to collect data on socio-demography, morbidity profile and work-related characteristics. Anthropometric measures, laboratory parameters and spirometry data (to evaluate respiratory function) were obtained from records of annual medical screening. Data was entered in Microsoft Excel and analyzed using SPSS V.21. Descriptive statistics were represented as frequencies and percentages. Chi square test was used to study association and between group differences. Binomial logistic regression analysis was performed with illness as the dependent variable and gender, shift work, body mass index (BMI) and spirometry readings as covariates. A p value of <0.05 was considered to be statistically significant. Results: Of the 641 workers, 277 (43.2%) were engaged in shift work including night shifts. The mean age of the participants was 40.85 ± 10.08 years and 89.7% were male. Majority of workers were between 36-45 years (34.9%), followed by 46-55 years (28.2%). The prevalence of hypertension was significantly higher among shift workers (20.1%) compared to regular workers (10.4%) (p<0.040). Diabetes was slightly more common among shift workers (10.8%) than regular workers (6.6%) (p30) was more prevalent among shift workers (18.3%) than regular workers (12.5%). Almost 8.1% of the workers had high total cholesterol levels with significant differences between night shift workers and regular shift workers (10.8% vs 6.0%, p=0.020). Spirometry findings showed a higher prevalence of mild restriction among shift workers (17.7%) compared to regular workers (10.4%). Binomial logistic regression showed that shift workers were at 1.5 times higher risk of developing chronic illness (p<0.001). Conclusion: The findings suggest that shift work is associated with a higher prevalence of hypertension, obesity and mild lung restriction compared to regular work schedules and this may predispose them to ill health conditions.

Wadekar Omkar Surendra, Gyana Ranjan Pradhan, Sreedevi T HAL Hospital, Bengaluru [email protected] Introduction: Methyl Ethyl Ketone (MEK), also known as butanone, is a widely used industrial solvent commonly found in paints, adhesives, cleaning agents, coatings, and degreasing products. In the aircraft industry, MEK is frequently used for surface cleaning, painting, and coating operations. It is a colourless liquid with a characteristic sweet odour. According to the Agency for Toxic Substances and Disease Registry (ATSDR), MEK exerts toxic effects on multiple organ systems primarily by inducing tissue injury through free radical generation. Acute exposure or ingestion may result in severe central nervous system depression, respiratory distress, and systemic toxicity. Reported cases of MEK poisoning are rare, and there is no specific antidote available. Aims and Objectives: to report a rare case of acute methyl ethyl ketone (MEK) poisoning in an industrial worker; to highlight clinical presentation, diagnostic challenges, and management strategies, and to emphasize the importance of psychiatric evaluation and preventive measures in industrial settings where hazardous chemicals are easily accessible Materials and Methods: This is a single-patient case report. A 58-year-old male industrial employee was brought to emergency services after being found unconscious by the roadside outside his workplace. Clinical examination, laboratory investigations, gastric aspirate analysis, and workplace exposure history were used to establish the diagnosis. Supportive management was provided in the Intensive Care Unit (ICU). Relevant literature was reviewed to guide treatment, as no specific antidote exists for MEK poisoning. Results: On presentation, the patient was unconscious with tachycardia, tachypnea, and bronchospasm. The breath had a pungent odour, excessive nasal and oral secretions were present, and pupils were reactive to light. Gastric lavage was performed, and aspirate was sent for toxicological analysis. Due to poor Glasgow Coma Scale (E1V1M3), the patient was intubated and shifted to the ICU with a provisional diagnosis of unknown poisoning. Atropine challenge test was negative, and serum pseudocholinesterase levels were normal, ruling out organophosphate poisoning. An empty MEK bottle was recovered from the patient’s workplace by coworkers, and gastric aspirate analysis confirmed MEK ingestion. Laboratory investigations revealed leukocytosis (total WBC count 27,000/mm³), elevated serum creatinine (1.5 mg/dL), raised liver enzymes (SGOT 80 IU/L, SGPT 105 IU/L), while arterial blood gas analysis and chest X-ray were normal. The patient was managed conservatively with ventilatory support and supportive care. Based on available literature, intravenous N-acetylcysteine (3 g or 50 mg/kg over 1 hour, for three doses) was administered. The patient showed gradual clinical improvement and was successfully extubated after 3 days. All laboratory parameters normalized during hospital stay, and the patient was discharged after one week. Post-extubation evaluation confirmed deliberate self-harm, and psychiatric consultation was undertaken. Conclusion: This case highlights the rare but severe toxicity associated with methyl ethyl ketone ingestion and underscores the importance of early recognition and supportive management. As MEK induces oxidative tissue injury through free radical generation, N-acetylcysteine may have a beneficial role in management. The case further emphasizes the need for regular mental health screening and psychiatric evaluation of industrial workers who have easy access to hazardous chemicals. Prompt intervention, supportive therapy, and preventive occupational health strategies are critical to reducing morbidity and mortality in such cases.

Babita Narula Ultratech Cement Limited [email protected] Introduction: UltraTech Cement Limited, the cement flagship company of the Aditya Birla Group, the largest manufacturer of grey cement and ready-mix concrete (RMC) in India. Awarpur Cement Works, a unit of UltraTech Cement Limited, operates as part of this conglomerate. Aims and Objectives: Non-communicable diseases in India are a major health concern which has reached epidemic proportions with common examples including cardiovascular diseases, diabetes etc. To address this issue, concept of a “health zone” has been introduced in Ultratech cement. Health zone concept is essential for monitoring employee health trends and assessing the overall health status within Ultratech cement works. It enables the evaluation of the effectiveness of interventions implemented through health promotion activities and enhances employees’ awareness and understanding of their current health status, thereby facilitating timely and appropriate interventions when necessary. Materials and Methods: Employees were categorized into red, amber, and green health zones based on specific health parameters, including body mass index (BMI), blood pressure, fasting and postprandial blood sugar (FBS/PPBS)/HbA1c, low-density lipoprotein (LDL) cholesterol levels. Baseline health zone data for employees at Awarpur were established using health check-up records collected in 2024. All health assessment data were systematically recorded in the PEHEL software, which automatically assigned each employee to a health zone using a predefined calculation algorithm. Following the baseline assessment, targeted interventions were initiated for employees in the red and amber zones, such as regular follow-ups, specialist consultations, and health awareness sessions. Subsequent follow-up data were also captured in the PEHEL software, enabling real-time monitoring of changes in health zone status for each employee. The baseline health zone data collected in 2024 were compared with health zone data obtained in 2025 following repeat health check-ups of employees. This comparative analysis with percentage comparison was conducted to evaluate the effectiveness of the implemented interventions on employee health status over one-year period. Results: After 6 months of intervention and follow up we could reduce 82% of employees from high-risk zone to medium and low zone. Conclusion: The study demonstrates that systematic analysis of key health indicators, combined with the health zone approach and targeted interventions for employees identified as high and medium risk, contributes to a reduction in the prevalence of non-communicable diseases within the workforce.

Deepthi Raj, Naresh Fadte, Celianne Carvalho Siemens Healthineers, Bangalore [email protected] Introduction: Dry Eye Disease (DED) is a multifactorial ocular surface disorder that significantly impacts visual comfort and occupational productivity. Healthcare professionals, particularly occupational health workers, are increasingly exposed to risk factors such as prolonged screen time and controlled indoor environments, predisposing them to DED. This study aims to evaluate the prevalence, types, and associated risk factors of DED in this population. Aim and Objectives: To assess the prevalence and classification of Dry Eye Disease and analyse its association with occupational and environmental risk factors among occupational health workers. Materials and Methods: A cross-sectional study was conducted among 101 occupational health workers in a machinery manufacturing assembly factory. Participants underwent a comprehensive ocular examination including Schirmer’s test and Meibomian Gland Dysfunction (MGD) assessment. Data regarding demographic profile and risk factors—such as screen time, environmental exposures, systemic illnesses, and medication use—were collected using a structured proforma. Dry Eye Disease was categorized into Aqueous Deficient, Evaporative, Mixed, and No DED. Results: The overall prevalence of DED in the study population was 30.7%. Of these, 27.7% had Aqueous Deficient DED, 2.0% had Evaporative DED, and 1.0% had Mixed-type DED. Significant associations were observed between DED and factors such as prolonged screen use, exposure to air conditioning and dusty environments, history of allergies, smoking, and use of antihypertensive medications. Females and older individuals were slightly more affected. Conclusion: DED is highly prevalent among occupational health workers and is significantly associated with modifiable occupational and lifestyle factors. Routine screening, targeted education, and workplace interventions are essential to mitigate risk and improve eye health in this high-risk group.

Vidya Kiran Bhat, Pranav Lunge, Sagar Pathak, Sunny Jani, Nikunj Desai Reliance Industries Limited [email protected] Introduction: In petrochemical industries, site medical officers often face challenges in accessing comprehensive and consolidated information about chemicals handled on-site. Critical data—ranging from classification, toxicological properties, permissible exposure limits, health hazards, and emergency management protocols—are usually scattered across multiple sources, limiting timely decision-making during routine surveillance and medical emergencies. To bridge this gap, a Chemical Dashboard was developed using Microsoft Power BI, designed to serve as a one-stop solution for medical and occupational health teams. Aims and Objectives: The primary aim of the dashboard is to provide a proactive, centralized, and user-friendly platform that consolidates A-to-Z information covering IH, OH, Medical emergency management and safety aspects about chemicals. This includes categorization, NFPA codes, IARC classification, threshold limit values (TLVs), physical appearance, target organs/systems, acute and chronic health hazards, biological exposure indicators, recommended laboratory tests for periodical medical examinations, and structured protocols for first aid and management at different levels—ambulance, on-site occupational health centres (OHC), and tertiary hospitals. Additionally, the integration of dynamic dashboards displaying real-time chemical quantities and storage locations enhances emergency preparedness and response. Materials and Methods: List of Chemicals and related data were sourced from internal medical and safety teams and reviewed with global standard repositories to build a relational database on SQL server (SQL Server is a relational database management system (RDBMS) developed and marketed by Microsoft.) to store detailed chemical inventory. Each chemical was mapped with its TLVs, physical description, affected target organs, BEIs, PMEs, acute and chronic health hazards and corresponding first aid and medical management protocols. These datasets were structured and integrated into Power BI, enabling interactive visualization, dynamic updates, mobile accessibility, to facilitate A-Z info about the chemicals at one place with real-time analytics, site-wise comparisons, antidote availability across sites, enabling prompt interventions to maintain safer and healthier workplace. The tool was customized to allow doctors and health teams to access critical information instantly, both on desktops and handheld devices. Results/Conclusion: The Chemical Dashboard in Power BI exemplifies the effective use of digital tools for safeguarding worker health in manufacturing industries. The integrated Chemical Dashboard offers occupational health professionals a robust tool for real-time risk assessment, hazard communication and emergency response planning. It supports proactive management by alerting stakeholders on risk levels of the chemicals ensuring compliance with global best OSH standards. This data-driven solution demonstrates the value of leveraging business intelligence and database technologies to strengthen chemical safety culture and operational readiness in industrial environments.

Rafat Saba OHC - Ultratech Cement Limited - Bela Cement Works [email protected] Introduction: In the industrial townships and rural areas around Bela Cement Works, Madhya Pradesh, adolescent girls face challenges such as nutritional deficiencies, reproductive health issues, poor hygiene, and gender-based barriers to care. To address these, a comprehensive and long-term Adolescent Girls Health Care Drive was launched. Aims and Objectives: The program aimed to improve the health and well-being of adolescent girls (ages 10–19) by increasing access to preventive and curative services, promoting menstrual hygiene, nutrition, mental health, and gender sensitization. Materials and Methods: The three-year initiative (April 2022–March 2025) covered 1,725 adolescent girls from nearby villages and factory townships. Structured questionnaires to assess health needs. The program implemented targeted interventions to address the diverse health needs of adolescent girls. Routine OPD checkups (2–5 girls daily) and monthly health camps ensured consistent medical care. Quarterly awareness sessions on menstrual hygiene, mental health, nutrition, and safe practices promoted knowledge and positive behaviour. Sanitary pad vending machines, incinerators, and the distribution of supplements and sanitary kits addressed menstrual hygiene and nutritional deficiencies. Menstrual waste disposal systems were established, mental health counselling and meditation workshops. The baseline data collected in 2022 was compared with the data obtained in 2025 and analysis of percentage comparison is captured for the measurement of outcome. Results: Baseline surveys among adolescent girls, with anaemia affecting 74.9%, nutritional deficiencies at 97.9%, anxiety and depression at 77.9%, menstrual health issues at 44.9%, and inadequate menstrual hygiene practices at 98.9%. Following sustained interventions, anaemia prevalence was reduced by 88% and nutritional deficiencies by 45%. Menstrual hygiene practices improved by 82%, and the establishment of proper disposal systems increased by 40%. Incidence of anxiety and depression decreased by 44%, while the prevalence of faulty practices, including molestation, dropped dramatically by 98%. Symptoms of PCOS and endometriosis were reduced by 68%, and urinary tract infections (UTIs) declined by 84%. Significant behavioural improvements noted. Conclusion: This initiative created a sustainable, community-based model for adolescent health improvement within an industrial setting. By integrating medical outreach, education, infrastructure, and psychosocial support, the program empowered girls to take charge of their well-being. The approach supports national and global goals for adolescent health and gender equality.

Azad Ali Khan, Rafat Saba, Mahendra Buruily OHC - Ultratech Cement Ltd - Aditya Birla Group [email protected] Introduction: Work-Related Musculoskeletal Disorders (WMSDs) remain a major occupational health concern in the cement industry, driven by repetitive lifting, awkward postures, vibration exposure, and prolonged standing during bag handling and railway loading. This study focused on identifying ergonomic risk factors and implementing manual, in-house ergonomic interventions using low-cost engineering and administrative measures, particularly targeting workers in the Packing Plant and Railway Siding areas where WMSDs are most prevalent. Aims and Objectives: To reduce musculoskeletal injuries and enhance safety by assessing risks, educating employees, and implementing ergonomic solutions for safer manual tasks. Materials and Methods: An initial ergonomic assessment conducted in May 2022 evaluated 124 workers from the Packing Plant and Railway Siding at Bela Cement Works using REBA and RULA tools to analyse postures and body mechanics. A series of targeted interventions were implemented to address key risk factors. Iron net stool stands with hand rests were added at packing tables to reduce spinal and leg strain, while adjustable bag weighing tables promoted better posture during lifting. Stable iron ladders replaced unsafe monkey ladder climbing on conveyor belts, and body dust cleaners at packing plant exits improved worker hygiene and comfort. In the Railway Siding area, a new iron platform enabled safer wagon door closure, minimizing bending and overreaching. Monthly ergonomic surveys and field audits and risk identification. Ergonomic awareness was enhanced through weekly toolbox talk sessions for all employees and annual distribution of posture models and body mechanics charts during National Safety Week. Additional improvements included inclined chutes, anti-skid flooring. Pre- and post-intervention REBA and RULA scores were summarized using means to compare pre- and post-intervention scores within each group. Results: Results of initial assessment in year 2022 revealed high-risk exposure, with mean REBA scores of 9.4 (Railway Siding) and 8.8 (Packing Plant), and RULA scores of 5.6 and 5.4, respectively. Following the ergonomic interventions, the June 2025 RULA and REBA reassessments demonstrated substantial risk reduction, with mean REBA scores in the Railway Siding dropping from 9.4 to 4.6 (a 51% decrease) and mean RULA scores from 5.6 to 3.4 (a 39% decrease); similarly, in the Packing Plant, REBA scores fell from 8.8 to 4.5 (49% decrease) and RULA from 5.4 to 3.3 (38% decrease). Conclusion: This study demonstrates that manual, low-cost ergonomic interventions—when scientifically guided by RULA and REBA analysis—can significantly reduce WMSDs and fatigue in industrial environments, enhanced productivity scale.

Prachee Hendre-Mhetras, Vaishali Lone, Ritwik Kulkarni Edgescan AI [email protected] Introduction: Early detection of oral cancer is essential because many lesions remain asymptomatic until advanced stages, when treatment outcomes are significantly poorer. Conventional screening, performed by trained dentists during routine annual checkups, is effective but difficult to scale, uncomfortable for some individuals, and often inaccessible in rural or non-clinical environments. Mobile technologies provide an opportunity to expand screening for oral cancer and potentially malignant disorders (PMDs) by enabling efficient, scalable, accessible assessments that support timely referral and improved outcomes. This study evaluates the effectiveness of scientifically designed mobile application with clinician-in-loop functionality for workplace-based oral cancer screening. Aims and Objectives: Evaluate effectiveness of a scientifically developed mobile application with clinician-in-loop functionality for oral cancer screening in an industrial workplace setting. Materials and Methods: A machine learning model for object recognition was trained on roughly 50,000 expert-annotated images representing more than 60 types of oral lesions collected across 18 hospital sites in India. In double-blinded validation on 661 subjects, the model achieved 91.6% precision and 93% accuracy. The validated model was deployed through the Mukhia® mobile application and tested among 1,014 tobacco-using factory workers during annual health examinations conducted by trained clinicians. A total of 3,289 intraoral photographs covering multiple anatomical angles were captured. The AI identified high-risk lesions such as tobacco pouch keratosis, oral submucous fibrosis, and leukoplakia, while clinicians made final diagnostic decisions, issued specialist referrals, and provided cessation counseling. Benign lesions, including chronic gingivitis and frictional keratosis, were also recognized, with tobacco-exposed individuals receiving counseling. The clinician-in-loop design ensured safe use of the model by preventing adverse outcomes from misclassification. Results: Of 1,014 screened workers, the AI system flagged 850 having high-risk lesions; 777 were clinically confirmed, giving a precision of 91.4%. 73 subjects (8.6%) were false positives. Among the 164 individuals not flagged by the model, clinicians identified 31 additional high-risk lesions, resulting in a negative precision of 81.1%. Notably, no cancers were missed. Overall accuracy was 89.7%, with an F1 score of 0.93. All participants received appropriate counseling, evaluation, or treatment recommendations. Conclusion: The cloud-based Edgescan AI model integrated into the Mukhia® mobile application demonstrated strong performance in identifying and documenting precancerous and cancerous oral lesions in an industrial setting. The clinician-in-loop framework supports rapid, scalable, and reliable screening while minimizing risks associated with incorrect predictions. This approach enables organizations to strengthen preventive oral health programs, potentially reducing absenteeism, lowering insurance-related costs, and improving workforce well-being through accessible early detection.

Soumi Sarkar Sidhi Cement works, Ultratech Cement Limited, Aditya Birla Group [email protected] Introduction: UltraTech Cement Limited, the cement flagship company of the Aditya Birla Group, is the largest manufacturer of grey cement and ready-mix concrete in India. Sidhi Cement Works (SDCW), a unit of UTCL, operates as part of this conglomerate. Non-communicable diseases (NCD) in India are a major health concern which has reached epidemic proportions with common examples including cardiovascular diseases, diabetes etc. To address this issue, concept of a “health zone” has been introduced in Ultratech cement. Health zone concept is essential for monitoring employee health trends and assessing the overall health status within UTCL. It enables the evaluation of the effectiveness of interventions implemented through health promotion activities and enhances employees’ awareness and understanding of their current health status, thereby facilitating timely and appropriate interventions when necessary. Aims and Objectives: Evaluate the effectiveness of targeted health interventions in reducing NCD burden at SDCW. Material and Method: Employees were categorized into red, amber, and green health zones based on specific health parameters, including body mass index (BMI), blood pressure, fasting and postprandial blood sugar (FBS/PPBS)/HbA1c, and low-density lipoprotein (LDL) cholesterol levels. Baseline health zone data for all employees at SDCW were established using health check-up records collected in financial year 2023-24. All health assessment data were systematically recorded in the PEHEL software, which automatically assigned each employee to a health zone using a predefined calculation algorithm. Following the baseline assessment, targeted interventions were initiated for employees of red and amber zones, such as regular follow-ups, specialist consultations and health awareness sessions. Subsequent follow-up data were also captured in the PEHEL software, enabling real-time monitoring of changes in health zone status for each employee. The baseline data collected in 2022 was compared with the data obtained in 2025 and analysis of percentage comparison is captured for the measurement of outcome. Results: FY 2023–24: Total employee Examined 652, Green 527 (80%), Amber zone -100 (15%), Red-25 (4%). 56% of red zone employees have been converted to Amber zone, 36% remains in red zone and 8% got self-transfer to another site of Ultratech. Conclusion: The study demonstrates that systematic analysis of key health indicators, combined with the health zone approach and targeted interventions for employees identified as high and medium risk, contributes to a reduction in the prevalence of NCD within the workforce.

Divya Mullassery Shell India Markets Private Limited [email protected] Introduction: Mental wellbeing is a critical component of occupational health, influencing staff engagement, productivity, and workplace culture. Shell launched the Global Mental Wellbeing Program (GMWP), a strategic initiative to foster psychological resilience and promote mental health across its global workforce. This abstract highlight the implementation strategy, activities, outcomes, and lessons learned from GMWP rollout in India, offering a replicable model for occupational health professionals looking to enhance mental wellbeing in organizational settings. Aims and Objectives: To promote psychologically safe and supportive work environment by enhancing awareness, reducing stigma, encouraging proactive engagement with mental health resources among staff; to assess mental wellbeing through structured surveys, to identify health and wellbeing needs of staff, to provide support by giving toolkits for integrating mental wellbeing into daily work culture, and to engage employees in location-specific wellbeing activities to foster community support. Materials and Methods: In 2024, the first survey was launched to assess employee’s mental health and identified three priority areas: physical activity, diet and nutrition, and stress management. Toolkits and Location Wellbeing Experiences (LWX) introduced, including yoga, Zumba, webinars, consultations with dieticians and psychologists, mindfulness and meditation sessions, and awareness campaigns on Employee Assistance Program (EAP) and line manager training module. In 2025, engagement deepened through evidence-based toolkits and behavior-focused LWX initiatives. Descriptive statistics calculated awareness and confidence percentages. Comparative analysis assessed changes between pre- and post-intervention surveys. Results: The survey conducted in 2025 showed significant improvement in awareness of the local mental wellbeing resources, reflecting growing awareness and trust in the program. Post-intervention data showed: 91.5% of respondents were aware of available mental health support. Eighty percent felt confident accessing support. Enhanced role clarity, support systems, and access to self-help tools. Notable progress in the three focus areas identified in 2024, showing the effectiveness of targeted interventions. Conclusion: Shell’s Global mental wellbeing program and Location wellbeing experience rollout in India prove a scalable evidence-based approach to embedding mental wellbeing into workplace culture. The program’s success was driven by data- driven approach, localized implementation, and commitment to creating a stigma-free environment empowering employees to prioritize mental health and support one another.

Bhargav V. Kanabar, Iva Chatterjee Guru Gobindsinh Hospital, Jamnagar [email protected] Introduction: Occupational Interstitial Lung Diseases are chronic pulmonary disorders resulting from prolonged exposure to workplace airborne agents such as metal fumes, silica, and dust. In brass foundry workers, continuous inhalation of zinc, copper, and lead particulates can trigger chronic alveolar inflammation and progressive fibrosis. The Usual Interstitial Pneumonia (UIP) pattern represents a fibrotic subtype of interstitial lung disease with irreversible architectural distortion and poor prognosis. The present case highlights the development of UIP-pattern OILD in a brass worker, emphasizing the need for early recognition, occupational hazard control, and the role of antifibrotic therapy in disease stabilization. Aims and Objectives: To report a rare case of occupational interstitial lung disease with a usual interstitial. Pneumonia pattern in a brass industry worker, evaluate the clinical-radiological features and management outcomes, and emphasize the importance of occupational exposure assessment and preventive strategies in industrial respiratory health surveillance. Materials and Methods: A detailed clinical evaluation was conducted on a 52-year-old male brass foundry worker with a 12-year occupational history and progressive dyspnea for two years. Comprehensive investigations included complete blood counts, autoimmune serology (ANA, RF), chest radiography, and High-Resolution Computed Tomography (HRCT) thorax. Pulmonary function testing (spirometry)assessed functional impairment. Occupational exposure history was analyzed, and differential diagnoses were ruled out. Management included exposure cessation, pharmacologic antifibrotic therapy (pirfenidone)), pulmonary rehabilitation, and vaccination, followed by longitudinal clinical monitoring. Results: The patient was a lifelong nonsmoker presenting with exertional breathlessness and dry cough. Clinical examination revealed bilateral fine end-inspiratory crackles with clubbing. Laboratory investigations were unremarkable with negative autoimmune markers. HRCT thorax demonstrated subpleural reticulation, traction bronchiectasis, and honeycombing in basal and peripheral lung zones — features consistent with a UIP pattern. Pulmonary function tests indicated a restrictive ventilatory defect (FVC 56% predicted). A diagnosis of OILD with UIP pattern secondary to chronic metal fume exposure was established. Following workplace avoidance, oxygen therapy, and antifibrotic treatment, symptomatic improvement and stabilization of lung function were noted during follow-up. Conclusion: Chronic exposure to metallic fumes in brass industry workers can culminate in irreversible fibrotic interstitial lung disease with a UIP pattern. This case underscores the necessity for early diagnosis, strict occupational safety practices, and timely antifibrotic therapy. Strengthening workplace hazard controls and implementing periodic health surveillance are pivotal to reducing the burden of occupational lung fibrosis.

Puran Singh, Paren Shah Reliance Industries Limited, Dahej Manufacturing Division [email protected] Introduction: LDL-C is a key biomarker for evaluating cardiovascular risk and guiding lipid-lowering interventions. The gold standard for measuring LDL-C is the direct assay method. However, it is commonly estimated using the Friedewald equation, and later modified approaches such as the Martin–Hopkins and NIH Equation 2. The direct method increases laboratory expenditure, while calculated methods are cost-free. Therefore, it is important to determine which calculated method provides values closest to the direct measurement. Aims and Objectives: To compare direct LDL-C measurements with calculated LDL-C values and determine the most accurate indirect estimation method, and to assess the additional cost incurred per high LDL-C case detected using the direct method. Materials and Methods: A cross-sectional study was conducted on 120 lipid profiles obtained during PME. LDL-C was measured using a homogeneous enzymatic assay (direct method) and calculated LDL-C derived using instrument software by Friedewald, Martin-Hopkins, and NIH Equation 2 methods. Sensitivity, specificity, predictive values, and diagnostic accuracy were calculated using OpenEpi 3.01. Results: A total of 120 males underwent lipid profile testing. The mean age of the participants was 40.56 years. Elevated LDL-C (>100 mg/dl) was detected in 81 % using the direct method, compared to 69 %, 76 % and 73 % by Friedewald, Martin-Hopkins, and NIH Equation 2 respectively. The diagnostic accuracy of the three calculated methods was 88 %, 95 % and 92 % respectively. Sensitivity was 62 %, 80 % and 72 % respectively. Conclusion: The Martin-Hopkins method demonstrated the highest diagnostic accuracy and sensitivity among the indirect methods. Using the Martin-Hopkins method can detect 95 percent of elevated LDL-C cases without additional cost. The remaining 5 percent of high LDL-C cases require direct measurement at an added cost of INR 2000 per individual. Direct LDL-C method is preferred over calculated when triglycerides level more than 400mg/dl.

Vishruth KP, Karthikayini S TVS Group, Madurai [email protected] Introduction: Down syndrome, often accompanied by mild to moderate Intellectual Disability, limits adaptive behaviour, vocational readiness, and social inclusion. Occupational therapy (OT) serves as a vital bridge to enhance independence and community participation through targeted skill development. Aims and Objectives: This case study presents the outcomes of a structured one-year OT and vocational rehabilitation program for a 30-year-old male with Down syndrome at Lakshmi Hospital, Madurai, focusing on improving workplace inclusivity and quality of life. Materials and Methods: A 12-month, structured OT program was conducted with three 60-minute sessions per week. The intervention targeted Activities of Daily Living (ADL), including grooming, dressing, and meal preparation; fine motor and cognitive skills such as hand–eye coordination, sequencing, attention, and memory and social–communication skills through role-play and empathy training. Vocational rehabilitation followed a hybrid model primarily Open Employment with elements of Sheltered Placement to provide structured supervision and gradual integration into front office duties at Lakshmi Hospital. Performance was assessed using a task-based productivity checklist measuring accuracy, time efficiency, and supervision needs. Adaptive and psychosocial outcomes were evaluated using the Vineland Adaptive Behaviour Scales-II (VABS-II, Indian adaptation), Indian Disability Evaluation and Assessment Scale (IDEAS), and qualitative caregiver feedback via the Family Impact Questionnaire. Continuous therapist observation and caregiver interviews monitored motivation, social confidence, and emotional well-being. Results: After 12 months, the participant achieved full independence in self-care and partial independence in community mobility. Vocational task completion improved to >85% accuracy with minimal supervision. Adaptive functioning (VABS-II) improved from a composite score of 60 to 76, while the IDEAS score decreased from 9 (moderate disability) to 5 (mild disability). Marked psychosocial gains were observed in self-esteem, communication confidence, and workplace behaviour. Family members reported reduced caregiver stress, enhanced pride, and improved social acceptance, reflecting the broader community impact of inclusive employment. Conclusion: This case highlights the pivotal role of occupational therapy integrated with vocational rehabilitation in enabling adults with intellectual disability to achieve independence, employability, and psychosocial stability. The Open Employment model, supported by structured supervision, created a safe and empowering platform for workplace inclusion. Beyond functional outcomes, the program fostered family resilience, community acceptance, and an overall improvement in quality of life, underscoring the transformative potential of inclusive employment initiatives in the Indian context.

Akshaya Prem Kumar, Vidhya Venugopal, Latha PK, Rekha S , Hemamalini AJ, Krishnan S. Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Climate change exacerbates occupational heat stress, endangering over 500 million informal sector workers in India. Despite extensive evidence of heat’s physiological burden, practical, low-cost interventions that workers can implement themselves remain critically absent. Nutritional cooling foods offer a potential, culturally acceptable intervention. However, the feasibility, acceptability, current awareness, and implementation barriers for such interventions remain largely unexplored, representing a critical gap in occupational health protection. Aims and Objectives: To assess the feasibility and acceptability of nutritional cooling food interventions among heat-exposed outdoor workers in rural Tamil Nadu. Materials and Methods: We conducted a cross-sectional study during April-May 2025 in Tamil Nadu, India, involving 291 outdoor workers from five occupational groups (brick kiln, stone quarry, agriculture, salt pan, and construction). Environmental heat exposure was objectively measured using the Wet Bulb Globe Temperature (WBGT) monitor. Data collection employed a validated, locally adapted questionnaire covering demographic details, self-reported heat-related illnesses (HRIs), awareness, current dietary practices, consumption frequency, implementation barriers, acceptability of educational interventions, and feasibility of workplace integration, using a modified High Occupational Temperature Health and Productivity Suppression (HOTHAPS) questionnaire. Statistical analyses included chi-square tests, and multivariable logistic regression was done using SPSS software. Results: Participants (mean age, 43.7±12.3 years) experienced a mean WBGT of 29.4±2.7°C, with 92.4% working above the threshold limit values, demonstrating a 3.9-fold increased odds of HRIs (adjusted OR, 3.9; 95% CI, 1.1-8.2). A striking knowledge-practice gap emerged (60.2% awareness vs. 25.6% regular consumption, p < 0.001), particularly notable given that 57% of participants were illiterate. Commonly consumed items included fermented rice water (70.4%), buttermilk (51.5%), and ragi porridge (40.2%), with suboptimal frequency. Key usage barriers included preference for unhealthy alternatives (87.3%), financial constraints (51.5%), time limitations (48.8%), limited workplace access (48.1%), inadequate awareness (41.6%), cultural misconceptions (37.8%), medication interactions (12%), and taste resistance (10%). Intervention acceptability was remarkably high, with 81.3% of participants indicating a willingness to adopt the interventions following heat-health education. Prior HRI experience significantly predicted willingness (OR: 2.7, 95% CI: 1.2-6.1). Additionally, 71.1% believed education would increase usage, and 60% supported workplace integration. Conclusion: Nutritional cooling food interventions demonstrate exceptional feasibility and acceptability among vulnerable outdoor workers. The substantial knowledge-practice gap represents a transformative opportunity for evidence-based intervention. High receptiveness to heat-health education establishes clear pathways for scaled implementation through culturally tailored campaigns, workplace integration, and embedding government schemes.

Nikitha D, Jibu George Varghese, Krishnan S, Rekha Shanmugam, Vidhya Venugopal Sri Ramachandra Institute of Higher Education and Research, Chennai, India [email protected] Introduction: Rising temperatures and frequent heatwaves caused by climate change have increased the risk of heat stress among workers performing physically demanding outdoor tasks. Prolonged exposure to high temperatures can lead to muscle fiber damage, as reflected by elevated creatine phosphokinase (CPK) levels, and impair muscle function, resulting in reduced grip strength and work capacity. Limited research in India has examined the effects of heat exposure on muscle performance. Understanding these effects is essential for developing effective interventions. Aims and Objectives: This study aims to investigate the relationship between heat-induced CPK levels and muscle grip strength in outdoor workers exposed to high temperatures in Tamil Nadu. Materials and Methods: A cross-sectional study was conducted among 120 outdoor workers from the agricultural, construction, and brick kiln sectors in Tamil Nadu from April to June 2025. Environmental heat exposure was measured using a Wet Bulb Globe Temperature (WBGT) monitor (Quest Temp 3M). Physiological parameters, including core body temperature (CBT) and urine specific gravity (USG), were recorded using standard protocols. A modified High Occupational Temperature Health and Productivity Suppression (HOTHAPS) questionnaire was used to collect information on perceptions of heat exposure, muscle performance, and self-reported heat-related illnesses (HRIs). CPK levels were analyzed using the CK-NAC IFCC method from post-shift blood samples, and handgrip strength was measured using a Jamar handheld dynamometer. Multivariable logistic regression analysis was performed using SPSS software. Results: The mean workplace WBGT was 29.9 ± 3.5°C. Workers exposed to heat stress had a significantly increased risk of HRIs (AOR 9.3; 95% CI: 1.4–88.4). Exposure above the recommended threshold was associated with elevated CBT (AOR 3.9; 95% CI: 1.2–11.8) and USG (AOR 1.5; 95% CI: 1.1–3.5), indicating dehydration. WBGT was significantly associated with reduced grip strength in both hands (left hand: AOR 1.3; 95% CI: 1.3–1.4; right hand: AOR 1.4; 95% CI: 1.2–1.9). Elevated post-shift CPK levels were significantly associated with decreased handgrip strength, with declines observed in 91% of workers for the left hand (AOR 3.0; 95% CI: 1.2–9.5) and 99% for the right hand (AOR 3.8; 95% CI: 1.1–8.2). Conclusion: These findings suggest that exposure to high ambient temperatures impairs muscle function and increases the risk of muscle injury. Workplace cooling measures and rest breaks are essential for preventing heat-induced muscle damage and maintaining worker performance and capacity. Integrating such measures into policies can enhance the long-term resilience of outdoor workers who face climate-related heat stress.

Sandhya Bharathi Shanmugasundaram, G. Pitchaimani Govindaraj Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Work participation in the elderly plays a major role in maintaining mental well-being by providing routine, purpose, and social interaction (Hou et.al., 2023). In contrast, the elderly who are not engaged in work may be more vulnerable to psychological issues such as depression (Dang et.al., 2022). Aim and Objective: The study aims to compare depression levels between working and non-working elderly to understand the mental-health implications of occupational engagement in later life. Materials and Methods: A cross-sectional study was conducted among 114 elderly individuals in rural Virudhunagar district, Tamil Nadu, India. Semi-structured questionnaire and the Geriatric Depression scale were used to collect Socio-demographic data and depression scores. The data on gender, living arrangements, marital status, and work engagement were summarized using descriptive statistics. An independent sample t-test was used to assess differences in depression scores between working and non-working elderly individuals. Result : The majority of the sample were females (79.8%) and more than half were widows (51.8%). Of all the residents, about 45.6% were single, living alone, and 54.4% were not in work, while 45.6% of those not in work reported to be currently unemployed/’. Depression was found among both working and non-working participants; the severity, however, varied dramatically. For non-workers, the mean depression score of non-workers (mean = 11.73, SD = 3.91) was higher than workers (Mean = 9.90, SD4.44), and it was a statistically significant difference. It indicates that although depression is a problem in both occupational groups of the elderly, the unemployed elderly are exposed to a higher level of depressive symptoms. Conclusion: Depression was experienced by both working and non-working elderly individuals. However, non-workers display greater depressive symptoms; employment or productive activity has a protective factor. Being in the labour force may promote mental health by providing structure, purpose, and social connectedness. These findings emphasize the importance of community-based programs, work engagement opportunities, and supportive environments that can contribute to positive mental health in late life when older adults are no longer in the labour force.

Rekha Shanmugam, Vidhya Venugopal Sri Ramachnadra Institute of Higher Education and Research [email protected] Introduction: Occupational heat stress poses significant risks to pregnant workers, particularly in tropical regions where labor-intensive work is common. In Tamil Nadu, diverse occupational environments expose women to elevated thermal conditions that may compromise maternal and fetal health. Understanding both physiological and behavioral adaptations to heat stress is essential for preventing adverse pregnancy outcomes(APOs) among vulnerable working populations. Aims and Objectives: To identify and quantify the physiological and behavioral determinants influencing APOs among working pregnant women exposed to occupational heat stress. Materials and Methods: A cross-sectional study was conducted among 600 pregnant working women across six districts of Tamil Nadu (2018–2022). Participants were recruited from agriculture, construction, brick kilns, and saltpan sectors. Heat exposure was measured using a WBGT Quest Temp 3M-34 monitor. Physiological responses, such as core body temperature (CBT) and urine specific gravity (USG), were assessed using standard protocols. Perceptual and behavioral data were collected using a modified HOTHAPS questionnaire, covering occupational heat exposure, workplace characteristics, hydration, rest-break patterns, protective clothing, and work–rest cycles. APOs included miscarriages, preterm birth, and low birth weight (LBW). Data were analyzed using chi-square tests and multivariate logistic regression (SPSSv16.0). Results: Nearly half of the women (48%) were exposed to WBGT levels exceeding 28°C, surpassing the American Conference of Governmental Industrial Hygienists (ACGIH) recommended limits for workers. The overall prevalence of APOs was 23% (n = 140), including miscarriages (4%, n = 22), preterm birth (12%, n = 74), and LBW (20%, n = 118). Women exposed to WBGT >28°C had significantly elevated APO risk (AOR:2.1;95%CI:1.4–3.6) after adjusting for age, socioeconomic status, BMI, hemoglobin, and years of occupational exposure. Elevated CBT combined with high USG (AOR:2.7;95%CI:1.5–4.7) and inadequate hydration (<2L/shift) (AOR:2.4;95%CI:1.5–3.9) were significant physiological predictors. Behavioral and environmental factors further compounded risk: lack of rest breaks (68.4%), absence of shade (53.2%), and irregular work-rest cycles (49%) collectively increased APO risk (AOR:2.2;95% CI:1.3–3.5). Conversely, adequate hydration, regular rest breaks, the use of protective clothing, and access to shade reduced APO risk by approximately 1.5-fold (95%CI:1.2–2.5). Conclusion: Occupational heat stress significantly elevates APO risk among working pregnant women in Tamil Nadu. Physiological strain from prolonged heat exposure, compounded by inadequate behavioral adaptations and poor workplace infrastructure, poses serious threats to maternal-fetal health. Immediate interventions, including mandatory rest breaks, accessible drinking water (≥2L/shift), shaded rest areas, and work restriction during peak heat hours are essential to protect pregnant workers from heat-related complications.

Gayathri KG, Vidhya Venugopal, Rekha Shanmugam, Vijayalakshmi P, Krishnan S Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Rising ambient temperatures driven by climate change have intensified occupational heat stress, disproportionately affecting informal workers engaged in physically demanding tasks in unprotected environments. Prolonged exposure to high heat not only increases the risk of heat-related illnesses (HRIs) but also exacerbates psychological distress. Informal workers often lack welfare facilities such as shaded rest areas, drinking water, and sanitation, further heightens physical and psychological strain. Aims and Objectives: This study examines prevalence of HRI and psychological distress among informal workers in Tamil Nadu and explores how occupational heat stress and poor working conditions interact to influence mental health, productivity, and gendered vulnerabilities. Materials and Methods: We conducted a cross-sectional study among 300 informal workers employed in construction, brick kiln, agriculture, and housekeeping work between April and May 2025. Ambient heat exposure was measured using a wet bulb globe temperature (WBGT) heat stress monitor (Quest temp 3M). Data were collected through structured questionnaires captured demographics, heat exposure patterns, self-reported HRIs, work characteristics, access to welfare facilities, productivity loss (PL), and mental health indicators. Statistical analysis, including chi-square tests, logistic regression, and multivariate models, was performed using SPSS version 26.0. Results: Participants (mean age, 42.4 ±10.4years) experienced an average WBGT of 28.8 ± 2.4°C, with 83% working above the recommended threshold (≥ 27.5°C). HRIs were prevalent among 85% of workers. Workers exposed to WBGT ≥ 27.5°C had 2.7 times higher odds of experiencing HRIs (95% CI: 1.3-8.2). Those with HRIs were 9.8 times more likely to experience psychological distress (95% CI: 4.1-23.5). Nearly 78% reported PL, strongly associated with heat strain and mental fatigue. Inadequate welfare facilities, particularly lack of safe drinking water (94%), shaded areas (89%), and rest breaks (83%) were significantly linked to elevated stress (OR = 5.1; 95% CI:2.3-9.5). Gender differences were evident; 90% of women reported inadequate shade/rest, and those juggling domestic responsibilities were 2.9 times more likely to experience anxiety, irritability, and social withdrawal than men (95% CI:1.3–8.0). Combined physical heat strain and mental fatigue increased absenteeism and wage loss (OR = 3.0; 95% CI: 1.76–4.69), underscoring the intersection of thermal and psychological stress. Conclusion: Occupational heat exposure substantially increases the risk of HRIs, psychological distress, and PL among informal workers. Policy actions must integrate heat-health surveillance, cooling infrastructure, regulated rest breaks, mental health awareness programs, psychosocial support, and gender-responsive welfare schemes into occupational safety frameworks, which can promote a resilient, equitable, and heat-adaptive workforce in a warming climate.

Tanya Sarah Isaac, Rekha Shanmugam, Vidhya Venugopal Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Climate change is intensifying workplace heat exposures globally, with particularly severe impacts in tropical regions. Pregnant workers face unique physiological vulnerabilities due to increased metabolic heat production, cardiovascular strain, and altered thermoregulation. These risks are especially critical for outdoor and informal sector workers in low- and middle-income countries where climate adaptation measures are limited. Despite growing evidence of heat-health risks, occupational heat exposure standards do not account for pregnancy-specific susceptibilities. Aims and Objectives: This study aims to compare heat exposure levels and heat-related health outcomes between pregnant and non-pregnant women workers, and to quantify how pregnancy modifies the temperature-risk relationship. Materials and Methods: We conducted a cross-sectional comparative study of 500 pregnant and 734 non-pregnant women workers in South India between 2017 and 2023. Workplace heat exposure was measured using the Wet Bulb Globe Temperature (WBGT) index. Dehydration was assessed via urine specific gravity (USG >1.020), and heat-related illness symptoms were captured through the HOTHAPS questionnaire. We employed generalized additive models (GAM) and logistic regression with interaction terms to examine effect modification by pregnancy status, adjusting for age and socioeconomic status. Results: Pregnant workers were exposed to significantly lower mean WBGT (26.54 ± 1.27°C) compared to non-pregnant workers (29.50 ± 2.60°C, p < 0.001), yet experienced higher HRI symptoms (80% vs. 71%, p < 0.001). Critically, 100% of pregnant workers showed dehydration versus 24% of non-pregnant workers. Categorical analysis revealed critical thresholds: compared to <26°C WBGT, HRI odds increased 6-fold at 28–30°C and 11-fold above 30°C (both p < 0.001), with pregnant workers showing 6-fold higher baseline risk (p < 0.001). GAM confirmed non-linear acceleration of risk above 28°C. Continuous modelling revealed a significant effect modification (WBGT × pregnancy interaction: OR 0.70, p < 0.001). This flattened dose-response curve reflects physiological saturation—pregnant workers already experience symptoms at moderate WBGT levels (26–28°C), tolerable for non-pregnant workers, leaving limited capacity for incremental worsening. Conclusion: Pregnancy fundamentally alters occupational heat vulnerability, with pregnant workers experiencing HRI symptoms at WBGT levels considered safe for non-pregnant populations. Current occupational heat standards fail to protect pregnant workers, who show universal dehydration and elevated symptom burden despite working in cooler environments. These findings underscore the urgent need for pregnancy-specific heat exposure limits (≤26°C WBGT), mandatory hydration protocols, and workplace accommodations, including modified work schedules and rest breaks, to safeguard maternal and foetal health in warming workplaces.

PK Latha, Vidhya Venugopal Sri Ramachandra Institute of Higher Education and research [email protected] Introduction: Rising global temperatures increasingly threaten worker health in indoor workplaces. While mechanical cooling offers one solution, many workplaces, particularly small and medium-scale industries, rely on passive building design. However, empirical evidence comparing building envelope performance in protecting workers from heat remains limited. Aim and Objectives: This study compared the impact of building envelope thermal properties on workplace heat exposure and worker health, specifically quantifying heat exposure, physiological heat strain, prevalence of heat-related illnesses, and renal function. Materials and Methods: A cross-sectional study was conducted among 1,600 indoor workers across 21 workplaces in Tamil Nadu during summer (2022-2024). Workplaces were categorized by roof material thermal transmittance (U-values). Indoor wet bulb globe temperature (WBGT) monitors heat exposure. Heat strain indicators, core body temperature (CBT) rise, sweat rate (SwR), and urine specific gravity (USG), were measured using standard methods. Heat-related illness (HRI) symptoms were assessed using validated questionnaires, and kidney function was evaluated through the estimated glomerular filtration rate (eGFR). Data were analysed using descriptive statistics and Chi-square tests (SPSS v29). Results: Building envelopes have a significant impact on heat exposure. Poorly insulated concrete panels (U-value ≤1.8 W/m²K) in 41% of workplaces resulted in an average indoor WBGT of 30.4±3.0°C, exposing 83% of workers to unsafe levels. Better-insulated buildings (U-value >1.8 W/m²K) demonstrated substantially reduced health impacts: HRIs (20% vs. 89%), CBT rise >1°C (13% vs. 9%), SwR >1 L/hr (11% vs. 7%), USG >1.020 (32% vs. 26%), and kidney impairment with eGFR ≤89 (19% vs. 34%). Conclusions: The thermal properties of the building envelope critically impact indoor heat exposure and worker health. Better insulation substantially reduced heat strain, heat-related illnesses, and kidney impairment. Findings underscore the need for mandatory insulation standards, thermal retrofitting, and affordable passive cooling technologies for climate-resilient workplaces.

Manisha Kankonker, Naresh Fadte, Bhagyashree Undre Gomeco alumnii private limited [email protected] Introduction: Workers in factory are exposed to various health hazards. The prevalence of oral diseases, particularly dental caries and periodontal diseases, is high among factory workers. Studies have shown that a significant percentage of workers in various industries, experience these conditions. Cases of oral cancer have increased considerably and increased deaths reported worldwide. Early diagnosis is the most important single factor in combating oral cancer and improving survival rate. Aims and Objectives: To find out the Proportion of oral health problems among factory workers. Materials and Methods: A cross-sectional study was conducted among 300 factory workers in Goa. The study was conducted over a period of 12 days, starting from 19th May 2025 to 30th May 2025. Data was collected by examination of each factory worker. Data was analysed using IBM SPSS Statistics version 14. Results: Out of 300 participants majority of the factory workers i.e. 223 (74.3%) were males are 77 (25.7%) were females. Majority of the study population belonged to 21-30 years age group. The prevalence of Oral mucosal lesions was 37%. Most common lesion among workers was dental cavity 36 (12%). Most common site affected by the lesion was buccal mucosa. Conclusion: The prevalence of Oral mucosal lesions was 37%. Most common lesion among workers was dental cavity 36 (12%) and the most common site affected by the lesion was buccal mucosa.

Sudha Bala, Rajiv Kumar, VGKS Vaishnavi, Archana Mavoori ESIC Medical College and Hospital, Sanathnagar, Hyderabad [email protected] Introduction: Gasoline, a petroleum-derived fuel, contains volatile organic compounds such as benzene, toluene, ethylbenzene, and xylene (BTEX), are known for their neurotoxic potential. Workers in the oil industry are frequently exposed to gasoline vapours during fuel handling, particularly in poorly ventilated environments. Acute exposure to these vapours may lead to a range of transient neurological symptoms, the exposure and severity of which remain under-researched in occupational settings.[1] Aims and objectives: To identify the most common acute neurological symptoms associated with gasoline inhalation and to assess the association between level of exposure and the severity of neurological symptoms. Material and Methods: A case control study was undertaken among 202 workers aged 18-59years at a single oil industry located in Hyderabad city using structured questionnaire to gather data on demographics, occupational roles, gasoline inhalation history, and acute neurological symptoms using standardized tool- Confusion Assessment Method(CAM Score) to assess severity.[2] Alcohol use was evaluated with the AUDIT score to control for confounding. [3] Data was entered and analysed using Microsoft Excel 2024. Descriptive statistics was used and Chi-square tests along with odds ratio to assess associations between exposure levels and neurological outcomes between cases and controls. Results: Neurological Symptoms included headache (75.2%), dizziness (65.3%), and fatigue (57.4%) were significantly more common among exposed(cases) compared to Controls, with CAM scores revealing a higher prevalence of acute confusion. Workers with daily exposure (>6 hours) were strongly linked to increased symptom severity with odds ratio 3.913(1.673-7.151). Respiratory protection usage also further contributed to symptom occurrence which was statistically significant with odds ratio 4.19 (1.574- 8.142). Conclusion: This study confirms significant association between occupational exposure to gasoline vapours and acute neurological symptoms . The study emphasizes the urgent need for targeted occupational health measures including mandatory respiratory protection use, work rotation and periodic health screening in order to reduce neurological health risks in fuel-handling environments.

Parth Anilbhai Parmar Shri M P Shah Government Medical College [email protected] Introduction: Healthcare worker burnout has emerged as a critical occupational health concern in India, While a previous meta-analysis has examined burnout among healthcare workers in India. Aims and Objectives: Our updated and expanded systematic review and meta-analysis aims to provide a more comprehensive synthesis of its prevalence and associated factors across various healthcare settings, worker categories, and geographical regions, incorporating recent studies through January 2024. Materials and Methods: We conducted a systematic review and meta-analysis following PRISMA guidelines and searched major databases from January 2013 to January 2024. Studies were included if they assessed burnout among healthcare workers via validated measurement tools, such as the Maslach Burnout Inventory (MBI). Statistical analysis: Random effect models were used to calculate pooled prevalence estimates and odds ratios. Subgroup, meta-regression, and sensitivity analyses were performed to explore heterogeneity. Results: Analysis of 22 studies (N=8,794) revealed an overall burnout prevalence of 52% (95% CI: 0.40–0.63). Significant variations were observed across burnout dimensions: depersonalization (43%, CI: 0.24–0.64), emotional exhaustion (38%, CI: 0.20–0.59), and reduced personal accomplishment (41%, CI: 0.19–0.68). Compared with dentists (27%, CI: 0.09--0.57) and ASHA workers (25%, CI: 0.21--0.29), doctors had a greater prevalence of burnout (56%, CI: 0.44--0.68). West India reported the highest regional prevalence (67%, CI: 0.49–0.81). Strong associations were found with stress (OR=9.30), anxiety (OR=6.96) and insomnia. Work-related factors, including emergency duties (OR=2.21) and night shifts (OR=2.00), showed moderate associations. High heterogeneity was observed across analyses (I²>97%). Conclusion: This meta-analysis revealed a substantial burnout burden among Indian healthcare workers, with significant variation across professional categories and regions. The strong associations with psychological and work-related factors suggest the need for targeted interventions focused on mental health support and workload management. To reduce the risk of burnout, policymakers should prioritize organized wellness initiatives, mental health counseling, and better working conditions. These findings provide actionable evidence-based insights for developing comprehensive strategies to address healthcare worker burnout in India.

Ranjit Tambe Reliance Industries Limited , Nagothane Manufacturing Division [email protected] Introduction: Cardiovascular disease remains a leading cause of morbidity and mortality among industrial employees. TMT positive indicates underlying ischemic heart disease risk. Early identification and risk profiling of TMT positive individuals are essential for effective workplace health interventions. Aims and Objectives: To study the cardiovascular risk profile of TMT positive employees and to identify key modifiable risk factors associated with positive TMT outcomes. Materials and Methods: A retrospective analytical study was conducted at the OHC of RIL NMD covering medical records from Jan 22 to Sep 25. Out of 533 employees who underwent TMT, 130 were found to be TMT positive. Using the propensity score matching (1: 1 ratio) based on age, BMI and work profile, 130 TMT-negative employees were selected as controls. demographic parameters, anthropometric data, lipid profile, blood pressure, fasting blood sugar and lifestyle habits were analysed. Statistical tests included paired t-test, chi square test and logistic regression analysis using SPSS version 25. Results: TMT positive employees showed significantly higher mean BMI, systolic blood pressure, fasting blood sugar andLDL cholesterol levels compared to matched controls (p<0.05). A higher prevalence of hypertension (42%), Dyslipidaemia (38%) and sedentary lifestyle (46%) was observed among TMT positive employees. Logistic regression identified elevated BMI (OR=2.3), hypertension (OR=2.8) and dyslipidaemia (OR =3.1) as significant predictors of TMT positivity. Conclusion: The study provides valuable insights into the cardiovascular risk distribution among industrial employees and reinforces the role of OHCs in early detection and prevention of cardiovascular diseases. The findings can be directly applied to design evidence-based employee wellness programs focused on Risk- based Health surveillance, Lifestyle Modification Initiatives and targeted interventions by OHC. These measures are expected to reduce further cardiovascular morbidity, absenteeism and improve overall productivity and employee quality of life.: Limitations: Dietary habits, Stress levels and genetic predisposition were not quantitatively assessed. Approximately 22% of TMT positive cases were found to be false positive hence confirmatory testing (2 D ECHO , angiography) is essential before definitive diagnosis.

Priya T, Naresh Fadte, Kiran Adabala Voltas, Gummidipoondi, Tamil Nadu [email protected] Introduction: Workers in factory are exposed to various health hazards which can eventually lead to Non-communicable disease (NCDs) such as coronary artery disease and cerebrovascular diseases. Hypertension and Obesity are the risk factors for coronary artery disease and cerebrovascular diseases which can be modified at each individual worker’s level unlike the various health hazards at factory level. Aims and Objectives: To find out the prevalence of hypertension and obesity among factory workers. Materials and Methods: A cross-sectional study was conducted among 204 factory workers in Goa. The study was conducted over a period of 12 days, starting from 19th May 2025 to 30th May 2025. Data was collected by examination of each factory worker. Data was analysed using IBM SPSS Statistics version 14. Results: 204 factory workers were examined out of which majority were males 131 (64.2%) while remaining 73 (35.8%) were females. The prevalence of hypertension was 24% among factory workers and prevalence of obesity was 5% among factory workers. 33 (16.1%) of the factory workers were in pre-hypertensive stage. Twelve (5.8%) workers were under-weight 66 (32.3%) were overweight. Conclusion: The prevalence of hypertension was 24% among factory workers and prevalence of obesity was 5% among factory workers.

Abdul Malik Tata Steel Limited, Jamshedpur, Jharkhand [email protected] Introduction: The steel industry is characterized by physically demanding tasks, including heavy lifting, repetitive motions, and awkward postures, etc., which contribute to a high prevalence of work-related musculoskeletal disorders (MSDs) among workers. Aims and Objectives: This study presents the implementation and evaluation of a comprehensive workplace ergonomics program within a steel manufacturing facility, aimed at systematically identifying, assessing, and mitigating ergonomic risk factors to improve worker well-being and operational efficiency. Materials and Methods: The program adopted a multifaceted approach, integrating management commitment, active employee participation, and a combination of engineering and administrative controls. The methodology involved extensive site-wide MSD studies and detailed ergonomics risk assessments across all operational locations. Ergonomic control measures were then implemented rigorously following the established hierarchy of controls. Validated tools, specifically the REBA and RULA, were used for the systematic identification and quantification of high-risk tasks associated with manual material handling, awkward postures, high repetition, and forceful exertions common in the steel industry environment.Ergonomic risk assessment done in 115 departments across all operational locations. Total 1,800 activities were covered and 305 control measures were implemented for reduction of ergo risks. Results: Post-implementation studies and subsequent assessments demonstrated highly significant positive outcomes like 55% reduction in the incidence of musculoskeletal disorder cases across all facilities and significant decrease in the average REBA score from 8.28 (high risk) to 3.00 (low risk) and average RULA score from 5.12 (Medium risk) to 2.9 (low risk) confirming a direct reduction in the ergonomic risk factors at the workplace level. Conclusion: In conclusion, this study validates the effectiveness of a centralized, professionally managed, and comprehensive ergonomics program in a demanding heavy industry setting. The results highlight the direct correlation between proactive risk management through the hierarchy of controls and the improvement of worker health and safety outcomes, ultimately driving enhanced operational sustainability and a healthier workforce.

Kiran Waghmare CDAC Mumbai [email protected] Introduction: The digitalization of workplaces has intensified mental health challenges due to workload pressure, screen fatigue, and remote work isolation. Conventional assessments like surveys or counseling fail to capture real-time psychological variations. There is a growing need for intelligent, continuous systems capable of identifying early stress indicators and preventing escalation. Artificial Intelligence (AI) offers transformative possibilities through predictive analytics and proactive intervention to enhance occupational wellbeing. Aims and Objectives: This study aims to develop an AI-enabled predictive framework for managing workplace mental health. The key objectives are; identify relationships between behavioral, physiological, and emotional variables and stress levels; develop and train machine learning models to predict mental health risks using multimodal data; and evaluate the impact of AI-driven interventions on reducing stress and improving wellbeing. Materials and Methods: Data from 400 employees were collected over a week, encompassing behavioral metrics (typing speed, communication latency), physiological indicators (heart rate variability, sleep hours), and emotional sentiment derived from workplace communication. Data were normalized and cleaned before training supervised learning models—Random Forest, Gradient Boosting, and SVM—using an 80:20 split. Models classified stress as Low, Moderate, or High based on aggregated features. Descriptive statistics summarized key variables. Predictive accuracy was evaluated using precision, recall, F1-score, and ROC-AUC through five-fold cross-validation. Paired t-tests assessed pre- and post-intervention wellbeing scores, while ANOVA examined variations among stress levels. Results: The Random Forest model achieved 88.7% accuracy and an F1-score of 0.86 in identifying high-stress individuals. Significant correlations (p < 0.05) were found between low heart rate variability, reduced sentiment, and increased workload. Post-intervention analysis indicated a 30% reduction in reported stress and enhanced employee engagement. Conclusion: The proposed AI-driven framework effectively integrates behavioral and physiological analytics to detect and mitigate workplace stress. Transitioning from reactive support to proactive prevention improves mental health, safety, and productivity. The study highlights the promise of ethical, data-driven AI in creating psychologically safe and resilient work environments.

B Ramakrishna Goud1, K Swarna2, H Chandrashekhar2 1Dept of Community Health, St John’s Medical College and Hospital, Bengaluru, 2ESIC Medical College and PGIMSR, Bengaluru [email protected] Introduction: Housekeeping staff in tertiary care hospitals are vital for hygiene and infection control, yet remain professionally marginalized and socially invisible. Limited research exists on their occupational health, psychosocial well-being, and job satisfaction. This study assesses depression, anxiety, and associated factors among housekeeping staff in a tertiary care teaching hospital in Bengaluru, India. Aims and Objectives: To assess depression and anxiety among housekeeping staff in a tertiary care hospital in Bengaluru; and to evaluate socioeconomic, demographic, and job satisfaction-related factors associated with depression and anxiety. Materials and Methods: A hospital-based cross-sectional study was conducted among 150 housekeeping staff using a structured questionnaire. Data included demographics, family structure, socioeconomic status (BG Prasad scale, 2025 revision), depression screening (PHQ-9), anxiety screening (GAD-7), job satisfaction (SIJS tool), comorbidities, and substance use patterns. Participation was voluntary with informed consent; data was collected during work shifts with supervisory support. Descriptive statistics (frequencies, percentages, means ± SD) and cross-tabulations with Fisher’s Exact Test were applied to explore associations (p<0.05). Analysis was performed using SPSS. Results: Participants were predominantly female (75.3%), married (78%), from nuclear families (83.3%), with mean age 42.06 ± 7.45 years. Socioeconomically, 52% were Class I (BG Prasad), though this masked lived precarity. PHQ-9 showed 88.7% with no symptoms, 99.3% in minimal/none category; yet 6% reported suicidal ideation (4.7% “several days,” 1.3% “more than half the days”). GAD-7 showed 87.3% scoring 0, with no moderate/severe cases. Job satisfaction was high (82%), significantly higher in males (100%) vs. females (76.1%; p=0.001). Comorbidities affected 40.7% (hypothyroidism 8.7%, diabetes/hypertension 5.3% each); musculoskeletal issues were common. Personal substance use was low, but spousal alcohol (40.7%) and tobacco (33.3%) use troubled nearly one-third of respondents. Conclusion: Despite high job satisfaction, housekeeping staff experience latent emotional distress, chronic health issues, and gendered stressors. Targeted mental health support, preventive care, and gender-sensitive policies are needed to address systemic invisibility and enhance workforce well-being.

Pankaj Raut, Arun Kale TATA Motors Ltd, Pune [email protected] Introduction: CVDs contributed to 28·1% of total deaths and 14·1% of total disability-adjusted life years (DALYs) in India. Cardiovascular diseases (CVDs) in industrial workers are a significant but overlooked public health problem. Aims and Objectives: This study aims to evaluate effectiveness of a CAD Prevention Program among employees of large automobile manufacturing company. The objectives were to introduce evidence-based, data-driven CAD Prevention Program and measure its impacts on 10-year QRISK3 score and Relative risk of developing heart attack. Materials and Methods: This intervention study enrolled employees from shopfloor and office areas of TMPV, Pune for a period of one year (October 2024 - September 2025). Universal sampling method was used for subject selection. The baseline survey was done using demographic questionnaire, anthropometry, pathology tests and QRISK3 score calculations. Medical interventions were introduced which included preventive pathology screening, personalized health coaching, annual TMT and medical management of risk factors. Follow up assessment was done after twelve months and changes in baseline parameters were studied. Results: Total 3180 employees were enrolled, and mean age of cohort was 46.5 years. Males constituted 97% of the total study population. At the end of twelve months Number of employees in “High Risk category” got reduced by 21.1% and in “Moderate Risk category” got reduced by 18.4%. Average QRISK3 score of study population got improved from 6.7 to 5.1 and Average Relative risk got improved from 2.2 to 1.6. Average QRISK3 score in “Moderate and High Risk category” combined got improved by 26.4% and Average Relative risk went down by 22%. Conclusions: The current research demonstrates the potential success of CAD Prevention Program in reducing risk of having a heart attack or stroke within the next 10 years among employees. All four interventions made significant contribution in improving overall QRISK3 score and reducing relative risk of developing heart attack.

Arpit Patel, Paten Shah Reliance Industries Limited, Dahej [email protected] Introduction: Uncontrolled diabetes among industrial employees adversely affects health, workplace safety, and productivity. At Reliance Industries Ltd., the Diabetes Control Mission (DCM) primarily relies on periodic HbA1c and self-monitoring, which often fail to capture short-term glycaemic fluctuations. Continuous Glucose Monitoring (CGM) provides real-time glucose trends that support timely behavioural change. This study evaluates the effectiveness of CGM-guided intervention versus standard DCM-based management in an occupational health setup. Aims and Objectives: To assess the impact of CGM-guided intervention on glycaemic control in employees with uncontrolled type 2 diabetes; and to compare HbA1c, mean glucose, glycaemic variability, and Time-in-Range (TIR) between CGM-assisted counselling and standard DCM care. Materials and Methods: A comparative interventional study was conducted among 70 employees with HbA1c >7%, grouped equally into CGM (n=35) and standard DCM (n=35). The CGM group underwent 14 days of continuous monitoring followed by structured counselling covering diet, physical activity, sleep hygiene, and medication adherence. The DCM group received routine care, including periodic HbA1c checks, dietary and lifestyle guidance, reinforcement of medication adherence, and general health education. Both groups were followed for four months. All parameters were analysed with p < 0.05 considered statistically significant. Paired t-tests were used for intra-group comparison and independent t-tests for inter-group differences. Results: After four months, HbA1c reduced significantly in the CGM group (9.2% to 7.1%; Δ = −2.1%, p < 0.001), compared with a smaller reduction in the DCM group (Δ = 0.8%, p < 0.05). Mean glucose decreased from 172 to 147 mg/dL; SD reduced from 48.2 to 30.7 mg/dL; and CV dropped from 28.6% to 20.9% (p < 0.01). TIR improved markedly from 68.4% to 91.2%, and TAR decreased from 28.4% to 7.1%, with no hypoglycaemia (8%, 57% in the CGM group achieved control (<8%) versus 18% in the DCM group. Conclusion: CGM-integrated counselling demonstrated a superior improvement in HbA1c, glucose stability, and TIR compared to standard DCM-based care. Real-time glucose visibility enabled employees to adopt targeted behavioural modifications—healthier food choices, physical activity after glucose spikes, improved sleep hygiene, timely medication adherence, and better regulation of work-related eating patterns. CGM represents a practical, effective, and scalable digital therapeutic tool for occupational health programs.

Najkumar Sankar, Latha PK, Somanth Panda Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Occupational heat stress is a serious and growing concern due to rising temperatures. Stone quarry workers are among the most vulnerable, performing intense manual labour under direct sunlight with limited access to drinking water, rest on shaded areas. To address this critical gap, we implemented a Water, Rest, and Shade (WRS) intervention to evaluate its effectiveness in reducing physiological heat strain. Aims and Objectives: This study aimed to assess the effectiveness of a WRS intervention in reducing heat strain among quarry workers. The specific objectives were to: (1) Quantify baseline occupational heat stress, (2) implement the WRS intervention, and (3) evaluate its effectiveness in reducing heat strain. Materials and Methods: A cross-sectional assessment was conducted among 32 quarry workers to measure heat exposure using Wet Bulb Globe Temperature (WBGT) and to evaluate physiological strain through core body temperature (CBT), sweat rate (SwR), heart rate (HR), heat-related symptoms, hydration status (USG), and renal function (eGFR). A quasi-experimental trial was then carried out among a subset of 15 workers, with participants assigned to an intervention group (n = 8) or control group (n = 7). The intervention group received approximately 750 ml of water, 10-minute hourly rest breaks, and access to shaded recovery areas, while the control group received no intervention. Over five consecutive workdays, CBT, HR, SwR, USG, and eGFR were monitored in both groups. Data were analysed using descriptive statistics and chi-square tests for between-group comparisons. Results: Among 32 workers, 84.4% of workers were exposed to WBGT above recommended thresholds, 87.5% were dehydrated (USG > 1.020), 69% reported heat related illness (p = 0.028). Following the WRS intervention, workers in the intervention group exhibited substantial physiological improvements. The rise in CBT was significantly lower (+0.030 °C) compared to controls (−0.348 °C), 62.5% reduction in intervention group, compared with no reduction in controls (p = 0.010; OR = 2.667; 95% CI: 1.090–6.524). USG improved in all intervention participants, indicating significantly better hydration compared with controls (p = 0.0001). Kidney function remained stable in the intervention group, while the control group showed a marked decline, with the risk of renal impairment being 2.3 times higher (95% CI: 0.251–20.131). Additionally, participants working under the intervention reported significantly greater comfort than controls (p = 0.005). Conclusion: The WRS intervention demonstrated measurable improvements in thermoregulation, hydration, and short-term renal stability, underscoring its feasibility and effectiveness in informal, high-heat occupational settings.

Prudvi Raj Ganne, Karunanidhi Sivagnanamoorthy, Saran Kumar T, Latha PK, Rekha Shanmugam, Akshaya Prem Kumar, Vidhya Venugopal Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Workplace accidents remain a critical occupational health challenge in India, with profound disparities between organized and unorganized employment sectors. India’s unorganized sector employs over 90% of the workforce, yet operates with severely deficient welfare infrastructure and mandated rest breaks. Despite their substantial economic contribution, unorganized sector workers remain invisible in occupational health policy frameworks due to insufficient research evidence. Aims and Objectives: This study compares workplace accident rates across industrial sectors (organized vs. unorganized) and examines the critical relationship between lack of welfare facilities and accident occurrence. Material and Methods: We conducted a comparative cross-sectional study in April and May 2025 in Tamil Nadu, India, involving 546 workers: 345 from the organized sector and 201 from the unorganized sector, drawn from manufacturing and construction industries. A structured, validated, and modified High Occupational Temperature Health and Productivity Suppression (HOTHAPS) questionnaire documented demographics, welfare facility access, and accident history. Statistical analyses included chi-square tests for categorical comparisons, with p<0.05 considered statistically significant. Results: Workplace accidents revealed a stark sectoral divide. Unorganized sector workers experienced accident rates 5.1 times higher than their organized counterparts (19.9% vs. 4.6%, p<0.001; OR: 5.1, 95% CI: 2.7-9.3). Welfare facilities, including hydration stations, toilet access, and flexible rest breaks, were unequally distributed across sectors. Toilet access emerged as the most critical differentiator: 81.6% of unorganized workers lacked toilet facilities compared to 21.4% in the organized sector (p<0.001; absolute risk difference: 60.2%). This disparity persisted despite equal access to drinking water across both sectors, strongly suggesting that flexible rest breaks, rather than hydration alone, serve as a key predictor of accident prevention. The organized sector provided scheduled breaks, which functioned as a protective mechanism against accidents. Across both sectors, the absence of flexible rest breaks was significantly associated with increased accidents (p<0.001). The higher accident rate among unorganized sector workers (19.8% vs. 4.9%) underscores the importance of rest breaks as a protective mechanism, particularly for heat-exposed workers. Conclusion: Unorganized sector workers face disproportionately higher accident rates due to inadequate welfare infrastructure, particularly the lack of flexible rest breaks and sanitation facilities. Mandating essential infrastructure including accessible toilets and flexible rest breaks across all unorganized sectors is essential for reducing workplace accidents and protecting India’s vulnerable workforce. Policy interventions must prioritize these basic protections to address the hidden crisis of occupational safety inequity in unorganized employment.

Rebanta Kumar Dash, Ashish Damaraju, Ratnakar Koyande, Vandana Shinde, Nikunj Desai, R Rajesh Reliance Industries Ltd [email protected] Introduction: Pre-diabetes represents a reversible stage of dysglycemia where timely lifestyle modification can restore normoglycemia and prevent progression to diabetes and its complications. Workplace-based health surveillance provides an accessible and sustainable approach to identify, counsel, and monitor such individuals. This study explores how structured annual screening and engagement contributed to measurable metabolic gains over three years. Aims and Objectives: To study three-year trends in fasting blood sugar (FBS), body mass index (BMI), and lipid profile among the pre-diabetic employees; and to study the impact of health improvement interventions among them. Materials and Methods : A longitudinal study was conducted using annual health check data of 150 employees diagnosed as pre-diabetic in 2022–23. Workplace lifestyle intervention like monthly mailers, doctor and dietician counseling, endocrinologist sessions, yoga and meditation, stress management techniques were done for them. Repeat evaluations were conducted in 2023–24 and 2024–25. Parameters assessed included FBS, BMI, total cholesterol, and triglycerides. Descriptive trends were summarized by year. Paired t-tests were applied between baseline (2022–23) and subsequent years. A p-value <0.05 was considered statistically significant. Results: Mean FBS showed a consistent and statistically significant improvement — 107.4 → 103.2 → 101.4 mg/dL over three years (p<0.001). Mean BMI also decreased gradually from 27.97 to 27.68 kg/m² (p=0.001). Lipid parameters showed favorable shifts, with total cholesterol reducing from 195.5 to 186.6 mg/dL and maintaining near 188.6 mg/dL, and triglycerides improving from 180.6 to 165.6 mg/dL before stabilizing at 172.6 mg/dL. Among participants 74.4% showed FBS reduction and 44.6% reverted to normoglycemia, while 50.4% demonstrated BMI improvement. Additionally, 62.8% of employees showed a reduction in total cholesterol and 62.0% showed improvement in triglyceride levels. Conclusion: This longitudinal follow-up of pre-diabetic employees demonstrated significant and sustained improvements in glycaemic and metabolic parameters, reaffirming the importance of structured workplace interventions combined with regular follow-up. Continuous engagement, periodic health reviews, and focused lifestyle counselling were pivotal in achieving positive outcomes. The findings emphasize that systematic workplace health programs can effectively translate awareness into measurable changes, reducing the risk of diabetes progression. These results support expanding workplace-based metabolic surveillance as a cost-effective, scalable model for non-communicable disease prevention.

Niharkumar Marathe, Jaydip Nakrani, Amar Kapadia Reliance Industries Limited [email protected] Introduction: Hypertension, diabetes, obesity, and dyslipidaemia are key components of metabolic syndrome and are recognized risk factors for cardiovascular disease and other chronic conditions. Industrial workers may be particularly vulnerable due to occupational environments, extended work hours, and irregular schedules. In large petrochemical complexes, rotational or fixed shifts may disrupt circadian rhythms, sleep, and lifestyle, potentially increasing metabolic disorder risks. Aims and Objectives: This study aimed to assess the prevalence of various metabolic diseases like hypertension, diabetes, obesity, and dyslipidaemia among rotational and day shift workers. Material and Methods: An observational cross-sectional study was conducted at Reliance Industries Ltd, Hazira, from April-2024 to March-2025. Total 2116 employees underwent Annual Health Check-up. Out of them 1256(59.35%) day shift workers (mean age 40.53 years) and 741(35.01%) rotational shift workers (mean age 40.05 years) were included in this study. Remaining 119(5.62%) workers were excluded from this study due to irregular shift work. Of the subjects, Data were collected via detailed medical history, physical examination and laboratory investigations conducted during annual health check-ups. Statistical analysis was performed using chi-square tests. Results: Medical data shows almost similar prevalence in both groups without any correlation with various age groups. Pre-diabetes (HbA1c 5.7–6.4) - 30.23%-rotational shift and 25.48%-day shift Diabetes (HbA1c andgt;6.4) – 13.19%-rotational shift and 14.41%-day shift Pre-hypertension (SBP 130–139 mmHg) – 8.91%-rotational shift and 8.84%-day shift Hypertension (SBP andgt;139 mmHg) – 17.81%-rotational shift and 15.45%-day shift Overweight (BMI 25–28) – 24.02%-rotational shift and 28.11%-day shift Obesity (BMI andgt;28) – 23.48%-rotational shift and 23.73%-day shift Dyslipidaemia (Cholesterol andgt;200 mg/dL) – 22.67%-rotational shift and 23.81%-day shift Done by chi-square tests shows no significant differences in prevalence. Pre-diabetes and diabetes (χ² = 5.45, p ≈ 0.066) Pre-hypertension and hypertension (χ² = 1.91, p ≈ 0.38) Overweight and obesity (χ² = 4.73, p ≈ 0.09) Dyslipidaemia (χ² = 0.222, p ≈ 0.63) Conclusions: The study suggests that rotational and day shift work do not significantly differ in their impact on the prevalence of hypertension, diabetes, obesity, and dyslipidaemia. Further research is warranted to evaluate the influence of other factors, including personal habits, duration of employment, prior job roles, and pre-employment health conditions.

Ankit Sheth, Ankit Viramgami, Rakshit Shah ICMR - National Institute of Occupational Health [email protected] Introduction: Coal-handling operations expose workers to coal dust, diesel exhaust, noise, vibration, and ergonomic strain, placing them at risk of respiratory, auditory, musculoskeletal, cardiovascular, and other systemic disorders. Despite handling 6–8 million metric tonnes of coal annually, Navlakhi Port lacked systematic health surveillance mechanisms, and evidence on the health status of its workers was absent. This study aimed to fill this gap and inform occupational health policy. Aims and Objectives: To assess the prevalence of restrictive and obstructive lung disorders, auditory impairment, and musculoskeletal problems among coal-handling workers; and to recommend preventive strategies and promote evidence-based medical surveillance at the port. Materials and Methods: A cross-sectional study was conducted among 269 coal-handling workers. Data were collected using a structured questionnaire capturing sociodemographic characteristics, occupational and medical history, lifestyle habits, musculoskeletal complaints, and healthcare utilization. Clinical examination included general and systemic assessment, vitals, and anthropometry. Diagnostic evaluations comprised spirometry (ATS/ERS standards), chest X-ray (300 mAh), audiometry, and laboratory investigations including liver and kidney function tests, lipid profile, and diabetes screening. Descriptive and inferential statistics were applied. Results: Of the 269 workers examined, 10% showed chest X-ray abnormalities suggestive of pneumoconiosis, and spirometry indicated both obstructive and restrictive patterns. High-frequency hearing loss, consistent with noise-induced impairment, was detected in 10% of workers. Musculoskeletal symptoms were widespread, particularly among machine operators (35%). Non-communicable disease risk was substantial: 30% were hypertensive, 51% pre-hypertensive, and 29% obese. Lifestyle risk factors included tobacco chewing (54%), smoking (25%), and alcohol use (32%). Socioeconomic vulnerability was pronounced—54% incurred out-of-pocket expenditure, and 16% experienced catastrophic health expenses; only 24.9% had PM-JAY insurance. PPE usage was inconsistent and inadequate across all job roles. Conclusion: Coal-handling workers at Navlakhi Port face a high burden of occupational and lifestyle-related health risks, exacerbated by poor PPE compliance and limited access to affordable healthcare. The findings underscore the need for structured medical surveillance and targeted preventive interventions. The study’s evidence was formally submitted to the Gujarat Maritime Board (GMB), resulting in the mandatory implementation of pre-employment and periodic medical check-ups for all coal-handling workers—marking a major policy advancement and demonstrating effective evidence-to-policy translation.

Rakshit Shah, Mihir Rupani, Nitishkumar Tank, Nikhil Kulkarni, Vyoma Mistry, Sanjay Kotadiya, Priyanka Mevada ICMR - National Institute of Occupational Health [email protected] Introduction: Silicosis is a progressive, irreversible occupational lung disease with no definitive treatment; therefore, improving health-related quality of life (HRQoL) remains the key therapeutic goal. The St. George’s Respiratory Questionnaire (SGRQ), is widely used to assess HRQoL in chronic respiratory diseases such as COPD, asthma, and idiopathic pulmonary fibrosis. Although the SGRQ has also been applied in studies involving silicosis patients, its psychometric properties have not been formally evaluated in this population. Given the clinical importance of HRQoL assessment in silicosis, such validation is essential. Aim and objectives: The main aim was to evaluate the internal consistency reliability and validity (including construct and known-groups validity) of the SGRQ tool in patients with a confirmed diagnosis of silicosis. Materials and methods: This analysis was conducted utilizing baseline data from 272 patients with silicosis, enrolled in an ongoing study assessing the effectiveness of community-based pulmonary rehabilitation in Rajasthan. HRQoL of the study participants was assessed using the SGRQ. Pulmonary function was evaluated using spirometry, yielding percent-predicted forced vital capacity (FVC%), percent-predicted forced expiratory volume in one second (FEV 1 %), and the FEV 1 /FVC ratio. Functional capacity was tested using the six-minute walk distance (6-MWD), recorded in meters. Internal consistency was evaluated using Cronbach’s alpha for each domain and the total SGRQ score. Construct validity was assessed using Pearson’s correlation coefficients between SGRQ scores and physiological measures. Known-groups validity was assessed by comparing mean SGRQ total scores between patients in the first and fourth quartiles of FVC% and 6-MWD, using independent sample t-tests. Results: Cronbach’s alpha indicated acceptable-to-good internal consistency for SGRQ domains (Symptoms: 0.745, Activities: 0.763, Impacts: 0.822) and total score (0.892). Construct validity was supported by weak, though significant, negative correlations of the SGRQ total score with FVC% (r = –0.27, p < 0.001) and 6-MWD (r = –0.35, p < 0.001). Significant correlations with physiological measures were also observed for the domain scores. Known-groups validity was demonstrated by higher (worse) SGRQ total scores among patients in the lowest quartile compared to those in the highest quartile of disease severity, based on FVC% (mean difference: +7.87, p < 0.001) and 6-MWD (mean difference: +11.66, p < 0.001). Conclusion: The SGRQ demonstrated strong psychometric properties, including internal consistency, meaningful correlations with clinical measures, and good discriminatory ability across disease severity, supporting its acceptability as a tool for assessing HRQoL in patients with silicosis.

D Ravi Krishna Reliance Industries Limited [email protected] Introduction: Occupational sedentariness has emerged as a potential risk factor for metabolic dysfunction and non-alcoholic fatty liver disease (NAFLD). This study tells the relationship between job activity (Sedentary vs active job) and Fibro scan parameters, including Controlled Attenuation Parameter (CAP) and Liver Stiffness Measurement (LSM), as well as metabolic parameters such as body mass index (BMI), triglycerides, and blood sugar. Aim and Objectives: To evaluate the association between occupational activity level (sedentary versus active jobs) and hepatic health among employees by comparing FibroScan parameters—Controlled Attenuation Parameter (CAP) and Liver Stiffness Measurement (LSM)—and to examine their relationship with metabolic markers including body mass index, triglycerides, and fasting blood sugar. Materials and Methods: A cross-sectional study was conducted among 121 employees, non-alcoholic, categorized as sedentary (n = 75), active (n = 46) based on occupational activit y. Data were collected through workplace health camps and periodic medical examinations, during which anthropometric measurements, triglycerides (TG), and fasting blood sugar (FBS) values were recorded. Hepatic assessment was performed on-site using Fibro Scan, as part of a dedicated liver health screening camp. Statistical analysis applied to compare CAP and LSM between groups. Spearman correlation was used to analyze relationships between liver parameters (CAP, LSM ) and metabolic markers (BMI, TG, FBS). Results: Results showed that sedentary workers had significantly higher CAP and LSM values (p < 0.01), indicating greater liver fat accumulation and stiffness. They also had higher BMI and triglyceride levels compared to their active counterparts. Both CAP and LSM demonstrated positive correlations with BMI and triglycerides, emphasizing the metabolic link between obesity, lipid levels, and liver status. Conclusion: Overall, the findings highlight that occupational sedentariness contributes to early hepatic metabolic alterations detectable through non-invasive FibroScan assessment. Encouraging workplace physical activity and regular screening may help in preventing progression toward fatty liver and metabolic complications.

Disha P Patel, Pradip Serathia, Balmukund Pesivadia, Ravi Ramani Reliance Industries Limited, Jamnagar [email protected] Introduction: Antenatal care (ANC) is a cornerstone of maternal and child health, particularly in low- and middle-income countries where community medical centres serve as the first point of contact for most women. The percentage of women with at least four ANC visits increased from 51.7% in NFHS-4 (2015-16) to 59.3% in NFHS-5 (2019-21). Aims and Objectives: To assess the utilization and challenges of antenatal services at a community medical centre. Materials and Methods: A cross-sectional study was conducted among 370 pregnant women attending ANC at a community medical centre in year 2024 and 2025 Data was collected through structured questionnaires, patient records, and direct observation and analysed using Microsoft Excel 2019 and SPSS v29 Results: Mean age to conceive in our sample was 24.17±1.16 years. Out of 370 women, 78% of women registered in the first trimester, but only 30% completed four or more ANC visits. Blood Pressure (BP) measurement and haemoglobin estimation were done in 100% of women out of them all women were having BP of <-140/90 mmHg. 1.10% women were having abnormal Random Blood Sugar and were on medication for gestational diabetes from private clinic. Regarding anaemia, 28.72% women were in normal range, 35.35% women had mild anaemia, 38.39% women had moderate anaemia and 1.10% were having severe anaemia. During the study period out of 370, 18 (4.9%) women were immunized against Tetanus Toxoid(TT) injection at centre while remaining women had taken TT injection from government facility. Awareness on nutrition and birth preparedness was comparatively low. Conclusion: Basic ANC services are well provided to beneficiaries, gaps remain in health education and continuity of care as majority of population in this ares are migratory and most of them having residence far from centre. Strengthening counselling, staff training, and community awareness can improve outcomes. We recommend digital integration like mHealth into antenatal care to improve awareness and outcomes in rural areas. Increase public education campaigns through pregnancy care camps and mother’s meetings to raise awareness about the importance of ANC, its benefits, and the recommended number of visits, especially among disadvantaged groups through teleconsultations.

Ashutosh Das Reliance Industries Limited [email protected] Introduction: Metabolic syndrome (MetS) – a clustering of central obesity, dysglycaemia, hypertension and dyslipidaemia – represents a major and growing non-communicable disease burden in India. A recent meta-analysis of 111 Indian studies found a prevalence of around 30%, with higher rates in urban than rural settings. Occupational groups like service sector employees where sedentary work is common, may be at elevated risk. Yet large multi-state occupational data remain scarce. Aims and Objectives: To estimate the overall prevalence and State-wise distribution of MetS among service-sector employees in India; and to determine the association of risk factors like Age, BMI with MetS Materials and Methods: We conducted a cross-sectional analysis of Periodic Medical Examination (PME) data between 1st April 2024 to 31st March 2025 from a large service-sector organisation with ongoing workplace wellness interventions across India. MetS was defined using World Health Organization (WHO) criteria and health records with complete key variables (anthropometry, BP, blood glucose, lipids) were included. We estimated overall and state-wise prevalence, and modelled dose–response trends across age and BMI categories. We used proportions for categorical variables with 95% confidence intervals. State-wise prevalence was tabulated and mapped using Arc GIS. Risk factors like age, BMI were assessed using Odds Ratios with 95% CIs. A p-value < 0.05 was considered statistically significant. Results: Out of 16,840 employees, 1971 had MetS (prevalence of 11.70%, CI: 11.21 to 12.19). Prevalence varied across states, highest in Southern states like Andhra Pradesh (20%) and Tamil Nadu (18%). Odds of MetS increases with Age (50-60 years 4.12, 41-50 years 3.59, 31-40 years 2.45, <= 30 years 1, p 30 Kg/m2 20.36, 25.0-29.99 Kg/m2 1.96 compared to < 25.0 Kg/m2, p<0.001). Conclusions: The lower prevalence may reflect the value of organisation-wide targeted occupational health programmes and risk-stratified interventions, although causality cannot be inferred from this cross-sectional design. For meaningful reduction in cardiometabolic burden within India’s service economy, sustained workplace wellness interventions and longitudinal follow-up are recommended.

Rajani G. Tumane, Shubhangi K Pingle, Rituja Deshmukh, Kartikey P. Matte ICMR Regional Occupational Health Centre Southern, Bengaluru [email protected] Introduction: Cement dust contains silica and chromium which have adverse health effects in occupationally exposed workers. These contents are known carcinogens (Group I), targeting the lung and sino-nasal areas in humans. Skin damage, ulceration, allergic reactions, hypersensitivity, respiratory distress, and COPD are commonly reported. Despite this, the precise molecular processes through which silica and chromium causes structural and functional anomalies at cellular and protein levels remain unclear. Aims and Objectives: This study aims to investigate the significant differential proteins expression patterns and associated molecular pathways in cement workers with a focus on understanding how joint exposure to silica and chromium influences the proteins. Materials and Methods: A pilot cross sectional study was also conducted on exposed cement workers and control via standard questionnaire and written consent form. Blood samples were collected. Serum protein were analyzed with 1D gel electrophoresis. Differentially expressed protein bands were excised and proteome profiling was done by mass spectrometric analysis. Protein-protein interactions, gene ontology and pathway enrichment analysis was performed. Descriptive statistics was performed using SPSS. Bioinformatics tools like STRING databases was used for protein-protein interaction. Pathway enrichment analysis was performed through Gene Ontology (GO). Specialized proteomics platforms, and results will be presented with appropriate confidence intervals. A value p <0.05 was considered as significant. Results: Beta-adrenergic receptor kinase, Notch 2-binding receptor, DENN domain-containing protein 4B, Humanin - like 3 were downregulated in cement-dust exposed workers STRING analysis revealed a protein-protein interaction network and biological Process (Gene Ontology) pathway enrichment analysis indicated significant cellular and molecular interactions with the obtained proteins. Conclusion: The identified protein network and pathway provided insights into the cellular and molecular mechanisms to understand its role in diseases. This study will be helpful to understand the mechanistic link between exposure to the content of cement and its impact on health.

Prashant Dave, Aditya Babriya Parul Institute of Medical Sciences and Research, Parul University [email protected] Introduction: The early years are the most extraordinary period of growth and development in a child’s lifetime. The foundations of all learning are laid during these years. Children who are not adequately nourished are at risk for failing to reach their developmental potential in cognitive, motor, and socioemotional abilities. These abilities are strongly linked to academic achievement and economic productivity. According to data from UNICEF, it is estimated that 250 million children are at increased risk of not achieving their cognitive development potential in the first five years of life. Aims and Objectives: To estimate the Prevalence of stunting, wasting and underweight and to find out the association between the various factors leading to malnutrition and developmental delay. Materials and Methods: A cross-sectional study was conducted in the rural areas of Vadodara among 226 under 6 age children of waghodia block, Gujarat. Data of demography details, anthropometric details like weight, height mid upper arm circumference are taken over a period of 3 months and according to who z score the data has been classified as wasting, stunting and underweight. Data were analysed using a SPSS version 25. Descriptive statistics, chi square test were done. Results: The studied was caried out in 226 samples out of them 120 (53.1%) were males and 106 (46.9%) were females More than half of the children belonged to joint families (122, 54.0%) Regarding the source of information; mothers were the primary informants for most of the children (90.3%). Observed Prevalence were for wasting (17.7%), stunting (39.8%), underweight (35.8%). Their association with maternal, birth and ANC characteristics were tested and found statically significant for cried immediately after birth (p <0.04) immediate breastfeeding started (p <0.034) and hospitalization (p <0.03) etc. Conclusion: The present study, conducted among 226 children, reveals a significant burden of malnutrition. These findings underscore the ongoing challenges of malnutrition in the community and associated ANC, Maternal and child health characteristics.

Vaishali Makarand Marathe, Vandana Shinde, Prashant Bardoloi Nagothane Manufacturing Reliance Industries Limited [email protected] Introduction: Body Composition Analysis (BCA) is an important indicator of health and fitness, offering valuable insights into fat mass, muscle mass, and overall body composition. In occupational health, structured wellness programs play a key role in improving employees’ physical fitness and addressing obesity related concerns. At NMD we have planned the “Fitness Challenge”: A workplace wellness initiative to encourage lifestyle modification, and enhance overall well-being, thereby contributing to the reduction of NCD’s risk through sustainable behavioral change. Aims and Objectives: To study the impact of an eight week Fitness Challenge on body fat percent and BMI among employees at NMD Materials and Methods: A Prospective study was conducted from July’24 to Sept’24 among employees and their dependents with a body mass index (BMI)>_28 kg/m2, Total 38 individuals (19 employees, 19 dependents) joined the program;65% i.e.25 ( 15 employees, 10 dependents) completed the full eight weeks, while rest 35% i.e. able to continue for two weeks. Baseline and post-intervention assessments included BCA metrics measured using a standardized Bioelectrical Impedence Analyser Tracky TR-CS10B. The intervention comprised guided physical activity sessions, individualized Nutrition Plans, and continuous health education focusing on regular follows ups and active lifestyle. Change in body fat percentage, visceral fat levels, skeletal muscle mass, and BMI were analysed pre and post -intervention. Paired T test was applied to analyse the changes in the body composition after eight weeks. Results: The Eight weeks Fitness Challenge resulted in significant reductions in the body weight, BMI, body fat percent and visceral fat of the participants (p<0.05). The body fat (%) significantly declined from 42.4+_6.0% to 38.9+_ 6.2% (t= 3.556,P<0.002). The muscle mass of the participants significantly increased from 43.9+_8.7kg to 46.0+_9.0kg by the end of the challenge (t=2.317,p0.059). Participants- reported in feedback form that they experienced improved energy levels, and are motivated towards healthy living. Conclusion: The NMD Fitness Challenge demonstrated measurable positive outcomes in body composition and BMI, emphasizing the effectiveness of integrated physical activity and nutrition based wellness programs in enhancing employee health and workplace productivity.

Jay R Nimavat Shri MP Shah Government Medical College [email protected] Introduction: Silicosis is a progressive, irreversible occupational lung disease resulting from prolonged inhalation of crystalline silica dust. Despite being preventable, it remains a significant public health concern in many industrial settings due to inadequate dust-control measures, delayed diagnosis, and inconsistent surveillance. To better understand the pooled burden of silicosis across studies and identify the variability between them, a meta-analysis was conducted using proportions derived from published data. Aims and Objectives: To estimate the overall pooled prevalence/proportion of silicosis across selected studies; to assess the extent of heterogeneity among the included studies and to interpret study-level variations using extracted effect sizes and confidence intervals. Materials and Methods: A systematic extraction of eight studies reporting the proportion of silicosis among exposed workers was performed. For each study, the proportion (p) and its 95% confidence interval (CI) were obtained. A random-effects model (RE model) was used due to expected variability in exposure levels, workforce characteristics, and diagnostic criteria. Heterogeneity was quantified using H², I², T, and T² statistics. A forest plot was generated to illustrate individual study effects and the pooled estimate. Results: Individual study proportions ranged from 0.287 to 0.737, indicating considerable variation in reported silicosis prevalence. The pooled meta-analytic estimate was 0.579 (95% CI: 0.466–0.692), suggesting that nearly 58% of workers across the included studies were affected. Heterogeneity was very high, with I² = 94.99%, indicating that most of the variation was due to real differences between studies rather than chance. The Diamond Ratio was 4.8704, further confirming substantial spread in effect sizes. The forest plot demonstrated wide differences in CI widths across studies, supporting the decision to use a random-effects model. Conclusion: The meta-analysis reveals a high pooled proportion of silicosis among exposed workers, with significant heterogeneity across settings. This suggests widely differing exposure conditions, preventive measures, and diagnostic practices. Strengthening occupational safety standards, enforcing dust control, and implementing regular medical surveillance are essential to reduce the burden of silicosis.

Shivani SS, Madonne Rufina Dishani, Naveen Ramesh, Farah Naaz Fathima, Noronha Levis Manuel, Susmita Chatterjee St Johns Medical College Bengaluru [email protected] Introduction: Homemakers in India perform extensive unpaid work involving domestic and caregiving tasks that demand significant time and effort. This unpaid and often overlooked work is a crucial form of labour that sustains households and the economy. Monetarily quantifying and valuing a homemaker’s contribution is essential to understanding its economic implications. Research studies valuing such unpaid work among rural women are few. Aims and Objectives: To estimate the cost of unpaid work and their associated factors among rural homemakers in Bengaluru Urban District and to determine the prevalence of anxiety and depression among the study participants. Materials and Methods: This cross-sectional study was conducted among 105 homemakers in villages under Mugalur Subcentre of Bengaluru Urban District. The sample size was divided between 11 villages by proportional allocation. In each village, the direction was selected randomly using lots from the centre of the village. Homemakers in houses in that direction were recruited till the required sample size was attained. Cost of household work was assessed using a pretested, face validated, semi-structured cost questionnaire. Valuation of time spent on each unpaid household activity was done using Human Capital Method with minimum wages for household work stipulated by Government of Karnataka. Mental health status of participants was assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder Scale-7 (GAD-7). Data were analysed using Jamovi (v2.4.11) Software. Costs were analysed using descriptive statistics (median and IQR) and stepwise linear regression was used to identify factors associated with unpaid work cost. Results: Among the 105 homemakers, mean age was 41.9±10.7 years, most (60%) lived in nuclear families, monthly family income was INR 24000 (IQR 15000 -35000), while 49.5% had children < 18 years old and 26.7% had elderly dependants at home. The median cost of unpaid work per month per homemaker was estimated as INR 13913 (IQR 11194 - 18894). Homemakers spend maximum time (19.6± 9.4 hours/ week) cooking. The prevalence of depression (PHQ-9 score ≥10) was 5.7%, while anxiety (GAD-7 score ≥10) was 3.8%. Women with children under 18 years [INR 2,843, (Adjusted 95% CI 302-5384)] and those living in non-nuclear families [INR 2,860, (Adjusted 95% CI 302 – 5418)] had higher unpaid work cost. Conclusion: The study highlights a substantial unpaid work cost among rural homemakers with a low prevalence of anxiety and depression. Women with children under 18 years and those in non-nuclear families had higher unpaid work cost.

Pooja Chotai, Bhavesh Khodadiya, R Rajesh Reliance Industries Limited [email protected] Introduction: Hypertension is a major contributor to non communicable diseases and adversely affects employee health and work performance. Hypnotherapy has emerged as a mind body therapeutic modality for stress reduction and autonomic regulation. This workplace based intervention was conducted to evaluate the effect of hypnotherapy as an adjunct to medicines on BP reduction among hypertensive employees. Aims and Objectives: To Assess the impact of a structured hypnotherapy based intervention program on blood pressure control among employee with hypertension. Materials and Methods: This interventional study included 42 employees with stage 1 and 2 hypertension who voluntarily enrolled in a structured hypnotherapy program. The intervention consisted of weekly hypnotherapy sessions, guided relaxation, self hypnosis practice and digital reinforcement materials. Blood Pressure was measured before and after the intervention. Results: Mean systolic BP reduced from 149+/-12.3 mmhg to 140+/-12.4 mmhg following hypnotherapy. Mean diastolic BP reduced from 91+/-7.4 mmhg to 87+/-7.6 mmhg indicating favourable improvement in BP Control after the intervention.The improvement is statistically significant with T stat 4.6. for systolic BP, 3.34 for diastolic BP and p value <0.001 for both. Conclusion: The findings suggested that a workplace based hypnotherapy program can support hypertension management and significantly improve blood pressure control among employees. This study underscores the potential role of mind body interventions in workplace health promotion strategies.

Raju Nagaraju, Adepu Vinay Kumar, Ravibabu Kalahasthi ICMR-NIOH- Regional Occupational Health Centre (Southern)1 ICMR-National Institute of Occupational Health, Bengaluru, Karnataka, India2 [email protected] , [email protected] Introduction: Lead has been used in paints for its vibrant color, durability and ability to prevent corrosion. However, occupational exposure to these paints can cause various health issues for painters. Aims and Objectives: To assess the impact of knowledge and work practices on blood lead concentration (BLL) among painters. Materials and methods: A cross-sectional study conducted on 159 painters working in domestic and commercial buildings in Karnataka, India. Data on knowledge about health hazards and work practices (usage of PPE and personal hygiene practices) among painters were collected using pre-structured questionnaires. The whole blood samples were collected and used for BLL analysis using ICP-OES. Participants were categorized based on their BLL according to ACGIH guidelines (20 µg/dL) to determine whether knowledge and work practices help painters regulate their BLL levels.The data was analyzed using SPSS version 23 software. The results were presented in the form of proportion for demographic details, knowledge and work practices and mean ± S.D for BLL. The influence of knowledge and work practices on blood lead concentration among painters were analyzed using a chi-square test. Results: The average age and work experience of the participants was 28.26 ± 7.36 and 6.78 ± 5.43 respectively. Among the subjects, 44% had a habit of chewing tobacco, 25% smoked, and 64% consumed alcohol. The mean BLL among painters were found to be 24.14± 10.27 µg/dL, with 60% of painters exceeded the BLL prescribed limits set by ACGIH guidelines. Chi-square analysis indicated that not bathing after work, smoking without washing hands, and residing at the workplace contributed to increase BLL among painters. Additionally, the painters having good knowledge on health hazards and work practices were found to considerably reduced BLL. While the type of painting work (spray or brush) and the duration of work appeared to influence BLL levels, but not found statistically significant. Conclusion: In summary, this study clearly demonstrates that having the good knowledge on health hazards, work practices and usage of PPE can significantly decrease BLL among painters. Hence, regular awareness program on health hazards and strict adherence to work practices might reduce lead burden among painters.

Panjakumar K, Ravichandran B, Raghavan S, Gorachand Dutta ICMR-NIOH- Regional Occupational Health Centre (Southern)-NIOH, Bengaluru, Karnataka, India [email protected] Introduction: Sewerage work involves cleaning and maintaining underground sewer lines, manholes, and septic tanks. In developing countries, much of this work is still done manually in several places, despite legal prohibitions, due to limited infrastructure, lack of mechanization, and socio-economic factors. Aims and Objectives: This study aims to assess the awareness levels, knowledge and safety practice of sewage workers in order to identify gaps and support improved occupational risk mitigation. Materials and Methods: The study employed a focused, cross-sectional methodology to assess the knowledge and practices of 400 sewage workers in Bangalore city and surrounding areas. Statistical analysis was performed using SPSS, including descriptive statistics and inferential statistics. Results: Among the participants, 22 % were illiterate, alcohol consumption 36%, and the majority were involved in sewage cleaning using a jetting machine (56.6%) as their primary tool. Regarding safety practices, 93.1 % of workers were aware of personal protective equipment (PPE), and 92.2 % reported using it during work. However, only 23.2% of workers checked for toxic gases in the pit before entering, despite 76.1% having received first aid training. During the survey, 22.7 % of workers reported exposure to toxic gases or unpleasant odors and employed appropriate methods to mitigate the effects. While most workers followed hygienic practices, 18% admitted to wearing the same clothes at work and home, posing potential health risks. Additionally, 90.3 % of workers reported being vaccinated. When asked about their involvement in sewage work, 73.5 % stated that they were the first in their family to take up this occupation, and only 28.9 % would recommend this job to their dependents for livelihood and income. Conclusion: This study reveals a workforce undergoing a partial transition toward modernization, yet still attempting with significant safety and wellbeing gaps. The study emphasizes that securing worker safety requires focusing on affordable, high-impact Personal Protective Equipment (PPE) and essential safety devices, ensuring they are accessible and widely adopted throughout these workforces. Health and life insurance coverage for all sanitation and sewage workers, addressing the critical social security. This must be coupled with enforcement of mechanization to eliminate all remaining high-risk manual activities, such as pit cleaning. Compulsory first-aid training to ensure complete worker welfare across the sector.

Priyanka Mankar, BB. Mandal NIOH- Regional Occupational Health Centre, ICMR, Bangalore, India [email protected] Introduction: In Indian mining, noise exposure is a serious occupational health risk that greatly contributes to permanent/temporary hearing loss among miners. When it comes to worker health and job performance, noise from different extraction activities in both open and underground pits is significant. Aims and Objectives: This study provides a thorough analysis of noise levels, patterns of noise exposure, frequency spectra present in the mining environment, identify high-noise prone area and the impact of mining noise on the working population. The results were compared with Directorate General of Mines Safety (DGMS) guidelines and international standards. Materials and Methods: Area and personal noise measurements were collected using calibrated Type 1 sound level meter and personal dosimeters (NoisePro DLX) for drilling, blasting, loading–hauling–dumping operations, crushing units, and other Heavy earth moving machinery (HEMM) under normal working conditions. Independent samples t-test, ANOVA, correlation analysis was done for comparing noise levels across different locations/machines in the mines. Results: Total 71 samples were considered (41-area noise; 30-personal noise samples) for noise monitoring over an entire working shift in an iron ore mines of Dantewada district, Chhattisgarh, India. Area noise levels at deposit 5 (n=27 no’s) for shovel 7A, dozer DZ-7A, dumper HP13B, crusher plant, scalping screen, secondary crusher, primary screen, secondary screen, tertiary screen, vibrator 1 at TCP, bunker at TCP, screen at TCP, downhill motor house-D, SS1; also at deposit 10/11A (n=14 no’s) such as dozer D11T, conveyor 28, primary screen, secondary screen, secondary crusher, secondary scalping screen and junction house-II were found to exceeded the danger limit of 90 dB(A) as prescribed by DGMS. Noise levels for dumper CAT77D, drill IDM-BHD7, drill IDM-70E, grader at south block 1056, primary crusher motor, crusher plant, downhill motor house-II and conveyor discharge at deposit 5; also for shovel hitachi and dumper HP40 had found to cross the warning limit of 85 dB(A) as prescribed by DGMS. At deposit 10/11A, central workshop operator was found to expose the personal noise levels beyond 90 dB(A) as prescribed by DGMS. However it was found to exceed the warning limit OH 85 dB(A) for the operators of dumper no. HP13B, dumper no.HM7B, drill IDM-70, dumper platform in-charge, MCO secondary level at screening plant at deposit 5 (n=17) and for operators of shovel EX1900, dumper HP38, dumper HP36, dozer 1, drill 1, MCO at screening plant I, MCO at secondary crusher and MCO at screening plant II at deposit 10/11A (n=13). Conclusion: Measures such as mandatory use of PPE during working hours, better isolation and sound proofing of the cabins of HEMM operators, regulation of work hours, workers job rotation in noise prone area, noise proofing, etc. was suggested to reduce the noise levels in the mines.

Merlyn Joseph, Bobby Joseph St. John’s Medical College, Bangalore [email protected] Introduction: Female workers form a critical segment of India’s garment manufacturing sector, yet gaps in menstrual, reproductive, antenatal, and postnatal health knowledge remain substantial. Limited awareness, cultural taboos, and low access to reliable information contribute to poor menstrual hygiene, improper self-care, and reduced utilization of maternal health services. Workplace-based peer education models may offer an effective strategy to strengthen health literacy and improve women’s well-being. Aims and Objectives: This study sought to elicit baseline levels of menstrual, reproductive, and maternal health knowledge and practices among women garment workers and to evaluate impact of a structured, peer-educator–driven women’s health intervention in menstrual hygiene in garment factories over a 12-month period. Material and Methods: A cluster-randomized controlled trial was conducted across 75 garment factories. Thirty-seven factories assigned to the intervention arm met eligibility criteria, including employing ≥80 women and maintaining long-term partnerships with the collaborating multinational company. The intervention consisted of four training sessions for workers, the formation of factory-level Women’s Health Committees (SAKHI’S), and capacity building of supervisors and managers on supportive practices. Women aged 18–45 years with at least four months of employment were surveyed at baseline and endline. Administrative data were collected monthly. Quantitative analyses included descriptive statistics and significance testing using χ² and t-tests at a 5% level. Results: Baseline findings (n = 906) highlighted significant gaps: despite 97% knowing the menstrual cycle duration, 19% believed menstruation is a disease, over one-third used cloth instead of sanitary pads, and 55% believed exercise should be avoided during menstruation. Cultural restrictions—such as restrictions on temple entry (62%) and certain foods (48%)—were widespread. While awareness of antenatal care was relatively high, only 34% had heard of postpartum depression. Endline results demonstrated clear improvements across key indicators. Correct menstrual hygiene practices increased substantially, including reduced use of cloth and increased adherence to recommended washing and disposal methods. Misconceptions related to menstruation showed marked decline (p<0.05). Awareness of antenatal, intranatal, and postnatal care improved, with significantly more women identifying the correct number of ANC visits, warning signs in pregnancy, and the concept of postpartum depression. Worker confidence in discussing health concerns increased, and management responsiveness improved following committee engagement and training. Conclusion: The peer-educator model produced measurable improvements in menstrual and maternal health knowledge, reduced harmful misconceptions, and enhanced workplace support systems. Findings underscore the value of integrating structured health education within supply chains to strengthen the well-being of women workers and promote healthier workplaces.

Jitendra B Patel, Himanshu Pandey IOCL Email: [email protected] Introduction: Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental, and behavioural factors. The main types of NCDs are HT, DM, Obesity & Dyslipidaemia. Risk factors of NCDs are – Tobacco use, Harmful use of alcohol, physical inactivity, unhealthy life style, Obesity/Overweight, Hyperglycaemia, hyperlipidaemia, raised blood pressure. Aims and Objectives: The programme initiatives included: • Advice on lifestyle modification. • Providing post medical checkup counselling & treatment. • Dietitian & Clinical Psychologist webinars to increase awareness regarding healthy diet & Mental wellbeing. • Introduction of Healthy diet Menu in Canteen & providing Treadmills at Workplace • Raised awareness by implementing corporate health awareness camps & Health promotional programs, Celebration of Annual health calendar days with senior management participation. • Innovative corporate programs like 1) 4R4U- wellness calendar. 2) Mental wellbeing addressed by psychologist. 3) Promotion of psychological health 4) Daily Live wellness hrs 6-7 AM & 7-8 PM (LIVE) - Yoga 5) 100 days of running 6) Informative-cum-Interactive Posters on Ailments/Diseases 7) Corporate fitness challenge. 8) Y chair Yoga – yoga at the workplace • Advice on lifestyle modification. • Providing post medical checkup counselling & treatment. • Dietitian & Clinical Psychologist webinars to increase awareness regarding healthy diet & Mental wellbeing. • Introduction of Healthy diet Menu in Canteen & providing Treadmills at Workplace • Raised awareness by implementing corporate health awareness camps & Health promotional programs, Celebration of Annual health calendar days with senior management participation. • Innovative corporate programs like 1) 4R4U- wellness calendar. 2) Mental wellbeing addressed by psychologist. 3) Promotion of psychological health 4) Daily Live wellness hrs 6-7 AM & 7-8 PM (LIVE) - Yoga 5) 100 days of running 6) Informative-cum-Interactive Posters on Ailments/Diseases 7) Corporate fitness challenge. 8) Y chair Yoga – yoga at the workplace Materials & Methods: It was a Trend analysis study of NCDs among the IOCl Employees from the year 2022 to the year 2025. The percentage of NCDs was calculated for the FY 22-23 , FY 23-24 & FY 24-25 to study the NCDs pattern. Result: The trend analysis study of NCDs shows a significant reduction in NCDs of Gujarat Refinery Unit Employees. Conclusion: This study shows that by implementing innovative health & wellness programs, and raising awareness regarding NCDs, there is significant achievement in the reduction of NCDs. There is an improved healthy lifestyle, and work-life balance among IOCL employees.

Om Prakash Pandey [email protected] Introduction: Sickness absenteeism is one of the important health problems in industry, measured as the number of workdays employees missed due to illness. Causes may be Economic, Social, Medical and Non-occupational. It is a valuable index for assessing the overall health and wellbeing of a workforce. It provides insights into potential health issues, the effectiveness of workplace health problems and can help identify risk factors related to both individual and organisational health. Aims and Objectives: To study the Sickness absenteeism (SA), morbidity among the industrial workers at TGS and the factors related to it. Materials and Methods: The study was conducted amongst NOPR and OPR working at TGS. (Jan.23- Dec.23) A structured pre-tested interview was taken for collection of health events data as for what reason and how many days of sick leave they have taken. Our absenteeism measure was the recorded sick leave that were processed and kept on payroll system. Inclusion criteria- Sickness due to common ailments- MSD, GI, CVS, RTI. Exclusion criteria- Workplace injury Results: Out of total 495 TGS employees, (NOPR-246 and OPR-249 ), 177 reported sick during the study period. (NOPR- 110 and OPR- 67). Most common reason for absenteeism was found to be MSD (34.4%) followed by GI (27.1%), RTI (22.5%) and others ENT, Dental, Gynae. (12.9%). NOPR reported sick- 62.1%, OPR reported sick- 37.8%, Overall sick days lost- 1306 days ,(NOPR- 821 (Male) + 159(Female) = 980 days, OPR- 326 days, Man-days lost per worker- 7.37 days, NOPR man-days lost- 8.9 days, OPR man-days lost- 4.8 days. Conclusions: Based on the result of the study, sickness absenteeism can be differentiated for shorter and longer period. SA of 3-4 days can be explained due to minor illnesses, Flu and Influenza, Diarrhoea and GI problems while leading health issues like HTN, MSD for longer SA for more than a week. Preventive activity such as good factory management, adequate pre-placement medical examinations, good human relation and application of ergonomics will play a definitive role. Considering the above findings, this study was conducted to know the burden of ailments and further we believe that the experimental research work will continue, the factors associated with SA in Iron and Steel Industry, though it was limited to TGS only.

Aditya Paliwal, Nandan Mishra Reliance Industries Limited, PMD [email protected] Introduction: The primary pathophysiological mechanism underlying metabolic syndrome is insulin resistance, which also occurs before type 2 diabetes mellitus and cardiovascular morbidity. Dysregulated glucose metabolism and systemic inflammation are fostered by excessive adiposity, especially an elevated total body fat percentage. In people who appear to be normoglycemic, glycated hemoglobin, HbA1c, a reliable predictor of prolonged glycemic exposure, can also be used as an indirect indicator of insulin resistance. Aims and Objectives: The purpose of this study is to clarify the relationship between HbA1c levels and total body fat percentage in workers who are not diabetics and to assess how structured lifestyle adjustment affects these metrics. Materials and Methods: A cross-sectional analysis was conducted among 80 industrial workers aged 18–58 years without a prior diagnosis of diabetes. Anthropometric indices, waist circumference and waist-to-hip ratio, WHR, were recorded. Body composition was quantified using bioelectrical impedance analysis, BIA, with the Tracky TS-CS10B analyzer. Venous blood samples were obtained for HbA1c estimation through standardized enzymatic methods. Participants exhibiting elevated body fat percentage, n=40, were subsequently enrolled in a multidisciplinary lifestyle management program comprising physiotherapy-guided exercise, nutritional counseling, and behavioral modification. Follow-up assessments were performed to evaluate changes in body fat percentage and HbA1c. Results : A total of 40 out of 80 demonstrated elevated body fat percentage, 23 exhibited WHR > 0.95, and 18 had waist circumference exceeding 40 inches. HbA1c analysis revealed that 14 were in the prediabetic range and 4 had borderline hyperglycemia. Following 6-month intervention, the mean post-intervention HbA1c, 5.57 ± 0.38%, was lower compared to baseline, 5.89 ± 0.42%, and a similar significant decline was observed in total body fat percentage, Post intervention -29.8 ± 4.1%; Baseline - 32.6 ± 4.8%; paired test, p < 0.05. The analysis demonstrated a positive correlation, indicating a moderate association between total body fat percentage and HbA1c among non-diabetic participants. These findings highlight that adiposity not only predicts early metabolic deviation but is also a reversible risk factor through targeted behavioral modification Therefore, combining body composition evaluation with HbA1c screening may improve identification of at-risk individuals and help target the preventative measures. Conclusion: In people without diabetes, the results show a positive correlation between total body fat and HbA1c, supporting the idea that adiposity is an early predictor of insulin resistance. Subclinical metabolic impairment can be reversed by certain lifestyle changes, as seen by the reported decrease in HbA1c following intervention.

Dipen Panara, Balmukund Pesivadia, Disha Patel, Ravi Ramani Occupational health physician, Reliance Industries Ltd Email: [email protected] Keywords : Addiction, BMI, Diabetes, Hypertension, Non-communicable diseases, Rural health, Screening Introduction: Non-communicable diseases(NCDs)such as hypertension, diabetes and obesity are major public health challenges especially in rural areas where awareness ,screening and healthcare access remain limited.NFHS-5 data shows prevalence of overweight/obesity(23.6%)in population while Hypertension prevalence is 18.3%nationally with a higher rate in men(21.6%)than women(14.8%).Early detection and regular monitoringofrisk factors are essential to prevent complications and improve community health outcomes. Aims and Objectives: To find out the prevalence of NCD and its risk factors including obesity andaddiction among adults in a rural community near petrochemical industry. Materials and Methods: A cross-sectional study was conducted among residents of a rural community nearMotkhavdi village for the period between June 2024-Oct 2025 in which purposive samplingtechnique was used to study 709 participants.Data was collected every month using astructured proforma including demographic details (name, age, gender), anthropometnc measurements (height, weight, BMI), lifestyle factors (addiction history), physiological parameters (blood pressure, blood sugar), and medication history when patient is visiting forfollow ups and then entered into Micro Soft Excel 2016 and analysed using the same.BMI wasclassified according to WHO criteria, and hypertension and diabetes were defined as perstandard guidelines.all study participants were provided with health card which includesFollow up records and preventive measures.one to one counselling to each participant wasdone. Results: Mean age of study participants was 55.55=10.65 years.Preliminary analysis showedthat a considerable proportion(45%)of participants were either overweight or obese based onBMI values.Prevalence of hypertension &diabetes among study population was 38.83% & 12.97%respectively.Normal blood pressure(62%)and normal sugar levels(55%)wereobserved in study participants,with all on medication for hypertension or diabetes.Addictionhabits such as tobacco and alcohol use(21%)were found in the study participants Conclusion: Strengthening primary healthcare services, promoting lifestyle modification,andimplementing regular community-based screening programs are essential to reduce thegrowing NCD burden. As this centre is providing free of cost services to beneficiaries whichwll reduce the out of pocket expenditure on health.As majority of population is migratory sothey left the treatment when going to their village which remains the factor for uncontrolledNCDs. Incorporation of digital health initiative like monthly reminders for follow ups anddietary advices remains the future innovations in rural community.

Ketan Patel Infinity Health Solutions Pvt Ltd, Ankleshwar, Gujarat [email protected] Aims and objectives: Studies aimed to determine the prevalence of metabolic syndrome in various working populations in Gujarat and identify associated risk factors and occupational disparities. Materials and Methods: Cross-sectional studies were conducted on employees in an industrial setup. Participants underwent periodic medical examinations, which included anthropometric measurements (waist circumference, BMI), blood pressure, and laboratory tests (fasting glucose, triglycerides, HDL cholesterol). Definitions such as the International Diabetes Federation (IDF) and the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria (modified for Asian Indians) were used for diagnosis. Results: Prevalence: The overall prevalence of Metabolic syndrome was found to be 17.8% in one industrial study; Occupational Status: In the industrial study, the prevalence was similar between non-manual (17%) and manual workers (17.3%); however, the single largest occupational category with Metabolic syndrome was managers and senior officials. Sedentary jobs and high sitting time were significant risk factors.Key Risk Factors: Prevalence increased significantly with age. Common components of Metabolic syndrome included high blood pressure, elevated fasting glucose, central obesity, elevated triglycerides, and low HDL cholesterol. Modifiable factors like lack of physical exercise, unhealthy dietary habits (frequent eating out, inadequate fruit intake), tobacco use, and high self-perceived stress were significantly associated with a higher risk of Metabolic syndrome. Conclusion: Metabolic syndrome is a significant and growing health problem in the Indian working population, with prevalence rates comparable to or higher than those in developed countries, particularly among sedentary urban workers. The findings underscore the need for targeted workplace health promotion programs focusing on lifestyle modification, regular physical activity, and dietary improvement to mitigate the risk of cardiovascular disease and type 2 diabetes.

Shreyas P Gamit, Iva S Chatterjee M P Shah Govt Medical College, Jamnagar [email protected] Introduction: Silicosis is an irreversible and incurable lung disease caused by the inhalation of silicon dioxide, commonly known as silica, in crystalline forms, usually as quartz, but also as other important crystalline forms of silica (I.e., cristobalite and tridymite). Silicosis is one of the most important occupational lung diseases in the world. Occupational exposure to crystalline silica occurs in mining, construction, stone works/quarries, pottery manufacturing and denim sandblasting. Aims and Objectives: To evaluate the demographic profile, occupational exposure history, clinical presentation, and radiological findings in patients diagnosed with silicosis. Materials and Methods: We have enrolled 10 patients , diagnosed as silicosis during November 2023 To october 2025 period. Enrolled pateints were subjected for basic epidemiological data, chest radiograph, spirometry and CT scan for detailed lung functional involvement. Observation: Longer duration of silica exposure correlated with more severe radiologic involvement, restricted lung function, and increased risk of complications such as tuberculosis and progressive massive fibrosis. Conclusion: Silicosis remains a preventable yet progressive occupational lung disease. The severity of disease in our series showed a clear association with longer duration and intensity of silica exposure. Progressive massive fibrosis and tuberculosis were frequent complications. Early screening, dust-control measures, respiratory protection, and regular follow-up are essential to reduce morbidity and improve outcomes.

Gyanendra Singh, Swapnil Tripathi, Dharati Parmar ICMR-National Institute of Occupational Health, Ahmedabad [email protected] Aims and Objectives: Numerous heavy metals, such as cadmium (Cd) and chromium (Cr), are hazardous industrial compounds that provide a risk of exposure in both occupational and environmental settings, potentially leading to detrimental consequences. Extended low-dose of Cd and Cr exposure is especially harmful to the neurological system of living beings. The fact that natural products have contributed significantly to the expansion of human pharmacological collections over time is scarcely noteworthy. They are the primary source of cutting-edge frameworks for creating potent medications to treat various medical conditions. Consequently, the current work examined the possible therapeutic advantages of coenzyme Q10 and Phloretin in Swiss albino mice that received both Cd and Cr as an established experimental model of neurotoxicity. Materials and Methods: Cadmium chloride (75 ppm) and potassium dichromate (75 ppm) were given orally in drinking water in conjunction with intraperitoneal administration of coenzyme Q10 (10 mg/kg) and phloretin (50mg/kg) for a period of two weeks. After the treatment period, mice were sacrificed, and brain tissues were dissected to perform biochemical and molecular assays. Results: In the Cd+Cr group exposed mice, the statistics showed decrease in body weight, and in other biochemical markers such as superoxide dismutase (SOD), glutathione-S-transferase (GST), reduced glutathione (GSH), total thiols (TT), catalase (CAT), and cholinesterase enzymes along with increase in levels of lipid peroxidation (LPO) and protein carbonyl content (PCC). The histological abnormalities were consistent with the previously mentioned findings, particularly with regard to the dysregulation of Akt-Keap-Nrf2, and its associated downstream gene expression of HO-1. The above-altered parameters were dramatically reversed by treatment with the chosen nutraceuticals, coenzyme Q10 and phloretin, restoring cellular homeostasis and mitigating the conciliated neurological aberrations caused by combined Cd+Cr mixture. Conclusion: Our results show that the coenzyme Q10 and Phloretin anti-oxidants have a wide therapeutic potential against the combined neurotoxicity of Cd and Cr, and could be used as a food supplement in the affected population .

Sudipta Saha ONGC [email protected] Introduction: ONGC ensures energy security of our nation through its diverse exploratory activities. Employees working in its Gas Processing Plant at Hazira are exposed to different chemicals, dust, vapours that may cause health issues on prolonged exposure. However, the greatest threat is posed by Hydrogen Sulphide gas (H2S) which can be lethal at a very high concentration. Aims and Objectives: The review paper intends to highlight the peculiarities of H2S toxicity, ways to identify its presence through workplace monitoring and strategies to be adopted to ensure that potential exposure may be avoided, enhancing the safety of the workers. Materials and Methods: The study was conducted by walk through survey with monitoring device to find out the presence of H2S in different units of the Plant for hazard mapping. Results and Discussion: The presence of H2S was detected, but was within the threshold limit value at the Gas Terminal, Sulphur Recovery Unit, Gas Sweetening Unit, Condensate Fractionating Unit and Caustic Wash Unit. The survey revealed that probability of exposure to high levels of H2S is only possible in case of leakage from the enclosed system following an accidental damage to the pipeline through which sour natural gas, rich in H2S flows. H2S is an extremely toxic and asphyxiating gas. It is formed by bacterial decomposition of organic matter and is one of the leading cause of sudden death. It is a colourless gas, heavier than air and has a rotten egg odour. A worker exposed to a very low concentration of H2S less than 10 ppm (TWA-TLV) notices its distinctive odour. Olfactory paralysis occurs at around 100-150 ppm, followed by severe systemic toxicity at 500 ppm when the gas inhibits cytochrome oxidase enzyme, blocks oxidative phosphorylation and hampers cellular respiration. Concentrations beyond 700 ppm is lethal. The strategies to ensure workers safety should include regular monitoring of H2S by detectors, mandatory awareness training, displaying of H2S safety signage and availability of Cyanide antidote kit for prompt resuscitation and treatment. Conclusion: The paper highlights that as long as the worker smells the gas, he is safe; beyond which his life in in danger. Earnest effort should be put in for early detection of H2S leakage, compulsory safety awareness training and ensuring availability of an effective disaster management plan.

Manisha Pandey Meja Urja Nigam Pvt Ltd [email protected] Introduction: Industries in India, whether private or Public sector undertakings (PSUs), rely heavily on contract labour for operational continuity. The policy framework in the majority of industries today places a high priority on worker safety and occupational health. Aims and objectives: The purpose of this paper is to emphasise the significance of psychological safety as a key element of occupational health- a powerful yet underutilised lever to strengthen safety culture in all types of industries. Materials and Methods: A keyword search emphasising articles in occupational safety and psychosocial risks was performed, supplemented by examination of the reference lists and reviews of recent meta-analyses for vulnerabilities faced by contract workers which impact safety practices. Informal verbal, face-to-face interviews were conducted with 300 workers in various diverse areas (operations as well as service functions) of a manufacturing industry regarding their perception of safety rules and challenges faced by them. The workers were in the age group 18-60 years,80% in the age group 20-40,90 % males and the educational qualification was up to intermediate in 70 % cases. The paper also proposes a contextualised framework to operationalise psychological safety in OSH environments. Results: The study found that factors like hierarchical barriers, fear of job loss, fragmented supervision and lack of integration into core safety systems hinder the reporting of hazards, jeopardise the ability to learn from near-misses, and raise the possibility of workplace accidents and mishaps. Conclusion: In an industrial operational environment, even minor changes like polite interactions, multilingual communication, peer support and safe-to-say reporting areas, can greatly increase contract labour involvement and reduce untoward incidents. A psychological Safety Framework for contract workers focusing on inclusive safety communication, supervisor behaviour transformation, hearing contract workers’ voices, Integrated OSH– HR–Contractor collaboration, and mental health and well-being support is proposed aa foundational component of safety culture.

Dayanand Shivaji Patil, Shweta Tilak, Divyang Shah, Rashmi Katta Larsen and Toubro Ltd [email protected] Introduction: Annual health check-ups (AHC) help in enhancing employee well-being and organizational efficiency. Aims and Objectives: Early Detection and Prevention: Regular health screenings facilitate the early identification of potential health issues, enabling timely intervention and reducing the risk of serious illnesses; Chronic Disease Management: Regular check-ups aid in the early detection and management of chronic diseases, contributing to a healthier workforce. Materials and Methods: This study deployed a mixed-methods approach, combining quantitative data analysis of health check-up outcomes with qualitative surveys and interviews of employees and management from different independent companies (IC). The data collected includes health metrics and employee satisfaction levels for Years 2023 to 2025. Results: AHC compliance has improved significantly by 42 %, reaching 85% in 2025 compared to 43% in 2023 for all eligible employees, and maintaining 100% compliance for those in hazardous operations. There has been a noticeable decrease in HbA1C by 42%, BMI by 2% and Cholesterol by 1%. The Customer Satisfaction Score for employees who underwent health checks-ups is 4.6 in year 2024 and 4.66 in year 2025. Conclusion: Annual health check-ups have proved to be a valuable and yielding substantial benefits in terms of employee health and wellbeing, impacting positively on the company’s Health Index.

Ravi Ramani, Pradip Serathia, Balmukund Pesivadia, Disha Patel Reliance Industries limited [email protected] Introduction: The school environment plays a crucial role in shaping the health and nutritional status of children. Early identification of nutritional deficiencies and health issues can significantly improve physical growth, cognitive performance, and overall well-being. Aims and Objectives: To assess the nutritional status and general health profile of school children; To promote awareness regarding preventive health and nutrition. Materials and Methods: A cross-sectional study was conducted near petrochemical industry among school children of 3 government schools of rural area in year 2023 and 2024 where total 550 and 584 children aged 6-15 years were examined respectively. Anthropometric measurements including height, weight, and BMI were recorded in all students to assess nutritional status as per WHO growth standards. General health check-ups were performed focusing on vision, dental hygiene, and common morbidities. Health education sessions were conducted for students and teachers on balanced diet, personal hygiene, and preventive health practices. Data was entered and analyzed using Microsoft Excel-2016 Results: The study shows 21.45% of children were underweight and 10.18% were obese in 2023 while in 2024, 24.82% children were underweight and 5.3% children were obese. Anemia (20%) was prevalent among school-going girls in year 2023 while in 2024 it reduced to 5.65%. Dental caries was present in 9.2% in year 2023 and refractive errors reduced from 8.7% to 6.67% from year 2023 to year 2024. Awareness sessions were conducted to enhance the understanding of healthy dietary practices among participants in subsequent years however, improvement was not formally measured. Conclusion: Regular school-based health screening combined with iron and folic acid supplementation, refractive error correction with health education, promoting nutrition and healthy eating, enhancing hygiene and sanitation and promoting physical activity and fitness are essential to improve health of children early in life. Strengthening school health programs can play a pivotal role in promoting holistic child development and fostering a healthier future generation. Integration to digital tool into school health program helps to track student in efficient way. As this study was conducted at govt. schools of one village so which may not represent the all schools in area, limiting the generalizability of findings

Ketankumar Pandya, Himanshu Pandey, Yogin Brambhatt Gujarat Refinery Hospital, IOCL Vadodara [email protected] Introduction: This report addresses the implementation of critical control measures and health guidelines for employees involved in the handling and transfer of Acrylic Acid (AA) and Butyl Acrylate (BA) at the Gujarat Refinery Unit. AA and BA are recognized as corrosive and irritant chemicals that pose significant health hazards upon exposure, including severe irritation to the eyes, skin, and respiratory system. Aims and Objectives: The primary objective is to detail the findings of the site survey and outline the corrective actions taken to ensure worker safety, regulatory compliance, and a reduction in occupational health risks associated with these substances. Materials and Methods: Site survey Method and BPCL Refinery visit Survey- Occupational Health Team visited to AA-BA Dumad-Gujarat refinery unit on 04 August 2025 to assess the working condition, protective clothing usage and washing facilities to ensure compliance with statutory requirement. OHC Team also visited BPCL Refinery Cocchi on 25th and 26th September 2025 to review the Sop and Control Measures taken at BPCL Refinery. Results (recommendation and suggestion): Use of Specialized PPE . the Details of PPE are – Light Weight PVC Suit (Lake Land company), Nitrile Gloves/Butyl Rubber Gloves , Safety Helmet with full face shield. Safey shoes/Gum boots when handling AA and BA . The Employees are instructed to Use of safety showers immediately in case of AA(Acrylic Acid) and BA(Butyl Acrylate) Exposure and Report immediately to Emergency Dept of Occupational Health Centre. Use of NS(Normal Saline)/Normal Tap Water if they come in contact with AA(Acrylic Acid) and BA(Butyl Acrylate). The informative Sign boards are placed at workplace regarding Use of PPE . To Increase the number of safety showers at workplace. Mandatory Six -monthly Job rotation. Comprehensive training to be provided to contract employees involved in handling AA and BA. SOP for Handling of AA and BA developed with help of HSE and Safety Department. Corrective Measures – SOP for handling AA and BA is developed. Optimum number of safety showers are installed at workplace. Use of specialized PPE is implemented. Informative sign boards are placed at workplace. Control Measures at workplace. Loading bay provide with top and bottom loading facility with vapour require system. Vent gas from tank yard in collected knock out drum and it send by PVG blower sent flare header. Conclusion: Sufficient control measure exist to reduce potential exposure to AA-BA vapour.

Aditya Lala Reliance Industries Limited [email protected] Introduction: Paroxysmal nocturnal haemoglobinuria (PNH) is a rare acquired hematopoietic stem cell disorder characterized by complement-mediated intravascular haemolyses and a high risk of venous thrombosis in atypical sites. Globally estimated incidents of PHN are 1 to1.5 per million individuals, in India mean presentation age is around 34years and usually mis diagnosed, prevalence is around 1.32 cases per million. Materials and Methods(Case Presentation): We here in CBM OHC are committed to serve not only employees but also medical facilities are extended to the families of reliance employees. As Shahdol is remote place without any full-time specialist doctor in neurology and cardiology, we have a responsibility to primarily diagnose and treat any health emergency presented to us from RIL family group. We take help of few local hospitals and diagnostic centres to deal with the situation. A 45-year-old female presented with left lower limb numbness and gait imbalance. We advised MRI brain with venography demonstrated cerebral venous thrombosis involving the superior sagittal sinus. Flow cytometry confirmed the presence of a PNH clone—neutrophils (38%), monocytes (62%), and RBCs (5%). heterozygous MTHFR mutation. Triple-phase CT abdomen demonstrated progressive hepatic vein thrombosis with multiple collaterals, consistent with subacute Budd–Chiari syndrome. Results(Management and Outcome): Primarily she was started on LMWH after confirmation of cerebral venous thrombosis followed by dabigatran, later switched to apixaban, she was advised Eculizumab therapy, a monoclonal antibody targeting complement protein C5, to prevent further thrombotic and haemolytic complications. We were involved in active discussion with family about the progress of disease, choosing right haematologist specialist and actively participated in providing primary Care and searching and contacting with brief history of patient with the senior doctors taking help of central medical team of RIL. Conclusion: Operating occupational health centre in remote place within the area where no true multi-speciality hospital operates, catering to the needs of RIL family. This case highlights the diagnostic complexity of PNH presenting initially with cerebral venous thrombosis and subsequent multivesicular venous thromboses. A high index of suspicion, comprehensive hematologic evaluation, counselling of patient and family and early initiation of complement inhibition therapy are pivotal for improving prognosis in PNH-associated thrombosis.

Shreedhar Kodiganti [email protected] Introuction: Nitric acid is a powerful oxidizing agent with several important applications in pharmaceutical manufacturing, engraving, metal refining, electroplating, and fertilizer manufacturing. It is highly corrosive and reactive in nature, hence handling nitric acid requires stringent safety measures to prevent accidents and ensure safety of workers. Aims and Objectives: Primarily contribute to medical knowledge, evaluate effectiveness of clinical management, highlighting occupational hazards and enhancing workplace safety protocols.Objective is to discuss the extensive nitric acid burn injury initial response, analyse short and long-term management plan for worker to return to work. Identify occupational hazards and develop safety recommendations that contribute to the guidelines for assessment, prevention and management of nitric acid burn injuries. Materials and Methods(Case Description): While manual shifting 45 kg nitric acid container slipped and fell on the ground and nitric acid splashed on to the hands and legs of two workers. During the process of evacuating the area, both injured workers slipped and fell-down on the spilled material. Worker #1 had 7% second/third degree burns involving both forearms, left leg, right foot and abdomen. Worker #2 had >25% (second/third degree) burns involving low back, both buttocks, both forearms and lower limbs. Resuscitated from burns shock and went three sets of procedures viz., 1) primary excision and skin grafting over both buttocks and back with split skin graft taken from left thigh and leg; 2) After 23 days of earlier procedure, primary excision of remaining burns wounds both upper and lower limbs were done and raw area was covered by split skin graft taken from right thigh and leg; 3) primary dressing was done post 5 days the second procedure and discharged (after 48 days of hospital stay) Results(Management and return to work): Regular follow-ups and return to work with restricted duties after 4 months from injury date. Continuous follow-ups on wound dressings followed by scar management for three more months. Psychological wellbeing support given throughout recovery phase. Conclusion(Recommendation): Medical emergency response planning to ensure rapid care access to specialized burn care facility. Implementing stricter safety regulations (manual handling, weight limitation, storage with secondary containment) following hierarchy of controls. Enhance safety trainings on handling of concentrated acids/chemicals. While effective medical management can ensure return-to-work of the injured workers, systemic approach to prevention will remain pivotal in preserving workers’ safety.

Anishaa Mallik, Shashwat Dutta CHRIST University, Bangalore [email protected] Introduction: The Indian corporate healthcare sector currently faces a “perfect storm” of rising service demand and critical workforce shortages, exacerbated by the recent surge in migration of health professionals to OECD nations. In this high-pressure environment, presenteeism, the act of working while ill, has evolved from a productivity metric into a significant patient safety hazard. While global research links stress to presenteeism, the specific drivers within India’s hierarchical and collectivist medical culture remain under researched. Aims and Objectives: This study aimed to assess the comparative levels of occupational stress and presenteeism among doctors and nurses and investigate the statistical correlation between these variables and explore the qualitative pathways compel clinicians to attend work despite illness. Materials and Methods: A convergent parallel mixed-methods design was employed across corporate hospitals in India. The quantitative strand where N = 200; 100 doctors and 100 nurses, utilised the Perceived Stress Scale (PSS-10) and the Stanford Presenteeism Scale (SPS-6). The qualitative strand involved semi-structured interviews (N = 8) with purposively sampled clinicians, analysed using Interpretive Phenomenological Analysis (IPA). Quantitative data was analysed using Jamovi software. Welch’s t-tests were used to compare group differences between professions. Pearsons’s product-moment correlation assessed the relationship between stress and presenteeism. Hierarchical regression analysis was conducted to determine the predictive value of profession and gender on presenteeism scores. Results: Nurses reported significantly higher levels of stress (M = 21.94, SD = 6.84) and presenteeism (M = 20.54, SD = 3.91) compared to doctors (p < .001). A significant positive correlation was found between occupational stress and presenteeism (r = .27, p < .001). Qualitative analysis identified four distinct pathways driving this behaviour; structural demands (chronic understaffing), moral identity (guilt and duty), policy enforcement (punitive attendance metrics) and cultural values (collectivist loyalty). These factors create a “dysfunctional presenteeism” where attendance is coerced by systemic deficits rather than functional adaptation. Conclusion: Presenteeism in Indian corporate healthcare is not merely and individual coping strategy but structural outcome of resource constraints and low Psychological Safety Climate (PSC). Addressing this requires systemic interventions, including mandatory staffing ratios and non-punitive leave policies, to safeguard both workforce retention and patient safety.

Jay Nagda, Yogesh M Shri M P Shah Government Medical College, Jamnagar [email protected] Introduction: Female healthcare workers experience unique occupational stressors and lifestyle-related challenges that predispose them to metabolic disorders. Early detection of metabolic risk is crucial for preventive health interventions. The Fatty Liver Index (FLI), a non-invasive marker derived from routine clinical parameters, has emerged as a potential predictor of metabolic syndrome. Aims and Objectives: To evaluate the utility of the Fatty Liver Index (FLI) as a predictor of metabolic syndrome and its related comorbidities among female healthcare workers in a tertiary care setting. Materials and Methods: A cross-sectional study was conducted among 450 female healthcare workers aged ≥18 years employed at a tertiary healthcare facility in Gujarat. Each participant underwent a detailed clinical examination, anthropometric assessment, and biochemical investigations. FLI was calculated using established formulae, and metabolic syndrome was diagnosed based on harmonized criteria. Statistical Analysis Used: Data were analyzed using logistic regression to determine predictors of metabolic syndrome. The diagnostic performance of FLI was evaluated using receiver operating characteristic (ROC) curve analysis. A P value <0.05 was considered statistically significant. Results: The mean age of participants was 44.2 ± 7.8 years, and the overall prevalence of metabolic syndrome was 61%. Higher FLI categories were significantly associated with worsening metabolic parameters. The odds of hypertension, diabetes mellitus, metabolic syndrome, and cardiovascular disease progressively increased with rising FLI levels (P < 0.001), indicating a dose-response relationship. The FLI demonstrated good diagnostic accuracy for metabolic syndrome, with an area under the ROC curve (AUC) of 0.86 (95% CI: 0.81–0.89). An FLI cutoff ≥30 offered an optimal sensitivity of 71% and specificity of 41%. Conclusion: The Fatty Liver Index shows a strong dose-dependent association with metabolic syndrome and its comorbidities among female healthcare workers. Owing to its simplicity and cost-effectiveness, FLI can serve as a practical screening tool for identifying individuals at high metabolic risk, particularly in resource-limited healthcare settings.

Richa Sanyal, Shukanto Das, Isha Shah, Divyesh Padhiyar, Nandkishor Patil, Subroto Das Lifeline Foundation, Vadodara [email protected] Introduction: India’s national highways constitute high-risk occupational environments where frontline toll operators, maintenance crews, highway patrol, and maintenance staff often encounter chemical spills and mass casualty incidents. Despite this, these non-clinical workers lack formalised hazardous materials (HAZMAT) response training. Aims and Onbjectives: Lifeline Foundation initiated a structured HAZMAT Response Training Programme in 2022 to address this preparedness gap through task-shifting principles, redistributing emergency response competencies to highway stakeholders traditionally outside the formal medical system. The programme has trained 2,912 stakeholders across five states (Gujarat, Rajasthan, Maharashtra, Tamil Nadu, and Assam), covering 3,911 kilometres of national and state highways. Materials and Methods: We analysed 17 simulation-based workshops conducted across Gujarat toll plazas in 2025 (n=662 participants). The standardised one-day curriculum taught hazard recognition, chemical classification systems, personal protective equipment protocols, decontamination procedures, and inter-agency coordination. Programme efficacy was assessed using Kirkpatrick’s Four-Level Evaluation Model: participant satisfaction (Level 1), knowledge acquisition via pre-post testing (Level 2), behavioural application through self-reported incident responses (Level 3), and documented field outcomes (Level 4). Results: Participant satisfaction reached 98.9% (90.7% rated Excellent/Very Good). Pre-post assessments demonstrated significant knowledge gains: ophthalmic injury management (+93.5%), HAZCHEM code interpretation (+93.2%), and HAZMAT identification (+90.2%). Whilst behavioural assessment remains ongoing, early findings indicate stronger adherence to safety protocols. Level 4 evaluation revealed over 20 documented interventions by trained personnel, including scene stabilisation, haemorrhage control, oxygen administration, wound dressing, airway management, and coordinated casualty evacuation, demonstrating successful task-sharing between trained non-medical responders and formal emergency services during the critical pre-hospital window. Conclusion: Systematic HAZMAT training for highway personnel is an effective strategy that builds India’s emergency response capacity. By extending response beyond traditional medical frameworks, this enhances occupational safety whilst improving community-level resilience across transport corridors

Vishal A Virja, Iva Chatterjee Guru Gobindsinh goverment hospital jamnagar [email protected] Introduction: Hypersensitivity pneumonitis (HSP) is an immune-mediated interstitial lung disease resulting from repeated inhalation of occupational or environmental antigens. Chronic forms often remain underdiagnosed, particularly among industrial workers exposed to metallic fumes, dust, and chemical vapors. Chronic HSP manifests with progressive exertional dyspnea, dry cough, and irreversible fibrosis, mimicking idiopathic pulmonary fibrosis (IPF) or other interstitial lung diseases (ILDs). Aims and Objectives: This report presents a case of a non-smoking male brass industry worker who developed fibrotic hypersensitivity pneumonitis due to long-term exposure to brass dust and metal polishing fumes. Metrials and Methods: A 54-year-old male brass parts worker with 10 years of occupational exposure presented with progressive breathlessness and dry cough for 2 years. There was no history of fever, hemoptysis, or autoimmune disease. Clinical examination revealed fine inspiratory Velcro crepitations over upper and mid-lung zones. Investigations included were as follows: Blood tests: Normal CBC, mildly elevated ESR (24 mm/hr), ANA and rheumatoid factor negative. Spirometry: Restrictive defect (FVC 58% predicted, FEV 1 /FVC = 0.88). HRCT Thorax: Showed interlobular and intralobular thickening, upper-lobe predominant fibrosis, parenchymal bands, traction bronchiectasis, microcysts, and areas of air trapping—findings consistent with fibrotic hypersensitivity pneumonitis. Echocardiography: No evidence of pulmonary hypertension or cardiac dysfunction. Diagnosis: Chronic fibrotic hypersensitivity pneumonitis secondary to long-term occupational metal fume exposure. Treatment included systemic corticosteroids (prednisolone 0.5 mg/kg tapered), antifibrotic therapy (tab pirfenidone 1200 mg), inhaled LABA + LAMA, mucolytics, and antioxidants. Non- pharmacological management included complete antigen avoidance, use of protective respirators, pulmonary rehabilitation, and vaccination. Results: Following initiation of therapy and strict occupational exposure control, the patient reported symptomatic improvement and stabilization of pulmonary function on follow-up. Serial HRCT showed no further progression of fibrosis. The case highlights the radiological pattern of upper-lobe predominant fibrosis, traction bronchiectasis, and air trapping typical of chronic HSP, alongside the importance of occupational history in differentiating it from IPF. Conclusion: Chronic hypersensitivity pneumonitis should be suspected in industrial workers with interstitial lung disease, especially when autoimmune markers are negative. HRCT findings and occupational exposure history are crucial for diagnosis. Early recognition, antigen avoidance, and antifibrotic therapy can prevent further fibrotic progression, improve functional capacity, and enhance quality of life.

Karan Kanzariya, Iva Chatterjjee Guru gobindsinh government hospital jamnagar [email protected] Introduction: Occupational asthma is one of the most prevalent work-related respiratory disorders,resulting from sensitization or irritation caused by inhaled agents in industrial environments. Flour mill workers are especially vulnerable due to prolonged exposure to organic dust, flour proteins (wheat, rye, barley), enzymes, and storage mites. Chronic inhalation of these allergens can induce airway inflammation, bronchial hyperresponsiveness, and long-term airway remodeling if unrecognized or untreated. Aims and Objectives: Early identification through clinical evaluation and spirometry is crucial to prevent irreversible damage and improve outcomes. Matrials and Methods: A 50-year-old male, employed in a flour mill for two decades, presented with persistent cough, wheezing, and exertional dyspnea for one year. His symptoms worsened during workdays and subsided on weekends, indicating a clear occupational pattern. The patient had no prior history of asthma, smoking, or atopy. Physical examination revealed bilateral expiratory wheeze with normal oxygen saturation. Diagnostic evaluation included spirometry, serial peak expiratory flow rate (PEFR) monitoring, complete blood count (CBC), serum immunoglobulin E (IgE), and chest radiography. Skin prick testing for specific allergens was also performed. Results: Spirometry revealed pre-bronchodilator FEV 1 of 1.98 L (62% predicted), FVC of 3.05 L (75% predicted), and FEV 1 /FVC ratio of 65%. Post-bronchodilator FEV 1 improved by 18%, confirming reversible airway obstruction consistent with bronchial asthma. Serial PEFR monitoring demonstrated more than 20% variability between working and non-working days, reinforcing the diagnosis of occupational asthma. Laboratory evaluation showed mild eosinophilia (6%) and elevated total serum IgE (420 IU/mL). Chest X-ray was unremarkable. Skin prick test was positive for wheat flour allergen. Based on clinical history, exposure assessment, and diagnostic findings, a diagnosis of Occupational Asthma due to Flour Dust Exposure was established. Management included reduction of exposure by recommending job rotation, installation of local exhaust ventilation, and use of N95 respirators during work. Pharmacologic therapy involved inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) combination, along with leukotriene receptor antagonist and antihistamines for symptomatic control. The patient received counseling on workplace hygiene, mask adherence, and periodic spirometric evaluation. At 3-month follow-up, symptoms had markedly improved with near-normal spirometric values. Conclusion: This case underscores the importance of early recognition of flour dust-induced occupational asthma. Timely diagnosis through spirometry and exposure correlation, combined with preventive workplace interventions and appropriate inhaled therapy, can significantly reduce morbidity and prevent chronic airflow limitation in exposed workers.

Koustubh Tiwari, Niraj Pandit, Maharshi Patel SBKS Medical Institute and Research Centre , Vadodara [email protected] Introduction: Work-related musculoskeletal disorders (WMSDs) are among the leading occupational health problems globally, contributing to reduced productivity, absenteeism, and long-term disability.Affecting muscles, tendons, ligaments, and joints,due to repetitive strain, awkward postures, excessive force, vibration, or prolonged static positions.Previous studies have shown a high prevalence of WMSDs among factory and production workers in India, especially in the sugar industry where repetitive lifting, bending, and prolonged standing are common. Assessing WMSDs through ergonomic and clinical evaluations helps in identifying risk factors and implementing preventive strategies to improve worker health and safety. Aims and Objectives: To assess the prevalence and associated risk factors of work-related musculoskeletal disorders among sugar industry workers in Northern India. Objectives are to determine the prevalence of WMSDs among sugar factory workers; to identify the most commonly affected body regions; to evaluate associations between demographic and lifestyle factors (age, BMI, duration of work, smoking, alcohol use) and WMSDs and to recommend preventive ergonomic interventions to reduce the burden of musculoskeletal disorders. Materials and Methods: A cross-sectional study was conducted at Daurala Sugar Works, Meerut (U.P.), among 56 production workers with at least one year of service. Data were collected using the standardized Nordic Musculoskeletal Questionnaire through face-to-face interviews. Ergonomic risk factors such as posture, force exertion, task duration, and repetitive motion were assessed. Demographic and lifestyle details including age, BMI, smoking, and alcohol use were recorded. Epi Info software, employing descriptive and correlation methods were used. Results: Prevalence of WMSDs was 82.1%, with the lower back (76.8%) and shoulders (57.1%) being most affected regions. Workers aged above 45 years and those with over 25 years of service showed a significantly higher risk. Awkward postures, bending, lifting, and prolonged standing were major contributing factors. Smoking (73.2%) and alcohol use (55.4%) were also associated with increased musculoskeletal symptoms. Conclusion: The high prevalence of WMSDs among sugar factory workers underscores the urgent need for ergonomic interventions, posture correction training, task rotation, and regular rest breaks. Workplace health promotion focusing on physical fitness, nutrition, and lifestyle modification is essential to enhance occupational health and productivity.

Levis Manuel Noronha, Naveen Ramesh, Shivani SS St Johns Medical College, Bangalore [email protected] Introduction: Housekeeping staff play a pivotal role in maintaining hospital hygiene and infection control. Outsourced staff often face physically demanding tasks, irregular shifts, and limited organizational support. These factors place them at increased risk for musculoskeletal disorders (MSDs), psychological distress, and poor work–life balance In India, evidence on the combined burden of these issues among outsourced housekeeping workers is limited. Aims and Objectives: This study aimed to assess the prevalence of MSDs and factors associated with it including depression, anxiety, and work–life imbalance among outsourced housekeeping staff in tertiary care hospitals. Materials and Methods: A cross-sectional study was conducted after obtaining ethical approval and included 170 housekeeping staff recruited proportionally from two tertiary hospitals in Bengaluru. Participants employed for at least 6 months were included. Data were collected using a structured questionnaire comprising sociodemographic details, the Modified Nordic Musculoskeletal Questionnaire (NMQ), Generalised anxiety disorder for Anxiety (GAD 2) and Patient Health Questionnaire (PHQ 2) for mental health, and the Work–Life Balance Culture Scale (WLBCS). Physical measurements included BMI, waist circumference, blood pressure, and random blood sugar. Data was analysed using Jamovi v2.4.11. Normality was assessed using the Shapiro–Wilk test, and appropriate non-parametric tests were used. Prevalence estimates were described using descriptive statistics, and associations were examined with chi-square tests and logistic regression. Results: Among 170 outsourced staff, 63.5% (95% CI: 56.3 – 70.7) were aged 18–44 years and 84.7% (95% CI: 79.3 – 90.1) were female. The prevalence of MSDs in the past 12 months was 52.4% (95% CI: 44.9 – 59.9), and 43.8% (95% CI: 36.3 – 51.3) had pain in the past 7 days. The most commonly affected anatomical regions were the low back (56%), followed by knees (47%) and shoulders (37%). Anxiety screening was positive in 28.8% (95% CI: 22.0% – 35.6%) and depression screening was positive in 15.3% (95% CI: 9.9% – 20.7). Work–life balance was rated good by 70% (95% CI: 63.1 – 76.9). No employee had poor work-life balance. Multivariable analysis showed moderate work–life balance [AOR 3.51; (95% CI: 1.7- 7.2)] was a significant predictor of MSDs. Conclusion: Over half of the outsourced housekeeping staff experienced MSDs, alongside a notable burden of anxiety and depression. Moderate work-life balance when compared with good work-life balance independently increased the odds of MSDs.

Jainam Mehta, Raghvendra Gumashta, Girjesh Gupta People’s College of Medical Sciences and Research Canter, Bhopal [email protected] Introduction: Transport-sector workers in India frequently experience prolonged working hours, air pollution exposure, inadequate rest, and limited access to occupational health services. These conditions increase the risk of respiratory impairment, hypertension, musculoskeletal weakness, and visual problems. Safety compliance—including adherence to the International Labour Organisation (ILO) Code of Practice—is often inconsistent. A pilot study was conducted to test the feasibility of study tools, refine measurement processes, and generate preliminary evidence on health disparities among transport workers in Bhopal. Aims and Objectives: To assess blood pressure, hand-grip strength, Peak Expiratory Flow (PEF) and cataract prevalence among truck drivers, bus drivers, cleaners, and controls.To evaluate awareness and compliance with the ILO Code of Practice on Safety and Health in Road Transport. To compare preliminary health parameter trends across groups based on pilot findings. Materials and Methods: A pilot cross-sectional study was conducted among 50 participants: 10 truck drivers, 10 bus drivers, 10 cleaners, and 20 age- and sex-matched controls. Data was collected using a pretested semi-structured questionnaire for demographic and occupational details; PEF measurement using a portable peak flow meter (best of three) - Model: Contec Handheld SP-10 Spirometer; digital blood pressure monitoring after adequate rest; hand-grip strength assessment using a digital handheld dynamometer - Model: Saehan Electronic Smedley hand dynamometer; basic ophthalmic screening for cataract; a compliance checklist adopted from the ILO Code of Practice covering rest norms, safety measures, and training. Feasibility parameters assessed included participant recruitment, tool acceptability, measurement consistency, and time required per participant. Data was compiled in Microsoft Excel. Descriptive statistics (mean, SD, proportions) were calculated. Results: Preliminary findings indicated lower mean PEF values among truck drivers and cleaners compared to controls; higher average systolic BP among truck drivers and bus drivers; reduced hand-grip strength in cleaners relative to other groups; early signs of cataract detected in several long-term drivers; compliance gaps noted in rest breaks, vehicle safety checks, and awareness of ILO safety guidelines. Data collection tools were found feasible, with an average assessment time of 22–25 minutes per participant. Conclusion: The pilot study confirms the feasibility of the full-scale research protocol and highlights early indications of occupational health disparities among transport workers. The observed trends underscore the need for comprehensive assessment and targeted occupational health interventions in the larger planned study.

JS Waghmare Oil and Natural Gas Ltd, Uran [email protected] Introduction: In the oil and gas sector, contractual workers are particularly vulnerable due to continuous exposure to physical, chemical, and ergonomic stressors during operational processes. Understanding the occupational morbidities and workplace safety practices among contractual workers is essential to improve their health, safety, and productivity. This study focuses on assessing the occupational health status and safety practices of contractual employees at the ONGC Oil and Gas Refinery, Uran, District Raigad, India. Aims and Objectives: The objectives of the study were to identify the prevalence of occupational morbidities among contractual employees; to analyze workplace safety practices and their impact on workers’ health., and to explore associations between hazardous exposures and health outcomes. Materials and Methods: This cross-sectional study was conducted at the Occupational Health Centre (OHC), ONGC Uran, during 2024–2025. A total of 475 contractual employees were surveyed as part of the Directorate of Industrial Safety and Health (DISH) medical examination under the QHSE policy. Each participant underwent a detailed pre-tested semi-structured questionnaire, health check-up and laboratory investigations at OHC. Descriptive statistics, box plot, heat map, Multivariate regression analysis. Result: The study revealed a high prevalence of diabetes(15%), hypertension(25%), dyslipidaemia(32%), abnormal ECG (6%),Low back pain (22%), and hearing impairment (10%) among contractual workers. Nearly 88.7% of participants had education below the secondary level and mostly are between 30-50 years age group. Despite observable health issues, statistical correlations between hazardous exposures and health conditions were not significant, possibly due to frequent workforce rotation and confounding non-occupational factors. Conclusion: The findings highlight unsatisfactory working conditions and a high incidence of occupational morbidities among contractual employees. Wage disparities, limited social security, and inadequate healthcare facilities further compound their vulnerability. A comprehensive approach focusing on HSE integration—along with improved social protection and medical care—is essential to ensure safer and healthier workplaces for contractual workers.

Somnath Panda, Rekha Shanmugam, PK Latha, Nikitha D, Vidhya Venugopal Sri Ramachandra Institute of Higher Education and Research [email protected] Introduction: Dengue transmission in India is increasingly influenced by climate variability, with rising temperatures, altered rainfall patterns, and high humidity expanding the habitats of the Aedes vector. Outdoor workers, including agricultural labourers and construction workers, face heightened exposure due to prolonged daytime activity in endemic environments. Aims and Objectives: To synthesize evidence on climate-dengue associations in India, assess occupational vulnerability among outdoor workers, identify climate-sensitive hotspots, and propose adaptive strategies. Materials and Methods: We conducted a systematic narrative synthesis of peer-reviewed literature (2010–2024), supplemented by Indian Meteorological Department and National Vector Borne Disease Control Programme data. Forty-seven studies examining climate-dengue associations across 18 Indian states were included. We extracted correlations between temperature, rainfall, humidity, and dengue incidence, with attention to occupational exposure patterns. Time-series regression models and GIS-based spatial analyses were reviewed to understand transmission dynamics and emerging hotspots. Result: Temperature demonstrated consistent positive associations with dengue incidence (reported r = 0.42–0.78, p < 0.05 across regions), with 32 studies identifying peak transmission at temperatures ranging from 28 to 32°C. Rainfall showed non-linear associations (r = 0.35–0.60), while humidity above 60–80% enhanced vector survival (r = 0.30–0.65, 24 studies). Time-series models from 18 studies indicated each 1°C temperature rise associated with a 5–15% increased incidence, and each 100 mm rainfall increase corresponded to a 7–12% rise in cases after 2–8 week lags. An occupational analysis of 12 studies revealed that outdoor workers had 2.1–3.8 times higher dengue seroprevalence than indoor workers, with agricultural labourers (aOR 2.8; 95% CI 1.9–4.1) and construction workers (aOR 3.2; 95% CI 2.1–4.9) being at the greatest risk. Peak exposure occurred during monsoon months when vector density and outdoor work coincide. GIS analyses identified expanding hotspots in northern (Delhi, Uttar Pradesh, Punjab) and eastern states (West Bengal, Odisha), with occupational clusters in peri-urban agricultural and construction zones. Conclusion: Climate change is reshaping dengue epidemiology in India, with outdoor workers facing a disproportionate burden. Consistent evidence linking climate variables with dengue transmission underscores the need for climate-informed surveillance and workplace interventions. Priority adaptations include integrating meteorological forecasting with early warning systems, targeted vector control in high-risk occupational areas, implementing workplace protective measures during high-risk seasons, and enhancing urban water management. Future research should evaluate climate-based prediction models and occupational exposure reduction strategies for vulnerable working populations.

Bala Venkataramani, Priyadarshini Gunaseelan Brakes India Private Limited [email protected] Introduction: Psychological distress is increasingly recognised as an important occupational health concern, particularly among employees in supervisory roles who carry greater responsibility and workload expectations. High work demands, limited control and organisational pressures may influence mental well being and contribute to varying levels of the distress. The Kessler Psychological distress scale is a widely validated tool used to screen for nonspecific psychological distress in workplace and community settings. Aims and Objectives: The study aims to assess the prevalence of psychological distress among supervisory level employee and above and to describe the distribution of selected workplace perceptions such workload manageability, perceived supervisor/colleague support and interest in counselling services. Materials and Methods: A cross-sectional study was conducted among supervisory level employees and above in an industrial setting. A total of 423 employees participated. Data was collected using a structures questionnaire that included demographic details (age, gender, department, workshift) and workplace related perceptions (workload manageability, supervisory /colleague support and interest counselling or stress management services. Psychological distress was assessed using the Kessler Psychological Distress scale , a validated Psychological Distress scale, a validated 10 item measure that categorises distress. Data were entered and analysed. Descriptive statistics such as frequencies and percentages were used to present demographic characteristics and workplace related variables. Result: Most participants (66%) were likely to be well, while 17.7% had mild distress and 6% had severe distress. Overall 34% showed some level of psychological distress. Majority feel (around 66%) feels supported by their supervisors/colleagues and only 23% felt the need for counselling/support from the organisation. Conclusion: This study provides useful insights into the mental well-being of supervisory level employees. The prevalence findings indicate that although the majority of the employees appear psychologically well, a meaningful proportion experiencing mild, moderate or severe psychological distress. The presence of the distress in approximately one third of the workforce highlights that mental health needs exist even in higher responsibility roles where pressures and expectations may be greater.