Occupational
injuries in welders – results from a six month follow-up study
Masood Ali Shaikh, Irshad
Ali Shaikh
Chester Health Department, Chester City Hall, 1
Fourth Street, Chester, PA 19013, United States of America
Background: Injuries are an
under recognized public health problem globally. We assessed the number and type
of occupational injuries in welders, in a prospective manner. Methods: A cohort of 208 welders was
re-interviewed twice at three-month intervals to determine the type and
frequency of injuries in the welders primarily involved in the automobile
sector, in the twin cities of Islamabad and Rawalpindi in Pakistan. Data was
analyzed for frequencies and counts with STATA 8. Results: Cumulatively, 105 injuries were reported by 61 welders in the
two follow-ups, who took 28 days off as a result of these injuries, in the past
six months. Four welders reported multiple injuries involving the same injury
episode. None of the welders reported any permanent disfigurement as a result
of these injuries. Conclusion: Occupational
injuries are common in the welders working primarily in the automobile sector
in the twin cities of
Key Words: Injuries, Welders,
Pakistan
Introduction
Health directly impacts labor
productivity, as output is increased in workers with better health.1
According to World Health Organization, there are about 250 million cases of
injuries per year at work worldwide.2 Occupational injuries are a
neglected area of health policy in Pakistan. Neither National Health Policy
approved by the Federal Cabinet on
Non-industrial welding workers are predominantly
involved in the automobile or real-estate sectors; welders involved in the
later sector generally undertake work entailing welding of mufflers or repairs
following automobiles following accidents or crashes. Often it means lying
underneath the vehicle for carrying out welding/repair. Welding produces
ultraviolet and infrared radiation at damaging levels5. The welding
process can result in various hazards such as bodily injuries on the face and
limbs, fire and explosion.6-13 Studying multiple occupations with
various study designs, welders in occupational settings like construction and
automobile factories have been identified as having a high risk of ophthalmic injuries
due to burns compared to other occupations.6-10 International Labor
Organization lists bodily including eye injuries due to sparks and fall related
injuries especially common in welders.13 Ranking of occupations
based on cost-related injuries has identified welders as a high risk occupation.12
While ocular melanoma and cataract have been reported as a long term sequels associated
with welding.9,11,13
The welders are
part of an informal occupational sector and like most other informal
occupational sectors in
This study was undertaken to determine the burden of
occupational injuries in a prospective manner in a cohort of welders working in
the automobile sector in the twin cities of
MATERIAL and Methods
A baseline survey was of 208
welders was completed in the twin cities of
Baseline survey in addition to demographic
information, collected information about type, involvement of body part, and
sequel of having sustained work related injuries in the past three and twelve
months. While during the two subsequent follow-ups same information about work
related injuries was collected. The original group of 208 welders was
re-interviewed twice i.e. from 4th to
Results
The average age of the
cohort of 208 welders followed was 30.3 years (range 15 – 63 years). Everyone
who reported for work on the day of follow-up visits was interviewed. During
the first follow-up 199 (95.7%) welders were successfully re-contacted and
interviewed, while in the second follow-up 201 (96.6%) were re-contacted and
interviewed. No one refused to be interviewed. The number and type of
occupational injuries reported at the two follow-ups is presented in
Table-1:
Number of occupational injuries reported during the past three months, at two
follow-ups, by welders.
Type of Injury |
1st
Follow-up |
2nd
Follow-up |
||
No. (199) |
% |
No.
(201) |
% |
|
Burns on face |
11 |
5.5 |
14 |
6.9 |
Burns on limbs or
body |
17 |
8.5 |
22 |
10.9 |
Foreign body in
the eyes |
18 |
9.0 |
23 |
11.4 |
Total number of
injuries |
46 |
23.1 |
59 |
29.3 |
Cumulatively, 105 injuries were
reported by 61 welders in the two follow-ups, who took 28 days off as a result
of these injuries, in the past six months. Four welders reported multiple
injuries involving the same injury episode. None of the welders reported any
permanent disfigurement as a result of these injuries. And neither any welder
reported knowing any welder who has either died as a result of occupational
injuries or was too sick to come to work.
During two follow up visits, interviewers specifically
inquired about the nine and seven individuals who were not available for first
and second follow up interview respectively. Reason for their absence on the
day of interview, at their work place was determined from either their
colleagues or neighbors. None of the missing individuals were absent from work,
owing to either any work related injury or death.
Discussion
Welding process uses heat to
melt and fuse together metal pieces. In
The results of this first follow-up study of
occupational injuries in welders indicated that injuries in welders involved
primarily in automobile sector are fairly common, based on three month recall
period, as over 20% of welders reported sustaining occupational injuries
requiring either self-treatment or visit to a physician in the first follow up,
while almost 30% in the second follow up. These results are somewhat higher
than the baseline study, which reported 18.7% welders sustaining injuries in
the past three months15.
During the two follow-ups at the interval of three
months, over 95% of the original group was successfully re-contacted. The
higher reported rates of injuries in the two follow-ups could be attributed to
the recall bias, as during the follow-up interviews welders were probably more
likely to have recalled the injuries, knowing that there will be follow-up
interviews.
The baseline study reported that 18.7% and 30.3% of
welders had sustained occupational injuries in the past three months and one
year, respectively. Although, the reported number of welders who sustained
injuries was higher in the two successive three-month follow-ups, the type and
frequency of occupational injuries sustained were essentially similar. As
baseline study reported the most common (40.3%) injury type was foreign body in
the eyes followed by burns on limbs or body (37.5) and facial injury/burns
(22.2); the same was the profile in the two follow-ups. A previous Pakistani study of 36 welders in
Results from this study need to be interpreted with
caution. The major limitation of this study was the use of convenience
sampling, which limits generalizability of results as representative of welders
in
There is a need for nationwide population based
survey on occupational injuries in the country, using indigenously standardized
instruments, for better understanding of correlates and determinants of
occupational injuries in the country. Prospective studies with longer duration
of follow-ups at shorter intervals would be required to better understand the
epidemiology of occupational injuries in the welders; this will further
elucidate seasonal pattern of occupational injuries. Additionally, these
studies will help policymakers to develop effective and meaningful occupational
standards for the safety of labor force, both in the formal and informal
sectors in the country.
Conclusion
Three month prevalence of occupational
injuries ranged from over 20% to almost 30% in two successive follow ups of
welders working primarily in the automobile sector in the twin cities of
References
1.
Strauss J, Thomas D. Health, nutrition and economic development. Journal
of economic development 1998; xxxvi: 766-817
2.
World Health Organization (WHO). The World Health Report 1998 – Life in
the 21st centaury: a vision for all.
3.
Ministry of Health (MoH). National Health Policy. Ministry of Health,
4.
Ministry of Health (MoH). National Health Policy 2001 – The Way Forward:
Agenda for Health Sector Reform. Ministry of Health,
5.
6.
Zenc C. Development in occupational medicine. Boston: Year Book Medical
Publications;1980:
7.
Antonini JM, Taylor MD, Zimmer AT, Roberts JR. Pulmonary responses to
welding fumes: role of metal constitutents. J Toxicol Environ Health A 2004;13;67(3):
233-49.
8.
Okoye OI, Umeh RE. Eye health of industrial workers in
9.
Guenel P, Laforest L, Cyr D, Fevotte J, Sabore S, Dufour C. Occupational
risk factors, ultraviolet radiation, and ocular melanoma: a case-control study
in
10. Islam SS, Nambinar AM, Doyle
EJ, Velilla AM, Biswas RS, Ducatman AM. Epidemiology of work-related burn
injuries: experience of a state-managed worker’s compensation system. J Trauma
2000; 49(6): 1045-51
11. Tenkate TD. Optical radiation
hazards of welding arcs. Rev Environ Health 1998;13(3):131-46.
12. Leigh JP, Miller TR. Ranking
occupations based upon the costs of job-related injuries and diseases. J Occup
Environ Med 1997;39(12):1170-82
13. Zlateva V, Toncheva R, Andreev
A. Epidemiological studies on occupational eye pathology. Eur J Opthalmol 1996;6(4):
440-5
14. Shaikh TQ, Bhojani FA.
Occupational injuries and perception of hazards among road-side welding
workers. J Pak Med Assoc 1991;41(8):187-8
15. Shaikh MA. Hazard perception
and occupational injuries in the welders and lathe machine operators of
16. Karvonen M, Mikhee M I. eds.
Epidemiology of occupational health.
17. National Institute of Occupational
Safety and Health (NIOSH). Worker Health Chartbook, 2004.Cincinnati, NIOSH,
2004, pp. 258.
18. Liberty Mutual Research
Institute for Safety. From research to reality – 2003 annual report of
scientific activity.
19. Imberger A, Altman A, Watson
W. Unintentional adult eye injuries in
_____________________________________________________________________________________________________________________
Address for Correspondence:
Dr. Masood Ali Shaikh, 301 W, 24th
Street, Chester, PA 19013, USA.
Email: masoodali1@yahoo.com