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Year : 2016 | Volume : 4 | Issue : 2 | Page : 126 - 128  


Original Articles
A Study of Substance Use among Construction Workers in Suburban Hyderabad

Suhasini V1, KVS Murthy2

1Assistant Professor, 2Professor, Department of Community Medicine, Gandhi Medical College, Secunderabad

Corresponding Author;

Dr. Suhasini V

Email: dr.suhasiniv@gmail.com

 

Abstract:

Background: Tobacco and Alcohol are the most important substances which influenced the health status of the population worldwide. Globally over 450 million tobacco related deaths may occur. Objective: To study the substance abuse among workers at a construction site in relation to the socio demographic profile. Methods: study design – community based cross sectional study done at construction sites in suburban Hyderabad. Convenient sample of work sites and systematic sampling of individuals was taken. The sample size was 353 adults with 295 men (83.53%) and 58 women (16.4%) aged above 18years. The socio demographic profile, tobacco and alcohol use, known morbidity were recorded, Height, weight, chest expansion and blood pressure were measured. The results were analysed on MSExcel and SPSS systems. Chi square test and t test were used for analysis. Results: 53.1% were using either tobacco or alcohol. 25.3% were consuming alcohol and 38.6 % were using tobacco, 20.2% were smoking and 25% were chewing tobacco. 52% of men and 20.6% of women abuse substance. There was significance in substance use in relation to gender, family size and morbidity. The socio economic class, education and occupation did not show a marked difference in substance use. There was no significant difference in means of BMI (21.3), blood pressure- Systolic (118.8mmHg), diastolic Blood Pressures (78.5mmHg), but a significant difference was there in chest expansion (83.4 & 81.3) and morbidity states. Conclusion:  Our study showed 25.3% using alcohol and 38.6% using tobacco. Nearly one third of the workers are abusing substance. Tobacco use especially chewing is very high in the study population.

Key words: alcohol, tobacco use, socio economic status scale, blood pressure, chest expansion, BMI.

INTRODUCTION:

Tobacco and Alcohol are the most important substances which influenced the health status of the population worldwide. Globally over 450 million tobacco related deaths may occur. 1 The National Family Health Survey-3 has revealed that 57% of males and 10.8% of females use some form of tobacco. 34.6% of adults use some form of tobacco in India. 2 Tobacco related mortality in India is among the highest in the world. 3 Annual oral cancer incidences in India is estimated as 10/100000 among males. 4 Tobacco use has been reported as the main cause of 90% of male and 79% of female Lung cancers. 5 21-4% of population use alcohol nationwide. 6 Alcohol misuse has been implicated in 20% of brain injuries and 60% of all injuries in an emergency room setting. 7 Alcohol abuse is associated with a wide range of medical complications as alcoholic liver disease, gastro intestinal motility changes leading to reflux oesophagitis, gastritis and GI bleeding,  pancreatitis and various neurological problems as Wernicke- Korsakoff syndrome, dementia and cerebellar degeneration. 8

MATERIAL AND METHODS

A structured pretested Questionnaire was administered and socio demographic profile, alcohol and tobacco use and known morbidity conditions were recorded. The height, weight, and blood pressure of the individuals were measured.

Study Design: A Community based cross-sectional study.

Sample: 353 adults working at different construction sites in suburban Hyderabad.

Sampling method: A convenient sample of the sites and a systematic sample of the individuals working at the site taken. Consent was taken from the authorities at the site and individuals participating in the study.

Analysis: data was collected and tabulated in MSExcel and also subjected to SPSS analysis for Chi square and t test.

 

 

RESULTS:

A total of 352 adults (294 men and 58 women) working at the construction site were interviewed by application of a pre tested questionnaire. Sociodemographic profile of Education, Occupation, Income, and tobacco and alcohol use were recorded. In or study, 53.1% were using either tobacco or alcohol, 25.3% were consuming alcohol and 38.6 % were using tobacco, 20.2% - smoking and 25% were chewing tobacco. 52% of men and 20.6% of women abuse substance. All the SE classes did not show much difference in substance use except for gender difference. Class1- 54%, Class 2- 54.8%, Class 3- 50.6%, Class4- overall 44.8% with males 52% and Females 15.3%.  The mean - Height (158.8cms), weight (54.01), waist circumference, BMI (21.3), Systolic (118.8mmHg), diastolic Blood Pressures (78.5mmHg) did not show any significance t test of chest inspiration(83.4 & 81.3) was only significant. Out of 187 non users 33(17.6%) and 165 users 60(36.3%) had some morbidity with a significant Chi square.

DISCUSSION:

GATS India 2 study revealed that more than one third of adults use tobacco in one form or other, our study has also shown similar results: 38.6% were using some form of tobacco, The National household survey 6 of drug use showed that 55.8% among males used some form of tobacco, 21.4% were taking alcohol, our study revealed 52% of males abused tobacco in some form and 25.3% were consuming alcohol. The NFHS -3 study revealed 57% of males and 10.8% females used tobacco our study revealed that 52% of males and 20.6% females abuse tobacco. A study among male construction workers in Brazil showed a risk of 32-5% for tobacco and 26.8% for alcohol. 9 The national survey on drug use was highest among construction workers. 10 Tobacco use is a major cause of preventable morbidity and deaths in India. World Bank predicted 450 million tobacco deaths in next 50 years. Annual oral cancer incidence has been estimated as 10/100000 males. 4 Aggressive tobacco cessation measures may decrease approximately 180 million tobacco related deaths if decrease in 50% tobacco consumption. 11 Evaluation of anti tobacco community education program in Karnataka showed that the program led to a quitter’s rate of 26.5% (males) and 36.7% (females). 12 Education for quitting in Kerala has showed 9.4% in study group when compared to 3.2% in control over a five year period. 13 Annual adjusted rates of leukoplakia also decreased in the group. 14 Tobacco is more addictive than any other substance with a quit rate of 55% and relapse of 23% with a brief advice. 15 The causal relationship between cigarette smoking and COPD has been absolutely proved with absolute relationship of FEV1 to pack years. 16 Our study showed significance, of t test of chest inspiration (83.4 & 81.3). Alcohol abuse is associated with a wide range of medical complications as alcoholic liver disease, gastro intestinal motility changes leading to reflux oesophagitis, gastritis and GI bleeding, pancreatitis and various neurological problems as Wernicke- Korsakoff syndrome, dementia and cerebellar degeneration. 8 Two thirds of alcohol dependent individuals meet the criteria for a psychiatric syndrome under DSM-IV of American psychiatric association and 80% of them demonstrate drug dependence. 17 Screening for alcohol use is important by AUDIT (the Alcohol use disorders identification test) 17 as a routine in the out patient department and identify users and start intervention. A study on construction workers in Alexandria, Virginia showed 14.1% illicit drug use and 12.4% heavy drinkers. 18 Another study conducted in Brazil among male construction workers showed a risk of 38.2% for Tobacco and 33.7% for alcohol. 19

CONCLUSION:

Our study showed 25.3% using alcohol and 38.6% using tobacco. Nearly one third of the workers are abusing substance. Tobacco use especially chewing is very high in the study population.  Cessation measures are to be instituted for construction workers by cooperation with builders.  Alcohol use is considerable and a significant increase in morbidity for people abusing any substance when compared to non users, so relevant health education to the workers to be encouraged.  Regular screening with standardized screening instruments as ASSIST- WHO (alcohol, smoking and substance involvement screening test – WHO), CAGE (cut down, annoyed by criticism, guilty and eye opener) or AUDIT (alcohol use disorder identification test) can reveal the status of abuse in the population or groups. Cessation counselling or treatment and appropriate health education has to be taken up. Legislation of restriction of substance at work place can be considered as the exposure to the substance will decrease to a great extent.

Table 1: Total workers using any substance

Substance use

No

Yes

Total

Any substance

189(53.1%)

165(46.9%)

352

Tobacco

216(61.36%)

136(38.63%)

352

T - smoking

281(79.8%)

70(20.2%)

352

T-Chewing

264(75%)

88(25%)

352

Alcohol

263(74.7%)

89(25.3%)

352

 

Table 2: Socio demographic profile of substance users

Characteristics

 

Substance use

 

Pearson’s chi square

 

 

No

Yes

 

Gender

Female

46

12

0.0001

 

Male

141

153

 

Social class

I

05

06

0.213

 

II

14

17

 

 

III

32

33

 

 

IV

136

109

 

Morbidity

No

154

105

0.0007

 

Yes

33

60

 

Education

Illiterate

87

71

0.566

 

Up to middle school

58

48

 

 

10th + Inter

32

34

 

 

Degree/PG

17

25

 

Table 3: Measurements and t test of substance users

 

SUB-USE

N

Mean

Std. Deviation

Std. Error Mean

T test

Height

Y

131

158.832

8.7276

.7625

 

N

106

157.104

8.4672

.8224

 

Weight

Y

155

54.019

9.3395

.7502

 

N

149

52.872

9.8614

.8079

 

Waist

Y

127

74.252

10.2794

.9121

.803

N

65

74.554

10.1397

1.2577

 

Chest Insp

Y

132

83.432

7.2588

.6318

.003

N

94

81.351

7.7760

.8020

 

SBP

Y

125

118.896

11.4059

1.0202

.461

N

122

118.951

12.4780

1.1297

 

DBP

Y

125

78.560

7.6679

.6858

.185

N

122

78.434

8.2752

.7492

 

BMI

Y

125

21.3449

3.50227

.31325

.215

N

96

21.4813

3.72040

.37971

 

 

 

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