Occupational Health

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Occupational health is essentially preventive medicine. The joint International Labor Organization(ILO) & World Health Organization(WHO) Committee- "occupational health should aim at the promotion and maintenance of the highest degree of physical, mental and social well being of the workers/employees in all occupations.
An industrial worker/employee may be exposed to five types of hazards depending on the occupations

1. Physical Hazards
2. Chemical Hazards
3. Biochemical Hazards
4. Mechanical Hazards
5. Psychosocial Hazards

 Physical Hazards
(a) Heat and Cold
The common physical hazard in most industries is heat. The direct effect of heat exposure are burns, heat exhaustion, heat stroke and heat cramps. The indirect effects are decreased efficiency, increased fatigue and enhanced accident rates. Important hazards associated with cold are chilblains, erythrocyanosis, immersion foot and frost bite as a result of cutaneous vaso constriction.
(b) Light
The acute effects of poor illumination are eye strain, headache, eye pain, lachrymation, congestion around cornea and the chronic effects on health includes "miner's nystagmus". Exposure to excessive brightness is associated with discomfort, annoyance and visual fatigue.
(c) Noise
Auditory effects consist of temporary or permanent hearing loss where as non-auditory effects include nervousness, fatigue, interference with speech etc.
(d) Vibration
Vibration affects hands and arms. After some months or years of exposure, the fine blood vessels of the fingers may be increasingly sensitive to spasm.
(e) Ultra Violet Radiation
Occupational exposure to UV radiation occurs mainly in arc welding. Such radiations affect the eye, causing intense Conjuctivitis and keratitis.
(f) Ionizing Radiation
Ionizing radiations are finding increased application in medicine and industry. X-rays and radioactive isotopes are widely used. The radiation hazards compromises of genetic changes, malformation, cancer, leukemia, ulceration and in extreme cases the death.
Chemical Hazards
Chemical agents act in three ways; local action, inhalation and ingestion
(a) Local Action
Some chemicals are absorbed through the skin and cause systemic effects. Occupational dermatitis are due machine oil, rubber, x-rays, caustic alkalies and lime.
(b) Inhalation

1. Gases: Carbon di-oxide, carbon monoxide, cyanide gas, sulphur dioxide cause gas poisoning
2. Dusts: Inorganic dusts such as coal dust, silica, asbestos, iron causes anthracosis, silicosis, asbestosis, cancer lung, siderosis. Organic dusts such as cane fibre, cotton dust, tobacco, hay or grain dust cause bagassosis, byssinosis, tobacossis and farmer's lung.
3. Metals and their compounds: This is due to various systemic effects caused by heavy metals like lead, mercury, cadmium, manganese, arsenic, chromium etc

(c) Ingestion
Occupational diseases may also result from ingestion of chemical substances such as lead, mercury, arsenic, zinc, cadmium, phosphorous etc


Biological Hazards
Worker may be exposed to infective and parasitic agents at the place of work. The occupational diseases includes leptospirosis, anthrax, tetanus, hydatidosis, fungal infections etc



Mechanical Hazards
The mechanical hazards in an industry center around machinery, protruding moving parts and the like. Around 10% of accidents in industry are said to be due to mechanical causes.



Psychosocial Hazards
The Psychosocial hazards arise from the worker's failure to adapt to an alien psychosocial environment. Frustrations, lack of job satisfaction, insecurity, emotional tension are some of the psychosocial factors that determine the physical and mental health of the workers/employees.

Teeth Mutilation

Since time immemorial the teeth,the mouth and the face have held s seemingly intrinsic fascination for mankind.They have been and continue to be the subject of many oral and written beliefs,superstitions,traditions and the object of a wide range of decorative and mutilatory practices.At the same time they have been the cause of considerable suffering for many.


WHERE IS IT SEEN?
In modern World body decoration and mutilation is universal in its occurrence and is observed in all regions of the developed and under developed world. Tooth related and oral soft tissue mutilations are well recognized forms of mutilation.
Many of the dental and orofacial mutilations have relatively specific features and patterns reflecting different ethnic or tribal affiliation. A knowledge of these practices is important for the valuable insights they provide into the cultural beliefs and traditions of the people who practice them and for the very pragmatic reason that many compromise examples of customs which directly give rise to pathology of the teeth and orofacial tissues.

Tooth mutilation practices have been recorded for the inhabitants of the non-tropical environments, but most of these customs are observed among the people living in the tropical regions of the world.
These practices include:

• Non therapeutic tooth extraction(evulsion)
• Breaking of tooth crowns
• Filling of tooth crowns by filling and chipping,dental inlay work
• Lacquering and staining of teeth
• Miscellaneous practices

REASONS FOR TEETH MUTILATION
Basic themes such as initiation identification and aesthetics underline many of the mutilation customs encountered throughout the tropics.
Beliefs and associations ascribed to the practice of tooth evulsions are

• Tribal identification
• Initiation rite
• Sign of manhood or bravery
• Differentiation of sexes
• Sign of marriageable age in females
• Sign of ceremonial rebirth
• To ensure a life after death
• Aesthetics and fashion
• Therapeutic purposes
• Sign of mourning
• Sign of subjugation
• Form of punishment
• Cultural mimicry
• To enable an individual to spit properly
• Local superstition associated with phenomena such as rain

A number of people ascribed prophylactic benefit to certain root mutilations. Mosha describes the removal of the permanent mandibular central incisors among the Iraq, Waarusha and Masai people of Tanzania. Over half of the individuals submitted to this procedure indicated that the space left following removal of these teeth provided a route allowing passage of fluids in the event of a person becoming ill and being unable to open his/her mouth(seen in tetanus-Lock jaw).
Among the Nigerian tribes the practice of deciduous canine(usually mandibular) germinectomy is considered to guard against symptoms such as high fever.
In Africa parents complained doctors regarding fever,diarrhoea and vomiting. Doctors adviced for the removal of lower deciduous tooth germs giving the reason that the symptoms suffered by child are due to a new type of tooth namely 'nylon tooth' .
The practice of blackening of the teeth among the Jivaro Indian people of northern Peru and Ecuadorians a custom carried out in order to prevent dental caries.Tooth lacquering and dyeing is a custom performed in several other countries of the world like Vietnam,Laos,Thailand,Indonesia and Philippines.
Tooth evulsion describes the deliberate removal of a tooth for ritual or traditional purposes. The tooth is generally knocked out rather than extraction. The age at which ritual tooth evulsions are performed varies.In general permanent tooth evulsions tends to be performed. In some countries the practice of tooth evulsion is associated with events such as puberty and initiation rites in males or the first time menstruation or marriage in females.
Mutilations of tooth crown include alteration in shape or appearance of teeth. The alteration is done by chipping and filling, dyeing and lacquering, decoration of teeth crowns by inlays and overlays. The custom of altering tooth crown shape is confined to anterior teeth(canine to canine) of both jaws.The reasons for these include aesthetics,tribal identity,initiation rituals,religious motives and identification with animals.Many of the people who submitted to customs such as flattening of incisors to the gum level were ignorant of the reason why they were done.The usual answer being 'it is the law of the old people,sir'.According to the village headman this practice related to the belief that at death all people enter a purgatory and undergo a trial of chewing green bamboo. If a person's teeth are sharp the bamboo is likely to splinter and pierce the mouth and intestine. If the teeth are smooth the bamboo can be chewed without ill effects.


MUTILATIONS OF SOFT TISSUES
TATTOOING
Tattooing of soft tissues is one of the famous practice which remains relatively popular in many non-tropical and tropical areas of the world.Skin tattooing is the most commonly encountered,tattooing of lips and gingiva is occasionally seen.The gingiva may be tattooed when females reach puberty,become betrothed or when they become married. It is practiced by men to relieve pain associated with 'diseased gums'. It is believed that gingival tattooing has therapeutic benefit.The material used for tattoo is obtained from calcified peanuts,burned wood or from lamp black.A tattooed lower lip in Sudanese woman signifies that the woman is married. Facial tattoos may incorporate a triangular shaped tattoo on the skin surface at the angle of mouth.It has its basis in ritual warding off the "evil eye"
Other forms of Soft tissue mutilation:

• Piercing of the lips and perioral soft tissues and insertion of materials such as wood,ivory or metal
• The temporary piercing of orfacial soft tissues for ceremonial purposes
• Uvulectomy(removal of uvula in mouth)
• Facial scarring

CONCLUSION
The developed and under developed regions of the tropics comprise a vast repository of beliefs and knowledge concerning health,disease and treatment.In some instances,these knowledge have been retained for hundreds of years.Awareness of them is important for those who are involved in the planning of dental health care delivery system.It is important in context of sensitive approach and respect for cultural belief by those treating patients according modern methods and by planning the dental care delivery system,convincing the people of the harmful effects of some practices.

Why should I take Insulin?

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Insulin-Facts and Fictions

Insulin is Hormone secreted by beta cells of pancreas called as Islets of Langerhans. It helps in maintaining blood glucose levels to a normal level of 65milli grams to 105milli grams per Deciliter. Any rise in blood glucose levels will cause clinical manifestations. Presently more than 40% of middle aged men of the entire world are Diabetic

There are several methods of treatment for Diabetes Mellitus. Not all the diabetic patients require hormonal insulin therapy. Many of them feel uncomfortable if they are advised for Insulin therapy. So let us know what are the misconceptions and facts regarding Insulin therapy.

Misconception: Because of insulin I couldn’t control the blood sugar levels
Fact: In order to maintain perfect glucose levels in blood, doctors advice to take insulin but its not an indication that the condition will deteriorate if you don’t undergo insulin therapy.
Type 2 diabetes will have a tendency to increase in severity. Even though you try to restore normal blood glucose levels but pancreas fail to produce sufficient insulin. Though you use many drugs for long time when the glucose levels are imbalanced you have to go for insulin therapy

Misconception: Insulin injections are painful
Fact: With the latest release of insulin syringes, first injection will be far less painful than expected. People will appreciate it by experience. They are not like other syringes. The needles of these syringes are very short, thin and fragile. Hence there will be no pain, literally.


Misconception: Insulin injection will cause reaction
Fact: Yes there might be reaction with blood. There can be hypoglycemia. Long term acting insulin drugs can cause hypoglycemia. If you are aware of insulin, its actions the risk of hypoglycemia can be decreased.

Misconception: Once I start insulin therapy, I should take it life long.
Fact: This is true in case of Type-1 type of diabetes. But in type-2 diabetes mellitus it depends on the insulin levels and it requires either when you are prone to diabetes or when you are in depression.

Misconception: Insulin will change my life entirely
Fact: Once you start taking insulin you think that, I have no independence of doing things on my own. Can’t live alone, can’t travel alone, and can’t eat proper food at home or away. None of these are true. If you have a proper plan you can live your life as you lived in past

Misconception: I will gain weight because of insulin
Fact: Many of them who used insulin for the first time have gained weight and is obvious. But people who use drugs for instead of insulin in higher amounts are more subjected to gain weight. And the reason for this is very simple; when the blood sugar levels are high the calories supplied through intake of food are expelled out of the body. This is a normal case. But when you take insulin the extra calories are converted into energy and stored in tissues. That means you are gaining the calories you’ve lost in past.
To regulate the weight gain and identifying the amount of calories required, you can decide what type of food to take along with proper exercise. Hence due to workouts the weight you gained will be purged.

Characteristics of Hypoglycemia:
Dizziness, upset mind, sweating, hunger, defects in vision, increase in heart beat (Tachycardia), sudden and reasonless change of mood. In these phases the blood sugar levels might be decreased. Hence immediately take one spoon of sugar. Take some cookies, chocolates along with you during journeys.

For more efficiency of insulin there should be some changes in life. For example

• Take proper food
• Do exercise regularly
• Often check glucose levels
• Undergo the treatment prescribed by doctor and use the medications without fail 

If you follow these, you can go on with your life better than past. If you follow the healthy changes you will become more energetic and active than past.