4^th International Conference and Exhibition on Occupational Health & Safety August 24-25, 2015 Toronto, Canada

Ni Yunxia, a second-year master’s degree candidate of Sichuan University. The main research direction is community care.She gained the Bachelor's degree of nursing of Sichuan University in 2013.She has participated in Clinical Practice at Department of Neurology, Respiratory Medicine ,Cardiology, Gastrointestinal Surgery, Emergency Department, Community.She has published several articles which topics cover community diabetes management ,the practice of nursing students in community and health literacy. She has gone to Curtin University to visit to learn in 2014.

Objective:To understand the health problem that students focus on.To explore the intervention methods to improve the health literacy of college students.To evaluate the effect of the intervention.
Methods: This pilot study design was single-group pre–post nonexperimental.The intervention was a combination of lectures and self-study format. Intensive classes held eight times in total which was a two-hours lectures once a week.The intervention content including the concept of health literacy, health promotion programs,self-care,etc. The self-study content was arranged according to the students' needs and teaching content. Conveying learning requirements, reference materials through public mailbox.Students can also consult the teacher through public mail, telephone, etc., to solve the health problems encountered. Intervention evaluation consisted of basic health literacy survey and the homework of open questions. The survey content inclued the health knowledge and ideas, healthy lifestyle and healthy behaviors and skills.The preliminary experiments showed the internal consistency of the questionnaire was 0.91. 17 open-questions were designed which involving health status,lifestyle,etc.Students select one of the questions to answer.
Result: 912 students have been involved in the project,and 832 students have completed the project full and effectively in reture. Before and after the intervention,the number of students with health literacy has a significant difference(X2=470.2,P=0.000),and various aspect of health literacy has been enhanced(P<0.05),the least improvement was chronic disease prevention(X2=13.3). The first three health issues that students most concerned about were: their health and how to enhance health level;their lifestyle nearly a week;the effect of environment on their health,and the percent were 20.6%,14.3%,14.1%,respectively.
Conclusion: The intervention can improve the health literacy level of college students effectively.However,many aspects of health literacy such as chronic disease prevention is difficult to improve and the behavior is difficult to change,so it is necessary to carry out special studies.

Noise-induced hearing loss (NIHL) has been extensively studied in industrial work environments. With the advent of new technologies, loud music has been increasingly affecting listeners outside of the industrial setting; Most research on the effects of music and hearing loss has focused on classical musicians.
The purpose of the current study was to examine the relationship between the amount of experience a professional pop/rock/jazz musician has and objective and subjective variables of the musician's hearing loss. This study also examined professional pop/rock/jazz musicians’ use of hearing protection devices in relation to the extent of their exposure to amplified music. Forty-four pop/rock/jazz musicians were interviewed using the Pop/Rock/Jazz Musician’s Questionnaire (PRJMQ) in order to obtain self-reported symptoms of tinnitus and hyperacusis. Forty-two of the subjects were also tested for air-conduction hearing thresholds in the frequency range of 1-8 kHz.
Results show that professional pop/rock/jazz musicians’ extent of exposure to amplified music was related to both objective and subjective variables of hearing loss: greater musical experience was positively linked to higher hearing thresholds in the frequency range of 3-6 kHz and to the subjective symptom of tinnitus. Weekly hours playing were found to have a greater effect on hearing loss in comparison to years playing. Use of hearing protection was not linked to the extent of exposure to amplified music. It is recommended that further research be conducted with a larger sample, in order to gain a greater understanding of the detrimental effects of of hours playing over years playing.

Mr. Ghana Shyam Khanal has completed his graduation (Bachelor of Science) from Manipur University, Eastern India. He had worked as Pharmaceutical sales executive in Nepal for three years. Since Last eight years he has been working as “Area Sales Manager” in Central part of Nepal for Sun Rise Drug Laboratories (Pvt. Ltd.). He is active as General Secretary of Pharmaceuticals Marketing Executives Association of Nepal (PEAN) for last three years. As General Secretary, He has participated in different conferences and workshops at National and international level. He has involved in different seminars entitled “Occupational Health and Safety”. He is the pioneer for advocating the rights of pharmaceutical marketing executives regarding the occupational health and safety in Nepal. He has conducted about half a dozen of action research in the field of Pharmaceutical marketing and its occupational hazards in Nepal. For his outstanding performance and extra remarkable contribution in pharmaceutical marketing and advocating for occupational health and safety, He was awarded as “Best Manager of the year” for three years regularly for 2011, 2012 and 2013 by Sun Rise Drug Laboratories (Pvt. Ltd.) in Nepal.

Background: Pharmaceutical marketing, often called medico marketing or Pharma-marketing is the business of advertising or otherwise promoting the sale of pharmaceutical products. It is evident that Pharmaceutical companies are spending more on marketing compared to its research budget. As nature of job, marketing and sales promotion needs consumer’s satisfaction and fulfilment of their queries. It needs specific skills for the personals involved. In Nepalese market, there is no fixed working hour and work schedule for marketing personals. Moreover, all the pharmaceuticals companies producing and marketing in Nepalese market are from private sector and they have no clear provision for occupational health and safety about their workers.
Methods: It is the study based on cross sectional and descriptive design. Most of the information was qualitative in nature collected from primary sources. It is the first study in Nepalese health care market ever conducted, targeting the workers in Pharma marketing. The study involved 316 medical sales representatives (at least one from each company). Among them only 300 had responded the hand delivered self-administered questionnaire. Data was entered and analysed by using SPSS. Simple frequency tables were used for presenting the on descriptive ways.
Results: Currently, there are approximately 316(49 Nepalese companies and 267 Indian and multinational) pharmaceutical companies selling their pharmaceutical products in Nepalese health care market. Approximately 3800 human resources are involved in Nepal as medical sales representative (MSR). Among them 400 are females; pursuing some 16000 medical doctors and around 25000 paramedical workers as pharmaceutical prescribers. On an average each MSR has to call 12 prescribers with average working hour of 10 hours. More than 90% of the MSR has felt the problem of fatigue and pain on lower limbs at the end of the each working day. Almost all MSR are graduates either in science or management faculty. Average travelling per day is of 25 kilometres. More than one fifth (23%) of them are using public vehicle for transportation while remaining were using private two wheelers. More than three fourth (77%) of the MSR were found to have feeling of stress due to uncertainty of meeting given sales target. About one fifth (19%) of them were found to have psychiatric consultation where as nearly one third (31%) of them were found to have orthopaedic consultation within last one year due to their own health problems. Only 85% of them were found to be affiliated with Nepal Medical and Sales Representative Association (NMSRA) as Member. More than 90% of the female MSR were found to have any form of anxiety while doing their duty at evening (even up to 9 PM in some occasion).
Conclusions: Excessive work load, uncertainty of working hour, elongation of waiting time, uncertainty of meeting the given sales target, travelling of longer distance on two wheeler, less family attachment and poor job security were some of the pit-falls of Medical and Sales Representatives working in Nepalese health care market. Though most of them were found to be affected by job related stress, Physical health problems were found to be at higher proportion compared to mental health problems. To explore the determinants of occupational health problems among MSR an analytical study should be conducted.

Introduction : The industrial revolution paved a new highway for charting newer territories and defining development in a newer perspective. Small scale and household industries (SSHI) employ on average nearly 40% of the workforce in the industrialized countries and up to 60% of the workforce in developing and newly industrialized countries. SSHI are gaining importance in national economies. They are employment-intensive, flexible in adapting to rapidly changing market situations, and provide job opportunities for many who would otherwise be unemployed. Their capital requirements are often low and they can produce goods and services near the consumer or client. The workforce of SSHI is characterized by its diversity. As a result, they often expose such vulnerable groups as children, pregnant women and the elderly to occupational health risks. Further, since many SSHI are carried out in or near the home, they often expose family members and neighbours to the physical and chemical hazards of their workplaces. Making working conditions safe and healthy is the interest of workers, employers and the Government. Although it seems simple and obvious, this idea has not yet gained meaningful recognition in Nepal.
Methods : The study was conducted in thirty small scale industries of Pokhara city, Kaski District in Jan, Feb, March 2014. Altogether 480 workers were involved for the study. The study was descriptive in design by using quantitative data. Similarly, Workplace Occupational Health Assessment was done in industrial setting. A thorough medical examination of 85 child workers was done using a structured questionnaire to find out the health effects due to occupational hazards. The preliminary list contained the name of the registered SSHI located inside as well as outside the industrial estates. Thirty industries were randomly picked up from the list of the industries. Prior informed consent was received from the respondents and assuring them that their personal details would be concealed. The procedures and methods used for study were limited to personal interviews, health examination of the child workers and occupational health risk assessment. The information collected was recorded and analysed using SPSS 16.0 version.
Results: The industries selected for study were as follows: Metal industry, Paint Industry, Tent industry, Drinking water bottling plant, Brick kiln, Stone crusher plant, Construction industry, Embroidery industry, Instant noodle industry and Carpet industry Out of the total 480 workers present in the industries under study, one fourth (24.8%) were child workers. Higher proportion of child workers (97%) was illiterate. Among the child workers, 23 (17%) were girls. The highest prevalence (53.3%) was found for ear problems, whereas 49.6% were suffering from other diseases (e.g. scabies, anaemia, and pin-worm infestation) and 38.5% from upper respiratory tract infection (URI) respectively. Also 37% of the respondents had nose problems. Subjective complaints of the child workers related to different psychological and physical effects induced by the work processes were also assessed.
Conclusion: The occupational health and safety practices in small scale industries in Pokhara have been found to be unsatisfactory. Child labour is a serious problem. Out of thirty industries, sixteen have employed child workers and the working conditions range from bad to terrible. Health and welfare of the child workers was also not satisfactory. There is an urgent need in Nepal to introduce a legally binding mechanism for OHS with the creation of an appropriate authority to supervise its implementation and enforcement. This will help to ensure a uniform standard of occupational health care at all levels ensuring workers efficiency and well being.There should be a strong provision of occupational health services, carrying out activities in the workplace with the aim of protecting and promoting workers’ safety, health and well-being, as well as improving their working conditions and environment.

Introduction: The business of beauty parlour has played a major role in generating employment for the less educated but eager-to-learn individuals. In order to remain inspiring and successful, this growing business needs to meet and maintain high standards of safety, health and hygiene so that no risk is present to customers and workers. Problems such as poor posture, mechanical loads on the joints, prolonged standing, longer working hours, missed meals, not taking breaks during work, as well as being subjected to physical factors such as noise and higher temperatures are important occupational health hazards for workers in beauty parlour.
Methods: The study was conducted in 690 beauty parlours, from April to May 2014 at Kathmandu Metropolitan City. Only those parlour workers were included in the sample who verbally agreed to participate in the research after knowing the objectives of the study. The direct unstructured observation and face-to-face interview were the key instruments of the study. The quantitative data were managed and analyzed using SPSS 16.0.
Conclusion: The level of OHS awareness, knowledge of risk and risk prevention practices among parlour workers associated with their profession is satisfactory. The study revealed that there were no pre-employment and periodical medical examination facilities salon workers. Most of the parlour workers notified hazards in salon and assigned to take part in OHS education program to their workers. The knowledge of the parlour workers about the risk related to salon was also pleasing. Majority of the parlour workers were knowledgeable about skin diseases. The study also revealed that the vast majority of the salon workers were knowledgeable about the role of contaminated blades, clippers, towels, aprons and combs in causing skin disease and knowledge about the razor/blades as the potential sources of contamination.

Introduction: The purpose of this study was to determine the institutional trajectory and future of young children in child welfare. Materials and methods: A catamnetic study – based on data from child welfare office in Maine-et-Loire, France, from 1994 to 2001 – was conducted by a child psychiatrist and a psychologist. Medical, judiciary and educational data (development, health, pathways in child protection) were collected and analyzed regarding the status of these children fifteen years later, adding information gathered by interviewing child welfare and foster family consultant. Results: We included 128 children admitted in the child welfare office before 4 years old. Admission in the child welfare suffers from care delays (13.1 months average between the first child protection referral and placement) with an average entry age of 17 months, frequent cases of child abuse e.g. 7 Silverman syndrome cases). The physical and mental health status of children was bad (poorly monitored pregnancies, prematurity, low birth weight). More than a third of children had growth failure at admission, with catch-up in half of the cases. The average length of stay in the child welfare was 13.2±4.6 years. At the end of the follow-up, there were specific measures to safeguard vulnerable adults: "young adult" (24 cases), "major protection" (8 cases) and "disabled living allowance" (9 cases). One hundred and sixteen children suffer from psychiatric disorders at the entrance and ninety eight at the end. The general functioning of children – assessed by the Children's Global Assessment Scale (CGAS) – showed a statistically significant improvement. One in two young adults showed difficulties in social integration with chaotic pathways: many foster placement, unsuccessful child return in his family, academic failures. Conclusion: Clinical situations of children in the child welfare office and their long-term evolution confirm the importance of this public health problem. If the measures can largely improve their physical and psychic recovery with evidence to thrive, these elements remains limited: only few of them are well integrated socially with school effectiveness.

Background: Tuberculosis (TB) infection represents a global health problem and a great risk to Health Care Workers (HCWs). Identifying individuals, particularly HCWs with Latent Tuberculosis Infection (LTBI) will support TB control through chemoprophylaxis and prevent cross-infection. Objectives: This study aimed to identify prevalence of Latent TB among a two-year new hires of HCWs in 4 major tertiary care hospitals in Riyadh, Saudi Arabia. Material and Methods: 2650 recently (2-years) hired HCWs were surveyed for latent TB using Tuberculin Skin Test (TST). Data was collected from January 2008 to December 2009. Induration due to TST equal to or more than 10 mm within 48-72 hours was considered positive. The results of TST were correlated with other variables such as age group, gender, job category, country of origin. Results: As an overall rate, 291(11%) out of 2650 were positive for TST, with the highest significant positive rates among physicians (14.9%) and nurses (12.9%) compared to students as a reference group.

Mercedes Guadarrama completed her Post Graduate studies in Occupational Health from Cartagena University in Colombia and Medical Toxicology from Los Andes University School of Medicine in Merida, Venezuela. Her last work was DROLANCA Medical Services Coordinator, a premier Health business company in her country. With teaching and research experience, she presented five of her research works and published three papers in reputed journals, also worked in the Venezuelan public Occupational Health Institute, INPSASEL (National Institute for Security and Health Prevention), and did volunteer work for two years.

Risk Factors and Muscle Skeletal Disorders (MSD) Prevalence in Makro-Merida Venezuelan Workers at 2007 (RF&MSDPM-MVW) was a descriptive study including as sample the universe of workers (70 persons) being at Makro-Merida, a whole-sale and retail sales company in 2007. To learn about prevalence and distribution of risk factors for MSD and MSD itself in the studied population we checked morbidity record archive and conducted a survey about Risk Factors for MSD among all the workers. Collected data was presented in tables and graphs after being analyzed with basic statistical methods including media average, median and Excel® program. Population under study included 68.57% male and 31.43% female with 85.71% age between 17 and 34 years old. Integral helper (utility man) was the most frequent position with 54.29% distributed mainly in three areas: check out 25.71%, sales in field 17.14% and produces management 15.71%. Top five Risk Factors to MSD included: weight handling or lifting, alternative and repetitive movements, prolonged stand up body position, prolonged curved or flexed body position and prolonged squatting body position. Major diagnoses conditions were Lumbar Pain 35.80%, Cervical Pain 25.93%, Upper limbs trauma 9.88%, Low limbscontusions 7.41% and Ankle Sprains 6.17%.

Basanta Kumar Shrestha completed Bachelor's Degree in Management and worked in NRCS from 1989 and got well versed in Community development sector like: Community health promotion, Community health and First aid as well as facilitated in many training. Currently he is working in NRCS a large humanitarian organization as project coordinator in Community Based Health & First Aid (CBHFA) Program, National Headquarter Kathmandu. He has trained large numbers of workers and volunteers through facilitation in different trainings like: First Aid, Health & hygiene promotion, DRR. He visited 72 district headquarter and some community of Nepal out of 75 districts. He participated in international level training, exposer visit workshop like: CBHFA Asia Pacific Workshop on Lessons Learnt, Behaviors Change Communication and Integration 2011 Bangkok, CBHFA Regional Facilitator workshop learning by doing approach in Sri Lanka 2008, Regional Disaster Response Tem (RDRT) Training in Sri Lanka 2006, study visit to Belgium Red Cross in 2005 and study visit to Bangladesh in 2004.

Nepal Red Cross Society (NRCS) is a member of the International Red Cross and Red Crescent Movement and established on 4th September 1963, It is working to reduce human suffering through providing humanitarian services from district chapters, Sub Chapters and junior /Youth Circles, volunteer mobilization overall country at remote and most vulnerable communities. Nepal has a difficult geo-physical structure, limited health facilities and difficult transport and limited means of communication. Availability of health services are confined to district headquarters only as well as mode of transportation. Due to insufficient availability of health services and transportation facilities in remote community, people have faced so difficulties during the accidents, injuries and health problem. Women are high risk for accidents, injured and health problem because they are directly involved in daily work in home, farming, forest for wood. In the context of Nepal, health problems have been acute because of serious accidents and of the apparently wrong attitudes towards on hygiene, Sanitation and health. In Nepal, thousand people died annually due to injuries or accidents and a large number of people died from inappropriate health practices. Maternal mortality ratio (per 100,000 live births), the proportion of women who delivered with the help of a skilled birth attendant (SBA) was 50%. Approximately 80% of the communicable diseases in Nepal are due to contaminated water and poor sanitation; 16 million Nepali people (57%) openly defecate every day due to the lack of latrines in their homes. According to a report, over half of Nepal’s population lacks basic knowledge of good hygiene practice. Only 37 per cent of people in Nepal wash their hands with water at critical times and just 12% use soap. Due to this big problem and to improve the health and sanitation status of remote community people, CHFA program activities has played vital role and worked exemplary in Nepal.

Background and Objective: Safety climate has been recently recognized as a fundamental and ultimate solution for improving workplace safety in various industries. The importance of safety climate rests on its ability to predict safety behavior. Based on this faculty, safety climate has shown its ability to predict important safety results, such as perceived risk, accidents and injuries. The purpose of the present study was to develop, and examine the component structure and internal consistency of a questionnaire designed to assess safety climate in the Iranian workplaces. Materials and Method: 410 Workers working in different worksite in Qazvin province completed the questionnaire. Items selection was determined by principal components analysis (PCA) which also defined the underlying structure of the questionnaire. Scales were constructed from the items that loaded on components and were tested for internal consistency using Cronbach α scores. Pearson correlation coefficients were used to examine inter-component correlations. Comparisons of safety climate scores among various groups by age, years of work experience and accident involvements were used to test Discriminant validity Findings: A 20-item Safety Climate Questionnaire (SCQ) was extracted through PCA; seven components were retained which represented the model of choice, and explained 71.19% of the data variance. The components were: management commitment, safety communication, safety environment, management responsibility, risk perception, safety awareness and job satisfaction. The internal consistency for the components was high; Cronbach α score ranged from 0.64 to 0.84. Significant differences on some safety climate scales among accidental involvement and years of experience were detected. Conclusions: The 20-item SCQ demonstrated good psychometric properties in terms of its face validity, component structure and internal consistency. The findings of this study provide a framework upon which accident prevention efforts can be effectively organized and underscore the importance of management commitment and safety communication as they affect employee safety perceptions.

Nyandoro George has submitted 15 manuscripts in his final year of MSc studies and has written 2 winning proposals (BCC Evaluation and GPE Baseline survey) for consultancy work at national level during his practicum. He is a consultant Statistician with a strong medical research background.

Objective: The aim of this study is to determine sensitivity and specificity of Kato-Katz technique in the absence of a gold standard using Bayesian modelling for the determination of S. mansoni and soil transmitted helminths infection (STHs) in Zimbabwe. Methods: This is a secondary analysis based on primary school children (n=15 818) aged 10-15 years who were enrolled in the national mapping of S. mansoni and STHs. A Bayesian approach was used to evaluate the diagnostic performance of the evaluation tool. Results: The fomol ether diagnostic technique was generally more sensitive with S. mansoni detection operational characteristics as follows (Sensitivity: 0.995; 95% Bayesian Credible Interval (BCI): 0.989-0.999), STHs- Hookworm detection (Sensitivity: 0.991; 95% BIC; 0.988-0.993 ), STHs– A. lumbricoides detection (Sensitivity:0.992; 95% BCI; 0.989-0.995) and STHs– T. trichiuria (Sensitivity:0.988 95% BCI: 0.926 - 1.00); than the Kato- Katz diagnostic technique (for S. mansoni detection (Sensitivity: 0.981; 95% BCI:0.971-0.994), STHs - Hookworm detection (Sensitivity: 0.966; 95% BCI; 0.963-0.970) , STHs – A. lumbricoides detection (Sensitivity: 0.967; 95% BCI;0.974-0.981) and STHs – T. trichiuria (Sensitivity: 0.988; 95% BCI; 0.974-0.981). However, specificity is higher for the Kato- Katz technique compared to the fomol ether concentration technique. Conclusion: The fomol ether concentration technique has better performance compared to the Kato-Katz technique and have increased the number of primary school children who need treatment in the field compared to recommended the Kato- Katz technique alone.

Aim: Health care providers are subject to a particularly high risk of violence in the workplace, and nurses are the most at risk. This study examines the physical and verbal violence of the health care providers in the city of Vlore. Methodology: 361 Health service workers participated in this study; they were from seven major health institutions in Vlore. The data was collected using a questionnaire and the analysis was performed through SPSS 19.0, in order to identify the type, frequency, distribution of violence. Results: In the state police department there were 23 reported violence cases to the health care workers for 2013. These cases were settled since the beginning and only 2 cases pressed charges. 55% of the participants were worried about violence, 33% weren’t. Disturbance by wards: Psychiatry 4-5 100%, Pediatrics-91%, Emergency-polyclinic-88%, Surgery-83%, Infectious disease-82%, Emergency-Admission-78%, Pathology-72%, Psychiatry department 60% 6-7. 28.8% were physically threatened more often in the 4-5 psychiatry department-84%, Emergency Admission-71%, Pediatrics-17%, Surgery-28%, 60%-RTI, microsurgery 60%, Psychiatry6-7 50%, Psychiatry-Admission-50% Infectious diseases-41%, Pathology-40%, OB-4%. 54.5% of the health personnel was verbally abused, most threatened were in the psychiatry ward unit 4-5 with 84%, psychiatry admission 90%, units 6-7 of psychiatry ward 80%, Emergency admission-71%, Infectious diseases 70%, Pathology-61%, Microsurgery-60%, Emergency-polyclinic 56%, Surgery-53%, 54%-Pediatrics, RTI-50%, Obstetric-44%. 41% of the threats have come from family members, from patients 19% and colleagues/supervisors 13.6%. Conclusions: Physical/verbal violence in our institutions is very high in all health services studied, and is spread in all age groups.

Background: Although various studies have been conducted to shed light on the pharmacological actions of khat, little or no data are available regarding khat’s effect on the renal redox system. The aim of this study was therefore to investigate the potential of nephrotoxicity associated with khat exposure in rats. Methods: Sprague Dawely rats were randomly assigned into eight experimental groups. Animals were treated with Tween 80, gentamicin 100 mg/kg and khat at various doses (100, 200 and 400 mg/kg) alone or in combination with gentamicin for ten days. The animals were then sacrificed to obtain blood and renal tissues for subsequent analysis. Renal markers, including creatinine, blood urea nitrogen, antioxidant enzymes as well as markers for lipid peroxidation were determined using established protocols. In addition, histopathological changes were evaluated with hematoxilin and-eosin staining technique. Results: Lower and moderate doses of khat did not alter the measured parameters compared to controls. By contrast, higher dose (400 mg/kg) of khat not only increased levels of serum creatinine and blood urea nitrogen (p<0.001) but also levels of malondialdehyde (p<0.01). Moreover, 400 mg/kg of khat significantly decreased enzymatic activities of superoxide dismutase (p<0.01) and catalase (p<0.001). When khat was administered with gentamicin, it was again the higher dose that significantly accentuated gentamicin-induced alterations in the renal system. Conclusions: Khat treatment at high dose is demonstrated to induce mild to moderate renal damage. Moreover, it creates synergy when combined with nephrotoxic drugs such as gentamicin.