prevalence of respiratory symptoms and...

PREVALENCE OF RESPIRATORY

SYMPTOMS AND THEIR ASSOCIATED

FACTORS AMONG PEOPLE LIVING

NEAR THE SPONGE IRON INDUSTRIES

IN BONAIGARH ODISHA INDIA

CHINMAYA KUMAR BEHERA

Dissertation submitted in partial fulfillment of the

requirement for the award of the degree of

Master of Public Health

ACHUTHA MENON CENTREFORHEALTHSCIENCE STUDIES

SREE CHITRA TIRUNAL INSTITUTE FORMEDICAL SCIENCESampTECHNOLOGY

Trivandrum Kerala India-695011

October 2017

2

DEDICATION

The work embodied in this dissertation is dedicated to my father Mr Kumuda Chandra

Behera my mother Mrs Mamata Behera my father-in-law Mr Gouranga Charan Samal

my mother-in-law Mrs Jayashree Samal and my beloved wife Subhashree Priyadarsini

They have sacrificed their time and comforts for me and offered unconditional support and

encouragement in making this work possible

This work is also a humble homage to my Sadgurudev Sri Satpalji Maharaj whose

preaching‟s and meditation techniques gave me peace of mind throughout the dissertation

work

3

ACKNOWLEDGEMENT

Thanks to my Sadgurudev for giving me this opportunity to study MPH at SCTIMST

which was like a dream coming true I am thankful to everyone who has contributed

directly or indirectly which led to the culmination of this work especially the faculty

members of Achutha Menon Centre for Health Science Studies (AMCHSS) for helping me

to conceptualize revisit and refine my dissertation work I feel extremely lucky to be

mentored under my research supervisor Dr Manju Nair R and I am very grateful to Dr

Tushar Kant Joshi and Prof Dr TK Sundari Ravindran for their help in the initial days

when I was searching for a topic for my dissertation I am also grateful to Dr Biju Soman

who provided me with a GPS machine to take the GPS locations of villages during my data

collection and also to Dr Jeemon P who is always ready to help whenever I approached

him for discussions related to my dissertation I am also thankful to Prof Dr Sankara

Sarma who helped me whenever I had any doubt about the analysis I am very thankful to

my sister Miss Madhusmita Behera and sister-in-law Suniyena Priyadarsini and Sushree

Samal for their encouragement and logistics support during the printing and editing on my

study tools I am very thankful to my batch mates Mr Manas Chacko and Mr Swadhin

Jena for their unconditional inputs at crucial times during the whole process Last but not

the least I am grateful to the community leaders and all the 410 study participants who

showed immense patience shared their experiences and time with me during data

collection phase which led to a high response rate and successful completion of this MPH

dissertation

4

DECLARATION

I hereby declare that this dissertation titled ldquoPrevalence of respiratory symptoms and their

associated factors among people living near the sponge iron industries in Bonaigarh

Odisha Indiardquo is the bonafide record of my original research It has not been submitted to

any other university or institution for the award of any degree or diploma Information

derived from the published or unpublished work of others has been duly acknowledged in

the text


Achutha Menon Centre for Health Science Studies (AMCHSS)

Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST)

Thiruvananthapuram Kerala India

October 2017

5

CERTIFICATE

Certified that the dissertation titled ldquoPrevalence of respiratory symptoms and their

associated factors among people living near the sponge iron industries in

Bonaigarh Odisha Indiardquo is a record of the research work undertaken by

CHINMAYA KUMAR BEHERA in partial fulfillment of the requirements for

the award of the degree of ldquoMaster of Public Healthrdquo under my guidance and

supervision

DR MANJU NAIR R

Scientist bdquoC‟



Thiruvananthapuram Kerala Indiandash 695011

October 2017

6

GLOSSARY OF ABBREVIATIONS

AAP Ambient Air Pollution

APL Above poverty line

ARI Acute Respiratory Infections

BMRC British Medical Research Council

BPL Below poverty line

CI Confidence Interval

COPD Chronic Obstructive Pulmonary Disease

DRI Directly Reduced Iron

ECRHS European Community Respiratory Health Survey

FVC Forced Vital Capacity

GARD Global Alliance against Chronic Respiratory Diseases

ICMR Indian Council for Medical Research

IEC Institutional Ethics Committee

INSEARCH Indian Study on Epidemiology of Asthma Respiratory Symptoms

and Chronic bronchitis

ISAAC International Study of Asthma and Allergies in Childhood

IUATLD International Union Against Tuberculosis and Lung Diseases

LPG Liquid Petroleum Gas

NFHS-4 National Family Health Survey-4

OR Odds Ratio

PM Particulate Matter

PVC Poly Vinyl Chloride

7

PHC Primary Health Care centres

SCTIMST Sree Chitra Tirunal Institute for Medical Sciences and Technology

SEC Socio- Economic Class

SPCB State Pollution Control Board

UK United Kingdom

WRS Work Related Symptoms

WHO World Health Organization

8

TABLE OF CONTENTS

_____________________________________________

Chapters Topics Page

List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13

12 Rationale of the study 15

2 Literature Review 17

21 Prevalence of respiratory symptoms 17

22 Air pollution and respiratory symptoms 18

23 Respiratory symptoms and occupational

exposures

19

24 Respiratory symptoms and indoor air

pollution

21

25 Smoking and respiratory symptoms 23

26 Alcohol and respiratory symptoms 24

27 Other factors and respiratory symptoms 25

28 Respiratory symptoms and populations

around industrial areas

26

281 Epidemiological methods used to study health

effects of pollution around industrial areas

26

282 Respiratory symptoms due to air pollution 27

29 Exposure assessment used 28

210 Tools used to study respiratory outcomes 28

211 Objectives 29

212 Research questions 29

3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30

34 Sample selection procedure 30

35 Selection of the individual participants 31

351 Inclusion criteria 31

36 Data collection techniques 32

37 Plan for data collection and analysis 32

38 Data analysis 33

381 Univariate analysis 33

382 Bivariate analysis 33

9

39 Study tool 34

310 Operational definitions 34

3101 Respiratory symptoms 34

3102 Adults 34

3103 Associated factors 34

311 Expected outcomes 34

312 Project Management 35

3121 Staffing 35

3122 Work plan 35

3123 Administration 35

3124 Data storage transfer and management 36

313 Ethical considerations 36

314 Plan for dissemination 36

4 Results 38

41 Sample characteristics 38

411 Education 39

412 Occupational status 39

413 Socio- economic status 39

414 Household size 40

415 Housing characteristics 40

4151 Dampness in the house 41

4152 Cooking practices and the nature of the

kitchens

41

4153 Cooking stove 41

416 Cooking fuel and practices 41

417 Residence in the area 42

42 Behavioural factors 42

421 History of smoking 42

422 History of alcohol use 43

423 Body Mass Index (BMI) 43


44 Association of respiratory symptoms with

individual and household factors

44

441 Wheezing and morning breathlessness


44

442 Breathlessness on exertion and without

exertion with individual and household factors

44

443 Breathlessness and cough at night with


45

444 Cough and phlegm in the morning with


45

445 Chest tightness and breathlessness on dust

exposure with individual and household factors

46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59

6 Appendiceshelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphelliphellip 65

Annexure-

I Participant information sheet English 66

Annexure-

II Participant consent form English 69

Annexure-

III Study tool English 70

Annexure-

IV Participant information sheet Odia 76

Annexure-

V Participant consent form Odia 78

Annexure-

VI Study tool Odia 79

Annexure-

VII IEC Approval letter 84

11

LIST OF TABLES FIGURES

Tables

Page

41 Socio- demographic factors of the sample 40

42 Housing characteristics of the sample 41

43 Behavioural factors of study population 42

44 Prevalence of respiratory symptoms in the study population 43

45 Association of wheeze and morning breathlessness with


46

46 Association of breathlessness on exertion and breathlessness

without exertion with individual and household factors

47

47 Association of breathlessness and cough at night with


48

48 Association of cough and phlegm in morning with individual

and household factors

49

49 Association of chest tightness and breathlessness on dust


50

51 Prevalence of respiratory symptoms among adults near

sponge iron industries Bonaigarh

51

Figures

Page

31 Work plan for the whole project 29

41 Distribution of males and females in different age

categories 39

42 Overall prevalence of respiratory symptoms 45

12

Abstract

Introduction Limited evidence exists in India regarding the burden of respiratory

morbidity among people living near industries with polluting emissions despite them

being a significant contributor to the ambient air pollution in the country The

objectives of the current study was to assess the prevalence of respiratory symptoms

and their associated factors in a community residing around a group of sponge iron

industries in Odisha India

Methodology A cross-sectional survey conducted among 410 adults in the age

group 18-65 years living within 5 kilometers radius of a group of sponge iron

industries in Bonaigarh Odisha India using a structured interview schedule

Respiratory symptoms were assessed using a validated International Union Against

Tuberculosis and Lung Diseases (IUATLD) respiratory symptoms questionnaire

Results The prevalence of wheeze cough in the morning cough at night phlegm in

the morning and breathlessness on dust exposure were 151 (95 CI 119 - 189)

234 (95 CI 196 ndash 278) 215 (95 CI 178 ndash 257) 207 (95 CI 171 -

249) and 505 (95 CI 457 - 553) respectively All the above respiratory

symptoms were significantly higher among men compared to women In addition

dampness inside homes was associated significantly with the having wheeze (p=

003) cough in the morning (p= 005)

Conclusion The results of the study indicate a higher prevalence of respiratory

among the people residing near sponge iron factories in Bonaigarh Odisha

compared to the prevalence estimates of rural Odisha from other studies Larger

studies with objective emission measurements and pulmonary function parameters

are required to explore these observations further

Keywords Air pollution Respiratory symptoms Odisha India

13

Chapter- 1

Introduction

___________________________________________________________________

11 Background

Air pollution is increasingly recognised as one of the major threats to human health

in the modern times According to estimates of the World Health Organization

(WHO) in 2016 ninety two percent of the world‟s population lives in areas exposed

to air quality that exceeds WHO standards leading to considerable avoidable

morbidity and mortality Air pollution is known to cross all boundaries of

geopolitical divisions of the world and therefore has aroused

The exposure to ambient air pollution (AAP) is further aggravated in areas that are

close to sources such as industries major cities roads and mines Such sites

facilitate the settlements of large numbers of people around them either directly

employed or related to opportunities such development offers Such industrial areas

in most cases become major sources of pollution and create high levels of exposure

to hazards of various kinds to the people living around them (WHO 2016)

The extent of the problem and the impact that ambient air pollution creates in the

developing countries are far higher than those in the developed countries The

developing nations in their pursuit of better economic growth and competitiveness in

the global market tend to set up industries that employ cheaper technologies and are

not stringently regulated for emission norms (Hegerl et al 2007) These occur often

at the cost of natural resources massive deforestation and give rise to high levels of

pollution

14

Air quality is threatened by most such industries set up at the cost of environmental

degradation and adds gaseous pollutants like nitrogen dioxide sulphur dioxide

pollutants like cotton and jute dusts carbon particles chemicals heavy metals and

particulate matters (PM) of different sizes These pollutants result in high burden of

disease and particularly affect the human respiratory system causing acute and

chronic respiratory morbidities like dyspnoea cough phlegm wheezing bronchitis

and asthma (Bakke et al 1991 Le Van et al 2006 Lynda JL and John RB 2000)

Respiratory morbidity due to air pollution is not limited to any particular group in

the society and is manifested differently among different populations according to

the type andor environmental exposures They tend to affect vulnerable sections of

the society who are forced to live closer to sources of pollution In the rural areas

and sections of the urban population the burden of diseases due to ambient air

pollution is further worsened by their use of biomass fuels for domestic energy

needs and consequent exposure to high levels indoor air pollution

According to the WHO Global Alliance against Chronic Respiratory Diseases

(GARD) ldquorespiratory symptoms are among the major causes of consultation at

primary health care (PHCs) centresrdquo (Bousquet and Khaltaev N 2007) A systematic

analysis on the prevalence of asthma in Africa reported that the prevalence percent

among children less than 15 years as well as adults aged more than 45 years showed

a consistently increasing trend between the 1990 and 2012 (Adeloye et al 2013)

In India according to a multi-centre study conducted by Indian Council for Medical

Research (ICMR) during 2006-2009 about nine percent of respondents were having

one or more of the twelve respiratory symptoms studied They found a large

15

variation between individual respiratory symptoms across centres among men and

women and between urban and rural localities (S K Jindal 2006) A study

conducted among sand stone quarry workers of Jodhpur found that the Forced Vital

Capacity (FVC) of workers decreased in relation to increased duration and

concentration of exposure (Singh et al 2007)

India is the largest DRI producer in the world for the last consecutive 13 years

30percentof the world‟s directly reduced iron (DRI) or Sponge iron(2nd India

International DRI Summit 2014) and about 80are coal based industries (Patra HS

et al 2012) These industries give rise to several pollutants including heavy metals

like Cadmium Chromium Mercury Lead Mercury amp Nickel Air pollutants like

oxides of Sulphur and Nitrogen and hydro-carbons Several of these especially those

from sponge iron industries give rise to respiratory symptoms like cough phlegm

chronic bronchitis etc (Patra HS et al 2012 Cerena Foundation 2006)

In India Odisha has vast reserves of coal and iron ore (Patra HS et al 2012)

Therefore it has several sponge iron industries sponge iron being an These

industries in Odisha are mostly situated in the two districts of Sundargarh

(Kuarmunda Kalunga Bonai Lathikata Rajgangpur) and Sambalpur (Rengali)

(Patra HS et al 2012)

12 Rationale of the study

Even though there are several studies on the prevalence of respiratory symptoms

across the world focused on general population based morbidity specific

occupational groups and populations around polluting industries there is a shortage

of such data in the Indian context Respiratory symptoms are mostly context specific

16

and the rise in industrial growth in different parts of India warrants more research in

this area Most of the studies India in relation to industries are focused on

occupational health issues related to workers or their families The fact that such

highly polluting industries tend to be situated in the rural and difficult to access

regions with no air quality monitoring centers studies on the burden of respiratory

morbidity among people living close to such industries are limited

17

Chapter-2

Literature Review

21 Prevalence of respiratory symptoms

A survey conducted in seventy six primary health centres of nine countries found

respiratory symptoms ranging from 84 to 370 among patients aged above 5

years A systematic analysis on the prevalence of asthma in Africa reported an

increasing prevalence of 121 among children less than 15 years 118 among

people aged less than 45 years and 117 in the total population in 1990 In 2000

the prevalence rose to 139 among children lt15 years 138 among people lt45

years and 128 in the total population In 2010 this estimate further increased to

139 among children lt15 years 138 among people lt45 years and 128 in the

total population (Adeloye et al 2013)

In a World Health Survey of WHO conducted in 70 member countries during 2002-

2003 they found a global prevalence of doctor diagnosed asthma in adults was

estimated to be 43 (95 CI 42 44) Highest prevalence of asthma was found in

Australia (215) Sweden (202) United Kingdom (UK) (182) Netherlands

(153) and Brazil (130) The global prevalence of wheezing was estimated to

be 86 (95 CI 85-87) (To et al 2012)

In India the pooled prevalence of asthma across all the 12 centres in different states

was 205 (228 in rural and 164 in urban) A population based study

18

conducted in north-west India shows a prevalence of chronic bronchitis bronchial

asthma and Chronic Obstructive Pulmonary Disease (COPD) as 336 118 and

421 respectively (Sharma et al 2016) In a recent study conducted in nine high

focus states of India on data extracted from Annual Health survey and census 2011

they found that households using clean cooking fuel record low incidence of Acute

Respiratory Infections (ARI) (Gouda et al 2015)

A multi centric study on asthma respiratory symptoms and chronic bronchitis

conducted by ICMR found a pooled prevalence across 12 centres for asthma and

chronic bronchitis was 205 (228 in rural and 164 in urban areas) and 349

(407 in rural and 250 in urban areas) respectively (S K Jindal 2006)

22 Air pollution and respiratory symptoms

Air pollution is proven to cause marked effects on the respiratory system Increased

exposure to particulate matter (PM) and other component of toxic air pollution is

associated with higher incidence of acute and chronic upper and respiratory

symptoms including cough and wheeze and chronic lung diseases such as asthma

COPD and lung cancer Adult and children with acute and chronic exposures to high

levels of traffic related air pollution are found to have statistically significant

reduction in pulmonary function parameters Strong links have been established

through both epidemiological and laboratory studies between air pollution and

bronchial asthma High concentrations of air pollutants especially PM10 and other

gaseous constituents have been associated with increased acute exacerbations of

asthma and related hospitalizations Some recent studies particularly in the

developed countries have estimated that there is an increase in PM25 related

19

cardiopulmonary pneumonia and influence related mortality (Arbex MA 2012)

23 Respiratory symptoms and occupational exposures

A Nigerian study conducted to determine the prevalence of respiratory problems and

lung function impairment on 403 male and female quarry workers in the age group

of 10-60 years where 983 used no protective devices and 05 either use apron or

other protective devices while working found a prevalence of respiratory symptoms

like occasional chest pain (476) occasional cough (407) and sputum mixed

with blood (05) (Nwibo et al 2012)

An Indian cross sectional study to assess the respiratory health status and to

determine its predictors on 258 coal based sponge iron plant workers found a

prevalence of 255 89 amp 171 with any chronic respiratory disease asthma

and rhino conjunctivitis respectively (Chattopadhyay 2015)

A cross-sectional study conducted to determine the frequencies of chest radiographic

abnormalities and respiratory symptoms and to study the relation between the

cumulative exposure to respirable dust and quartz and risk of radiographic

abnormalities and respiratory symptoms among 1852 men working in 18 heavy clay

industries found a prevalence of chronic bronchitis (chronic cough and phlegm)

breathlessness while walking with others of the same age group on level ground) and

wheeze (attacks of wheezing or whistling in the chest at any time in the last 12

months) as 142 44 and 206 respectively (Love et al 1999)

A study conducted five decades ago to find out the prevalence of byssinosis and

respiratory symptoms and to compare the ventilatory capacities in the two

20

population due to air pollution comprising 414 English and 980 Dutch male cotton

workers they found an overall prevalence of persistent cough andor phlegm for all

ages (15-64 years) of English town (6835) Dutch town (2794) Dutch rural

(1951) in the card and blow room In the spinning room the prevalence was

3696 2105 1108 in the respective places (Lammers et al 1964)

An Indian study conducted to find out the prevalence of respiratory symptoms and

lung function status on 274 male workers with a reference group of 54 subjects of

various processing units in the carpet industry at Bhadoi found an overall prevalence

of respiratory symptoms like wheezing chest tightness shortness of breath cough

etc among the exposed workers 314 (Plt 001) compared to 74 among the

control group (Rastogi et al 2003)

An Iranian study conducted to evaluate the respiratory symptoms and lung capacities

on 176 workers exposed to silica dusts and various chemicals like kaolin Na2SO4

NaCo3 ZnO2 and 115 unexposed workers of a tile factory in Yazd found a

respiratory symptoms prevalence of Work Related Lower respiratory symptoms of

(188 amp 78) Work Related Upper respiratory symptoms of (17 amp 52) and

Chronic Obstructive Pulmonary Symptoms of (21 amp 104) respectively (Halvani

et al 2008)

A study conducted to find out the possible respiratory effects resulting from air-

borne exposures to metal-working fluids on 1042 male automobile machinists and

744 unexposed assembly workers in Michigan at three General Motors facilities

found a respiratory symptoms prevalence of usual cough (2015 vs 2570) usual

phlegm (1815 vs 2582) wheezing (2361 vs 1854) chest tightnessgt1

21

week (1239 vs 1523) and dyspnoea (8322 vs 6648) (Greaves et al

1997)

A study conducted to find out whether welding at work increases the risk of asthma

symptoms wheeze and chronic bronchitis symptoms of males in 22 European

centres in 10 countries on 316 welders exposed to welding fumes and a comparison

group of 2610 they found a prevalence of asthma symptoms or medication (77)

wheezing (170) and chronic bronchitis (158) in welders and 96 139 and

111 in the referent group respectively (Lilienberg et al 2008)

A study conducted to estimate the prevalence of work-related symptoms suggesting

the presence of allergic disease reported by cleaners on Polish workers (957

women) of cleaning service in their workplaces found a prevalence of 472 during

cleaning work for at least one respiratory symptoms among dyspnoea cough and

wheezing (Lipinska-Ojrzanowska et al 2014)

24 Respiratory symptoms and indoor air pollution

In most developing countries indoor air pollution due to use of biomass fuels for

cooking is a risk factor for respiratory morbidity Research in Mozambique to assess

the exposure levels of indoor air pollution on the health status of adult women

Maputo found those who used wood as the principal fuel had a significantly higher

cough index than users of modern fuel (plt 00005) Prevalence of cough among

wood users was 9 percent compared to (322) among modern fuel users (Ellegard

1996)

In a study based in a semi-rural area of Cameroon to determine the prevalence of

22

respiratory symptoms and the factors associated with reduced lung function on adult

women exposed to cooking fuel smoke with women using wood (n= 145) and

women using alternative sources of energy (n= 155) they found a prevalence of

chronic bronchitis of 76 amp 06 and dyspnoea on exertion of 221 amp 52

respectively (Ngahane et al 2015)

A study conducted on 1082 never smoking women aged 20-40 years to determine

the effects of indoor air pollution exposure on respiratory symptoms and illnesses in

non-smoking women and who were not occupationally exposed to Indoor Air

Pollution They found cough (334) as the highest prevalent respiratory symptom

and wheezing (82) was lowest and others were phlegm (178) blocked-runny

nose (164) and shortness of breath (328) They found statistically significant

association of Environmental Tobacco Smoke and use of biomass fuels with cough

[OR (95 CI) 134 (111-161) amp 136 (107-174) respectively] and shortness of

breath [OR (95 CI) 127 (104-155) amp 140 (112-175) respectively] (Stankovic

et al 2011)

A Chinese study on 5231 seventh grade school children in the spring of 1999 at 22

public schools in and around Wuhan China found a prevalence of respiratory

symptoms wheezing with cold (194) wheezing without cold (71) bringing up

phlegm with colds (167) bringing up phlegm without colds (57) coughing

with colds (247) coughing without colds (45) Those who used coal in their

households either only for cooking or heating in those households wheezing was

found to be strongly associated with cooking But when coal was used for both

heating and cooking the association with wheezing was found to be stronger

23

(OR=178 95 CI 108-291 for wheezing with colds OR=157 95 CI 094-

264) (Salo et al 2004)

Indian study conducted in rural Odisha where 94 of households were using

traditional stove with biomass fuel as their primary cooking stove and found that

12 of males and 10 of females were having obstructive respiratory disease

About 40 of the population were having moderate to severe restrictive respiratory

disease They have also found that using a clean fuel is associated with lower

probability of having a cold or flu in the last 30 days (Duflo et al 2008)

A study conducted on Indian women using domestic cooking fuels found an overall

13 prevalence of respiratory symptoms Mixed cooking fuel (Chullah Stove and

Liquefied Petroleum Gas (LPG)) users had respiratory symptoms prevalence of 16

percent Whereas the respiratory symptoms were 13 and 11 among chullah and

stove users respectively (Behera and Jindal 1991)

25 Smoking and respiratory symptoms

In an analysis of postal questionnaire surveys conducted to examine the relationship

between cigarette smoking and asthma prevalence in two general practice

populations of less than 45 years including 3488 subjects of whom 407 were

current smokers 163 ex-smokers and 430 never-smokers they found a

prevalence of wheezing (447 236 and 208) cough (439 280 286)

shortness of breath (147 83 84) and chest tightness (282 181 152)

respectively (Frank et al 2006)

A cross-sectional study conducted to examine the association between Second Hand

24

Smoke exposure and respiratory symptoms among non-current smokers in the Unites

States (US) trucking industry including 1562 participants who quitted smoking for

more than 10 years and those exposed to Second Hand Smoke in the last 7 days found

that about 63 were exposed to second hand smoke in the last 7 days and 70 were

exposed to second hand smoke in their childhood They found a prevalence of chronic

cough (98) chronic phlegm (117) any wheeze (478) and any symptoms

(508) respectively (Laden et al 2013)

26 Alcohol and respiratory symptoms

A study conducted to examine the prevalence of Alcohol Induced Nasal Symptoms

and to explore associations between Alcohol Induced Nasal Symptoms and other

respiratory diseases found that it is 3 more than the general population and is often

associated with other important respiratory diseases like COPD asthma and allergic

rhinitis (Nihlen et al 2005)

A similar study conducted to evaluate the incidence and characteristics of alcohol-

induced respiratory reactions in patients with Aspirin Exacerbated Respiratory Disease

in the upper and lower respiratory reactions found that the prevalence of alcohol

induced upper respiratory reactions in patients with Aspirin Exacerbated Respiratory

Disease was 75 compared to 33 in Aspirin Tolerant Asthmatics 30 in Chronic

Rhino Sinusitis and 14 in healthy controls The prevalence of alcohol induced lower

respiratory reactions (wheezingdyspnoea) in patients Aspirin Exacerbated Respiratory

Disease was 51 compared to 20 in Aspirin Tolerant Asthmatics and 0 in both

Chronic Rhino Sinusitis and healthy controls (Cardet et al 2014)

27 Other factors and respiratory symptoms

25

A study conducted through postal questionnaire to study obesity nocturnal gastro-

esophageal reflux and snoring as independent risk factors for onset of asthma and

respiratory symptoms among 16191 adult respondents (53 were female) with a

mean (SD) age of 37 (71) years found that the prevalence of asthma onset gradually

increased with increasing Body Mass Index (BMI) in both males (p for trend= 002)

and females (p for trend= 003) (Gunnbjornsdottir et al 2004)

A Japanese study was conducted on the home environment and the asthma

symptoms of school children in which questionnaires were filled by their parents

They found that presence of dampness absence of ventilation in the living or bed

room residence within 200 meters of the main road water leakage condensation on

window panes and wall to wall carpeting are associated with asthma symptoms

(Cong et al 2014)

A study conducted to find out the association of children‟s respiratory symptoms

with asthma and recent home innovations among 31049 Chinese school children

found that 34 children had home renovation in the past 2 years and the prevalence

of respiratory morbidities like doctor diagnosed asthma current asthma current

wheeze cough and phlegm among children was 66 23 63 96 and 46

respectively Asthma was highest among children with new Poly Vinyl Chloride

(PVC) flooring 111 another renovation 118 and new synthetic carpet 52

(Dong et al 2014)

A Swedish study conducted to assess the association between socio-economic status

and impaired respiratory health in a 10-year follow-up of a population based postal

survey on 2341 males and 2413 females found that manual workers in service

26

showed a significantly increased risk of developing wheeze attacks of shortness of

breath the asthmatic symptom complex chronic productive cough and use of

asthma medicines with Odds Ratios (OR) ranging from 14-18 whereas the socio-

economic class (SEC) professionals showed the lowest incidence of asthma and

most symptoms (Hedlund et al 2006)

28 Respiratory symptoms and populations around industrial areas

Populations around industries are more likely to be in situations that expose them to

high and complex elixir of exposures and also perceive themselves to be at higher

risk of morbidity These are also the most cited reasons for initiation of studies

among people living around these industries (Pascal M et al 2013)

281 Epidemiological methods used to study health effects of pollution

around industrial areas The most commonly used methods are cross

sectional surveys cohort studies case control and panel studies (Pascal M et

al 2013) Ecological studies based on disease incidence and hospital

admissions and association between respiratory symptoms and

measurements of air quality using time series analysis and cross over

analysis also have been used (Pascal M et al 2013) The health outcomes of

most studies done around industrial areas have been on chronic morbidity

including cancers respiratory and other chronic morbidities mortality birth

outcomes and few on mental health Epidemiological areas attempting to

study the effect of industrial pollution on populations are in general limited

by methodological issues like the simultaneous multiple exposures effective

measurement tools confounding factors and the type of outcomes to be

studied

27

282 Respiratory symptoms due to air pollution Epidemiological studies

focused on the effects of air pollution has mostly concentrated on the

prevalence of respiratory symptoms acute and chronic non-specific

respiratory symptoms and those of chronic bronchitis and asthma

(Roychoudhury S et al 2012) The symptoms are considered as an

indication of an underlying respiratory morbidity and are usually a) Upper

respiratory symptoms like runny and stuffy nose cold dry cough sore throat

etc and b) Lower respiratory symptoms like wheezing phlegm shortness of

breath chest tightness etc Symptoms of itchy nose sneezing watery eyes

runny nose characterize allergic rhinitis or inflammation of the mucous

lining of the nose and throat due to allergic reaction Sore throat could

indicate underlying pharyngitis or tonsillitis Cough is the most frequently

reported respiratory symptom in relation to air pollution and could be dry or

productive with mucous Cough is generally indicative of inflammation of

the upper airways and may also indicate severe morbidity conditions like

bronchitis or pneumonia Chronic obstructive lung disease is thought to

represent two lung conditions with varying degrees of air way obstruction -

chronic bronchitis and emphysema Chronic bronchitis is usually

characterized by cough sputum and may have associated symptoms like

chest pain or tightness of the chest and wheezing Bronchial asthma is

characterized by narrowing of airways and produces symptoms like

wheezing chest tightness cough and dyspnoea (Roychoudhury S et al

2012)

28

29 Exposure assessment used

Distance to the concerned chemical plant was used as a surrogate measure for

exposure and have used distance ranges of 0 -10 Kms in concentric circles around

the plants with radii from 1 to 10kms defining different groups Residential history

at a particular location also was taken into account in some studies Lack of emission

data is the most important limitation in exposure assessment and affects even

modeling exercises also Air quality monitoring network for specific criteria were

used by studies where available In addition more objective and clinical assessment

of lung function is carried out by measurement of lung function like forced vital

capacity (FVC) and other flow rates using spirometers In addition more specific

quantitative exposure assessments and modeled concentrations of exposure have

been studied for setting regulatory limits (Pascal et al 2013)

210 Tools used to study respiratory outcomes

Several standard questionnaires have been developed to study respiratory symptoms

COPD and asthma The British Medical Research Council (BMRC) questionnaire

was the earliest to be developed and modified later to be used for epidemiological

purposes to study respiratory symptoms COPD and chronic bronchitis Other

common questionnaires used for epidemiological purposes include the American

Thoracic Society ISAAC questionnaire from the International Study of Asthma and

Allergies in Childhood (ISAAC) and the bdquoBronchial symptoms questionnaire‟

developed by the International Union against Tuberculosis and Lung Disease

(IUATLD) questionnaire and European Community Respiratory which is a modified

version of it(Pascal et al 2013) The Indian council for Medical Research (ICMR)

29

used a standardised and validated questionnaire based on the IUATLD questionnaire

for its multi-centre study to assess the national estimate of prevalence of chronic

nonspecific respiratory symptoms chronic bronchitis and asthma in9 districts one

each from 9 different states (S K Jindal 2006)

211 Objectives

To study the prevalence of respiratory symptoms among the adult population

living near the sponge iron industries in Bonaigarh Odisha India

To study the risk factors associated with the respiratory symptoms among

them

212 Research questions

What is the prevalence of respiratory symptoms among the adult population


What are the socio-demographic factors associated with those respiratory

symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design

Cross sectional study

32 Study setting

The study was conducted among adults aged 18-65 years of 29 villages within a

radius of 5 kilometres of a group of sponge iron industries in Bonai Block Odisha

India

33 Sample size

The sample size was calculated assuming a prevalence of respiratory symptoms as

17 (Hinson et al 2016) with a precision of 4 at 95 confidence interval The

total population of all the villages was assumed as 26000 (Census 2011) Expecting

a non-response rate of 20 the minimum sample size estimated was 402 and was

rounded off to 410

34 Sample selection procedure

A multi stage random sampling method was used to select the respondents Twenty

nine villages within a radius of 5kms from any of a group of 13 sponge iron

industries There were a total of 6350 households with a total population of 26000

in these villages

31

The villages were divided into 3 strata according to the number of households

Strata -1 had 11 villages (less than 100 households)

Strata -2 had 9 villages (101-200 households)

Strata -3 had 9 villages (more than 200 households)

From each strata the following number of households were selected in proportion to

the number of households in the

i) Strata-1 (646 households) 42 participants from 11 villages

ii) Strata-2 (1315 households) 85 participants from 9 villages

iii) Strata-3 (4389 households) 283 participants from 9 villages

The first household in each village was selected using a random number method and

if any of the randomly chosen household were closedrefused to consent then the

next household was approached and this process was continued till sample size was

achieved

35 Selection of the individual participants

The eligible participants within each household were listed and one member was

randomly selected and interviewed

351 Inclusion criteria

1 Participants residing in the selected study villages since last 6 months prior

to the date of study

2 Participants in the age group of 18-65 years

32

36 Data collection techniques

A structured interview schedule based on the Indian Study on Epidemiology of

Asthma Respiratory Symptoms and Chronic bronchitis (INSEARCH) by Indian

Council for Medical Research (ICMR) in the local language Odia was used to

collect data The principal investigator himself collected the data

Consent was taken from individual respondent with a participant information sheet

and a consent form ensuring of privacy and confidentiality before the interview

Privacy of data was ensured during the interview by conducting it in a space within

the participant‟s house as per herhis choice

37 Plan for data collection and analysis

Data collection was done from June 10th

to August 31st 2017 by the principal

investigator Data entry was done simultaneously using Epi Data version

31software

All the interviews were recorded in the structured questionnaire for respiratory

symptoms and then the collected quantitative variables were analyzed using

Quantitative Data Analysis Software SPSS version20

Data cleaning was done in three phases In the first phase it was cleaned concurrent

to data collection in the field The second phase was manual rechecking of hard

copies just before digitization of records In the final stage that is just after data entry

using Epi Data version 31software records were rechecked for wrong entries and

the errors were rectified After validation it was saved as (csv) file and then data

was imported using IBM SPSS Statistics for Windows Version 210 IBM Corp

2012for further analysis

33

38 Data analysis

Data was analyzed using bdquoIBM SPSS Statistics‟ software version 21 to study the

sample characteristics and to estimate the prevalence and associated factors of

respiratory symptoms among the adults (18-65 years) The p value of lt005 was

considered as significant with 95 Confidence Interval (CI)

381 Univariate analysis

Prevalence of respiratory symptoms was assessed by measuring the frequencies of

various respiratory symptoms

382 Bivariate analysis

Both predictor and outcome variables were recorded into binary (dichotomous)

variables with reference category (value label=0) and non-reference category (value

label=1) before doing bivariate analysis The bivariate analysis was done by cross

tabulation of various categorical variables with the outcome variable (Respiratory

Symptoms) using Chi-square tests to identify significant associations between

independent variables Independent variables showing significant chi-square (p-

values) test were considered as possible associated factors

The data collected was analysed using univariate and bivariate analysis A

preliminary analysis to look for the prevalence of the various respiratory symptoms

and bivariate analysis was done to look for associations between the outcome

variable (respiratory symptoms) and the independent variables

34

39 Study tool

A structured interview schedule was used for data collection was adapted from the

validated questionnaire used in the Phase II of the Indian Study on Epidemiology of

Asthma Respiratory Symptoms and Chronic bronchitis (INSEARCH) (S K Jindal

2006)

310 Operational definitions

3101 Respiratory symptoms Symptoms of wheezing and tightness in the chest

shortness of breath cough and phlegm in the morning and night breathing difficulty

and shortness of breath and chest tightness due to exposure to dust were called

respiratory symptoms Participants were asked whether they have experienced such

symptoms in the last 12 months and all of them were collected using binary codes 0

for No and 1 for Yes

3102 Adults Participants above the age of 18 years and less than equal to 65 years

were called adults

3103 Associated factors Factors like Age Sex Body BMI Smoking Alcohol

Separate kitchen Dampness Physical Activity Occupation Fuel type Ventilation

Residential status and Socio-economic factors like Housing type Type of ration card

were taken as associated factors

311 Expected Outcomes

The expected outcomes were the prevalence of respiratory symptoms among the

adult population living near the sponge iron industries in Bonaigarh Odisha India

The other expected outcome was to study the find out the association of those

symptoms with various demographic factors like agesexreligiontype of

housefamily sizeSocio-economic status and individual and household factors like

35

type of house dampness in the house cooking fuel use and smokingalcohol

consumption

312 Project Management

3121 Staffing

The study was done by the Principal Investigator himself The structured interview

schedule was administered and filled by the principal investigator

3122 Work plan Work plan is given in the Gantt chart Fig 31

Fig 31 Work plan for the whole project

____________________________________________________________________

2017 April May June July August September October

Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration

Principal investigator himself has carried out the data collection data entry data

analysis and report submission The data collected daily was reviewed and entered in

Epi Data version 31software on the same day Any doubts that arise from the

questionnaire were clarified on the next day by visiting the household again

36

3124 Data storage transfer and management

The data collected was stored in the computer with password encryption of the file

The hard copy of the filled questionnaire consent form and data from the structured

interview schedules was strictly confined to personal locker of the principal

investigator in sealed covers and were not shared with anyone After three years the

entire hard copies will be destroyed Only the final report will be shared with the

concerned persons authorities scientific or government bodies

313 Ethical considerations

Ethical clearance was obtained from the Institutional Ethics Committee (IEC) of

Sree Chitra Tirunal Institute for Medical Sciences and Technology (SCTIMST) vide

letter no SCTIEC1041MAY-2017 dated 13062017 An information sheet was

provided to the prospective subjects and their queries were addressed After they

agreed to participate in the study their signatures were taken on the informed

consent form Those who denied for participating in the study were asked about the

reason for denial and then noted Next household was approached Those subjects

who were found with respiratory symptoms were referred to the local hospital for

further diagnosis and treatment A unique participant ID was provided to each

subject (001-410) to maintain the anonymity and confidentiality of the data The

unique identifiers were used during analysis

314 Plan for dissemination

The final thesis report was submitted for the fulfillment of the requirements of the

MPH degree by the end of October 2017 The findings of the study will be shared

37

with the local panchayat leaders and non-governmental agencies The study and its

findings will be shared with peers through journal articles and scientific conference

presentations

38

Chapter- 4

Results

This chapter presents the findings of the cross-sectional community based survey on

the prevalence of respiratory symptoms in Bonaigarh block conducted from 10th

June to 31st August 2017The names must be the same throughout

A total of 495 houses were visited and of those 85 households (172) did not

consent to take part in the study (response rate= 83) Bonaigarh is a rural area and

based on the observation that most of the households in the study area were locked

in the mornings and due to the rains the sample collection was done during the

evenings The main reasons reported for refusing to take part in the survey were

exhaustion after their day‟s work in fields and the absence of incentives to take part

in the study final sample included 410 households The socio-demographic

characteristic of the sample is detailed in section 41

41 Sample characteristics

In this study sample majority of respondents were men (639) It was partly due to

the social practices in the area wherein women participated in the study only if the

males were absent or were busy at the time of data collection

The median age of the participants was 40 years (18-65) Median age of men and

women was 42 years (18-65) and 395 years (18-65) respectively Distribution of

males and females in different age categories is given in Fig 41 (page-39)

39

411 Education About a quarter of the sample population had no schooling and

only less than 10 percent were graduates Sixty seven percent of the sample had

attended primary school or up-to high school and 33 percent above high school

412 Occupational status Majority of the study population were agriculturists or

manual laborers About 280 were home makers Rest 720 had regular income

earning occupations There were about 93 participants who have ever worked in a

factory and all of them have worked in either a sponge iron factory or in a steel

plant Presently there were only 31 factory workers means there was a high rate of

leaving factory jobs (667) in the study population

413 Socio - economic status The socio-economic status of the population was

determined by the type of ration card they own The proportion of households with a

bdquobelow poverty line‟ or bdquoBPL‟ category ration card was 783 (including those

under Antyodaya scheme and BPL) and those who belonged to the bdquoAPL category‟

were 217

Fig 41 Distribution of males and females in different age categories

Almost all of the participants were Hindus and only 48 (117) were currently not

married (neverdivorcedwidow) Table 41 (page-40) gives the sample

characteristics

40

Table 41 Socio-demographic factors of the sample

Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)

Education No schooling 99 (241)

Primary 133 (324)

High school 142 (346)

Graduate 34 (83)

Post graduate and above 2 (05)

Occupation Office work 24 (59)

Manual work 75 (183)

Agriculturist 103 (251)

Business 28 (68)

Factory 31 (76)

Others 149 (363)

Family size 1-4 members 225 (549)

gt4 members 185 (451)

Pet animals House with pet animals 263 (641)

House without pet animals 147 (359)

414Household size On an average the households had 47 (47 plusmn 19) members

including children

415 Housing characteristics Table 42 (page-41) gives the housing characteristics

of the sample

41

Table 42 Housing characteristics of the sample

____________________________________________________________________

Housing Characteristics Total 410 (100)

Kuchcha building 236 (576)

Pucca building 174 (424)

Separate kitchen 191 (466)

No kitchen 219 (534)

4151 Dampness in the house Around 69 percent reported dampness in any one

of their rooms

4152 Cooking practices and nature of the kitchens About 191 (47) of the

households had a separate kitchen and 327 (80) cooked cooking inside the house

and about 20 percent reported that they cooked outdoors in the open Among those

with separate kitchen around 80 had no windows 162 had windows About

half of those who had a separate kitchen had ventilators and only less than two

percent had exhaust fans

4153 Cooking stove Chullahs were the most common (76) followed by LPG

stove in about 23 percent of the houses

The average number of bedrooms per household was 19 (19 plusmn 13) And the mean

number of doors and windows excluding toilet and kitchen was 24 (24 plusmn 19) and

14 (14 plusmn 19) respectively

416 Cooking fuel and practices Wood was the most commonly used fuel for

cooking purposes (746) followed by LPG (Liquid Petroleum Gas) The high

percentage of LPG use was because many BPL households had new LPG

connection through the bdquoUjjwala scheme‟ of the Government of India Only about

42

twenty four percent of the households regularly used clean fuels (LPG electricity)

while the rest used biomass fuels or kerosene

Among 36 percent of the respondents who reported that they regularly cook around

91 percent were women The average time spent on cooking was found to be 33 plusmn

10 hours

417 Residence in the area All the respondents selected were living in the study

area for more than six months as per the inclusion criteria Most of the participants

(n=358 873) were residing in the study area The median number of years of

residence in the area was 400 (05-650) years Around 87 were born and brought

up in the area

42 Behavioural factors Table 43 gives the list of behavioural factors found in the

study population

Table 43 Behavioural factors of the study population

________________________________________________________________

Factors Category Total 410 (100)

Smoking history Yes 78 (190)

No 332 (810)

Alcohol use Yes 153 (373)

No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)

421 History of smoking More than 80 of study participants were Non-smokers

There were 78 (190) ever smokers out of which 22 (54) admitted to smoking in

the last one month and the rest have left smoking All the smokers were men except

single women

43

422 History of alcohol use About one third of study participants (373) had ever

consumed alcohol out of which 119 (290) admitted to have taken alcohol in the

last one month Most of the ever alcohol users were males (n=147 359) except 6

females (15)

423 Body Mass Index (BMI) The proportion of the study sample that were

overweight was 102 and obese was 32 The mean BMI of males and females

was 2036 (2036 plusmn 348) and 2027 (2027 plusmn 368) kgm2


The overall prevalence of respiratory symptoms is presented in Table 44 and Fig 42

(page-45)

Table 44 Prevalence of respiratory symptoms in the study population

Respiratory Symptoms

Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189

Morning breathlessness 53 (129) 100 - 165

Breathlessness on exertion 155 (378) 332 - 426

Breathlessness without exertion 33 (80) 58 - 111

Breathlessness at night 64 (156) 124 - 194

Cough at night 88 (215) 178 - 257

Cough in morning 96 (234) 196 - 278

Phlegm in morning 85 (207) 171 - 249

Usually breathless 91 (222) 184 - 265

Breathing never satisfactory 13 (32) 18 - 54

Chest tightness on dust exposure 38 (93) 68 - 125

Breathlessness on dust exposure 207 (505) 457 - 553

Ever Asthma 9 (22) 11 - 42

Any of the above symptoms 325 (793) 751 - 829

Around half of the respondents reported having suffered breathlessness on dust

exposure in the reference period and about 793 percent had any one of the

44

respiratory symptoms listed

44 Association of respiratory symptoms with individual and household factors

441 Wheezing and morning breathlessness with individual and household

factors Wheezing was found significantly higher among smokers than non-

smokers Similarly participants who reported dampness in any one of their rooms

were more prone to wheezing than those without dampness Dampness at home was

also associated with higher proportion of morning breathlessness See Table 45

(page-46)

442 Breathlessness on exertion and without exertion with individual and

household factors Breathlessness on exertion was significantly higher among

participants with educational status below high school level than high school and

above Having pet animals at home also increases the chance of breathlessness than

not having pet animals

Breathlessness on exertion was found to be significantly higher those who reported

dampness in their homes where as breathlessness without exertion was found to be

significantly associated with dampness in their homes and among males See Table

46 (page-47)

45

Fig 42 Overall Prevalence of respiratory symptoms

443 Breathlessness and cough at night with individual and household factors

Prevalence of breathless at night and cough at night was not associated with any of

the individual and household characteristics See Table 47 (page-48)

444 Cough and phlegm in the morning with individual and household factors

Cough in the morning was significantly higher in households with more than 5

members According to the inclusion criteria all the respondents were living in the

area for more than 6 months Males and those with dampness inside home had a

significantly higher experience of having both cough and phlegm in the morning

Respondents living in the study area since birth had significantly higher proportion

of cough in the morning than the others See Table 48 (page-49)

46

445 Chest tightness and breathlessness on dust exposure with individual and

household factors Presence of chest tightness on dust exposure was significantly

higher among males and among agriculturalmanual laborers See Table 49 (page-

50)

Table 45 Association of wheeze and morning breathlessness with individual


Respiratory symptoms

Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)

Office workBusiness 13 (210)

12 (226)

Home makers 12 (194)

12 (226)

Factory workers 7 (113)

4 (76)

Socio-economic status 0626

0373

AntyodayaBPL 50 (156)

39 (736)

APLNo ration card 12 (135)

14 (264)

Residential status 044

0572

Living since birth 56 (156)

45 (849)

Lived for at least 6

months 6 (115)

8 (151)

Smoking history 0029

0685

Ever smoker 18 (231)

9 (170)

Never smoker 44 (133)

44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47

Table 46 Association of breathlessness on exertion and breathlessness without



Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051

Below Highschool 99 (639)

24 (727)

Highschool and above 56 (361)

9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48

Table 47 Association of breathlessness and cough at night with individual and

household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office

workBusiness 16 (250)

15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49

Table 48 Association of cough and phlegm in morning with individual and

household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50

Table 49 Association of chest tightness and breathlessness on dust exposure

with individual and household factors

____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51

The objectives of this study was to find out the prevalence of respiratory symptoms

among the adult population living near the sponge iron industries in Bonaigarh Odisha

India and the factors associated with those respiratory symptoms among them The

prevalence of various respiratory symptoms estimated by the current study is presented in

Table 51

For comparison the estimates for rural Odisha from the Indian Study of Asthma

Respiratory Symptoms and Chronic Bronchitis (INSEARCH) multi-centric study done in

2007-2009 is also included

Table 51Prevalence of respiratory symptoms among adults near sponge iron industries

Bonaigarh

Respiratory symptoms Current study

(Bonaigarh)

Prevalence (95 CI)

ICMR multi-centre study

estimates for rural Odisha

Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)

Morning breathlessness 129 (100 - 165) 23 (15 ndash 35)

Breathlessness on exertion 378 (332 - 426) 51 (39 ndash 67)

Breathlessness without

exertion

80 (58 - 111) 33 (24 ndash 46)

Breathlessness at night 156 (124 - 194) 21 (14 ndash 32)

Cough at night 215 (178 - 257) 39 (29 ndash 53)

Cough in morning 234 (196 - 278) 29 (20 ndash 42)

Phlegm in morning 207 (171 - 249) 25 (17 ndash 37)

Breathing never satisfactory 32 (18 - 54) 19 (12 ndash 30)

Usually breathless 222 (184 - 265) 10 (05 ndash 17)

Chest tightness on dust

exposure

93 (68 - 125) 34 (24 ndash 47)

Breathlessness on dust

exposure

505 (457 - 553) 32 (23 ndash 45)

Ever asthma 22 (11 - 42) 28 (19 ndash 40)

Any of the above symptoms 793 (751 ndash 829) 69 (55 ndash 87)

The prevalence of the various respiratory symptoms among the people living near the

sponge iron industries in Bonaigarh estimated by the current study is considerably

52

higher than the figures estimated for rural Odisha by the INSEARCH national study

on the prevalence of respiratory symptoms The rural study site for the multi-centric

study was Berhampur Odisha where there are no sponge iron industries but is known

to have only smaller crusher and granite processing units rice mills and distillation

units (Brief Industrial Profile of Ganjam District MSME- Development Institute

Cuttack 2012-13) Sponge iron industries emit high levels of dust sulphur dioxide

and coal char and are known to cause respiratory symptoms like cough phlegm

chronic bronchitis etc (Patra HS et al 2012 Cerena Foundation 2006) All the

participants of this study lived within five kilometers of a group of twelve sponge

iron factories in Bonaigarh Their exposure to the emissions from the nearby factories

may be a factor responsible for such high prevalence of respiratory symptoms in the

study population However larger studies would be required with more objective

measurements of source emissions exposure assessment and lung function to

determine whether the observed high prevalence of respiratory symptoms are indeed

due to the emissions from the sponge iron factories Despite industrial air pollution

being a major cause of industrial air pollution studies on respiratory symptoms of

people near them are limited Most prevalence studies conducted in India on

respiratory symptoms have either data on their work exposure or exposure to indoor

pollution or respiratory symptoms of school children (Jindal 2007 Viswanathan et

al 1966 Chhabra et al 1998 Gupta et al 2001) Periodic surveillance of industrial

emissions and health outcomes of people living close to the industries is also required

in India to prevent such avoidable morbidity

The other objective of the current research was to study the factors associated with

the respiratory symptoms in the study population In the current study wheeze was

53

significantly associated with smoking (p= 003) Similar findings has been reported

by other studies the one conducted on elderly individuals in Japan found that the

odds of having wheeze and phlegm was two times higher among heavy smokers

compared to non-smokers (Ichimura et al 2001) There are other studies which

show an association of wheeze with smoking (Chhabra et al 2008 Brunekreef

1992 Kumar 2014 Bakke et al 1991)The other major factor associated with

wheezing (p= 001) as well as cough in the morning (p= 005) morning

breathlessness (p= 002) and breathlessness on exertion (p= 001) was dampness

inside homes Previous studies have reported significant association between

respiratory symptoms like cough and phlegm with dampness in the house in both

men and women (Brunekreef 1992) A meta-analysis of the association of the health

effects with dampness and mould in buildings has found that adults living with

dampness in their homes had 168 times risk of having wheeze than those without

dampness (Fisk et al 2007)

Breathlessness on exertion was found to be associated with education (p= 002)

Those who were less educated reported more respiratory symptoms than those who

were educated This could be due to the fact that most of the less educated were

farmers or manual laborers and are more likely to be exposed to ambient air

pollution Studies from similar settings have found similar association between

higher education and lower rates of respiratory symptoms (Ehrlich et al 2004)

In this study cough in the morning was found to be associated significantly with male

sex (p= 001) family size of (p= 0021) dampness inside the house (p= 0045) and

having lived in the area since birth (p= 0012) We found that the residents living in the

54

area from their birth onwards (n= 91 254) had a higher prevalence of cough in the

morning Similar findings were observed in population on prevalence of respiratory

symptoms with a lifetime exposure to occupational dust or gas (n= 4469 29) which

shows an increase in the prevalence when adjusted for sex smoking habits and age

(Bakke et al 1991) Association of family size and cough in the morning was also

found in a study done in England on the home environment of school children

belonging to ethnic groups They found that families with four or more than four was

had significantly higher prevalence of cough in the morning Area of residences was

also found to be associated with the area of residence with the prevalence of morning

cough wheezing and bronchitis Association of cough with overcrowding or family

size was rarely explored in studies done in India whereas one study which looked into

it found no association between overcrowding on prevalence of respiratory symptoms

in adults (Mathew et al 2015) There is a potential scope for such research in India

where overcrowding and large family sizes are common and to examine its impact on

people‟s respiratory health

Phlegm in the morning was also significantly associated with males Prevalence of

phlegm in particular was found to be more among men in various studies (Jindal 2006

Boezen et al 1995 Chhabra et al 2008 Ichimura et al 2001 Kumar 2014)Whether

the association of phlegm and cough in the morning with male sex is due to the

biological ability to cough out sputum or culturally more acceptable for men to spit out

sputum or due to differentials in exposures needs to be explore further

In the current study cough at night and breathlessness at night were not associated

with any of the socio-demographic factors studied However several studies have

55

found older adults to have higher prevalence of cough at night including the Dutch

participants of the European Community Respiratory Health Survey (ECRHS)

(Boezen et al 1995) A study in India reported higher prevalence of chronic cough

among adults in the age group of 51-70 (Chhabra et al 2008) However cough at

night and chronic cough were found to be more prevalent among old adults in many

studies further studies can be designed to explore this association further

Breathlessness on exertion was also associated with participants having pet animals

(plt 0001) in their home and dampness inside homes as described earlier More than

half of the respondents who reported that they had pet animals were also farmers

andor manual laborers Pets included mostly cows andor bullocks andor hens

andor cocks This indicates the possibility of multiple exposures and therefore

more exploratory research with objective exposure measurements will be required to

comment on any conclusive linkages between pet ownership and respiratory

symptoms A study from Japan has reported pet ownership being associated with

higher prevalence of respiratory symptoms (wheezing andor breathlessness andor

cough) (Suzuki et al 2005) Similarly a study from Denmark found that dairy

farming was associated with breathlessness andor wheezing andor cough (Iversen

et al 1988) Another study among European animal farmers found a dose-response

relationship between the occurrence of shortness of breath cough with phlegm flu-

like illness and the number of hours spent daily inside the confinement houses for

pigs Similar dose-response relationship between wheezing and nasal irritation

among poultry farmers (Radon et al 2001) In this study almost all the households

had few animals in number Based on observations during data collection for this

study the animals were raised as free-range and were only kept under bamboo

56

baskets outside homes and had separate sheds for cows and bullocks Whether

ownership of pet animals is associated with higher prevalence of respiratory

symptoms could be explored in future studies related to respiratory symptoms in the

country

However breathlessness without exertion was found to be significantly more among

women (p= 0021) Reasons for such an association can only be speculated Since

females were solely responsible for cooking household chores like dusting and

cleaning taking care of animals and also may be involved in other occupations it

could be due to indoor air pollution or a due to multiple exposures due to their roles

and activities within the household and outside Further studies can be conducted to

find out the relationship of respiratory symptoms considering the differentials in

exposure to indoor and outdoor air pollution

Breathlessness on dust exposure was reported by more than fifty percent of the

respondents but was not associated with any of the socio-demographic variables

studied Since lung function impairment was not assessed and identification of

breathlessness was through a questionnaire it is difficult to differentiate whether the

symptom of breathlessness on dust exposure was a result of reduction in lung

function or a just the physical difficulty in taking a breath during exposure to dust

Chest tightness on dust exposure was reported by close to ten percent of the

respondents and was significantly more among men and among agriculturalmanual

laborers

51 Strengths

57

Inter observer bias was minimized since the whole data was collected by a single

investigator

The self-reported respiratory symptoms was assessed using a standardized and

validated bronchial symptoms questionnaire

52 Limitations

The study used a cross-sectional design and therefore firm conclusions about the

associations and directions of causality cannot be drawn

Objective measurement of exposure levels and lung function were not done due to

economic and practical constraints

53 Conclusion The prevalence of respiratory symptoms among people living near a

group of sponge iron industries in Bonaigarh is considerably higher than those

reported from similar rural areas in Odisha However due to the limitations in the

design sample size and measurements these findings can only be indicative of such

morbidity in the community Further studies with appropriate study designs objective

emission and exposure measurements and consideration of the multiple exposures in

the community (including indoor air pollution) are required to assess whether ambient

air pollution due to emissions from polluting industries like sponge iron industries

predispose communities living near them to excess risk of respiratory morbidities

In the short term steps could also be taken by the regulatory authority to set up

ambient air pollution monitoring stations around such polluting industries to regular

monitor the industrial emissions

References

58

2nd India International DRI Summit (2014) Hotel Le Meridien New Delhi NMDC

Limited Available from httpwwwspongeironindiainupcoming-events-

august2014pdf

Adeloye D Chan KY Rudan I et al (2013) An estimate of asthma prevalence in

Africa a systematic analysis Croatian Medical Journal 54(6) 519ndash531

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(accessed 27 October 2017)

Aleksandra Stanković NikolićMaja and ArandjelovićMirjana (2011) Effects of

indoor air pollution on respiratory symptoms of non-smoking women in Niš

SerbiaMultidisciplinary Respiratory Medicine 6(6) 351ndash355

Arbex MA Santos U de P Martins LC et al (2012) Air pollution and the

respiratory systemJornalBrasileiro de Pneumologia 38(5) 643ndash655

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Bakke P Eide GE Hanoa R et al (1991) Occupational dust or gas exposure and

prevalences of respiratory symptoms and asthma in a general population

European Respiratory Journal 4(3) 273ndash278

Behera D and Jindal SK (1991) Respiratory symptoms in Indian women using

domestic cooking fuelsChest 100(2) 385ndash388 Available from

httpjournalchestnetorgarticleS0012-3692(16)37168-9pdf

Boezen HM Schouten JP Postma DS et al (1995) Relation between respiratory

symptoms pulmonary function and peak flow variability in adultsThorax

50(2) 121ndash126

Bousquet J and Khaltaev N (eds) (2007) Global surveillance prevention and control

of chronic respiratory diseases a comprehensive approach Geneva WHO

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httpwwwwhointgardpublicationsGARD20Book202007pdf

Bousquet J Ndiaye M T-Khaled NA et al (2003) Management of chronic

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Saharan Africa Allergy 2003 Allergy Review Series VIII Allergy a global

problem 58 265ndash283

Brunekreef B (1992) Damp housing and adult respiratory symptomsAllergy 47(5)

498ndash502 Available from httpdoiwileycom101111j1398-

99951992tb00672x (accessed 21 October 2017)

Cardet JC White AA Barrett NA et al (2014) Alcohol-induced Respiratory

Symptoms Are Common in Patients With Aspirin Exacerbated Respiratory

59

Disease The Journal of Allergy and Clinical Immunology In Practice 2(2)

208ndash213e2 Available from

httplinkinghubelseviercomretrievepiiS2213219813005072

Căruntu F Angelescu C and Predoviciu F (1976) [Short-term alternating

corticotherapy with single doses at 48 hour intervals in acute viral

hepatitis]Revista De MedicinaInterna Neurologe Psihiatrie

Neurochirurgie Dermato-VenerologieMedicinaInterna 28(3) 205ndash210

Chattopadhyay K Chattopadhyay C and Kaltenthaler E (2015) Respiratory health

status and its predictors a cross-sectional study among coal-based sponge

iron plant workers in Barjora India BMJ Open 5(3) e007084ndashe007084

Available from httpbmjopenbmjcomcgidoi101136bmjopen-2014-

007084

Chhabra P Sharma G and Kannan AT (2008) Prevalence of respiratory disease and

associated factors in an urban area of delhi Indian journal of community

medicine official publication of Indian Association of Preventive amp Social

Medicine 33(4) 229

Cong S Araki A Ukawa S et al (2014) Association of Mechanical Ventilation and

Flue Use in Heaters With Asthma Symptoms in Japanese Schoolchildren A

Cross-Sectional Study in Sapporo Japan Journal of Epidemiology 24(3)

230ndash238 Available from

httpjlcjstgojpDNJSTJSTAGEjeaJE20130135lang=enampfrom=CrossR

efamptype=abstract

Dong G-H Qian Z (Min) Wang J et al (2014) Home Renovation Family History

of Atopy and Respiratory Symptoms and Asthma Among Children Living in

China American Journal of Public Health 104(10) 1920ndash1927 Available

from httpajphaphapublicationsorgdoi102105AJPH2013301438

Duflo E Greenstone M and Hanna R (2008) Cooking stoves indoor air pollution

and respiratory health in rural Orissa Economic and Political Weekly 71ndash

76 Available from

httpwwwgramvikasorgdocsArticle_on_Smokeless_Chullahs_by_Esther

_Duflo_MITpdf

Ehrlich RI White N Norman R et al (2004) Predictors of chronic bronchitis in

South African adults The International Journal of Tuberculosis and Lung

Disease 8(3) 369ndash376

Ellegard A (1996) Cooking Fuel Smoke and Respiratory Symptoms among Women

in Low-income Areas in MaputoEnvironmental Health Perspectives

104(9)

Fisk WJ Lei-Gomez Q and Mendell MJ (2007) Meta-analyses of the associations of

60

respiratory health effects with dampness and mold in homesIndoor air

17(4) 284ndash296

Frank P Morris J Hazell M et al (2006) Smoking respiratory symptoms and likely

asthma in young people evidence from postal questionnaire surveys in the

Wythenshawe Community Asthma Project (WYCAP) BMC Pulmonary

Medicine 6(1) Available from

httpbmcpulmmedbiomedcentralcomarticles1011861471-2466-6-10

Gouda J Gupta AK and Yadav AK (2015) Association of child health and

household amenities in high focus states in India a district-level analysis

BMJ Open 5(5) e007589ndashe007589 Available from

httpbmjopenbmjcomcgidoi101136bmjopen-2015-007589

Halvani G Zare M Halvani A et al (2008) Evaluation and Comparison of

Respiratory Symptoms and Lung Capacities in Tile and Ceramic Factory

Workers of Yazd Archives of Industrial Hygiene and Toxicology 59(3)

Available from httpwwwdegruytercomviewjaiht200859issue-

310004-1254-59-2008-187810004-1254-59-2008-1878xml

Hedlund U (2006) Socio-economic status is related to incidence of asthma and

respiratory symptoms in adults European Respiratory Journal 28(2) 303ndash

410 Available from

httperjersjournalscomcgidoi101183090319360600108105

Hegerl GC F W Zwiers P Braconnot NP Gillett Y Luo JA Marengo Orsini

N Nicholls JE Penner and PA Stott 2007 Understanding and Attributing

Climate Change In Climate Change 2007 The Physical Science Basis

Contribution of Working Group I to the Fourth Assessment Report of the

Intergovernmental Panel on Climate Change [Solomon S D Qin M

Manning Z Chen M MarquisKB Averyt M Tignor and HL Miller

(eds)] Cambridge University Press Cambridge United Kingdom and New

York NY USA Available from httpswwwipccchpdfassessment-

reportar4wg1ar4-wg1-chapter9-supp-materialpdf

Ian A Greaves Ellen A Eisen Thomas JS et al (1997) Respiratory Health of

Automobile Workers Exposed to Metal-Working Fluid Aerosols Respiratory

Symptoms American Journal of Industrial Medicine 32 450ndash459

Iversen M Dahl R Korsgaard J et al (1988) Respiratory symptoms in Danish

farmers an epidemiological study of risk factors Thorax 43(11) 872ndash877

Available from httpthoraxbmjcomcgidoi101136thx4311872


Janson C Chinn S Jarvis D et al (2001) Determinants of cough in young adults

participating in the European Community Respiratory Health Survey


61

Jindal SK (2006) Indian Study on Epidemiology of Asthma Respiratory Symptoms

and Chronic Bronchitis (INSEARCH) INSEARCH Multi-Centre study

India Indian Council of Medical Research Available from

httpicmrnicinfinalINSEARCH_Full20_Reportpdf

Kashiva D (2016) Snapshot of Indian DRI IndustryHotel Shangri-La New Delhi

INDIA Available from httpswwwgooglecoinsearchei=41jzWd7ZGIT-

vASZz6zoDwampq=Sponge+iron++SIMA2C+2014ampoq=Sponge+iron++SI

MA2C+2014ampgs_l=psy-

ab332422383620389271916000023016555j8j114001164ps

y-

ab6350635i39k1j0i7i30k1j0i67k1j0i7i10i30k1j0i8i7i10i30k10PxzDW

2vSJzM

Kumar M (2014) An occupational health exposure study in Iron Industry of

MandiGobindgarh Punjab India IOSR Journal of Environmental Science

Toxicology and Food Technology 8(9) 17ndash24 Available from

httpiosrjournalsorgiosr-jestftpapersvol8-issue9Version-

3D08931724pdf

Laden F Chiu Y-H Garshick E et al (2013) A cross-sectional study of secondhand

smoke exposure and respiratory symptoms in non-current smokers in the

US trucking industry SHS exposure and respiratory symptoms BMC

Public Health 13(1) Available

fromhttpsbmcpublichealthbiomedcentralcomtrackpdf1011861471-

2458-13-93site=bmcpublichealthbiomedcentralcom

Lammers B Schilling RSF Walford J et al (1964) A Study of byssinosis Chronic

respiratory symptoms and ventilator capacity in English and Dutch cotton

workers with special reference to atmospheric pollution British Journal

Industrial Medicine 21 124

LeVan TD Koh W-P Lee H-P et al (2006) Vapor dust and smoke exposure in

relation to adult-onset asthma and chronic respiratory symptoms the

Singapore Chinese Health Study American journal of epidemiology 163(12)

1118ndash1128

Lillienberg L Zock J-P Kromhout H et al (2008) A Population-Based Study on

Welding Exposures at Work and Respiratory SymptomsThe Annals of

Occupational Hygiene 52(2) 107ndash115 Available from

httpsacademicoupcomannweharticle522107278819A-

PopulationBased-Study-on-Welding-Exposures-at

Lipińska-Ojrzanowska A Wiszniewska M Świerczyńska-Machura D et al (2014)

Work-related respiratory symptoms among health centres cleaners A cross-

sectional study International Journal of Occupational Medicine and

Environmental Health 27(3) Available from httpijomeheuWork-related-

62

respiratory-symptoms-among-health-centres-cleaners-a-cross-sectional-

study203202html

Love RG Waclawski ER Maclaren WM et al (1999) Risks of respiratory disease

in the heavy clay industry Occupational Environmental Medicine 56 124ndash

133Available from

httppubmedcentralcanadacapmccarticlesPMC1757705pdfv056p00124

pdf

Lynda JLombardo and John R Balmes (2000) Occupational Asthma A Review

108(4) 697ndash704 Available from

httpswwwncbinlmnihgovpmcarticlesPMC1637677pdfenvhper00313-

0096pdf

Mathew P Er I Ur S et al (2015) Prevalence and risk factors for respiratory

morbidity among high school students of South India International Journal

of Research in Medical Sciences 3(5) 1149 Available from

httpwwwmsjonlineorgmno=181928

MbatchouNgahane BH AfaneZe E Chebu C et al (2015) Effects of cooking fuel

smoke on respiratory symptoms and lung function in semi-rural women in

Cameroon International Journal of Occupational and Environmental Health


httpwwwtandfonlinecomdoifull1011792049396714Y0000000090

Nihlen U Greiff LJ Nyberg P et al (2005) Alcohol-induced upper airway

symptoms prevalence and co-morbidity Respiratory Medicine 99(6) 762ndash

769 Available from


Nwibo AN Ugwuja EI and Nwambeke NO (2012) Pulmonary Problems among

Quarry Workers of Stone Crushing Industrial Site at Umuoghara Ebonyi

State Nigeria TheInternational Journal of Occupational and Environmental

Medicine 3(4) 178ndash185

Pascal M Pascal L Bidondo M-L et al (2013) A Review of the Epidemiological

Methods Used to Investigate the Health Impacts of Air Pollution around

Major Industrial Areas Journal of Environmental and Public Health 2013

1ndash17 Available from httpwwwhindawicomjournalsjeph2013737926

Patra HS Sahoo B and Mishra BK (2012) Status of sponge iron plants in Orissa

Bhubaneswar India Vasundhara Available from

httpbmjopenbmjcomcontentbmjopen53e007084fullpdf

Radon K Danuser B Iversen M et al (2001) Respiratory symptoms in European

animal farmersThe European Respiratory Journal 17(4) 747ndash754

Available from

63

httpspdfssemanticscholarorgc19d4255429bea14c42268592365ae35fc51

5503pdf

Rastogi SK Ahmad I Pangtey BS et al (2003) Effects of Occupational Exposure

on Respiratory System in Carpet WorkersIndian Journal of Occupational

and Environmental Medicine 7(1) 19ndash26 Available from

httpmedindniciniayt03i1iayt03i1p19pdf

Risk appraisal study Sponge iron plants Raigarh District (2006) Cerana

Foundation

Roychoudhury S Darbari T and Agrawal S (2012) Study on ambient air quality

respiratory symptoms and lung function of children in DelhiEnvironmental

health management series Delhi Central pollution control board ministry of

environment and forests Available from

httpcpcbnicinuploadNewItemsNewItem_191_StudyAirQualitypdf

Salo PM Xia J Johnson CA et al (2004) Respiratory symptoms in relation to

residential coal burning and environmental tobacco smoke among early

adolescents in Wuhan China a cross-sectional study Environmental Health

3(1) Available from

httpehjournalbiomedcentralcomarticles1011861476-069X-3-14

Sharma V Gupta R Jamwal D et al (2016) Prevalence of chronic respiratory

disorders in a rural area of North West India A population-based study

Journal of Family Medicine and Primary Care 5(2) 416 Available from

httpwwwjfmpccomtextasp201652416192342

Singh SK Chowdhary GR Chhangani VD et al (2007) Quantification of

Reduction in Forced Vital Capacity of Sand Stone Quarry Workers

International Journal of Environmental Research and Public Health 4(4)

296ndash300

Suzuki K Kayaba K Tanuma T et al (2005) Respiratory symptoms and hamsters

or other pets a large-sized population survey in Saitama Prefecture Journal

of epidemiology 15(1) 9ndash14

To T Stanojevic S Moores G et al (2012) Global asthma prevalence in adults

findings from the cross-sectional world health surveyBMC Public Health

12(1) Available from

httpbmcpublichealthbiomedcentralcomarticles1011861471-2458-12-

204

WHO (2016) WHO releases country estimates on air pollution exposure and health

impact Geneva 27th September Available from

httpwwwwhointmediacentrenewsreleases2016air-pollution-

estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11

Participant Information Sheet

Prevalence of respiratory symptoms and their associated factors among people


Namaskar I am Mr Chinmaya Kumar Behera a Master of Public Health (MPH)

scholar from Achutha Menon Center for Health Science Studies Sree Chitra Tirunal

Institute for Medical Sciences and Technology Trivandrum Currently I am

undertaking a study ldquoPrevalence of respiratory symptoms amp their association with

socio-demographic factors of an adult population living near the sponge iron

industries in Bonaigarh Odisha Indiardquo It is being carried out as part of my course

requirement The consent requested is for this study This research subject

information sheet may contain words that you do not understand Please ask me if

any word or information is not clearly understood by you

Purpose of the Study Bonaigarh has about 12 sponge iron factories which are very

close to each other and is causing a lot of pollution due to various pollutants coming

out of those factories in the form of smoke and dust I want to study whether those

pollutants are affecting the respiratory health of the people Not only the factory but

every day we produce a lot of pollutants in our households which may be due to

regular cooking by the use of mosquito repellants or due to tobacco smoking in the

home environment so I am also interested to know whether they affect the

respiratory health of the people living in it

Procedure The survey would take approximately 30 to 45 minutes of your

valuable time You will be asked questions relating to your households occupation

respiratory symptoms if any and other habits like smoking and drinking height and

weight will be taken The data collected will be used for research purposes only I

may contact you again if the collected information is found to be incomplete

Risks and Discomforts Participation in this study imposes no risk to your health

66

However you would be asked questions which you may find personal in nature for

example I will ask you about your personal habits like smoking and alcohol

drinking which might give some discomfort to you but I can assure you that

whatever information will be provided will be kept confidential I will also ask

about your household details like what type of fuel do you use while cooking what

is your ration card type which might further bring some discomfort but I assure you

that all the data collected by me will be only for the purpose of my research and

you need not have to worry about the misuse of such detailed data

Benefits There may not be any direct benefit for you from this study other than

knowing your BMI which I can calculate and tell you after taking the height and

weight with the help of instruments which will be carried by me during the data

collection The information collected from you and other participants will be

helpful in understanding the type and prevalence of respiratory symptoms found in

your locality

Confidentiality You will be interviewed and physical measurements will be taken

in a private area in your household All information related to you will be kept

confidential in a safe keeping and at no stage will your identity be revealed Each

participant will be given an identification number (ID) which will help in

maintaining the confidentiality of the data collected Principal investigator of the

study will alone have access to the data collected

Voluntary participation Your participation in this study is purely voluntary

which means you can decide whether to participate in the study or not If at any

stage you wish to discontinue you are free to do so without any adverse

consequences

Contact Information If you have any research related questions or you would

like to verify my credentials you may contact me or a member of our institute‟s

Ethics Committee at the following address

67

DrMalaRamanathan

Member Secretary

Institutional Ethics Committee

(IEC SCTIMST

Thiruvananthapuram-11)

Office(Ph 0471-25224234 E-

mail (malasctimstacin)

MrChinmaya Kumar Behera

MPH 2016

AchuthaMenon Centre for Health

Science Studies

SCTIMST Trivandrum-11

Mob- 9446780541 7077240541

E-mail- ckbeherasctimstacin ckbehera1986gmailcom

68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________

Participant Consent Form

I have read the details in the information sheet The purpose of the study and my

involvement in the study has been explained to me By signing on this consent form

I indicate that I am willing to participate in the study and I understand what will be

expected from me I know that I can withdraw my participation at any time during

the interview without any explanation I have also been informed who should be

contacted for further clarifications

I---------------------------------------------------------------------------agree to participate

in the study

Place

Date

Signature of the participant

Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID

Village code serial no

Latitude Longitude

Date Time

1 Demographic data

11 What is your age as on your last

birthday

12 Sex 0) Female 1) Male 2) Transgender

13 Religion 1) Hindu 2) Muslim 3) Christian

4) Sikh 5) Others please specify

______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling

2) Primary 3) High school

4)

Graduate

5) Post-graduate and above Others please

specify

___________

15 Marital

Status

1) Never married 2) Currently married

3) Widowed 4) Divorcee

5) Others please specify_______

16 No of

family

members

Usually living here including

infants small children

Excluding domestic servants

guests or visitors

17 Ration Card type 1) Antyodaya 2) BPL

3) APL 4) No ration card

18 Since how many years have

you been residing in

Bonaigarh

1) Since birth 2) Others please

specify

(monthsyears)

______________

70

2 Physical Measurements

21 Height (cms)

22 Weight (Kgs)

3 Household Data

31 How many rooms in this house are used for sleeping

32 Number of doors and windows excluding toilet and

kitchen

Doors Windows

33 Does any of your rooms in the house gets damp 0) No 1) Yes

34 Where is the cooking usually

done in the house

1) In the house 2) In a separate building

3) Outdoors 4) Others please specify

35 Do you have a separate room

used as a kitchen

0) No 1)

Yes

If No go to 39 else

36

36 In the kitchen number of

Doors Windows Ventilators

37 Do you have exhaust fan in the kitchen

0) No 1) Yes

38 Do you use the exhaust fan while cooking 0) No 1) Yes

39 How do you cook food 1) Stove 2) Chullah

3) Open fire 4) Others please specify

310 Type of fuel used for cooking 1) Electricity 7) Wood

2) LPGNatural gas 8) StrawShrubsGrass

3) Biogas 9) Agricultural crop waste

4) Kerosene 10) Dung cakes

5) CoalLignite 11) No food cooked in the

house

6) Charcoal 12) Others please specify

311 What do you do with the burning fuel

inChullah after cooking is over

1) Leave as it is 2) Doused with water

3) Cover the kiln

with a cover

4) Boil water

312 Do you routinely cook 0) No 1) Yes If No go to 314

313 No of hours spent in cooking per day

314 What do you use to protect

from mosquito bite

Mosquito coil Leaf smokes Jhuna

0) No 1) Yes 0) No 1) Yes 0) No 1) Yes

315 How often do you use the above items

to prevent from mosquito bite

1) Everyday

2) Occasionally

3) Never

71

4 Occupational details

316 Does anyone smoke at home 0) No 1) Yes If No go to

318

317 How often does anyone smoke inside

your house

1) Daily 2)

Occassionaly

3) Never

318 Does your household own any of the

following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps

2) Camels 5) DogsCats

3)Horses

DonkeysMules

6) ChickensDucks

7) No animals in the house

41 Present Occupational Status 1) Office work 2) Manual work If 5 Go

to 43

3) Agriculturist 4) Business ) In

a

5) Factory 6) Others please

specify

42 How many hours do you work for your main occupation

in a day

43 If in a factory (no of months workedworking)

44

Type of factoryfactories worked

1) Chemical

based

2) Steel plantSponge Iron plant

3) Plastic

based

4) Others please Specify

45 Type of unit in the factory 1) Open 2) Closed

46 AreWere you exposed to second

hand smoke (beedicigarettes smoked

by others) at work place

0) No 1) Yes If No go to 5

47 How often wereare you exposed to

second hand smoke at work place

1) Everyday 2) Occasionally

3) Never

72

5 Personal habits

Smoking History

51 Have you ever smoked 0) No 1) Yes If 099 go to

53

52 Have you smoked in the last

one month

0) No 1) Yes

Alcohol intake History

53 Have you ever taken alcohol

0) No 1) Yes If 099 go to 55

54 Have you ever taken alcohol in the last one

month

0) No 1) Yes

History of Physical Activity

55 Do you practice yoga 0) No 1) Yes If No go to

57

56 How much time do you

spend for it per day

1) 5 minutes 2) Less than

30 minutes

per day

3) More than 30

minutes per day

57 Do you practice breathing

exercise

0) No 1) Yes If No go to

6




30 minutes

per day

3) More than 30

minutes per day

6 History of Past Illness

6 Have you ever had a diagnosis of or been diagnosed with any of the

following Illnesses

61 An injury or operation affecting chest 0) No 1) Yes

62 Other chest trouble 0) No 1) Yes

63 Heart trouble 0) No 1) Yes

64 Asthma 0) No 1) Yes

65 Diabetes 0) No 1) Yes

66 Hypertension 0) No 1) Yes

73

7 Respiratory Symptoms

Please answer Yes or No If yes please specify duration of symptoms (months)

71 Wheezing amp Tightness in the chest 0) No 1) Yes

711 Have you ever had wheezing or whistling

sound from your chest during the last 12

months

712 Have you ever woke up in the morning

with a feeling of tightness in the chest or

of breathlessness

0) No 1) Yes

72 Shortness of breath 0) No 1) Yes

721 Have you ever felt shortness of breath

after finishing exercises sports or other

heavy exertion during the last 12 months


when you were not doing some strenuous

work during the last 12 months

0) No 1) Yes

723 Have you ever had to get up at night

because of breathlessness during the last

12 months

0) No 1) Yes

73 Cough and Phlegm 0) No 1) Yes


because of cough during the last 12

months

732 Do you usually cough first thing in the

morning

0) No 1) Yes

733 Do you usually bring out phlegm from

your chest first thing in the morning

0) No 1) Yes

733 Do you usually bring up phlegm from

your chest most of the morning for at least

3 consecutive months during the year

0) No 1) Yes

74 Breathing

741 Select the most appropriate out of the

following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well

3) My breathing is never

completely satisfactory

75 Dust Feather and Pets

751 When you are exposed to dusty areas or

pets like dog cat or horse or feathers or

quilts or pillows etc do you

1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History

81 Have you taken anytreatment for any of the above

respiratory problems in the last two weeks

0) No 1) Yes

82 If Yes Please Specify____________________

9Observation

91 Main

material of

the floor

Natural floor Rudimentary floor Finished floor

1)MudClayEar

th

1)Raw wood planks 1)Parque

tPolishe

d wood

5)Carpet

2)Sand 2)PalmBamboo 2)Vinyl

Asphalt

6)Polished

stoneMarbleGranite

3)Dung 3)Brick 3)Cerami

c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof

Natural roofing Rudimentary roofing Finished roofing

1) No roof 1) Rustic mat 1)

MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass

2) PalmBamboo 2) Wood 7) Tiles

3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls

Natural walls Rudimentary walls Finished walls

1) No walls 1)Bamboo

with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets

3)Mud 3)Plywood 3)Burnt bricks 7) Others

please specify 4)GrassReedsT

hatch

4)Cardboar

d

4) Cement

blocks

Sources

National Family Health Survey (NFHS)-4 Household Questionnaire

INSEARCH study conducted by ICMR

Thank you

75

ANNEXURE ndash IV

____________________________________________________________________

ଓଡଶାଯ ଫଣାଇଗଡ ସଥତ ସପଞ ଅଆଯନ କାଯଖାନା ନକଟଯ ଯହଥଫା ରୌଢଫୟକତ ଭାନଙକ ଭଧୟଯ ଦଖାଜାଈଥଫା ଶୱାସ ସଭବନଧୟ ରକଷଣ ଏଫଂ ଏଥସହତ ସଭବନଧତ ସାଭାଜକ ଓ ଜନସଂଖୟାସଭବନଧୟ ଗଣ|

ଅନସନଧାନର ସଂଶଳଷଟସଦସୟଙକସଚନା ନମେ

ଭ ଚନମୟ କଭାଯ ଫହଯା ଭ ଜଣ ତରବାନଧଭ ସଥତ ଶରୀଚତରା ତଯନାର ଅୟଫଜଞାନ ଏଫଂ ରୌଦୟାଗକୀ ନସନଧାନ ସଂସଥାନଯ ଥଫା ଚୟତ ଭନାନ ସାଭାଜକ ଫଜଞାନକନଧଯ ସନାତକ ଛାତର ଟ| ଫରତତଭାନଭ ଏକ ଧୟୟନ କଯଛ ମାହାଯ ଫଷୟଟ ହଈଛ ଓଡଶାଯ ଫଣାଇଗଡ ସଥତ ସପଞ ଅଆଯନ କାଯଖାନା ନକଟଯ ଯହଥଫା ରୌଢଫୟକତ ଭାନଙକ ଭଧୟଯ ଦଖାଜାଈଥଫା ଶୱାସ ସଭବନଧୟ ରକଷଣ ଏଫଂ ଏଥସହତ ସଭବନଧତ ସାଭାଜକ ଓ ଜନସଂଖୟାସଭବନଧୟ ଗଣ|rdquoଏହା ାଠୟକରଭଯ ଅଫସୟକତା ଯଣ କଯଫା ାଆ କଯାମାଈଛ|ଏହ ନଭତ କଫ ଏହ ଧୟୟନ ାଆ ଟ| ଏହ ସଚନାଫ ଯ ଏଭତ ଭଧୟ ଶବଦ ଥାଆାଯ ମାହା ଅଣ ଫଝନାଯନତ| ଏହ ସଚନାଫ ଯ ଏଭତ ଭଧୟ ଶବଦ ଥାଆାଯ ମାହା ଅଣ ଫଝନାଯନତ| ଦୟାକଯ ମଈ ଶବଦ ଫା ସଚନାଟ ସମପଣତ ବାଫ ଫଝନାଯଛନତ ତାହାଚାଯନତ|

ଅଧୟୟନର ଉେଶୟ ଫଣାଆଗଡଯ ରାୟ ୧୨ଟ ସପନଜ ଅଆଯନ କାଯଖାନା ଛ ଏଫଂ ଏଗଡକ ଫହତ ାଖା-ାଖ ଛ| ଏଥଯ ନଗତତ ନକ ରକାଯଯ ରଦଷତ ଫାୟ ଏଫଂ ଧ ଫହତ ରଦଷଣ କଯଛନତ|ଭ ଏହ ରଦଷଣ ମାଗ ଏଠାଯ ଫସଫାସ କଯଥଫା ରାକଭାନଙକଯ କଈ କଈ ଶୱାସ ସଭବନଧୟ ରକଷଣଦଖାଜାଈଛତାହା ଧୟୟନ କଯଫାକ ଚାହଛ| ନା କଫ ଏହ କାଯଖାନା ଫଯଂ ରତଦୀନ ଅଭ ଅଭ ଘଯ ଯାସଆ ମାଗ ମଈ ରଦଷଣ ଶଷଟ କଯଛ ମଈ ଝଣା ଓ ଭଶାଫତୀ ଅଭ ଭଶା ଦାଈଯ ଯକଷା ାଆଫା ାଆ ଜଆଥାଈ ଫା ଘଯ ବତଯ କହ ଧମରାନ କର ମଈ ଧଅ ଶଷଟ ହା ଆଥାଏ ତାହା ଭଧୟ ଅଭଯ ଶୱାସଥୟ ରତ ହାନକାଯକ ଟ| ତଣ ଏଥମାଗ ରାକଭାନଙକଯ କଈ କଈ ଶୱାସ ସଭବନଧୟ ରକଷଣଦଖାଜାଈଛତାହାଭଧୟଧୟୟନ କଯଫାକ ଚାହଛ| କାଯୟ ବଧ ଏହ ରକରୟାଯ ଅଣଙକଯ ତ ଭରୟଫାନ ସଭୟଯ ଭାତର ୩୦-୪୫ ଭନଟ ସଭୟ ଅଫଶୟକ ହା ଆାଯ| ଅଣଙକ ଣଙକଯ ଘଯ ଯାଜଗାଯ ନଥା ଏଫଂକଈ କଈ ଶୱାସ ସଭବନଧୟ ରକଷଣଦଖାଜାଈଛଏଫଂ ନୟାନୟ ବୟାସ ଜଯକ ଧମରାନ ଏଫଂ ଭଦୟାନ କଯଫାଫଷୟଯ କଛ ରଶନ ଚାଯଫଏଫଂ ଏଥସହତଶାଯୀଯକ ଭା ଜଯ ଓଜନ ଓ ଈଚଚତାଭଧୟ ଭାଫ| ଏହ ତଥୟ ଗଡକ କଫ ନସନଧାନ ାଆ ଫୟଫହତ ହଫ| ଭ ଜଦ କୌଣସ ତଥୟଯ ତଟ ାଏ ତାହର ଭ ଅଣଙକ ନଫତାଯମାଗାମାଗ କଯାଯ| ବପଦ-ଆପଦ ଏହ ଧୟୟନମାଗ ଅଣଙକ ସୱାସଥୟଯ କୌଣସ କଷୟତ ହା ଆଫ ନାହ|ମଦୟ ଭ କଛ ଏଭତ ରଶନ ଚାଯାଯ ମାହା ତୟନତ ଫୟକତଗତ ହା ଆାଯ ମଯକ ଭ ଅଣଙକଯ ଫୟକତଗତ ବୟାସ ମଭତ ଧମରାନ କଯଫା ଏଫଂ ଭଦୟାନ କଯଫା ମାହା ଅଣଙକ କଞଚତ ସଫଧାଯ କାଆାଯ କନତ ଭ ଅଣଙକ କଥା ଦୌଚ ମ ଅଣଙକ ଦୱାଯା ଦଅମାଆଥଫା ତଥୟ ତୟନତ ଗାନୟ ଯଖାମଫ|ଭ ଅଣଙକ ଅଣଙକଯ କଛ ଘଯା ଆ ତଥୟ ଚାଯଫ ମଭତ କ ଅଣ ଯାସଆ ାଆ କଈ ଜାଣ ଫୟଫହାଯ କଯନତ ଅଣ କଈ ଯାସନ କାଡତ ଶରଣୀଯ ନତବତ କତ ମାହା ଅଣଙକ ନଫତାଯ କଞଚତ ସଫଧାଯ କାଆାଯ କନତ ଭ ଅଣଙକ ନଫତାଯ ରତଶତ ଦ ଈଚ ଜ ଭା ଦୱାଯା ସଂଗରହ କଯାମାଈଥଫା ତଥୟ କଫ ଅନସନଧାନକ କାମତୟଯ ରାଗଫ ଏଫଂ ଏବ ଂଖାନଂଖ ତଥୟଯ କୌଣସ ଦଫତୟଫହାଯ କଯାମଫ ନାହ|

76

ାଭ ଏହ ଧୟୟନଯ ଅଣଙକ ରତୟକଷ ଯଯ କୌଣସ ରାବ ଭଫ ନାହ କଫ ଭ ଅଣଙକ ଅଣଙକଯ ଈଚଚତା ଏଫଂ ଓଜନ ଭାଫା ଯ ଅଣଙକ ଫଏମ ଅଆ ହସାଫ କଯ କହାଯ ମାହାକ ଭାଫାାଆ ଅଫସୟକ ଥଫା ସଭସତ ଈକଯଣ ଭ ଭା ସାଥୀଯ ଅଣଛ|ଅଣଙକଠାଯ ଏଫଂ ନୟଭାନଙକଠାଯ ସଂଗରହ କଯାମାଈଥଫା ସଭସତ ତଥୟଯ ଏଠାଯ କଈ କଈଶୱାସ ସଭବନଧୟ ରକଷଣଭାନଦଖାମାଈଛ ଏଫଂ ତାହା କବ ରାରଙକ ସୱାସଥୟ ଈଯ ରବାଫ କାଈଛତାହା ଜାଣଫାଯ ସହାୟକ ହା ଆାଯ| ାପନୟତା ଅଣଙକ ସହତ ସାକଷାତ କାଯ ଏଫଂ ଅଣଙକ ଶାଯୀଯକ ଭା ଅଣଙକ ଘଯ ଏକ ଏକାନତ ସଥାନଯ କଯାମଫ| ଅଣଙକଯ ସଭସତ ତଥୟ ତୟନତ ସଯକଷତ ଏଫଂ ଗାନୟ ଯଖାମଫ ଏଫଂ ଏହାକ କୌଣସ ସଥତ ଯଫ ରଘଟ କଯାମଫ ନାହ| ଏହ ଧୟୟନଯ ନତବତ କତ ସଭସତ ସଦସୟଙକଯନାଭ ରତୟକଷଯଯ ଯହଫ ନାହ କଫ ଭାତର ଯଚୟ ସଂଖୟା ଯହଫମାହା ସଭସତ ସଂଗହତ ତଥୟଯ ଗାନୟତାକ ଫଜାୟ ଯଖଫାଯ ସାହାଜୟ କଯଫ| କଫ ଭଖୟ ମାଞଚ କତତାଙକ ହ ଅଣଙକଯ ସଭସତ ତଥୟ ଜଣାଯହଫ| େଛାକତଭା ଦାର ଏହ ଧୟୟନଯଅଣଙକଯବାଗଦାଯ ସମପଣତ ବାଫ ସୱଛାକତ ଟ ଥତାତ ଅଣ ନ ଜହ ନଶଚତ କଯାଯ ଫ କ ଅଣ ଏହ ଧୟୟନଯସାଭଲ ହଫ ନା ନାହ| ମଦ କୌଣସ ସଭୟଯ ଅଣ ଏହ ଧୟୟନଯ ଓହଯଫାକ ଚାହ ଫ ତାହର ଅଣ ଏହା ସମପଣତ ସୱାଧନ ଏଫଂଏହା କୌଣସ ାସୱତ ରତକରୟା ଫହନ ବାଫଯ କଯାଯ ଫ| ଯା ାଯା ବବରଣୀ ଏହ ନସନଧାନ ଫଷୟଯ କଭବା ଭାଯ ଯଚୟକ ମାଞଚ କଯଫାକ ଚାହଥର ଅଣ ଭାତ କଭବା ଅଭଯ

ସଂସଥାନକଅଚାଯ ସଞଚାନ ସଭତଯ ସଦସୟ ସଚଫଙକ ନ ଭନାକତ ଠକଣାଯ ମାଗାମାଗ କଯାଯ ଫ

ସଥାନ ସୱାକଷୟଯ ତାଯଖ

ଧନୟଫାଦ

ଚନମୟ କଭାଯ ଫହଯା ଏମ ଏ -୨୦୧୬ ଚୟତ ଭନାନ ସାଭାଜକ ଫଜଞାନକନଧ| ଏସ ସଟଅଆଏମ ଏସ ଟତରବାନଧଭ-୧୧

କଯାଯ ଫ (ଭାଫାଆଲ ନଂ 9446780541

ଆଭଲ ckbeherasctimstacin

ckbehera1986gmailcom)

ଡା ଭାରା ଯାଭନାଥନ ସଦସୟ ସଚଫ

ସଂସଥାନକଅଚାଯ ସଞଚାନ ସଭତ (ଅଆ ଆ ସ ଏସ ସଟଅଆଏମ ଏସ ଟ ତରବାନଧଭ-୧୧)

ପସ (ପା ନଂ 0471-25224234 ଆ ଭଲ malasctimstacin)

77

ANNEXURE ndash V

____________________________________________________________________

ଓଡଶାଯ ଫଣାଇଗଡ ସଥତ ସପଞ ଅଆଯନ କାଯଖାନା ନକଟଯ ଯହଥଫା ରୌଢ ଫୟକତ ଭାନଙକ ଭଧୟଯ ଦଖାଜାଈଥଫା ଶୱାସ ସଭବନଧୟ ରକଷଣ ଏଫଂ ଏଥସହତ ସଭବନଧତ ସାଭାଜକ ଓ ଜନସଂଖୟା ସଭବନଧୟ ଗଣ|

ID Number______________

ଅନମତ ନମେ ପତର ନଭସକାଯ ଭ ଚନମୟ କଭାଯ ଫହଯା ଭ ଜଣ ତରବାନଧଭ ସଥତ ଶରୀଚତରା ତଯନାର ଅୟଫଜଞାନ ଏଫଂ ରୌଦୟାଗକୀ ନସନଧାନ ସଂସଥାନଯ ଥଫା ଚୟତ ଭନାନ ସାଭାଜକ ଫଜଞାନ କନଧଯ ସନାତକ ଛାତର ଟ| ଏହ ାଠୟକରଭଯ ଅଫସୟକତା ଯଣ କଯଫା ାଆ ଭ ଏକ ଧୟୟନ କଯଛ ମାହାଯ ଫଷୟଟ ହଈଛ ଓଡଶାଯ ଫଣାଇଗଡ ସଥତ ସପଞ ଅଆଯନ କାଯଖାନା ନକଟଯ ଯହଥଫା ରୌଢ ଫୟକତ ଭାନଙକ ଭଧୟଯ ଦଖାଜାଈଥଫା ଶୱାସ ସଭବନଧୟ ରକଷଣ ଏଫଂ ଏଥସହତ ସଭବନଧତ ସାଭାଜକ ଓ ଜନସଂଖୟା ସଭବନଧୟ ଗଣ|rdquo ଏଥ ନଭନତ ଭ ଅଣଙକ ସହତ ଏକ ୩୦-୪୫ ଭନଟ ସଭୟଯ ସାକଷାତକାଯ କଯଫାକ ଚାହଛ| ଭ ଅଣଙକ କଥା ଦଉଚ ମ ମଈ ତଥୟ ଅଣ ଭାତ ରଦାନ କଯଫ ତାହା ତୟନତ ଗପତ ଯହଫ ଏଫଂ ଏହାକଫ ଭାତର ନସନଧାନ କାଜତୟ ଫା ସୈଧୟାନତକ କାମତଯ ଫୟଫହତ ହଫ| ଏହ ନସନଧାନ କାମତୟ ମାଗ ଅଣ ରତୟକଷ ବାଫଯ ରାବାନବତ ହା ଆନାଯନତ କନତ ଅଣ ମଈ ତଥୟ ରଦାନ କଯଫ ତାହା ବଫଷୟତଯ ନତନ ନୀତ ରଣଧାନ କଯଫାଯ ଈମାଗ ହା ଆାଯ| ଏହ ନସନଧାନଯ ଅଣଙକଯ ବାଗଦାଯ ସମପଣତ ସୱଛାକତ ଟ| ଅଣ ଚାହ ର କୌଣସ ରଶନଯ ଈରତଯ ନଦଆ ାଯନତ ଏଫଂ ଅଣ ଏହ ସାକଷାତକାଯଯ ମକୌଣସ ଭହରତତଯ କାଯଣ ନଦଶତାଆ ଭଧୟ ନବକତାଯ ସହତ ଓହାଯ ମାଆାଯନତ| ଅଣଙକ ସହମାଗ ଫୈଜଞାନକ ଜଞାନକ ଫହ ବାଫଯ ଫରଦଧତ କଯଫ ଏଫଂ ସଭାଜଯ ଭଙଗ ସାଧନ କଯଫ| ଏହ ଧୟୟନ ଫଷୟଯ ଧକ ଜାଣଫାକ ହର ଅଣ ଭାତ ସଧା-ସଖ ବାଫ କର କଯାଯଫ ( ଭାଫାଆଲ ନଂ 9446780541

ଆ ଭଲ ckbeherasctimstacin ckbehera1986gmailcom| ମଦ ଅଣ ଏହ ଧୟୟନ ଫଷୟଯ ଅହଯ ଧକ ଜାଣଫାକ ଚାହାନତ ତାହର ଅଣ ଅଭ ସଂସଥାନଯ ଅଚାଯ ସଞଚାନ ସଭତଯ ସଦସୟ ସଚଫ ସହତ ମାଗାମାଗ କଯାଯଫ ଡା ଭାରା ଯାଭନାଥନ କଯାଯଫ (ପା ନଂ 0471-

25224234 ଆ ଭଲ malasctimstacin)| ସଥାନ ସୱାକଷୟଯ

ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI

ଓଡଶାଯ ଫଣାଇଗଡ ସଥତ ସପଞ ଅଆଯନ କାଯଖାନା ନକଟଯ ଯହଥଫା ଫୟକତ ଭାନଙକ ଭଧୟଯ ଦଖାଜାଈଥଫା ଶୱାସ ସଭବନଧୟ ରକଷଣ ଏଫଂ ସାଭାଜକ ଓ ଜନସଂକଷୟା ସଭବନଧୟ ଗଣ| Participant ID


Latitude Longitude

Accuracy Date Time

1ଜନସଂକଷୟା ସଭବନଧୟତଥୟ

11 ଶଷ ଜନମଦନ ସରଦଧା ଅଣଙକ ଣତ ଫୟସଟ କତ

12 ରଙଗ 0) ଭହା 1) ଯଷ 2) ସଭରଙଗ

13 ଧଭତ

1) ହନଦ 2) ଭସରଭାନ 3) ଖଷଟଅନ

4) ସଖ

5) ନୟ ଧଭତ ଦୟାକଯ ନାଭ କହନତ__

99) ଈରତଯ ନଭ ର ଜାଣନଥର

14 ଶକଷାଗତ ମାଗୟତା

1) ସକର ଜାଆନ

2) ରାଥଭକ

3) ହାଆସକର ଭଟରକ

4) ଗରାଜଏସନ ସନାତକ

5) ଜ କଭବା ତଦରଧତ 6) ନୟ ଦୟାକଯ କହନତ

15 ଫୈଫାହକ ସଥତ

1) ଫଫାହତ 2) ଫଫାହତ

3) ଫଧଫା ଫଧଯ 4) ଛାଡତର ହା ଆମାଆଛ

5) ନୟ ଦୟାକଯ କହନତ ______________________

16 ଯଫାଯ ସଦସୟଙକ ସଂଖୟା

ସାଧାଯଣତଃ ଏଠାଯ ମଈଭାନ ଯହନତ ନଫଜାତ ଶଶଛାଟ ରାଙକ ଭଶାଆ

ଘଯଯ ଚାକଯ ଏଫଂ ତଥଭାନଙକ ଛାଡକ

17 ଅଣଙକ ାଖଯ କଈ ଯାସନ କାଡତ ଛ

1) ନତୟାଦୟ 2) ଫଏର

3) ଏଏର 4) ଯାସନ କାଡତ ନାହ

18 ଅଣ କତ ଫଷତ ହରା ଫଣାଆ ଫଲzwj ଯ ଯହଛନତ

1) ଜନମଯ

2) ନୟଭାନ ଦୟାକଯ କହନତ ଅଣ ଏଠାଯ କତ ଭାସ ଫଷତ ହରାଣ ଯହଛନତ______________

79

2ଶାଯୀଯକ ଭା

21 ଈଚଚତା (ଭଟଯଯ)

22 ଓଜନ (କଗରା ଯ) 3 ଘଯ ସଭବନଧୟ ତଥୟ

31 ଅଣଙକ ଘଯ କତଟ କାଠଯ ଶା ଆଫା ାଆ ଯହଛ 32 ଯାଷଆ ଓ ଗାଧଅ ଘଯ ଛାଡ ଅଣଙକ ଘଯ କତାଟ କଫାଟ ଝଯକା

33 ଅଣଙକ ଘଯଯ କୌଣସ କାଠଯ ସନତ ସନତଅ ରଗ କ 0) ନା 1) ହ 34 ଘଯ ସାଧାଯଣତଃ ଯାଷଆ

କଈଠାଯ କଯାମାଏ 1) ଘଯ ବତଯ 2) ନୟ ଏକ ଘଯ 3) ଘଯ ଫାହାଯ 4) ନୟ ଦୟାକଯ କହନତ

35 ଅଣଙକଯ ସୱତନତର ଯାଷଆ ଘଯ ଛକ 0) ନା 1) ହ

36 ଯାଷଆ ଘଯ କତାଟ__ ଛ କଫାଟ ଝଯକା ବନରଟଯ 37 ଅଣଙକ ଯାଷଆ ଘଯ ଧଅ ନସକାସନ କଯଥଫା ପୟାନ ଛ କ 0) ନା 1) ହ

38 ଅଣ ସହ ପୟାନ କ ଯାଷଆ କଯଫାଫ ଫୟଫହାଯ କଯନତ କ 0) ନା 1) ହ 39 ଅଣ ଖାଦୟ କଯ ଯାଷଆ କଯନତ 1) ଷଟାଭ 2) ଚର

3) ଖାରା ନଅ 4) ନୟ ଦୟାକଯ କହନତ 310 ଅଣ କଈ ରକାଯଯ ଜାଣ

ଫୟଫହାଯ କଯଛନତ 1) ଫଦୟତ 2) ଏରଜରାକତକଗୟାସ 3) ଜୈଫକ ଗୟାସ 4) କ ଯାସନ 5) କାଆରାରଗ ନାଆଟ 6) ାଈସ 7) କାଠ 8) ନଡାଫଦାଘାସ 9) ଚାଷଯ ଈତପନନ ଫଜତୟ ଫସତ 10) ଗାଫଯ ଘସ 11) ଘଯ ଯାଷଆ ହଏ ନାହ 12) ନୟ ଦୟାକଯ କହନତ

311 ଯାଷଆ ସଯରା ଯ ଫକା ନଅଯ ଅଣ କଣ କଯନତ

1) ସଭତ ଛାଡ ଦଆଥାଈ 2) ାଣଦୱାଯା ରବାଆଦଆଥାଈ

3) ଚରକ ଢାଙକଣ ସାହାଜୟଯ ଘାଡାଆଦଈ

4) ାଣ ଗଯଭ କଯ

312 ଅଣ ରତଦନ ଯାଷଆ କଯନତ କ 0) ନା 1) ହ 313 ରତଦନ ଯାଷଆ ାଆ କତ ସଭୟ ଫୟୟ କଯନତ

314 ଭଶାଙକ ଦାଈଯ ଯକଷା ାଆଫାାଆ କଣ ଫୟଫହାଯ କଯନତ କ

ଭଶା ଧ ତର ଧଅ ଝଣା 0) ନା 1) ହ 0) ନା 1) ହ 0) ନା 1) ହ

315 ଅଣ ଭଶାଙକ ଦାଈଯ ଯକଷା ାଆଫାାଆ ଈଯାକତ ଜନଷ ଗଡକ କଭତ ଫୟଫହାଯ କଯଥାଅନତ

1) ରତଦନ

2) ଫଫ

80

316 ଅଣଙକ ଘଯ କହ ଧମରାନ କଯନତ କ 0) ନା 1) ହ 317 ସ କବ ବାଫଯ ଧମରାନ କଯନତ 1) ରତଦନ 2) ଫଫ 318 ାସୱତଯ ଦଅମାଆଥଫା ଗହାତ ଶ ଭାନଙକ ଭଧୟଯ କଈଟକଈଗଡକ ଅଣଙକ ଘଯ ଛ

1) ଗାଇଫଦଭ ଆଷ 2) ଓଟ 3) ଘାଡାଗଧ 4) ଛଭଣଢା 5) କକଯଫ ରଆ

6) କକଡାଫତକ 7) ନା ଅଭ ଘଯ କୌଣସ ଗହାତ ଶ ନାହାନତ

4ଫୟଫସାୟ ସଭବନଧୀୟ ତଥୟ

41 ଫରତତଭାନଯ ଫୟଫସାୟଯ ଫଫଯଣ

1) ପସ କାଭ 2) ଶାଯୀଯକ କାମତୟ 3) ଚାଷୀ 4) ଫୟଫଶାୟୀ 5) କାଯଖାନାଯ କାଭ 6) ନୟାନୟ ଦୟାକଯ କହନତ

42 ରତଦନ ଅଣ ଅଣଙକ ଭଖୟ ଫୟଫସାୟକ କତ ସଭୟ ଦଆଥାଅନତ 43 ମଦ କାଯଖାନାଯ କାଭକଯଥାଅନତ (କତ ଭାସ କାଭ କଯଛନତକଯଛନତ)

44 କଈ ରକାଯଯ କାଯଖାନା କାଯଖାନା ଗଡକଯ କାଭ କଯଛନତ

1) ଯାଶାୟନୀକ 2) ଆସପାତ ରହା କାଯଖାନା 3) ପଳାଷଟକ କାଯଖାନା 4) ନୟାନୟ ଦୟାକଯ କହନତ

45 କାଯଖାନାଯ କାମତୟ କଯଫାଯ ସଥାନଟ କଯ 1) ଖାରା 2) ଅଫରଦଧ 46 ଅଣ ମଈଠାଯ କାଭ କଯନତ ସଠାଯ ନୟ ରାକଙକ ଧମରାନ ଧଅ ଦୱାଯା

ଅଣ ଗରସତ କ 0) ନା 1) ହ

47 ନୟ ରାକଙକ ଧମରାନ ଧଅ ଦୱାଯା ଅଣ କବ ବାଫଯସମମଖୀନହନତ

1) ରତଦନ

2) ଫଫ 3) କଫନହ

5ଫୟକତଗତ ବୟାସ ତଥୟ ଧମରାନ ଆତହାସ

51 ଅଣ କଫଧମରାନକଯଛନତକ 0) ନା 1) ହ 52 ଅଣ ଗତଭାସଯ ଧମରାନକଯଛନତକ 0) ନା 1) ହ

ଭଦ ଆଫା ଆତହାସ 53 ଅଣ କଫଭଦ ଆଛନତକ 0) ନା 1) ହ

54 ଅଣ ଗତଭାସଯ ଭଦ ଆଛନତକ 0) ନା 1) ହ

ଶାଯୀଯକଫୟIୟାଭ 55 ଅଣ ମାଗ ରାଣାୟାଭ ବୟାସ କଯନତ

କ 0) ନା 1) ହ

56 ଅଣ ରତଦନ ଏଥାଆ କତ ସଭୟ ଫୟତତ କଯନତ

1) ାଞଚ ଭନଟ 2) ୩୦ ଭନଟ

3) ୩୦ ଭନଟଯ

81

ଧକ

57 ଅଣ ରାଣାୟାଭ ବୟାସ କଯନତ କ 0) ନା 1) ହ


1) ାଞଚ ଭନଟ 2) ୩୦ ଭନଟ 3) ୩୦ ଭନଟଯ ଧକ

6 ଫତତନ ଯାଗଯ ଆତହାସ 6 ନ ଭନାକତ ଯାଗ ଗଡକ ଅଣଙକ ଦହଯ କଫଫ ଚହନଟ ହାଇଛ କ

61 ଛାତ ଯ କୌଣସ କଷତ ଫା ରାଚାଯ 0) ନା 1) ହ

62 ଛାତ ଯ ନୟ ସଫଧା 0) ନା 1) ହ

63 ହଦୟ ଯାଗ 0) ନା 1) ହ

64 ଶୱାସ ଯାଗ 0) ନା 1) ହ

65 ଡାଆଫଟସ 0) ନା 1) ହ

66 ଈଚଚଯକତଚା 0) ନା 1) ହ

7 ଶୱାସ ସଭବନଧୟ ରକଷଣ 71 କ କ ଶବଦ ହଫା ଓ ଛାତ ଯନଧ ହଫା

କତ ଭାସ ହରାଣ

711 ଫଗତ ୧୨ ଭାସ ବତଯ ତଭ ଛାତ ଯ କଫ କ କ ଶବଦ ହାଇଥରା କ

0) ନା 1) ହ

712 ଣନଶୱାସୀ କଭବା ଛାତ ଯନଧ ହାଇ କଫ ବାଯଯ ନଦ ବାଙଗଛ କ

0) ନା 1) ହ

72 ଣନଶୱାସୀହଫା କତ ଭାସ ହରାଣ

721 ଫଗତ ୧୨ ଭାସ ବତଯ ଫୟାୟାଭ କଯଫା ସଭୟଯ କଭବା ଫା ସଭୟଯ କଭବା ଅଈ କଛ ବାଯ କାଭ କଯଫା ସଭୟଯ ତଭ କଫ ଣନଶୱାସୀ ହାଇଡ କ

0) ନା 1) ହ

722 ଫଗତ ୧୨ ଭାସ ବତଯ ତଭ ବାଯକାଭ ନକଯରାଫ ଭଧୟ କଫ ଣନଶୱାସୀ ନବଫ କଯଛ କ

0) ନା 1) ହ

723 ଫଗତ ୧୨ ଭାସ ବତଯ ତଭ କଫ ଯାତ ଧଯ ଣନଶୱାସୀ ନବଫ କଯଈଠଡଛ କ

0) ନା 1) ହ

73 କାଶ ଏଫଂ କପ କତ ଭାସ ହରାଣ

731 ଫଗତ ୧୨ ଭାସ ବତଯ ତଭ କଫ ଯାତ ଧଯ କାଶ କାଶଈଠଡଛ କ

0) ନା 1) ହ

82

732 ତଭଯ ସକା ଈଠଫା ସଙଗ ସଙଗ କାଶ ରାଗ କ

0) ନା 1) ହ

733 ତଭଯ ସକା ଈଠଫା ସଙଗ ସଙଗ ଛାତଯ କପ ଫାହାଯ କ 0) ନା 1) ହ

734 ଗତ ୧୨ ଭାସ ବତଯ ସକା ସକା ତଭ ଛାତଯ ୩ ଭାସ ଧଯ ରଗାତାଯ କଫ କପ ଫାହାଯଛ କ

0) ନା 1) ହ

74 ନଶୱାସ ରଶୱାସ ନଫା 741 ଡାହାଣଯ ଦଅମାଆଥଫା ସଚ ବତଯ ସଫଠାଯ ଠzwj ସଚୀ ଫାଛ 1) ଭ କୱଚତ ଣନଶୱାସୀ ହଏ

2) ଭ ରାୟ ଣନଶୱାସୀ ହଏ କନତ ଠzwj ହାଇମାଏ

3) ଭାଯ ନଶୱାସ ନଫା କଫହର ସନତାଷଜନକ ନହ

75 ଗହାତ ଶ ଓ କଷୀ ଯ ଧ 751 ତଭ ଧ ାଷା କକଯ ଫ ରଆ ଘାଡା ଅଦ ଜନତ କଭବା କଷୀ କଷୀଯ ଯ କଭବ ତକଅ ଅଦ ଜନଷଯ

ସମପକତଯ ଅସର ତଭକ କଯ ରାଗ 1) ଛାତ ଯ ଯନଧ ହଫା ବ ରାଗ 2) ଣନଶୱାସୀହଫା ବ ରାଗ

8ଚକତସା ସଭନଧୀୟ ରଶନ 81 ଗତ ଦଆ ସପତାହଯ ଅଣ ଈଯାକତ ଶୱାସ ସଭବନଧୟ ରକଷଣ

ାଆ ଔଷଧ ସଫନ କଯଛନତ କ 0) ନା 1) ହ

82 ଜଦ ହ ତାହର ଦୟାକଯ ତାହା କହନତ ___________________________________________

83

9Observation 91 Main

material of

the floor


1)MudClayEarth 1)Raw wood planks 1)ParquetPolish

ed wood

5)Carpet

2)Sand 2)PalmBamboo 2)VinylAsphalt 6)Polished

stoneMarbleGr

anite

3)Dung 3)Brick 3)Ceramic tiles 7)Others Please

specify 4)Stone 4)Cement

92 Main

material of

the roof


1) No roof 1) Rustic mat 1) MetalGI 6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4) Asbestos

sheets

9) Burnt brick

5)

PlasticPolythene

sheeting

5) Loosely packed stone 5)RCCRBC

Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets

3)Mud 3)Plywood 3)Burnt bricks 7) Others please

specify 4)GrassReedsTh

atch

4)Cardboard 4) Cement

blocks

Sources National Family Health Survey (NFHS)-4Household Questionnaire


Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

2

DEDICATION

The work embodied in this dissertation is dedicated to my father Mr Kumuda Chandra

Behera my mother Mrs Mamata Behera my father-in-law Mr Gouranga Charan Samal

my mother-in-law Mrs Jayashree Samal and my beloved wife Subhashree Priyadarsini

They have sacrificed their time and comforts for me and offered unconditional support and

encouragement in making this work possible

This work is also a humble homage to my Sadgurudev Sri Satpalji Maharaj whose

preaching‟s and meditation techniques gave me peace of mind throughout the dissertation

work

3

ACKNOWLEDGEMENT




















dissertation

4

DECLARATION






the text





October 2017

5

CERTIFICATE






supervision

DR MANJU NAIR R

Scientist bdquoC‟




October 2017

6





















OR Odds Ratio



7





UK United Kingdom



8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



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50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

3

ACKNOWLEDGEMENT




















dissertation

4

DECLARATION






the text





October 2017

5

CERTIFICATE






supervision

DR MANJU NAIR R

Scientist bdquoC‟




October 2017

6





















OR Odds Ratio



7





UK United Kingdom



8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

4

DECLARATION






the text





October 2017

5

CERTIFICATE






supervision

DR MANJU NAIR R

Scientist bdquoC‟




October 2017

6





















OR Odds Ratio



7





UK United Kingdom



8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

5

CERTIFICATE






supervision

DR MANJU NAIR R

Scientist bdquoC‟




October 2017

6





















OR Odds Ratio



7





UK United Kingdom



8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

6





















OR Odds Ratio



7





UK United Kingdom



8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

7





UK United Kingdom



8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

8

TABLE OF CONTENTS

_____________________________________________


List of Tables 11

List of Figures 11

Abstract 12

1 Introduction 13

11 Background 13






exposures

19


pollution

21






26



26




211 Objectives 29


3 Methodology 30

31 Study design 30

32 Study setting 30

33 Sample size 30






38 Data analysis 33



9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

9

39 Study tool 34



3102 Adults 34




3121 Staffing 35

3122 Work plan 35





4 Results 38


411 Education 39







kitchens

41











44



44



44



45



45



46

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

10

5 Discussion 51

51 Strengths 57

52 Limitations 57

53 Conclusion 57

References 59


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


Annexure-


11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

11


Tables

Page







46



47



48



49



50



51

Figures

Page



categories 39


12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

12

Abstract

























13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

13

Chapter- 1

Introduction

___________________________________________________________________

11 Background



















pollution

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

14
























15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

15
























16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

80













1) ରତଦନ







କ 0) ନା 1) ହ




81

ଧକ














0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ


0) ନା 1) ହ


0) ନା 1) ହ



0) ନା 1) ହ

82


0) ନା 1) ହ



0) ନା 1) ହ









83


material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

Button2

Button3

Button4

16







17

Chapter-2

Literature Review
















be 86 (95 CI 85-87) (To et al 2012)



18
























19























20


















et al 2008)






21


1997)



















1996)


22















et al 2011)









23


264) (Salo et al 2004)





















24
























25












(Cong et al 2014)








(Dong et al 2014)




26
























studied

27























2012)

28
























29





211 Objectives




them





symptoms

30

Chapter- 3

Methodology

____________________________________________________________________

31 Study design


32 Study setting



India

33 Sample size





rounded off to 410





in these villages

31













achieved








32














31software











33

38 Data analysis




















34

39 Study tool




2006)









were called adults











35


consumption


3121 Staffing





____________________________________________________________________


Technical

clearance

Ethical

clearance

Data

Collection

Data Entry

Data

Analysis

Submission

of Results

3123 Administration





36























37



presentations

38

Chapter- 4

Results



















39














were 217




characteristics

40


Variables Category

Frequency ()

N=410

Age (years) 18 - 25 48 (117)

26 - 60 327 (798)

61 - 65 35 (85)

Sex Male 262 (639)

Female 148 (361)


Primary 133 (324)


Graduate 34 (83)





Business 28 (68)

Factory 31 (76)

Others 149 (363)






including children


of the sample

41


____________________________________________________________________







of their rooms
















42





10 hours





up in the area


study population


________________________________________________________________



No 332 (810)


No 257 (627)

BMI lt 185 134 (327)

185 - 249 221 (539)

250 - 299 42 (102)

gt=300 13 (32)




single women

43




females (15)






(page-45)



Prevalence N= 410

n() 95 CI

Wheeze 62 (151) 119 - 189





Cough at night 88 (215) 178 - 257







Ever Asthma 9 (22) 11 - 42




44








(page-46)









46 (page-47)

45












46




50)




Factors

Wheeze

n=62 n ()

P-

values

Morning

breathlessness

n=53 n ()

P-

values

Age (years)

0945

0701

18 - 25 8 (129)

8 (151)

26 ndash 60 49 (790)

41 (774)

61-65 5 (81)

4 (75)

Sex

0209

079

Male 44 (709)

33 (623)

Female 18 (290)

20 (377)

Occupation 0291

0795

AgricultureDaily

wagers 30 (484)

25 (472)


12 (226)


12 (226)


4 (76)


0373


39 (736)


14 (264)


0572


45 (849)


months 6 (115)

8 (151)


0685


9 (170)


44 (830)

Dampness 0005

0017

Yes 52 (184)

44 (830)

No 10 (78)

9 (170)

47




Factors

Breathlessness on

exertion n=155

n ()

P-

values

Breathlessness

without

exertion n=33

n()

P-

values

Age (years) 0218

0686

18 - 25 18 (116)

3 (91)

26 - 60 119 (768)

26 (788)

61-65 18 (116)

4 (121)

Sex

0664

0021

Male 97 (626)

15 (455)

Female 58 (374)

18 (545)

Occupation 0895

0427

AgricultureDaily

wagers 72 (465)

13 (394)


6 (182)


13 (394)


1 (30)


0608


27 (818)


6 (182)


0322


27 (818)


months 21 (135)

6 (182)


0129


3 (91)


30 (909)

Dampness

0012

0092

Yes 118 (761)

27 (818)

No 37 (239)

6 (182)

Education

002

0051


24 (727)


9 (273)

Pet animals lt 0001

0949

House with pet

animals 116 (748)

21 (636)

House without pet

animals 39 (252)

12 (364)

48


household factors

____________________________________________________________________


Factors

Breathlessness at

night n=64 n()

P-

values

Cough at night

n=88 n ()

P-

values

Age (years) 016

0161

18 - 25 9 (141)

13 (148)

26 - 60 46 (719)

64 (727)

61-65 9 (141)

11 (125)

Sex

0664

0418

Male 41(641)

53 (602)

Female 23 (359)

35 (398)

Occupation 0619

0387

AgricultureDaily

wagers 26 (406)

37 (420) Office


15 (170)


31 (353)


5 (57)


054


71 (807)


17 (193)


0435


79 (898)


months 7 (109)

9 (102)


0594


15 (170)


73 (830)

Dampness 0079

0146

Yes 50 (781)

66 (750)

No 14 (219)

22 (250)

49


household factors


Factors

Cough in

morning n=96

n ()

P-

values

Phlegm in

morning n=85

n ()

P-

values

Age (years) 0899

09

18 - 25 12 (125)

9 (188)

26 - 60 75 (781)

68 (208)

61-65 9 (94)

8 (229)

Sex

001

0028

Male 72 (750)

63 (741)

Female 24 (250)

22 (259)

Occupation 0453

0339

AgricultureDaily

wagers 47 (489)

44 (518)

Office


17 (200)


18 (212)


6 (71)


0647


65 (765)

APLNo ration

card 19 (198)

20 (235)


008


79 (929)

Lived for at least

6 months 5 (52)

6 (71)


0235


65 (765)


20 (235)

Dampness 0045

0146

Yes 74 (771)

64 (753)

No 22 (229)

21 (247)

Family size 0021

0084

1-5 members 63 (656)

55 (647)


30 (353)

50



____________________________________________________________________


Factors

Chest tightness on

dust exposure

n=38 n()

P-

values

Breathlessness on

dust exposure

n=207 n ()

P-

values

Age (years) 0734

0235

18 - 25 5 (132)

20 (97)

26 - 60 31 (816)

172 (831)

61-65 2 (53)

15 (72)

Sex

0043

05

Male 30 (789)

129 (623)

Female 8 (211)

78 (377)

Occupation 0041

0086

AgricultureDaily

wagers 22 (579)

82 (396)

Office


48 (232)

Home makers 4 (105)

57 (275)


20 (97)


0463


159 (768)

APLNo ration

card 8 (211)

48 (232)


0334


184 (889)

Lived for at least

6 months 3 (79)

23 (111)


0924


39 (188)


168 (812)

Dampness 0258

0576

Yes 31 (816)

145 (700)

No 7 (184)

62 (300)

Chapter- 5

Discussion

51





Table 51





Bonaigarh


(Bonaigarh)

Prevalence (95 CI)



Prevalence (95 CI)

Wheeze 151 (119 - 189) 22 (14 ndash 33)




exertion

80 (58 - 111) 33 (24 ndash 46)








exposure

93 (68 - 125) 34 (24 ndash 47)


exposure

505 (457 - 553) 32 (23 ndash 45)





52

























53
























54
























55

























56




country

















laborers

51 Strengths

57


investigator



52 Limitations

















References

58



august2014pdf



















50(2) 121ndash126



Available from











59












007084




Medicine 33(4) 229






efamptype=abstract







76 Available from


_Duflo_MITpdf






104(9)


60


17(4) 284ndash296














310004-1254-59-2008-187810004-1254-59-2008-1878xml



410 Available from





















61









ab332422383620389271916000023016555j8j114001164ps

y-


2vSJzM





3D08931724pdf














1118ndash1128










62


study203202html



133Available from


pdf




0096pdf












769 Available from















Available from

63


5503pdf






Foundation









3(1) Available from









296ndash300








204




estimatesen

64

Chapter- 6

Annexures

65

ANNEXURE ndash I

____________________________________________________________________



Trivandrum-11



























66














your locality










consequences




67

DrMalaRamanathan

Member Secretary


(IEC SCTIMST


Office(Ph 0471-25224234 E-



MPH 2016


Science Studies


Mob- 9446780541 7077240541


68

ANNEXURE ndash II

____________________________________________________________________



ID Number______________









in the study

Place

Date


Thank you

69

ANNEXURE ndash III

____________________________________________________________________



Participant ID


Latitude Longitude

Date Time

1 Demographic data


birthday




______________________

99) No replyDon‟t

know

14 Educational

status

1) No

schooling


4)

Graduate


specify

___________

15 Marital

Status




16 No of

family

members




guests or visitors





Bonaigarh


specify

(monthsyears)

______________

70


21 Height (cms)

22 Weight (Kgs)

3 Household Data



kitchen

Doors Windows



done in the house




used as a kitchen

0) No 1)

Yes

If No go to 39 else

36




0) No 1) Yes









house





3) Cover the kiln

with a cover

4) Boil water




from mosquito bite





1) Everyday

2) Occasionally

3) Never

71



318


your house

1) Daily 2)

Occassionaly

3) Never


following animals

1)CowsBulls

Buffaloes

4) GoatsSheeps


3)Horses

DonkeysMules

6) ChickensDucks



to 43


a


specify


in a day


44


1) Chemical

based


3) Plastic

based










3) Never

72

5 Personal habits

Smoking History


53


one month

0) No 1) Yes



0) No 1) Yes If 099 go to 55


month

0) No 1) Yes



57




30 minutes

per day

3) More than 30

minutes per day


exercise


6




30 minutes

per day

3) More than 30

minutes per day



following Illnesses







73






months



of breathlessness

0) No 1) Yes








0) No 1) Yes



12 months

0) No 1) Yes




months


morning

0) No 1) Yes



0) No 1) Yes




0) No 1) Yes

74 Breathing


following

1) I hardly

experience

shortness of

breath

2) I usually

get short of

breath but

always get

well







1) Feel

tightness in

chest

2) Feel

shortness of

breath

74

8Treatment History



0) No 1) Yes


9Observation

91 Main

material of

the floor


1)MudClayEar

th


tPolishe

d wood

5)Carpet


Asphalt

6)Polished

stoneMarbleGranite


c tiles

7)Others Please

specify

4)Stone 4)Cemen

t

92 Main

material of

the roof



MetalGI

6) Roofing shingles

2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

Calamine

Cement

fiber

8) Slate

4) SodMud and

Grass mixture

4) Unburnt brick 4)

Asbestos

sheets

9) Burnt brick

5)

PlasticPolythen

e sheeting

5) Loosely packed

stone

5)RCCR

BCCeme

nt concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unbur

nt brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone

with mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



hatch

4)Cardboar

d

4) Cement

blocks

Sources



Thank you

75

ANNEXURE ndash IV

____________________________________________________________________





76




ଧନୟଫାଦ








77

ANNEXURE ndash V

____________________________________________________________________


ID Number______________




ତାଯଖ

ଧନୟଫାଦ

78

ANNEXURE ndash VI



Latitude Longitude

Accuracy Date Time




13 ଧଭତ


4) ସଖ





2) ରାଥଭକ







5) ନୟ ଦୟାକଯ କହନତ ______________________








1) ଜନମଯ


79




















1) ରତଦନ

2) ଫଫ

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81

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material of

the floor



ed wood

5)Carpet


stoneMarbleGr

anite



92 Main

material of

the roof



2) ThatchPalm

leafReedGrass


3) Mud 3) Raw wood

planksTimber

3)

CalamineCe

ment fiber

8) Slate

4) SodMud and

Grass mixture


sheets

9) Burnt brick

5)

PlasticPolythene

sheeting


Cement

concrete

10) Other specify

93 Main

material of

the exterior

walls



with mud

5)Unburnt

brick

1)Cement

Concrete

5)WoodPlanks

Shingles

2)CanePalm

TrunksBamboo

2)Stone with

mud

6)Raw

wood

Reused

wood

2)Stone with

limeCement

6)GIMetal

Asbestos sheets



atch


blocks



Thank you

Annexure VII

Annexure VII

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prevalence of respiratory symptoms and...

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