DOI: 10.5958/j.2319-5886.2.2.

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International Journal of Medical Research & Health Sciences

www.ijmrhs.com
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Volume 2 Issue 2 April - June

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Coden: IJMRHS

Copyright @2013

ISSN: 2319-5886
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Received: 8 Feb 2013 Research article

Revised: 4 Mar 2013

Accepted:8

Mar 2013

A STUDY ON HEALTH HAZARDS IN DRY CHILI MARKET WORKERS IN THE AGE GROUP OF 16 TO 55 YEARS OLD Avinash P Tekade1, Gullapalli HS 2, *Namrata H Gullapalli3
1

Associate Professor, Department of Physiology, Katuri Medical College and Hospital, Guntur, Andhra Pradesh. 2 Associate Professor, Department of Physiology, Vinayaka Missions Medical College and Hospital, Karaikal, Puducherry. 3 Dietitian and nutritionist, Vinayaka Missions Medical College and Hospital, Karaikal, Puducherry. *Corresponding author email: hgullapalli2000@gmail.com
ABSTRACT

Background: The workers who are involved in the handling dry chili face some occupational hazards. In this industry there is always danger of polluting the environment with very small irritating particle. Inhalation of this fine particulate matter is responsible for the various respiratory symptoms which include chronic obstructive disease (COPD) and allergic rhinitis and associated ocular symptoms like itchy eye, red eye and conjunctivitis. Exposure of this fine chili particle is associated with the skin problems like burning sensation, irritation and dermatitis. Methods and material: This is the casecontrol observation study in which 378 male workers who are involved in handling the chili powder were selected after they meet the inclusion and exclusion criteria. 203 control subjects are selected who are not associated with the chili market at all. Detail history taking and physical examination done all study and control subjects to see for the respiratory, eye and skin problem. The symptoms are compared between the study and control subjects. Results: The incidence of the respiratory, eye and skin related problems are significantly at a higher level than the control subjects. Conclusion: The worker in the dry chili market significantly facing the health hazards due to the exposure of the finest chili powder which can be prevented with the some measures such as using face masks, socks and cotton shirts and pants which will prevent the contact of the body with the fine irritating particles. Keywords: Chili powder, COPD, Dermatitis, Itchy eye
INTRODUCTION

Guntur the biggest chili market in Asia, India is one of the leading producers of fresh and dry chili along with China it is accounting for around 50% of the world total production of chili market. These chilies producing giants are also

the biggest consumers of fresh chilies, and consume over 90% of their own production4. Chili crop has the potential to create more jobs than rotational crops (such as paddy rice) and

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alternative crops (such as cucumber, watermelon etc.) owing to a higher requirement for intensive care throughout the crop life mainly due to chilis higher vulnerability to diseases. The worrying matter for the dry chili market workers is that they are continuously exposed to irritating fine particles (e.g. smokers, industrial workers concerned with fine particles, chili workers). They show the symptoms of cough, expectoration, sore throat, etc. In the chili market the workers who are exposed continuously to the irritating chili particles and they usually show the classical symptoms of COPD as cough, sputum expectoration, exertional dyspnea (increased efforts to breathing, Heaviness, air hunger, or gasping)1. Various documented studies indicate the chronic inhalation of the fine particle matter will increase the incidence of the COPD or exacerbate the symptoms of existing COPD5, 6. In chili markets workers due to the irritating chili products particles the problem of allergic rhinitis is more common, which is characterized by sneezing, rhinorrhea, obstruction of nasal passages; conjunctival, nasal, and pharyngeal itching and lacrimation. 40% of rhinitis patient manifest with asthma. Rhinitis patient nasal mucosa is pale and boggy. The conjunctival congestion and edematous swelling of the turbinates and mucous membrane with obstruction of the sinus ostia and eustachian tubes precipitates secondary infection of the sinuses and middle ear respectively.2 Nasal polyps representing mucosal protrusions containing edema fluid with variable numbers of eosinophils can increase obstructive symptoms and can concurrently arise within the nasopharynx or sinuses2.
METHODS AND MATERIALS

This study is performed in the Department of Physiology, Katuri Medical College and Hospital after getting the clearance certificate for the study from the Institutional Ethical Committee. The subjects are selected from the Guntur Chili Yard which is the biggest in Asia. The selected

study subjects should have been facing the dry chili exposure at least since last 7 years continuously. The methods adopted for the present study are consent taking, history taking, general & systemic examination. Then the complete history is obtained regarding their work and physical examination is carried out. For the study subjects exclusion criteria and inclusion criteria applied. The subjects who met the inclusion and exclusion criteria given below, such 378 male workers selected were included in this study. Inclusion criteria: In the Age group of 16- 55 year Exclusion criteria: 1. Below 16 years and above 55 years 2. Congenital abnormality 3. Any chronic illness To find the risk at which the study subjects are exposed compared to non exposed subjects, we have taken the control group (n = 203) which is not related to chili market works anyway. All the participants were informed about the purpose of studying nature, and informed consent has been obtained. Observation: The workers in the dry chili markets are mostly males. In the process of this study we found that there are certain conditions which are more prevalent in the workers of the dry chili market are following:Respiratory problems: 1. Dry Cough with wheeze or without wheeze 2. Cough with expectoration 3. Exertional dyspnea 4. Sore throats 5. Nasal irritation 6. Nasal polyp Eye problems: 1. Burning sensation in the eyes 2. Increased tear flow 3. Conjunctivitis Skin Problems: 1. Burning sensation 2. Irritation 3. Dermatitis These problems are significantly higher in the dry chili market workers than control groups; obviously the reason is continuous exposure to the dry chili and its products.

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RESULTS AND DISCUSSION

Table 1: Concise table showing Prevalence of Respiratory, Eye and Skin Problem among workers Age in years Respiratory problems 119(31.48%) 18 (8.86%) Eye problems 91 (24.07%) 11 (5.41%) Skin problems 64 (16.93%) 6 (2.95%)

Group Worker group (N=378)

16-55 Control group (N=203)

The Respiratory problem in the control group it is 8.86%, in chili market workers is 31.48% which is significantly higher. (Chi sq = 37.46, df= 1, p < 0.001). The Eye problem in the control group is 5.41% and in chili market workers is 24.07% which is significantly higher. (Chi sq = 56.13, df= 1, p < 0.001) The Skin problem in the control group it is 2.95%, in chili market workers is 16.93% which is significantly higher. (Chi sq = 24.32, df= 1, p < 0.001 It shows the there is a significant increase in the respiratory, skin and eye related problems. There is an increase in the respiratory problems such as cough arising due to the handling of the chili powder is also supported by some other studies18. The origin of any respiratory problem can be traced to the effect of the fine particulate matter in the development of the COPD. An important defense mechanism against inhaled particles in the airways is the mucociliary escalator. Mucus has a major role in protecting the airways, particularly as it is a rich source of antioxidants7. In the large proximal airways, goblet cells secrete mucus, which traps deposited particles and is then propelled upwards by ciliated cells to be either expectorated or swallowed. Although mucus may in some circumstances have a protective role, induction of increased mucus secretion by irritating particle or the particulate matter8 may contribute to the development of exacerbations of COPD, by increasing airway resistance and by the development of mucus plugging in the smaller

peripheral airways9. Macrophages present in the airway walls and on the surfaces of the airways can phagocytose particles, but may, as a result, release inflammatory mediators such as IL-8 and tumor necrosis factor (TNF). In COPD, numbers of macrophages are increased9; consequently, the levels of inflammatory mediators are elevated in sputum10. The additional insult of an inhaled irritant particle could clearly aggravate the background inflammation in COPD leading to exacerbations. These mechanisms due to the inhalation of the fine particulate matter arising due to the chili handling are involved in the aggravating the respiratory disease symptoms mainly COPD. The incidence upper respiratory tract disease such as allergic rhinitis also increases. The exposure of fine chili particles causes the production of the immunoglobulin (Ig) -E is the proximate cause of perennial allergic rhinitis. Circulating IgE antibodies bind to the high affinity IgE receptor on mast cells and basophils. IgE antibodies, bound to the receptors cross linked by an allergen, initiate the secretion of inflammatory mediators including histamine, leukotrienes, and cytokines. These mediators can induce both acute and chronic changes that result in symptoms of allergy sneezing, rhinorrhea, obstruction of nasal passages; conjunctival, nasal, and pharyngeal itching and lacrimation11. The allergic rhinitis is the cause of troublesome ocular symptoms like itching eyes, watery eyes, red eyes and swollen eyelids12. Apart from these problems there is increased incidence of the skin related problem like the irritant contact dermatitis can be attributed to the presence of the
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capsaicin in the chili. Capsaicin, the active principle of hot peppers of the genus Capsicum, exhibits broad bioactivity. It targets neuronal structures which contain substance P, clinically seen as gastrointestinal and dermatologic irritation, bronchospasm and fibrinolysis13. When the sensitive skin comes repeatedly in contact with the chili powder, capsaicin depolarizes nerves leading to vasodilatation, smooth muscle stimulation, glandular secretions, and sensory nerve activation. Because the nerves, and not the skin itself, are affected, dose-related cutaneous burning pain, irritation, and erythema, but not blistering ensue14. The pain has been described as a dull ache, like sunburn, or like an intense, radiating heat, throbbing and prickling. These symptoms are often delayed and may last hours to days15. This problem, known as Hunan Hand Syndrome16,17. Hunan hand syndrome, managed successfully by using a multimodal approach comprised of a continuous stellate ganglion block, gabapentin, local ice water, and fluocinonide application19. The problems arising due to the handling of chili powder can be prevented by following ways. Simple preventive technique can alleviate these health hazards to the workers. 1.To prevent the respiratory system related problems the use of a face mask which will cover the mouth and nose completely and effectively so that the entry of the fine particulate matter in the respiratory tract can be prevented. In effect this will prevent the problems arising due to the inhalation of the fine particles on the respiratory tract. 2. Prevention of the Eye related problems use of the goggles which will cover the eyes completely and effectively should be promoted. This will prevent entry of the fine particulate matter in the eye which can effectively prevent the eye related problems arising due to the handling of chili in the market. 3. For the prevention of the skin related problems we have to take into account the

atmospheric condition of the Andhra Pradesh which quite on the hot side, so these workers should use the thick cotton shirts, pants, socks and shoes which will cover the body completely and effectively. Aim behind using such clothing is to prevent the contact of the fine particulate matter in the chili market with the skin so that eventually it will prevent the skin related problems. 4. Personal cleanliness While using the face mask, goggles, thick cotton shirts, pants, socks and shoes precaution should be taken that these should not be shared among the workers, which might lead to the spread of communicable diseases.
CONCLUSION

Chili market workers are suffering from the health hazards like respiratory, eye and skin related problems which can be prevented by the use of some simple preventive techniques.
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