Today is World Day for Safety and Health at Work:

Hidden dangers affect health at work

By Carol Aloysius

The ILO celebrates the World Day for Safety and Health at Work on April 28 to promote the prevention of occupational accidents and diseases globally. It is an awareness-raising campaign intended to focus international attention on emerging trends in the field of occupational safety and health and on the magnitude of work-related injuries, diseases and fatalities worldwide.

April 28 is also a day on which the world's trade union movement holds its international Commemoration Day for Dead and injured Workers to honour the memory of victims of occupational accidents and diseases and organise worldwide mobilisations and campaigns on this date.

The celebratoin of the World Day for Safety and Health at Work is an integral part of the Global Strategy on Occupational Safety and Health of the ILO and promotes the creation of a global preventative safety and health culture involving all stakeholders. The Theme for the World Day for Safety and Health at Work in 2013 is:

“The Prevention of Occupational Diseases”

In Sri Lanka with a current labour force of almost an equal number of men and women , with females edging out the male worker slightly, ensuring their safety in their varied work places is a matter the deserves the highest priority by employers, as well as health and Labour authorities.

Injured

The numbers of men and women who have injured themselves from falls, or while doing their routine work has increased despite laws that have been set in place by the International Labour Organisation. Many employers continue to flagrantly flout these laws and continue to exploit their workers especially women in garment factories and those engaged in cottage industries, forcing them to work long hours without proper facilities such as ventilation and non toxic surroundings to ensure that the work place is safe and environmentally friendly for them. Pregnant women often don’t have sufficient breaks in between their work and nursing mothers are not provided with separate nursing rooms within the workplace itself.

Similarly we have young men and women working long hours in front of computers and other high tech gadgets, without any facilities given them to make sure that they have proper ventilation, lighting and seating arrangements.

Recent studies on these different categories of workers have revealed just how badly affected their health has been by these unsafe, unfriendly work environments.

Let’s take a look at our first category of workers: the Garment or factory workers and those in cottage industries, who are largely dominated by women.

As we know, female workers in garment factories play an important role in our country’s economy. Yet how many of them are adequately protected at their work places? A study among female garment workers in Sri Lanka in 2011, showed that garment factory workers are exposed to the physical demands and repetitive nature of industrial work, place them at risk for work-related musculoskeletal disorders. The cross-sectional study conducted on 1,058 female garment factory workers in the Free Trade Zone (FTZ) in Kogalla, found 15.5 percent of workers reporting musculoskeletal symptoms occurring more than three times or lasting a week or greater during the previous 12-month period. The back was the most frequently affected region (57.3 percent), followed by knees (31.7 percent), shoulders (9.1 percent), hand and wrist (7.3 percent), neck (6.7 percent), and forearm and elbow (3.0 percent).

Quality

Most individuals (55.8 to 83.3 percent) reported difficulty maintaining work quality as a result of pain. Nearly all women (more than 90 percent) felt their problems affected their leisure activities and household work, though few reported missing work as a direct consequence of their discomfort. Frequency of musculoskeletal complaints increased monotonically with increasing age.

Higher monthly income, 60 or more months spent working in the industry, and lower educational attainment, all correlated positively with complaints, the study stated.

Repetitive work involving awkward bending as in beedi wrapping has also resulted in lower back pain, while workers in cottage industries where much needed insulated tools, gloves are lacking for those making jewellery out of gold and silver dust for example, are equally at risk.

Then we come to the next category of workers who are primarily young males working in the computer industry, who suffer from a host of musculosskeletal ailments, largely affecting due largely to poor lighting, poor posture and incorrect placing of the computers, they are forced to look at all day...

Nimal aged 29 and his friend Ajith aged 27, are typical examples.

They, along with four others share a common desk on which are rows and rows of computers hooked to T.V.monitors. Leg space is minimal and in some of the computers the switch has to put on by stretching one’s leg to the wall and contorting one’s body to a side. If you are on the short side, you have to crawl under the table to switch it on or get the hep of some good Samaritan.

When Nimal started work he was a healthy young man who played football and attended gym classes each evening. A few months after he started work however he began developing a pain in his arm which spread to his shoulders and then to his neck and spine. Now manages to get through the day with pain killers while he no longer plays football or goes to the because of the constant pain. Ajith his colleague who joined with him has similar complaints and is threatening to quit work and join a less demanding job which will not take such a heavy toll on his health.

Their female colleague Nirmala says she has begun to have migraine attacks and attributes it to bright glare of the TV screen and the poor lighting in the room. Her friend an older woman in her fifties has expressed fears of developing early osteoporosis due to her bad seating position. “The computer table is too high for my chair which does not give me a proper back rest either”, she complains.

Ailment

All of them suffer from a common ailment which has been described as CANS - Complaints of Arms, Neck and Shoulders. This according to medical studies is a rising health hazard in our country. Thousands of young people mostly those working in high tech IT firms across the country, suffer from this complaint. According to statistics in a 2011 study of 2,500 office workers conducted by the Diabetes Research Unit of Clinical Medicine and the Faculty of Medicine, University of Colombo this condition afflicts mostly computer workers whose ages range from 30-38 years. So, what has contributed to this growing complaint? According to the researchers, they included, poor posture, poor lighting, incorrect placing of computers in relation to the user and psychosocial factors.

So serious were these complaints , that many of the victims were forced to be absent from work and to seek medical help.

It was found that 9.3 percent of the workers who had been interviewed, had reported CANS related absenteeism from work, while 15-4 percent reported that CANS had disrupted their normal activities including extra curricular activities.

While vast strides in technology in recent years have helped to improve our quality of life, still many of these advances have also left negative impacts on our health such as the above mentioned musculoskleletal pains referred to which have become a leading cause for adults seeking outdoor patient consultations and general feeling of tiredness. Studies have also shown that some of these health disorders begin in childhood and become more severe with age.

In 2007, a research study on 1,607 schoolchildren concluded that many children experience discomfort due to sub-standard seating arrangements in the classroom.

Other findings include a significant proportion had to turn their necks to see the blackboard, a majority of children perceived discomfort due to mismatched classroom furniture, gross deficiencies with schoolbags in weight, model, ergonomic features and the way the schoolchildren carry them, and children experience several negative effects such as musculoskeletal pain attributable to mismatched ergonomic. Recent studies have shown that sitting long hours in front of computers and TVs can result in backaches and nearsightedness.

It deprives people of much needed exercise. This in turn leads to obesity and overweight. Studies have also shown that constantly listening to loud music or talking for hours on mobile phone can cause hearing problems.

Laws

While Sri Lanka has many clear cut laws including those passed by the International Labour Organisation (ILO) to protect workers against occupational hazards, they still lack proper implementation.

Lack of awareness and training among workers, loose statutory provisions in legislature and inappropriate classification with regard to Personal Protective Equipment (PPE) are collectively responsible for inhibiting the implementation of such safety laws.

Hence until this oversight is addressed, the health of workers both in the formal and informal sectors will continue to be compromised - even after they have retired from work.

Today as we observe World Occupational Safety Day, let’s hope that the real significance of this day will not be lost in publicity stunts by activists, trade unionists and politicians.

Rather let the focus be on the main message of the day: ‘Preventing occupational diseases and making safety in workplaces a reality for the millions of men, women and even children engaged in labour in our country.

Metastasis stem cells in breast cancer patients

Individual cancer cells that break away from the original tumor and circulate through the blood stream are considered responsible for the development of metastases.

These dreaded secondary tumors are the main cause of cancer-related deaths. Circulating tumor cells (CTCs) detectable in a patient's blood are associated with a poorer prognosis.

However, up until now, experimental evidence was lacking as to whether the “stem cell” of metastasis is found among CTCs.

“We were convinced that only very few of the various circulating tumor cells are capable of forming a secondary tumor in a different organ, because many patients do not develop metastases even though they have cancer cells circulating through their blood,” says Prof. Andreas Trumpp, a stem cell expert. Trumpp is head of DKFZ's Division of Stem Cells and Cancer and director of the Heidelberg Institute for Stem Cell Technology and Experimental Medicine (HI-STEM) at DKFZ. “Metastasis is a complex process and cancer cells need to have very specific properties for it.

Our hypothesis was that the characteristics of cancer stem cells, which are resistant to therapy and very mobile, are best suited,” says Trumpp.

Irène Baccelli from Trumpp's team developed a transplantation test for experimental detection of metastasis-initiating cells. In collaboration with Prof. Andreas Schneeweiss along with colleagues, the researchers analysed the blood of more than 350 breast cancer.

Using specific surface molecules, Baccelli isolated circulating tumor cells from the blood and directly transplanted them into the bone marrow of mice with defective immune systems. “Bone marrow is a perfect niche for tumor sells to colonise,” Trumpp said.

After more than one hundred transplantations, metastases actually started forming in the bones, lungs and livers of some of the animals.

This proved that CTCs do contain metastasis stem cells - even though apparently with a low frequency. What characterises these cells? To characterise their molecular properties, the researchers analysed the surface molecules of those CTCs where the cell transplantation had led to metastases.

Metastasis stem cell

In a systematic screening process, Baccelli first isolated cells carrying a typical protein of breast cancer stem cells (CD44) on their surface from the CTCs. This protein helps the cell to settle in bone marrow. Next, the researchers screened this cell population for specific surface markers which help the cells to survive in foreign tissue. These include, for example, a signaling molecule that protects from attacks by the immune system (CD47) and a surface receptor that enhances the cells’ migratory and invasive capabilities (MET).

Using a cell sorter, the researchers were then able to isolate those CTCs which exhibit all three characteristics (CD44, CD47, MET) at once.

Another round of transplantation tests showed that these really were the cells from which the metastases originated. Depending on the patient, cells exhibiting all three surface molecules (“triple-positive” cells) made up between 0.6 and 33 percent of all CTCs. “It is interesting that only cells with the stem cell marker CD44 carry the combination of the other two surface molecules,” said Irène Baccelli.

“It looks like the triple-positive cells are a specialised subtype of breast cancer stem cells circulating in the blood.”

Prognostic biomarkers

Are the triple-positive cells a more precise bio-marker of breast cancer progression than the number of CTCs alone? In a small patient group, the researchers observed that as the disease advances, the number of triple-positive cells increases, but the total number of CTCs does not.

In addition, patients with very high numbers of triple-positive cells had particularly high numbers of metastases and a much poorer prognosis than women in whom only few of these metastasis-inducing cells were detected.

“On the whole, triple-positive cells seem to have a substantially higher biological relevance for disease progression than previously studied CTCs,” Andreas Schneeweiss said. The researchers plan to confirm these new results in a large study.

Andreas Trumpp considers it good news that the two proteins CD47 and MET are the ones characterising metastasis-initiating cells. Therapeutic antibodies targeting CD47 to inhibit its functions are already being developed. A substance inhibiting the activity of the MET receptor has already been approved and shows good effectiveness for treating a certain type of lung cancer. The substance may also help breast cancer patients with detectable metastasis-inducing cells.

“The triple-positive cells we have found turn out to be not only a promising bio-marker of disease progression in breast cancer but also a prospect for potential new therapeutic approaches for treating advanced breast cancer,” said Andreas Trumpp.

- MNT

One soft drink a day increases Type 2 diabetes risk

Western lifestyles blamed as one in 20 UK adults now thought to suffer from the disease

Drinking a can of cola a day increases the risk of developing diabetes by a fifth, according to research.

The largest study of the link between soft-drink consumption and Type 2 diabetes in Europe has found that the sweetened beverages not only cause weight gain, which is associated with a higher rate of diabetes, but also increase the risk of the condition independently.

Almost one in 20 adults in the UK has diabetes, of which 2.6 million are diagnosed and 500,000 are undiagnosed. Rates are rising in this country and around the world, driven by Western lifestyles, and the number of cases is expected to exceed 4 million in the UK by 2025.

Researchers from Imperial College, London, led the study of more than 12,000 people with Type 2 diabetes whose diets were compared with 16,000 controls in nine European countries, including the UK.

The results showed that people who drank one can of sweetened soft drink a day had a 22 per cent increased risk of diabetes.

The risk remained almost as high, at 18 per cent, even after account was taken of how overweight the individuals were and how much they ate.

Sweetened soft drinks contain a lot of calories which contribute to overweight and obesity, which in turn is a cause of diabetes. But the drinks appeared to increase the risk separately from this effect, possibly by triggering insulin resistance, reducing the body's ability to use glucose.

Diet drinks, with artificial sweeteners, did not appear to increase the risk once account was taken of individuals’ weight and calorie intake.

Dr Dora Romaguera, of Imperial College, who led the study published in Diabetologia, said: “There was an association in normal weight individuals, overweight and the obese. Even in normal weight individuals, those who drank a glass of soft drink a day were more likely to develop diabetes.”

No link with diabetes was found for those who drank fruit juice. But the researchers were unable to distinguish between pure unsweetened fruit juice and the sweetened and diluted fruit juices known as nectars, because the data was collected in the 1990s and no distinction was made.

Dr Romaguera said: “The hypothesis for fruit juice is different. We know they naturally contain sugar but fruits are not associated with an increase in diabetes, rather they are protective.

It may be the anti-oxidants they contain that counter the effect of the sugar.”

- The Independent