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Prevention of respiratory problems among traffic police: A cross sectional study in Kathmandu valley exploring knowledge and practice

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Abstract

Background: Air pollution is high in Kathmandu valley due to heavy traffic and ongoing road constructions. The objective of the study was to identify the knowledge and practice regarding prevention of respiratory problems among traffic police. Methods: A descriptive cross sectional study was conducted in Kathmandu valley. The areas have been selected on the basis of traffic pollution and participants were selected by random sampling technique. The sample size of study was 166. Data was collected by using self administered questionnaire and analyzed using SPSS. Results: Among the participants, more than half (53%) were from age group of 20-29 years and 40.4% were from age group of 30-39 years. Regarding the respiratory problems, more than four fifth (85.5%) responded difficulty in breathing as a type of respiratory problem. Similarly, 89.2% participant had not offered any protective device by the government and 71.5% had used protective devices during their duty hour. Majority (72.2%) of participants were only using mask as a protective device. Nearly one fourth (19.3%) had adequate knowledge and very few (4.8%) had adequate level of practice on preventing respiratory problems. Conclusion: It can be concluded that one fourth participant traffic polices had knowledge but very few were practicing the preventive measures for respiratory problems. It is recommended to conduct awareness campaign to the traffic police and advocate the government to provide the protective measures.
© 2018. Al Ameen Charitable Fund Trust, Bangalore
142
A l Am een J Me d S c i 2 0 1 8 ; 1 1 ( 3 ) : 1 4 2 - 1 4 6 US National Library of Medicine enlisted journal IS SN 0 9 7 4 - 1 1 4 3
O RIGINAL AR TI CL E
C O D E N : A A J MB G
Prevention of respiratory problems among traffic police: A cross
sectional study in Kathmandu valley exploring knowledge and
practice
Kshitij Karki
1,3*
, Sushmita K.C.
2
and Shrijana Neupane
1
1
Department of Public Health, Asian College for Advance Studies, Lalitpur, Nepal,
2
Department of
Home Sciences, Padma Kanya Multiple Campus, Kathmandu, Nepal and
3
Group for Technical
Assistance, Lalitpur, Nepal
Abstract: Background: Air pollution is high in Kathmandu valley due to heavy traffic and ongoing road
constructions. The objective of the study was to identify the knowledge and practice regarding prevention of
respiratory problems among traffic police. Methods: A descriptive cross sectional study was conducted in
Kathmandu valley. The areas have been selected on the basis of traffic pollution and participants were selected
by random sampling technique. The sample size of study was 166. Data was collected by using self
administered questionnaire and analyzed using SPSS. Results: Among the participants, more than half (53%)
were from age group of 20-29 years and 40.4% were from age group of 30-39 years. Regarding the respiratory
problems, more than four fifth (85.5%) responded difficulty in breathing as a type of respiratory problem.
Similarly, 89.2% participant had not offered any protective device by the government and 71.5% had used
protective devices during their duty hour. Majority (72.2%) of participants were only using mask as a protective
device. Nearly one fourth (19.3%) had adequate knowledge and very few (4.8%) had adequate level of practice
on preventing respiratory problems. Conclusion: It can be concluded that one fourth participant traffic polices
had knowledge but very few were practicing the preventive measures for respiratory problems. It is
recommended to conduct awareness campaign to the traffic police and advocate the government to provide the
protective measures.
Keywords: Knowledge, practice, prevention, respiratory problems, traffic police.
Introduction
Vehicles, household combustion devices,
industries and fires are major sources of air
pollution. Common pollutants from transportation
sector that causes public health problems include
particulate matter (PM), ozone, carbon monoxide,
sulfur dioxide and nitrogen dioxide. Indoor and
outdoor pollution causes respiratory and other
fatal diseases [1-2]. Scientific evidence also
associates PM to harmful respiratory effects,
including asthma [3].
In the U.S., air pollution causes deaths of 50,000
people per year and costs about $40 billion per
year in health care and lost productivity [4].
About 30% of particulate emissions (PM) in
European cities were due to road transports and
up to 50% of particulate matters emissions in
OECD countries were due to diesel traffic. Under
developed and developing countries particularly
in Asia, Africa and the Middle East suffer
disproportionately from transport-generated
pollution [5-6]. In developing countries,
polluted air is a major health hazard. Current
pollution monitoring methods can detect
significant increases in the incidence of
respiratory diseases and cardiopulmonary,
bronchitis, coughing, and lung cancer.
Premature deaths had occurred from these
diseases resulting from high concentrations of
particulate matters [5, 7].
Since traffic polices are continuously exposed
to heavy noise, vehicular emissions and
polluted environment, they face multiple
occupational hazards. Multiple studies have
concluded that traffic police are highly
stressed. Occupational health studies help us
to provide opportunity for defined exposures
measurements and precise risk assessment [8].
A study among 235 traffic police in India
showed that 31% had reduced lung function
and 20% had some form of respiratory system
Al Ameen J Med Sci; Volume 11, No.3, 2018 Karki K et al
© 2018. Al Ameen Charitable Fund Trust, Bangalore 143
problems [9-10]. According to the Metropolitan
Traffic Police office in Kathmandu, as many as
50 traffic police personnel fall ill daily due to
hazardous dust [11]. Thus, traffic police are
highly exposed to air pollution during their
working period and prone to respiratory illness.
The study was purposed to identify the
knowledge and practice regarding prevention of
respiratory problem among traffic police. So, this
research is being helpful to plan the awareness
campaign and provision of personal protective
measures.
Material and Methods
The cross sectional descriptive study design was
applied to conduct the research in Kathmandu
valley. Study population was traffic police
working in different metropolitan traffic police
division of Kathmandu valley. The sample size
for the study was 166 considering the total 1349
traffic police in Kathmandu valley, calculated
with seven percent error. The sample was
selected randomly from two highly polluted areas
of Kathmandu valley. Data was collected using
pretested self-administered questionnaire
translated in local language. Traffic police who
was present in the time of data collection and
willing to participate were included.
Ethical approval was taken from research
committee of Asian College for Advance Studies.
Written permission was taken from metropolitan
traffic police division and verbal consent was
taken from each participant before data
collection. Data analysis was done through the
SPSS Software (20 version). The data was
interpreted by using frequency, percentage and
measuring level of knowledge and practice.
Knowledge and practice level were categorised
into three level such as below average (<50%),
average (50-69%) and above average (70% and
above)by adding all the respective questionnaires.
Results
Among the total 166 participants, more than half
(53%) were of age group 20-29 years, followed
by 30-39 years (40.4%) and remaining were
above 40 years (Table 1). Out of total participant,
majority (76.5%) were male and married (72.9%),
and only 14 percent had education level of above
bachelor degree. Likewise, one fourth (25.3%)
had worked less than five years and very few had
worked for above 10 years during the study
period. About a half participants (49.4%) had
a duty hour of 14 hours followed by 16.9%
had 18 hours, 15.1% had of 16 hours, 13.9%
had of 12 hours, 3.6% had of 15 hours, 0.6%
had of 10 hours and 0.65 had of 8 hours.
Table-1: Distribution of participants by age group
Age group Frequency Percentage
<19 3 1.8
20-29 88 53.0
30-39 67 40.4
40-49 8 4.8
Total 166 100
Almost all (97.6%) had not attended the
conference or training related to the
prevention of air pollution and diseases.
Table-2: Knowledge on source of air pollution
Sources Frequency Percentage
Motor vehicles 122 73.5
Industrial smoke 114 68.7
Road construction 96 57.8
Toxic gases 82 49.4
*Multiple responses
Among 166 traffic polices, three quarters of
participants (73.5%) said that motor vehicles
are the source of air pollution followed by
industrial smoke (68.7%), road construction
(57.8%) and toxic gases (49.4%) (Table-2).
Majority of traffic police responded that peak
time for air pollution is office time (9 to 11
am) and very less (5.4%) told evening (6 to 10
pm).
Table-3: Knowledge on the type of respiratory
problem caused by air pollution
Respiratory
problem* Frequency
Percentage
Pneumonia 150 90.4
Bronchial asthma 127 76.5
Lung cancer 101 60.8
Don't know 10 6.0
*Multiple responses
Al Ameen J Med Sci; Volume 11, No.3, 2018 Karki K et al
© 2018. Al Ameen Charitable Fund Trust, Bangalore 144
Majority of the participants (90.4%) responded
that air pollution causes pneumonia followed by
bronchial asthma (76.5%) and lung cancer
(60.8%) while about six percent did not know
about respiratory problems (Table 3).
Over a half of participants (57.8%) knew the
preventive measures for respiratory problem
whereas 42.2 percent didn’t know. All traffic
police participants did not know about N95 mask.
About one fifth (18.7%) participants were
suffering from any of the respiratory problems.
Table-4: Respiratory diseases among
participants
Respiratory diseases Frequency Percentage
Common cold 14 45.2
Throat allergy 11 35.5
Cough and chest pain 4 12.8
Tonsillitis 2 6.5
Total 31 100
Almost half (45.2%) were suffered from common
cold followed by throat allergy (35.5%), cough
and chest pain (12.9%) and tonsillitis (6.5%)
(Table 4). More than two third of the participants
(74.2%) had treated at home during illness and
very few went to hospital.
Nearly half of the participants (48.1%) were
using mask, gloves, boot, jacket and goggles in
duty. Likewise, one third of the participants
(33.5%) had used mask and 15.2 percent had used
mask and gloves and rest of the participants used
mask, gloves, jacket and boot (Table 5). Majority
of participants (89.2%) had not received any
protective device while 10.8 percent were
offered from the government. Similarly, three
quarters of participants (71.5%) wore
protective device everyday in duty, and others
in heavy pollution and if desire.
Table-5: Protective device used by
participants
Type of protective
device Frequency %
Mask, gloves, boot,
jacket, goggles 76 48.1
Mask 53 33.5
Mask, gloves 24 15.2
Mask, gloves, jacket 3 1.9
Mask, boot 2 1.3
Total 158 100
Table-6: Preventive measures followed by
participants
Preventive measures*
Frequency
%
Wearing mask during work 143 86.1
Avoid smoking 80 48.2
Regular health check up 59 35.5
*Multiple responses
More than half of the participants (86.1%) had
used mask while working in polluted area,
48.2 percent avoided smoking and 35.5
percent performed regular health check up
(Table 6).
Table-7: Level of knowledge and practice of participant
Knowledge Practice
Levels
Frequency Percentage Frequency Percentage
Below average (<50%) 44 26.5 128 77.1
Average (50%-69%) 90 54.2 30 18.1
Above average (70% and more) 32 19.3 8 4.8
Total 166 100 166 100
Out of total participants, majority (54.2%) had
average level of knowledge on respiratory
problem, 26.5 percent had below average level of
knowledge and 19.3 percent expressed above
average level of knowledge. Likewise, more than
two third (77.1%) had below average practice
level in prevention of respiratory problems,
18.1 percent had average level of practice and
4.8 percent had above average level of
practice (Table 7).
Al Ameen J Med Sci; Volume 11, No.3, 2018 Karki K et al
© 2018. Al Ameen Charitable Fund Trust, Bangalore 145
Discussion
This research showed that participants were
suffering from various respiratory problems. 45.2
percent participants were suffered from common
cold followed by 35.5 percent had throat allergy,
12.9 percent had cough and 6.5 percent had
tonsillitis. Similar study conducted in Patiala,
India showed 68 percent had frequent cough, 22
percent had shortness of breath and 36 percent
had irritation in respiratory tract [12]. The present
study showed that the traffic police had
knowledge regarding the negative effects of air
pollution on their health. They had knowledge
that air pollution can cause difficulty in breathing,
lung cancer, common cold, pneumonia. Studies
conducted in India have also found that there is
increased risk of getting different respiratory
problems when traffic police are exposed to
polluted air for a longer time [13]. A study in
Thailand showed that 74.4 percent traffic police
had not been trained which is similar to this
research [14].
Level of knowledge regarding the prevention of
respiratory problems among the traffic police was
comparatively higher than the level of practice.
Similar results were obtained in a study done in
Kathmandu, level of knowledge was found to be
average 41 percent, while the level of practice
was below average 88 percent [15]. Research
finding reveals that 19.3 percent explicated
above average knowledge on respiratory
problem but in practice, finding reveals that
only 4.8 percent of participant had above
average practice on prevention of respiratory
diseases caused by air pollution.
Conclusion
Traffic Police are prone to health problems
due to their working nature including various
other factors. They stayed at the polluted
streets bravely, standing for hours on end and
ignorant of health hazards. From the findings,
we could conclude that the level of practice on
preventive measures for respiratory problems
were very less than the level of knowledge. It
is recommended to conduct training and
regular awareness program for traffic polices
regarding prevention of respiratory problem
related to air pollution. Similarly, provision of
protective measures for traffic polices should
be made.
Acknowledgement
We would like to thank all the participant traffic
polices and appreciate for the technical guidance
from experts of Asian College for Advance
Studies. We appreciate those who supported to
complete this research.
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Cite this article as: Karki K, Sushmita KC and
Neupane S. Prevention of respiratory problems among
traffic police: A cross sectional study in Kathmandu
valley exploring knowledge and practice. Al Ameen J
Med Sci 2018; 11(3):142-146.
*All correspondences to: Mr. Kshitij Karki, Associate Professor, Department of Public Health, Asian College for Advance Studies,
Lalitpur, Nepal. E-mail: kshitijkarki@yahoo.com
... It clearly shows that traffic police who had adequate level of awareness also had adequate level of practice (Table 7). bronchial asthma (76.5%) and lung cancer (60.8%) as effects of air pollution on respiratory system while about 6.0% did not know about respiratory problems [13]. Similarly, studies carried out in India have also reported that there is increased risk of getting different respiratory problems when traffic police are exposed to polluted air for a longer time [14,15]. ...
... This difference might be due to difference in study period, population and sample size. In present study, 57.8% traffic police had knowledge about need to do regular health checkups to prevent respiratory problems caused by outdoor air pollution which is similar as findings of the another study done in Kathmandu [13]. respectively. ...
... by Karki, K.C. and Neupane where (54.2%) had average, 26.5% had below average and 19.3% above average level of knowledge on the respiratory problem. Likewise, 77.1% had below average, 18.1% had average and 4.8% had above average practice level in the prevention of respiratory problems[13].Present study did not find any significant association between level of awareness and age, gender, education level, designation, work experience, and participation in seminars/conference. This finding is contradicted to the study of Kathmandu reported a significant association between level of education and level of awareness[16]. ...
... [20][21][22] At this point, all respondents completed a questionnaire primarily regarding self-information, occupational data, knowledge of air quality, health effects of bad air exposure and measures taken to prevent bad air exposure. This part of the questionnaire, adapted from Karki et al., 23 was translated into Bahasa Malaysia. ...
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Objectives Designs for low-cost air monitors and associated performance data appear in many peer-reviewed articles; however, few manuscripts provide feedback from end user's experiences or comprehensive evaluation. The present study addresses the usability of the wireless outdoor individual exposure indicator system from the viewpoint of the Malaysian Traffic Police (end users). This study is one of the first to chronicle end user experiences for low-cost pollution sensing. Method The evaluation involved 12 target end users to assess the usability of a prototype for Malaysian Traffic Police to manage their exposure to outdoor air pollution. The test evaluation includes a pre-test, post-task and post-test questionnaire (Post-Study System Usability Questionnaire). The main components in this Post-Study System Usability Questionnaire are Overall satisfaction, System Usefulness, Information Quality and Interface Quality. Findings The results of the Post-Study System Usability Questionnaire indicated the mean score of the Overall satisfaction item (2.33), System Usefulness (2.25), Information Quality (2.36) and Interface Quality (2.17) on a scale of 1–10. Prototype users were satisfied with the system because the score is close to 1 on the Post-Study System Usability Questionnaire. Conclusions A user-friendly wireless outdoor individual exposure indicator system is now available for Malaysian Traffic Police. Users have stated that they are happy to use the system at work. However, in addition to more technological advances, practical implementation requires evidence supporting its efficacy, viability and effectiveness.
... In this test, the respondents were required to complete the questionnaire mainly on self-information, occupational information, knowledge of air quality, health effects from exposure to bad air, and actions taken to prevent exposure to bad air. These parts of the questionnaire are adopted from [39] which has been translated to Malaysian Language. 3. Post-task questionnaire (Task scenarios) Next, the respondents were asked to install the application of this system on their smartphones and are required to follow the instructions given by the examiner according to the scenarios. ...
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Abstract. The respiratory health of Malaysian Traffic Police has been compromised by working in heavy traffic and congested junctions with bad air for long hours. A wireless outdoor individual exposure device is vital to track their exposure, however, the efficacy of the system remains uncertain. While existing techniques exist to examine the efficacy of such system, there is a lack of methodology for engaging multiple assessment methods to evaluate the degree of user experience. This paper aims to propose a methodological framework tool for a quantitative evaluation of the wireless outdoor individual exposure indicator system prototype. A systematic search was conducted in major electronic databases (MEDLINE, Web of Science, Google), grey literature sources and all relevant data in the field. A three-stage framework consisting of simulation real-time monitoring, in-field testing, and usability testing is assembled. The three stage framework proposed serves as a generic approach for evaluating the prototype with the purpose of tracking individual outdoor exposure. The method is capable of describing the complete evaluation process, from the accuracy and performance of the sensor to the extent of the end-user experience. Using the three-stage approach, future researchers may be able to create a monitoring system that is relevant to their needs.
... A similar study on respiratory morbidities and pulmonary functions among traffic policemen in Bengaluru [5] was conducted in 2019 which revealed allergic rhinitis in 17.5% and 12.9% suffered from chest symptoms including cough, wheeze and chest tightness. Another study conducted in Kathmandu, that aimed to identify the knowledge and practice regarding prevention of respiratory problems among traffic police [4] showed results where 45.2% officers suffered from common cold and 12.9% suffered from cough and chest pain. This study also reveals that traffic police personnel's are well aware about the hazards that they are at risk for due to their occupation. ...
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Introduction. Traffic police in Kathmandu are continuously exposed to air pollution and are at an increased health risk. This study aimed to assess the knowledge and practice regarding prevention of respiratory problems among traffic police in Kathmandu. Methods. A descriptive exploratory study was conducted among the traffic police ( n = 83 ) working in six areas of the Kathmandu Metropolis from July to August 2013. Self-administered questionnaires were distributed to all the participants. Results. The mean age (±SD) of the respondents was 28.8 ± 4.3 years. More than half of the respondents had 6–10 years of work experience, the mean (±SD) years of experience being 7.9 (±3.6). The level of knowledge regarding the prevention of respiratory problems was better than the level of practice among the respondents. Education of the participants did not affect the level of practice of the respondents while there was association between working experience and level of practice ( p = 0.04 ). Conclusion. Since the preventive practice is poor, the government should come up with plans such as distribution of antipollution masks to improve the level of practice among traffic police to prevent respiratory problems.
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Air pollution due to road traffic is a serious health hazard and thus the persons who are continuously exposed, may be at an increased risk. Although several studies have confirmed the ill effects of air pollutants on the lung function of traffic policemen, only a few have investigated the relationship between respiratory health and duration of exposure in this category of occupationally exposed persons. The study was carried out with the aim of evaluating the extent of impairment in lung function in traffic policemen in respect to an unexposed control group having the same age group. A cross-sectional study was conducted in which the spirometric parameters of a group of 100 nonsmoking traffic policemen, aged 20-55 years, working in and around Patiala city, were compared with those obtained in an age-matched control group, consisting of 100 healthy males, serving in the Punjab Police, who have never done traffic duty and are thus not exposed to traffic pollution. Lung function was done with MEDSPIROR. The data on the overall health status of the subjects was collected using the standard Respirator Medical Evaluation Questionnaire. The statistical analysis was carried out with SPSS PC software version 13. Traffic policemen recorded a significant decline in various parameters, such as forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), and peak expiratory flow rate (PEFR) when compared with controls, and is probably due to exposure to vehicular pollution. It was also observed that in traffic policemen with >8 years of exposure, the values of FVC (2.7 L), FEV(1) (1.8 L), and PEFR (7.5 L/s) were significantly lower than those obtained in traffic policemen with <8 years of exposure, in whom the values were 2.9 L, 2.3 L, and 7.7 L/s for FVC, FEV(1), and PEFR, respectively. The effect of pollution by vehicular exhausts may be responsible for these pulmonary function impairments.
Air quality crisis in cities is mainly due to vehicular emissions. Owing to the expanding economic base Indian cities are growing at a faster rate. Transportation systems are increasing everywhere and the improved technology is insufficient to counteract growth. The effect of vehicular emission on urban air quality and human health has been described. A survey has been conducted in an Indian mega city to evaluate the status of air pollution at traffic intersections and the unique problem arising out of vehicular emissions in the study area has been narrated. Approach for the selection of the air monitoring stations, methodology adopted for data collection and the results have been discussed. Vulnerability analysis (VA) has been carried out to identify the zones at what pollution stress. Options for reducing mobile source emission have been discussed and a strategic air quality management plan has been proposed to mitigate the air pollution in the city.
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