Role of OT in preventing in-door pollution

    Pollution is greatest threat ever to human life, which needs to be attended to by the community of the Occupational Therapist of our country. We can understand pollution in two types i.e. Indoor and Outdoor. The outdoor pollution get neutralized to an extent that it may be diluted to affect human body but it is not always so. The serious threat is posed by indoor air pollution to which many of the human beings of various ages are exposed to most of their life spans.

     The indoor pollution is generally in homes, schools, offices, picture halls, under one roof markets, shopping malls, hospitals, community centers etc. with this we see that health professionals are thrown a challenge under such circumstances. The individuals who are presenting with environmentally associated symptoms are opt to have been exposed to airborne substances originating not outdoors, but indoors.

     The industrialized nations spend 90% of their time indoors. For children, aged, disabled with chronic diseases, most of the events where such problems occur. Three problems need careful examination of the pollutants as in case of allergies, influenza and common cold. Many effects may be associated with stress, work pressure and seasonal discomforts.

     Some of the noticeable indoor air pollution may be “environmental tobacco smoke and sick building syndrome” need to be brought to notice of public attention and suggestions of connection between respiratory or other symptoms in home or work place of which we need to make the individuals of such places and produce awareness.

     The mild symptoms can be cared for and may be avoided with precautions/ prevention measures for healthy living workplaces.

     The signs and symptoms in infants and children are a typical. A chart can be drawn in form of

 

 

 

 

      Respiratory disorders like rhinitis, nasal congestion, epistaxis, pharyngitis, cough, wheezing worsening asthma, dyspnea, severe lung disease etc. The other disorders are conjuctival irritation, headache or dizziness, lethargy, fatigue, malaise, nausea, vomiting and anorexia, cognitive impairment, personality change, rashes, fever, chills, tachycardia, retinal, hemorrhage, myalgia, hearing loss etc. which are sufficient proof that to prevent such type symptoms, diseases, stresses and strains can be taken care of by Occupational Therapy role many folds.

     Occupational Therapist can investigate by matching the individuals signs and symptoms to those pollutants category for which, the checklist of OT can be somewhat on these lines as under:

1.      When did symptoms occur or complaint made?

2.      Does (I) exist all the time or not?

3.      Are you in the same place when symptoms occur?

4.      Does the problem cease immediately or gradually?

5.      What is your work?

6.      Have you changed your employer or assignments?

7.      Has employer changed location of your work or not?

8.      Has placed been redecorated or refurnished?

9.      Have you started working with new or different materials?

10.  What is the smoking policy at your work place?

11.  Are you exposed to environmental tobacco smoke at work, school, home etc.?

12.  Describe your work area.

13.  Have you recently changed your place of residence?

14.  Have made any changes recently in your home, office etc. or additions?

15.  Have you recently acquired a new pet?

16.  Does anyone else in your home have similar problems? Or anyone with whom you work? (if yes it may be common source or a communicable disease).

     In addition to above Occupational Therapist can play a vital role in prevention of indoor air pollution by addressing to above questions.

            Environmental Tobacco Smoke is major source of indoor air containment. ETS in indoor air environment indicate that some unintentional inhalation of ETS by non-smokers in unavoidable. ETS is a dynamic, complex mixture of more than 4000 chemicals found in both vapors and particle phases. Many chemicals out of these are carcinogenic substances, which will occur in indoor space where there is smoking. This warrants a major attention of OT’s to make public awareness of these facts to prevent such health threats in masses.

            The remedial action by Occupational Therapist can be:

a)      Improve general ventilation in indoor spaces in the above listed places.

b)      Whenever generally accepted ventilation methods fail, there by word of mouth through camps and public education, the intentions are achieved.

c)      In the instances of complex gaseous mixtures and particulate components- the general ventilation measures do not work. Provide separately designed smoking rooms for the smokers for the purpose if very essential.

d)      Use of higher efficiency air cleaning systems, under some select conditions can be installed.

e)      Air cleaners (Desktop model) of the same may not be effective. Even some are designed but are not effective to remove dangerous gases.

f)        Tobacco control is a must and it is essential to invest more time in eradication through campaigns of educating public on health hazards of these consumables to human life.

g)    Most effected are children and their lungs are more vulnerable due to poor body resistant build in system.

        REMEDIAL ACTION BY O.T.'s

        i.      Provide adequate outdoor air ventilation to dilute human source aerosols.  

             ii.      Keep equipment water reservoirs clean and potable water systems adequately chlorinated as per manufacturers                instructions.

            iii.      See that there is no stagnant water in air conditioners.

           iv.      Repair leaks and seepages.

             v.      Thoroughly clean and dry water damaged carpets, any building materials within 24 hours of damage or remove or replace.

           vi.      Keep relative humidity below 50%

          vii.      Use exhaust fans in bathrooms, kitchen and vent clothes dryers to outside.

        viii.      Control exposure to pets.

           ix.      Use vacuum cleaners for carpets and upholstery of furniture.

             x.      Keep area dust free as much as possible.

           xi.      Cleaning re-suspends fine particles during and immediately after the activity.

          xii.      Sensitive individuals to be cautioned of dusty/polluted environments etc.

        xiii.      Use commercially available HEPA (High Efficiency Particulate Air) filtered vacuum.

        xiv.      Cover mattresses.

     xv.   Wash bedding and soft toys frequently in water at a temperature above 130 F to kill dust mites.

   Biological air pollutants are found in every home, school and workplace. Sources are outdoor aid of human occupants who shed viruses and bacteria, animals occupants i.e. insects and other arthropods, mammals etc. that shed allergens and indoor surfaces and water reservoirs where fungi and bacteria grow such as humidifiers are important to be taken cognizance of. Factors, which allow biological agents to go release into air, are:

a)      High humidity increases dust mite population in house in damp places so avoid it.

b)      Mite and fungus contamination by flooding, damp carpets on poor damp flooring- so avoid it.

c)      Mechanical heating, ventilating and air conditioning systems may cause to serve as reservoirs of microbial amplifications so may be avoided. 

The biological agents in indoor air cause three types of human disease: -

o       Injections where pathogens invade human tissue.

o       Hypersensitivity diseases causing specific activation of the immune system causes disease.

o       Toxicosis where biologically produced chemical toxin cause direct toxic effects.

o       Biological contaminations i.e. dampness of water damage are related to non specific upper and lower respiratory symptoms, sick building syndrome is related to microbial contamination in buildings as discussed earlier. 

Occupational therapists are the community contact persons directly and hence are most apt to perform preventive education role to masses on the hazards and management ways of the indoor air contamination pollution.

Author thanks the director, PDUIPH New Delhi and AIOTA conference organizers to give an opportunity to express views before the delegates on the theme of the conference.

 

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