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1 RESPIRATORY MORBIDITY AMONG WOMEN AND CHILDREN BIDI BINDERS OF BLOCK I AND BLOCK II OF DISTRICT BANKURA, WEST BENGAL, INDIA By Dr. Jayati Das, Associate Professor, Shri Shikshayatan College,Kolkata Dr. Saibal Moitra, Allergy And Asthma Research Centre, Kolkata Miss. Manisha Bhor, Research Scholar, Shri Shikshayatan College, Kolkata

2 INTRODUCTION Today tobacco is one of the most important commercial crops grown in India which is the third largest producer and sixth largest exporter of tobacco in the world. India produces several types of tobacco, such as Virginia, Country Tobacco. Brown coloured tobaccos known, as the Gujrat-Nippani varieties are considered most suitable for bidi making. Today, nearly 33 crore people are employed in the tobacco industry.

3 Kendu leaf is considered best for producing bidis. It is a natural forest product and grows as heavy forest vegetation in the states of Madhya Pradesh, Andhra Pradesh, Orissa, Bihar, West Bengal and Maharashtra. Kendu leaves have traditionally been providing livelihood to lakhs of tribals and other backward classes residing near Kendu bearing areas. INTRODUCTION

4 Bidi industry consumes Kendu leaves worth several crores. Kendu leaf collection is done by the government agencies that engage contractors for this purpose. It provides, according to rough estimates employment to nearly 75 lakh people for nearly 75 days in a year. Bidi making is a skilled job. In true sense bidi is an indigenous cigarette in which tobacco is rolled in a processed kendu leaf and tied with a cotton thread

5 Bidi binders at the factory

6 HEALTH HAZARD The air borne tobacco dust is present while making the bidis, the tobacco and the leaves are kept on the lap of the workers and it is very much close to the nostrils and mouth. Besides different microbes and air borne fungal spores may be added into the working atmosphere from the processed kendu leaves.

7 These are all the probable risk factors causing the respiratory disorders among the workers. Most of the activities of bidi making performed in sitting posture. Prolonged sitting with forward trunk bend which lead to sustained static construction of the back muscle and there are joint pains and back aches



10 OBJECTIVES The major objectives of this study are: To document and analyze the presence of bidi workers in C.D. blocks I and II of Bankura To study the socio economic aspects of the bidi workers. To study the respiratory health conditions of the bidi workers through Pulmonary Function Test and analyze the relation between their work and health. Health mapping of the bidi workers over the two blocks. Monitoring Indoor air quality of bidi factories, houses of binders and control population.

11 METHODOLOGY Keeping in mind the above objectives in view following methodology has been adopted: Interviews: The bidi workers were interviewed extensively to know their social and economic conditions. Interactive sessions: Interactive sessions and group discussions were held with bidi workers in order to get the level of awareness among the workers regarding the aids given by the government. Making them aware of the fact that kendu dust is creating an adverse effect on their lung capacity and diversification regarding their job is a necessity.

12 METHODOLOGY Questionnaire : A questionnaire was prepared to generate data on aspects of family details, basic amenities, daily details, finance and health. The data obtained from these was quite significant and useful for the study. Field Visits: Field visits were made to many villages where the bidi working population was found. Data obtained from the observations were supplemented with data got through the questionnaires. Medical camps : Arrangement of regular medical camps to monitor the lung function capacity of the bidi workers for a time period of 2 years.

13 METHODOLOGY Secondary Sources: Secondary sources used in this study included books, handouts, journals, reports as well as census data. The data were mainly about the history of bidi workers movement, major demands raised by the unions in the past and present, emergence of bidi industry, major struggles fought by the trade unions etc.

14 DISCUSSION Bidi workers come from lower socio-economic strata. Traditionally lower Hindu castes and poor Muslim communities have been the source of labour in bidi industry. Even today the bidi workers are found to be from the backward castes. They are socially and economically backward communities.

15 DISCUSSION Bidi workers mostly reside in Katcha houses, as they are very poor and are unable to afford better accommodation. Katcha houses have very poor ventilation system. The workers are divided into yearly and seasonal basis. 93% are yearly workers who are either binding bidis inside a factory or getting the kendu leaves and utilizing his/her home space for bidi binding.

16 DISCUSSION 7% of the binders are seasonal in nature, involved in this profession on a part time basis. 87% of workers are directly attached to bidi factories. Rest are either dealing with middle men who supply the binders with kendu leaves and collect the bidi packet after process completion in exchange of very nominal charges or collect the kendu leaves from the forests and selling the bidis in local market.

17 Women and Children at work

18 The children are not registered in the factories of the study area thus health care facilities are not provided to those children. The main bidi manufacturers do not formally(unregistered) employ children to roll bidis, the system of sub-contracting to home based workers and the logic of the piece rate system of payment (the more you produce, the more you will earn) leads to the involvement of children.

19 The children, whether they go to school or not, end up helping out the family in rolling bidis (such as cutting the kendu leaves, tying the threads to the rolled bidis and folding the tips of the bidis). There are more girls than boys engaged in the bidi industry. There is however no reliable estimate of the number of children who are engaged in the bidi rolling activities.


21 The bidi workers belong to the lower income group status with 60.31% illiterate. Education as an attribute of social quality is not present in 60.31% of the surveyed population. 30.73% of this population has received primary education, 8.67% upto secondary education and a mere 0.29% have received higher education.


23 There are five mauzas with the highest index range indicating population with a slightly higher income, twenty mauzas with an index indicating population with moderate income and twelve mauzas with an index indicating population with low income.

24 A close study of the percentage of population engaged in different spans of working hours will indicate 78.33% of the binders work for a span of more than 4hrs to 8hrs exposing themselves to a higher risk of being affected by respiratory disorders. Another 13.29% of the populations are exposed for more than 8hrs which increases their vulnerability to diseases. Only a 8.38% of the population are working for upto 4 hrs.

25 The bidi workers earn a living by binding bidis for long hours in a day. Their income varies between Rs 1 to Rs 80 per day depending on the hours of binding bidis. Around 66% earn below Rs 40 per day. 32% belong to the group who earn between Rs 40 to Rs 80 and 2% earn above Rs 80 per day.


27 Since health and education in particular affect social outcomes, they deserve policy attention. Social policy directly impacts social outcomes and, through the feedback loops, indirectly impacts economic outcomes. Since the government formulates social policies, it has an important role to play in ensuring that a majority of the population gets access to basic social services, by attaching higher priority to health and education

28 Long years of experience leads to long exposure to dust particles of kendu leaves which has led to shortness of breath and has often seen giving rise to complain of blood with cough.

29 Chewing tobacco or smoking have a profound ill effect on the health of the bidi workers. Through GIS different parameters of health.

30 Three Medical Camps were arranged each year. The dates of the camps coincided with the seasonal changes in a year. Patients were given free medical checkup, medicines and chest X-ray. A notice for the dates of the tests was circulated a long time in advance so that they could find it easier to come. The camp was held at central place convenient for all. For those who still could not attend arrangements were made to carry the spirometer to their workplaces

31 Medical Camp

32 A Comparison of PFT tests of bidi binders:

33 HEALTH and ENVIRONMENT------------- A Relationship Environmental disruptions, such as dispersion of dangerous substances, acidification, over fertilization, photochemical air pollution, climate change, ground pollution and nuisance have impact on human health Environmental Tobacco Smoke Exposure (E T S) exposure among nonsmoker subjects, in particular women and children, is rather common

34 But the role of ETS exposure in causing COPD is not established as yet. Parental smoking is reported to result in a small but statistically significant decline in FEV1 in school aged children. But a significant prevalence of COPD, inspite of a relatively low prevalence of smoking in women eludes to the role of ETS exposure in addition to exposure to domestic combustion of solid fuels. This is strongly supported by our field data.



37 The maximum level of SPM is found inside the house of a bidi worker living adjacent to the factory while minimum is found inside the house of a control population whose house is farthest from a factory. This clearly shows that SPM are found floating in the air inside as well as outside the bidi factories. In both the cases i.e within the factories and indoor air monitoring of bidi workers and control population houses the SPM level is much higher during the winter months.

38 The pulmonary function test done seasonally on bidi binders show that the lung capacity of female workers is comparatively bad as compared to the male counterparts. In winter months it gets worse



41 The deterioration of lung capacity in winter coincides with the high values of SPM level recorded while monitoring indoor air pollution in winter

42 . The binders of above 65 years of age were diagonised with poor lung capacity due to their long association with bidi making Female binders are exposed to ETS as well as to CO given off by fossil fuel used as cooking media. Female binders are spending five to six hours in the kitchen as well as are exposed to dust of kendu leaves while binding bidis.

43 Pulmonary Function Test was performed on children binders and was compared with children control subjects. Control children recorded a marginal better lung function capacity






49 Statistical Analysis ANOVA FEV1 Smoking Sum of Squaresdf Mean SquareFSig. 0 Between Groups 2.0981 4.741.032 Within Groups 50.434114.442 Total52.531115 1 Between Groups 4.5581 7.620.007 Within Groups 47.85580.598 Total52.41381 Comparison depending upon the smoker and non-smoker group: For both the groups – smoker and non-smoker, the test is significant. So the capacity is significantly different among the control population and the Binder’s population at 5% level of significance when smoking is considered. But, when smoking =0, capacity of control population is significantly lower at 5% level and when smoking =1, capacity of control population is significantly higher at 5% level (as well as 1% level) of significance.

50 Correlations _11_09_10 _FEV1 _11_09_10 _BMI _11_09_10_FE V1 Pearson Correlation 1.195 * Sig. (2-tailed).017 N150 _11_09_10_B MI Pearson Correlation.195 * 1 Sig. (2-tailed).017 N150 *. Correlation is significant at the 0.05 level (2-tailed). Dependence of FEV1 on BMI The correlation between FEV1 and BMI is significant. It means that, there is a significant linear relationship at 5% level of significance between BMI and FEV1.

51 Correlations _11_09_10 _FEV1 Experience _Int _11_09_10_FEV1 Pearson Correlation 1-.290 ** Sig. (2-tailed).000 N150 Experience_Int Pearson Correlation -.290 ** 1 Sig. (2-tailed).000 N150 **. Correlation is significant at the 0.01 level (2-tailed). Dependence of FEV1 on Experience The correlation is significant. It means that, there is a significant linear relationship at 5% level (as well as 1% level) of significance between Experience and FEV1.

52 CONCLUSION The ground floor of the factories have women and children workers mainly the girl child. They come around a little early to mid-day, collect the raw materials and bind the units at home.. The combination of poverty and the lack of social security network form the basis of the even harsher type of child labour – bonded child labour. For the poor, there are few sources of bank loans, governmental loans or other credits.

53 CONCLUSION Even though poverty is cited as the major cause of child labour, it is not the only determinant. Inadequate schools, or lack of schools, or even the expense of schooling leaves some children with little else to do but work. The attitudes of parents also contribute to child labour; some parents feel that children would work in order to develop skills useful in the job market, instead of taking advantage of a formal education.

54 CONCLUSION The socio-economic condition was in a sharp contrast to this feeling of eternal bounty. Most of the binder families in villages like Bhadul and Shyamdaspur had an unhappy incidence of death from respiratory diseases or family members affected with Tuberclosis.

55 CONCLUSION GIS plays a critical role in determining where and when to intervene, improving the quality of care, increasing accessibility of service, finding more cost- effective delivery modes, and preserving patient confidentiality while satisfying the needs of the research community for data accessibility


57 REFERENCES Aghi, Mira B, Exploiting Women and children – India’s bidi industry. Aparna N., et al., Occupational exposure to unburnt bidi tobacco elevates mutagenic burden among tobacco processors, in Carcinogenesis, vol.16 (5), 2004. Chauhan Yash, History and Struggle of Beedi Workers in India. Chattopadhayay, B.P., et al., A study to assess the respiratory impairments among the male bidi workers, in Indian Journal of Occupational and Environment Health, vol.10(2), pp. 69-73, Kolkata, India, 2006.


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