How Rice Husk Leads to Syndrome

Health State Taluk

Rice miller’s in siruguppa are suffering from Rice Miller’s syndrome 

BY SA Gayatri

Bangalore, April 20, 2019

Ever wondered what will happen if you walk towards the rice mill and spend an hour while the miller’s are continuously working with the rice husk in the open. You will cough and end up feeling breathless .

Vijay Mandal, a 34-year-old rice mill worker from Bihar continuously coughs and holds his chest and complains of chest tightness and ‘dyspnea’ which is a condition of shortness of breath also called as ‘air hunger’.

He introduces himself as working with 10 years of experience in the industry .Vijay  feels like an outsider in the small taluk ‘Siriguppa’ of Bellary in Karnataka, which is on the border of Karnataka and Andhra Pradesh. The plot is set at the rice mill which is 5 kilometers away from the heart of the city where he  sits on the ground after lifting 30 rice bags for chai break. He lights his beedi, drinking chai altogether.

Suddenly His eyes turn red and watery, he says, “I don’t know why I cough all day. I end up spitting blood sometimes but then it cures by itself and doesn’t aggravate again. “

His hands were calloused and bruised, often he complains about pain in the throat to his  brother in law and when he visits the nearby government hospital, they charged him Rs. 200 -300 for a general visit which shouldn’t be charged as the treatment in general main PHC is free for everyone irrespective of the state or place he\she belongs to. When asked to why does he pay , he exclaimed that the pain is much that there is no time to protest and ask for free medicines.

The Rice Mill Association notes that  Siruguppa alone contains more than 80 rice mills which have put many laborers health in risk called the ‘rice millers syndrome’ that occurs when exposed to extreme dust of rice husk for a longer duration. Many people work in rice mills of Siruguppa, almost 26 workers in each mill are affected but the main problem is there is no extensive research and exact effective medication for this syndrome as it is long term and chronic, the people think they suffer from normal respiratory disorders whereas the reality is they are not provided with any equipment while handling the rice husk in the mill. Thus, this affects their health and also it has no medication in a small place like Siruguppa where the population is 2, 69,104 ,which has just one 100 bed hospital . The hospital is always full and many people have to wait hours for check up.

The last time Vijay visited the hospital, he got an X-Ray done of his lungs which he couldn’t understand but tells it is fancy to look at it in the light. He said, ”The doctor told me that my lungs are deteriorating and the cause might be smoking and asthma but he also mentioned that there are some structures in sac-like structures called bronchi-oles in the lungs that are filled with some of the small but odd-looking structures which can irritate the lungs surface”.

So small but irritating

Rice grain is made up of an external husk layer, a bran layer, and the endosperm. The husk layer (lemma and palea) is responsible for 20 percent of the weight of paddy. The husk layer is taken out from the paddy by friction and the process is called de-husking or de-hulling.

There are two types of rice husk  with average particle size of 5 micron which are ultra fine particles and 95 micron . The ultra fine particles irritate the lungs and cause symptoms that lead of excess burning and degradation of bronchioles.

De-husking was traditionally done using mortar and pestles but, in modern rice mills, it is done by sending the paddy grains between two coarse surfaces that move at different speeds. After separating the husk from paddy, the husk is removed by suction (aspirated) and then transported to a storage dump outside the milling plant.

As stated by National Occupational Safety and Health Profile, It should be noted that occupational hazards that are related to airborne risks can be operated and regulated by engineering controls, ventilation, and use of equipment like gloves, suits, and masks.

Suresh Gowda, Taluk Health Officer, Siriguppa says “there is a great history behind the respiratory diseases that are caused due to occupational hazards. Farmers were the first people to get respiratory illnesses through organic dust, inorganic dust, pesticides, and agrochemicals. Farmers and workers who are involved in the agriculture sector have a potential to be exposed to a wide range of allergens; inorganic dust from the soil, organic dust from microorganisms, fertilizers, pesticides, and insecticides. These all are believed to be affecting farmer’s lungs which can be also exposed to vegetable dust.

There are very few cases and reports that have been documented or reported on the effects of occupational effects of grain dust. Similarly, a large quantity of dust is released in the ecosystem of grain processing industries while agricultural produce is converted into an edible form of human consumption.

It doesn’t end with cough

When there was less research conducted in India on this subject, The Research Prevalence of respiratory symptoms and disorders among rice mill workers in India brought to the light the respiratory symptoms which might be the signs of this unknown, chronic syndrome. These include Chest Tightness which is the constriction of the chest occurring any time during the work shift.

Around 2 in the afternoon, when the sun was burning in the middle of the spring season,  Radhe Shyam holds his chest and cries out of pain but his brother consoled that it’s just because of the common seasonal cold.

A similar symptom known as chest phlegm which is sputum production that occurs persists a minimum of three months. This was clearly seen when RadheShyam, a mill worker who had nine years of experience couldn’t speak properly because he had chronic phlegm because of which he couldn’t eat and swallow.

The next symptom categorized is chronic cough which means cough without sputum occurring on most five days a week for a minimum of three months a year for at least two consecutive years. The last symptom is dyspnea which means having to walk slower than a person of the same age at an ordinary pace on level ground because of breathlessness.

When chest X-rays were taken of rice mill workers according to the above mentioned research, it showed thickening of tissues in the lungs and tubular heart shadow. This gives an idea of how the syndrome prevails but is unaddressed.

No time for fields

In the heart of the district Bellary, there is a District Government Hospital which is cream color building with four pillars holding it strong and still. There is a district health office in the same compound where the District Health Officer ,Shivaraj Hede , sits in attending hours of meetings. He is served hot tea and evening snacks when IIJNM reporters waited to meet him.

He finally says, “Such syndromes do exist and I am quite aware of that but the Taluk Health Officer and Chief Medical Officer do not have time to visit the fields and there are no specific records about it as of now.”

Sipping his hot tea, he munches those freshly fried ‘pakoras’ and adds “Even though they have respiratory diseases we treat them like asthma and bronchitis. Also, we have special TB programs so there no chance of misdiagnosis even. They should be provided with protective equipment like masks and gloves.

The government is not responsible for such measures only the supervisors or the head of the rice mills should take up the initiative”.

He sighs and says that this is how it works in India; such syndromes are treated in America but will prevail in India.

It’s just fate

As documented by the old dusty records from the Siriguppa Taluk Hospital. There are 21 asthma cases reported in the span of tenth January to thirteenth February in 2018

There is no sight of rice mill workers using or being provided with any protective measures.  Vikas, a rice mill worker cleans his hands with hot water as he lifts rice bags. His hands are bruised, red and callous. He says “It’s my fate, my hands’ pain they bleed but still I feel happy whenever I work because I have to send money to my family at the end of the month that stay in Bihar. Also, I cannot breathe sometimes I feel dizzy but I sleep for an hour or two and get back to work. “

He holds his family picture which is half torn close his chest and goes back to work again.

 

Incomplete medicine

Rajaratne AAJ, Faculty of Medicine and Allied Science, Rajarate University, Sri Lanka says “When I did a research on factors affecting the respiratory function of rice millers in Anuradhapura district, I found that the deficiencies in lung functions of rice millers were probably caused by occupational exposure to rice husk and tobacco smoke.

“We have recommended wearing face masks, worker education and adequate ventilation in mills. There are very few studies and even medicines regarding this syndrome which generally develops in chronic stages and over a long period of time. Well, the workers suffer a lot and they are innocent too because even medicine is not able to tell them their cause of bad respiratory disorders, “he added

“Such a small husk is harmful, it does more harm than good, there are very few medications and even reported cases but I do believe they are many millers out there suffering”. He exclaimed

There are very fewer reports written and few types of research on this subject. It is very hard to find out as it can be misdiagnosed with TB sometimes even though people claim that these days the misdiagnosis of Tb has almost ended “, says Phanender Ketha, pulmonologist, Visakhapatnam.

“In my entire study, I have hardly read a good book about syndrome or heard from anyone. It is so rare still medicine has to come with more research on this syndrome. But there is a great risk if it prevails as it is still unknown . If every rice mill has environment pollution control devices like Electrostatic Precipitator , Lime Scrubber , diffuser then it can be easy to remove the husk particles from the air. It is also important to include new technology so that rice miller’s health can be given utmost importance“, he added.

Vijay and his other mates pose for a group photo with their supervisor for a meeting and ask him to provide for protective equipment. They still didn’t hear a word from the supervisor. They hope that soon they might get masks and gloves at the earliest.

Vijay says,” I am tired of coughing, I just want to work and I never imagined such a small husk can be so hazardous for our health.”

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