MFCM050: Draft Manuscript - The Bhopal Disaster Aftermath - an epidemological and socio-medical study.pdf
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THS
BHOPAL
L I S A 5 T S It
A F T E a M k T H
—an epidemiological and socio-Eiedical study
15—25 March 1985
medico friend circle
■
&
1
Dedicated to the thousands
who died or were disabled
by the Bhopal Ge>s Disaster
—one of the worst industrial
accidents in
recorded history;
with a
resolve to prevent
cedi cal research
from becoming an exploitation
of human suffering
with a
resolve to make
me di c cl r es e ar ch
an expression of
humane concern
/
*
L
t
Compcjrisons of some of the important characteristics of
J
Hagar ana Anna Hagar populations (study/control
populations )
Table 1A
Age-Sex Structure
Age
Sex
J P Hagar
%
148
n
Anna Hagar
%
138___
n
11-15 years
M
8.10
10.14
F
0.46
4.35
1/1
35.81
34.78
F
33.78
31.88
6.08
10.14
6.75
8.70
16-45 years
43 +
F
S^leJLB
History of smoking anc chronic
diseases
8poking
U)
Chronic
(b)
6.1s e co ec
+
+
J P Hagar
n “3548
%
Anna Hager
22.75
25.0
77 ..24
75.0
0.58
10.37
99.41
83.62
n = 138
%
z (a) a smoker is ... ne v?ho has smoked at least one ciga- rette per day lor at IccOt one year in a life time.
(b) chronic diseases specifically included
thna,
chronic bronchitis, tuberculosis and others.
%
i
J
Table 10
Oc cupat 1o ns anc inc oae
levels
J P Mag ar
%
n = 148
/jana Nag ar
7o
138
n
Uns killed
18.91
27.73
Skilled
7.43
8.73
Sell-enployed
13.51
15.32
Service
14.18
10.21
Houo evork
29.72
24.08
Oth ere
16.21
13.86
•j-esc than ks.5G.0C
4 • 68
4.58
~£ ,51-75
10.93
22.93
.76-100
16.40
21.10
ks .101-125
‘ 14.84
13.76
53.12
37.61
Occupation
Per c ap 11 a 1 nc <ie pe r
Lion th he f Dre
exposure
Lis . 12 6 o 0 0 a n5. aho ve
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Tej le_1g
Comparison oetweer bocy curlace croa
(1.? ) ir. JF Hagar ere. Anna Hagar accor
ding to_a0e-OGZ. (i’igurec it- bracket
:— O7J S . jj )
Fody sur ace area
(ciean)
in 3^ 1-5'
11-15 years
15-45 year;;
45-60 years
61 •> years
J F blage,:?
%
n
136
Anna Hagar
%
n = 137
Izi
1.23 (C.14)
1.2,2 (0.1S)
F
1.23 (C.12)
1.15 (0.13)
M
1.4S (0.09)
1.51 (0.12;)
F
1.37 (0.11)
1.35 (0.12)
i;
1.50 (0.14)
1.53 (C.CS)
F
1.37 (O.CS)
1.41 (C.22)
LI
1.35 (0.04)
1.30 (0,15)
F
1.32 (C.CG)
1.28 (0.05)
bote: The c iflc,r eno es in :cean Bbl’s vzere testec by !t *
test — all the c ill’erences \?ere statistically
n o n- sig n i 11 c E n t (1 £>)
gable 2
Leath cor.pensat ion v?ith or v/J-triout acc.it ion al
loan* in tvjo areas
. Coi-ipenst.ti on............. <> y/jLr-
without
Tot al
10cX
■?7 it li out
loan
uith
loan
2
3
2
4
11
Ho death
8
2
20
12
42
Total
10
5
22
16
53
nith
u
CUT
lOC.Ei
F Nag ar
jUHic, ik££.r
2
Leath
1
Ho death
17
32
46
Total
18
33
51
Table s 3 A
Comparison of Symptoms reported by individuals in
J.P. Nagar and Anna Nagar. (Expressed in percentage.
Numbers of cases are shown in bracket.)
SL.
NO.
Symptoms
1. • Dry Cough.
J.P.Nagar %
Ao Nagar %
P. Value
27.70 (41)
14.49 (20)
P
OoOl
2.
Cough with Expectoration.
47.29 (70)
23.91 (33)
0.001
3.
Breathlessness at rest.
10.13 ‘(15)
2.89 (04)
0.025
4.
Breathlessness on
usual exertion.
87.16 (129)
35.50 (49)
« o.ooi
5.
Chest pain / tightness.
50.0
(74)
26.08 (36)
« 6“. 001
6.
Weakness in Extremities.
65..54 (97)
36.95 (51)
7.
Fatigue.
81.-08 (120)
39.85 (55)
C< o.ooi
8.
Anorexia.
66.21 (98)
28.26 (39)
«0.001
9.
Nausea.
58.10 (86)
16.66 (23)
« 0.001
10. Abdominal pain.
53.37 (79)
25.39 (35)
0.001
11. Flatulence.
68.91 (102)
25.36 (35)
/ <0.001
12. Lacrimation.
58.78 (87)
42.62 (58)
<0.01
13. Blurred vision/photophobia
77.02 (114)
38.40 (53)
<<0.001
14. Loss of memory
45.27 (67)
11.59 (16)
«0.0Cl
15. Tingling/numbness .
54.72 (81)
20.28 (28)
<<0.001
*(a)
P Values were calculated by X
?
o
method.
Table ; 3 B
Comparison of Symptoms reported by individuals in
J.P.Nagar and Anna Nagar, (Expressed in percentage.
Numbers of cases are shown ,in bracket.)
(Symptoms significantly different but not analysed further)
*
P. Value (a)
SL.
NO.
Symptoms
1.
Skin problems
29.05 (43)
11.59 (16)
<0.01
2.
Bleeding tendency
9.45 (14)
2.89 (04)
<0.025
3.
Headache
66.89 (99)
42.02 (58)
4.
Muscle ache
72.97 (108)
36.23 (50)
5.
Impotence
8.10 (12)
0.72 (01)
6.
Anxiety/Depression
43.92 (65)
10.14 (14)
A. Nagar %
J.P.Nagar %
.05
Table s 3 C
Comparison of Symptoms reported by individuals in
J.P.Nagar and Anna Nagar. (Expressed in percentage.
Numbers of cases are shown in-bracket.)
( Symptoms-—Non - significant )
*
SL.
NO.
Symptoms
J.P.Nagar %
A.Nagar %
P.Value (a)
1.
Blood in Sputum
10.13 (15)
7.24 (10)
N.S.
2.
Fever
27.70 (4J.)
28.98 (40)
N.S.
3.
Jaundice
0.67 (01)
00
N.S.
4.
Blood in vomit/stool/
malena
12.16 (13)
-------
10.14 (14)
N.S.
5.
Vomitting
11.48 (11)
5.79 (08)
N.S.
*(a)
P Values were calculated by X
2
method.
Table 3D
Symptoms
No ./Total
%
p + G.i. + IJye + CNS
92/148
62.16
p (Pulmonary only )
4/148
2.7
P - NIL (ie G.I./CNS/Eye)
52/148
35.14
Symptom groups
(For symptoms included in grouping please refer 5.4.2.2
Table 3E
Symptom Complexes other than
Pulmonary System
Symptom Groups
No ./Tot al
%
G • I. (with or without eye/CNS)
31/148
20.94
3ye
(with or without GI/CNS)
32/148
21.62
CNS (with or without, Gl/gye)
2'3/148
15.54
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Table : 4
Patterns, of disturbance of vision.in .10 — 45 yrs.,
of population in J.P. Nagar and A. Nagar. (Figures
in bracket indicate actual numbers.)
J.P. NAGAR %
ANNA NAGAR
Blurring of vision (1)
74.24 (98/132)
. (a)
28.57 (34/117)
(2)
Abnormal distant vision
42. U
(65/141)
(a)
21.88 (21/96 )
17.55 (20/114)
(b)
8.74 (9 /103)
(3)
Ab normal near vision
%
4
(4)
Corneal Opacity
4.7
( 7/148)
(b)
2.8
(4 /138)
NOTES-
1.
2.
3.
4^
Includes Photophobia.
Normal vision 6/9 - Distant Vision tested
by means of Snell Ws chart
By means of near vision chart
In J.P. Nagar and Anna Nagar each there
are two -central opacities.
2
^a) tested by X d.f.l
p
,, X .
v2- - (b)
testeda by X
d.f.l
P - Non-signifi-cant.
0.001
*4
‘ii
4
Table
5A
Mean pulse rate/minute (S.D.)in males &
females of J.P. Nagar and Anna Nagar.*
ANNA NAGAR
J.P. NAGAR
Male
77.13 (11.28)
n = 67.
77.94 (10.68)
n = 73
Female
85.73 (13.21)
n - 78.
85.05 (11.20)
n
59
Total
81.70 (13.20)
n = 145.
80.4 (13.0)
n ~ 132.
* All the differences in mean pulse rates
were tested stassically by ’ t* test and
found to be non-significant.
Table s 3 3
Mean Respiration Rate/m-. n te (S.D.) in
males & females ^f J.Pa Nagar and .Anna Nagar.
•k
J.P„ NAGAR
ANNA HAGAR
Male
21.73 (3.98)
n = 59
21.21 (3.84)
n = 74
Female
21.84 (4.93)
n = 70
20.9 > (3.70)
n = 56
Total
21.87 (4.51)
n = 139
21, 09
3.77)
n = 130
All the differences in mean resn Lration rates
were tested stastically ’t‘ tes-i and found to
be non-significant.
Table 2
5 C
Mean'blood Haemoglobin in gm.% in J.P.Nagar &
Anna Nagar. (The figures in bracket are S.Ds
of means.) n - sample size.
J.?, NAGAR
ANNA NAGAR
MaJ
14.68 (1.79)
n
11.
(a)
12.70 (1.35)
n = 17.
Female
12.7 (1.46)
n
20.
(b)
10.79 (1.34)
n =: 18.
(a)
(b)
td.f26 = 3.18
~d o f 36
v
<0o01
I'
,<0.001.
Table s C A
Mean Menstrual cyclo length in days in
J.P. Nagar and Anna Nagar after and before
gas exposure - ( Figures in bracket indicate
S.D. in days.)
J. P. N A G A R
After
Before
A N $ A
NAGAR
Before
After
32.32
25.59
35.41
36.10
(13.51)
(12.04)
(20.09)
(19.89)
n = 31.
n
n =•• 29.
n
31.
29.
0.131
t. = 2 o C13
J
d.f.60 ■'
d <. f. - 56
P <0.08
>0.8
t.
j .a.
d Lffe.rences in means menstrual cycles
Ir.ngth in da; s between J.P.Nagar and
Anna Nagar j^fter the gas exposure.
■j oa
2 <. <5
C<fo
58
P
/ 0,05
’ J
Table ; 6 B
Percentage distribution of Flow in J.P. Nagar &
Anna Nagar before and after the gas exposure.
( Figures in bracket are number of cases )
A N N A - N- A G A R
N A G A R
J. P.
Scanty
Excess Total
'
Scanty
- Excess
Total
Before
5,5
(2)
11
(4)
100
(36)
2,6
(1)
18.4
(7)
100
(38)
After
25,7
(9)
31.4
100
(35)
5,8
(2)
20.7
(7)
100
(34)
(ID
2
x2 =
11.96
d.f. = 2.
0.01
P
X"
< 1
d.f. “ 2.
P > 0.50
After the gas exposure
J.Po & A a N.
x2
7.82
d. f. = 2.
P< 0.025
Table s 6 C
Percentage distribution of colour of menstrual
flow in J.PoNagar and Anna Ne car before and after
the gas exposure (Figures ir bracket are No. of cases.
J.P. NAGAR
Before
After
ANKA
N AGAR
E1 ack
Total .
Black
Total
5-. 8
(2)
100
(34)
(0)
(37)
46.8
(15)
100
(32)
E .8
(3)
100
(34)
2
X r= 3.41
d.f. = 1
P - N.S.
X2 =
14.46
d.f. = 1
P zl 0.001
After the gas exposure
2
X = 12.03
d.f. = 1
P
100
0.001
- JP Nagar s AN = Anna Nagar
Jrl • and A.N>
I
Table s 6 D
Percentage distribution of Dysmenorrhoea
in J.P.Nagar and Anna Nagar, before and
after the gas exposure. (Figures in bra
cket are number of cases.)
J.P. N A G A R
A N N A
N A G A R
+ve
Total
4-ve
Total
Before
28.5
(10)
100
(35)
48.7
(19)
100
(39)
After
65.6
(21)
100
(32)
39
(14)
100
(36)
x2
x2
9.21
d.f. = 1
P
0.71
d.f. = 1
N.S.
P
0.01
After the gas exposure
J.P. and A.N.
x2 = 4.89
d.f. = 1
0.05
P
Table ; 6 E
Percentage distribution of Leucorrhoea in
J.P. Nagar and Anna Nagar - before and
after the gas exposure. (Figures in bra
cket are number of cases)
N A G A R
P.
NonSpecific Speci
Total
fic Leu.
Leu.
ANNA
N A G A R
Non
Specific Total
Specific
Leu.
Leu.
Before
15.5
(7)
0
(0)
100
(45)
16.6
(7)
14.3
(6)
100
(42)
After
22.2
(10)
35.5
(16)
100
(45)
14.6
(6)
14.6
(6)
100
(41)
J.
2
X 5= 22.5
d.f. = 2.
x2
1
d.f. = 2
Aftcar the gas exposure
Jo P. & A.N.
x2 = 7.455
d.f. = 2.
P
0.025.
J P = JP Nagar
s
A N = Anna Nagar
P N.S
Table s 7
2
Distrib^einn of Mor-in values.of Body Surface Area (M ) ,
FEV, (Litre.), FVC (Lit..), FEV/FVC~% in different age
sex gp. in J.P. Nagar'and Anna Nagar.(a)* (Figures in
• bracket are S.Ds) n = number of persons in each cell,
p - P value.
Age-Sex
—
BSA (M )
in yrs.
J.P
10-14
JF
15-44
14
15-6C
' 14
6i^
F
FEV,(Lit.)
FVC (Lit.J
FEV,/FVC
%
J.P.
A.N.
A.N.
J.P.
1.23
1.22 1.59
1.93
(0.14)(0.19)(0.74) (0.48)
n~4
n=4 P=NS
1.72
(0.77)
P=N.S.
2.20
87.05
(0.51)
87.8
1.77
1.22 1.15 1.75
(0-12) (0,13)(0.84) (0.33)
n=3
n=6
P=NS
2.07
(0.88)
P=N.S.
2.10
84.3
(0.40)
84.2
1.49 1,51 2.04
2.66
(0.09) (0.12)(0.47) (0.51)
n~=45 n~55 P40.0^1
2.99
2.39
79.1
(0.55)
(0.47)
P<0.001
88.9
1.-37 1.35 1.64
2.25
(0.11) (0.12)(0.44) (0.42)
n=56 n~52
1.97
2.54
(0.38)
(0.43)
P<0.001
76.3
88.6
1,50 1.53
1.88
2.26
(0.14) (0.09)(0.53) (0.19)1
n= 12 n— 6
P-< 0.05
2.20
(0.43)
P-0.05
2.54
85.3
(0.24)
88.9
•1.37 1,41 1.51
2.13
(0.09) (0.22)(0,48) (0.18)
n=±l n=7
P40.01
1.86
(0.58)
P<0.01
79.8
2.48
(0.21)
85.9
1.35 1.38 0.94
1.91
(0.04) (0.15)(0.39) (0.15/
n=2
n-4
P40.02
1.83
(0.35)
P=N.S.
2.17
51.8
(0.16)
88.0
1.32 1.28 1.39
1.90
(0.05) (0.05)(0.31) (0.07)
n=3
n=3
P40.05
1.96
(0.31)
P=N.S.
2.13
(0.15)
63.4
86.2
(a)*
A.N
P.
A.N.
All the differences in Mean Values between J.P. Nagar &
Anna Nagar in each age-sex category’ were tested by
!t‘ test.
1
Table 8
Exposure_History and Safety Measures
Nil
Anna Nagar
Ran Nil
Wet
towel Blanket out
124
8
9
1
2
Where at
J P Nagar
the
Ran
time of leak Wet
towel Blanket out
m the Basti.
5
Out cf home
(in Bhopal)
1
7
6
64
52
2
5
11
10
Out of Bhopal
Total Noe148
Total No. 158
Notes Nil means remained in the house without safety measure.
Table 9
Number of attacks (respiratory infections)
in the one month preceding the study__
Anna Nagar
J P Nagar
Age
One attack
often
Nil
One attack
Often
Nil
10-15 yrs
3
13
15
4
1
16
16-45
15
46
35
24
7
68
46 -l-
3
14
4
4
4
11
_21
73
54_
32
_ _12 _ _
95
Position: 219 (9 views)