Prevalence of leukoplakia, oral submucous fibrosis, papilloma and its relation with stress among green marbles mine laborers, India.

OBJECTIVES To determine the prevalence of leukoplakia, oral submucous fibrosis and papilloma among "Green Marble Mines" laborer and uncover its relation with occupational stress. METHODS Mines were divided in four geographic zones, and participants were selected by stratified cluster sampling technique. A total of 513 subjects were included in final study which were alienated among the four age cohort 15-24 , 25-34 , 35-44, 45-54 respectively. The study was been conducted following the research methodology recommended by World Health Organization- Oral Health Surveys 1997. A questionnaire from "Union of Shops, Distribution and Allied Worker (USDAW) Nationwide, Manchester" was used for stress assessment of mine workers and clinical examination for oral mucosa was conducted by one of the three examiner with the aid of an artificial light source. The kappa statistics for diagnosis of leukoplakia, oral submucous fibrosis and papilloma was determined (field teams versus expert) 0.81, 0.92 and 0.89 respectively two days prior to the examination. Data was analyzed using bivariate and multivariate analysis. RESULTS An overall elevated prevalence of all three oral-mucosal lesion was found among mine workers (36.7%), mainly leukoplakia affecting 171 mine workers (33.3%). The affected workers were having body problems like headache, backache and stressed due to under-payment. Individuals having papilloma have faced problem at work like noise, dust or fumes and poor maintenance of equipment. Multiple logistic regression analysis model of oral-mucosal lesion have shown highly significant relation (p<0.01) with increased stress, age, alcohol habits and malnutrition. CONCLUSION The prevalence of oral mucosal lesion is higher, among marble mine laborers, and occupational stress can intensify the disease condition. Curative services along with prevention and stress reduction program, requires primary anticipation.