Introduction: The labor-intensive nature of cement brick manufacturing, its unorganized nature and internal migration, expose the employees to several occupational health hazards. The objective of the study was to assess the occupational risks in cement brick unit settings and to estimate the prevalence of respiratory and musculoskeletal morbidities among the cement brick unit workers in a rural area of Bangalore urban district. Methods: A cross-sectional study was conducted among cement brick unit workers over two months. A semi-structured questionnaire was used to capture sociodemographic details. Multiple observations on the field and the World Health Organization semi-quantitative risk assessment matrix were used to obtain risk scores of the occupational hazards. A structured questionnaire on respiratory symptoms and Minispir Portable Spirometer were used to assess the respiratory morbidities and lung functions. Musculoskeletal morbidities were assessed using the Modified Nordic questionnaire. Proportions were used to describe respiratory and musculoskeletal morbidities. Chi-square test, Fisher’s exact test and multivariate logistic regressions were done to identify significant variables. Results: Among 120 subjects, 110 (91.6%) were men and 85.8% were migrants. Injury due to falls of heavy objects, back injury, respiratory complaints and slips/falls were found to be high-risk health hazards. The prevalence of respiratory morbidity was 21.7% and that of musculoskeletal morbidity was 51.7%. Workers receiving a higher salary (≥ 1500 Indian rupees) had higher odds of having respiratory morbidity. Conclusion: The prevalence of respiratory and musculoskeletal morbidities was high. Introduction of mechanical equipment, decreasing work hours, periodic medical examinations and appropriate use of personal protective equipment will help in risk reduction as per this study.

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Epidural hematoma (EDH) classically occurs secondary to trauma. Spontaneous EDH is uncommon and can be a rare complication of sickle cell disease (SCD). We report the case of a 20-year-old Indian male with sickle cell anemia, who presented with a sickling bony crisis and suffered a non-traumatic EDH within 24 hours of admission. A 20-year-old male presented with generalized body pain, suggestive of a sickling bony crisis. He was promptly admitted and received standard treatment for the same. The next day, he developed severe right-sided headache, associated with orbital pain, decreased movements on the right side, and altered sensorium. He had a Glasgow coma scale score of 8/15, and reduced power of the right upper limb and lower limb. Computed tomography (CT) and magnetic resonance imaging (MRI) of the brain showed a left-sided large parieto-temporal epidural hematoma with midline shift and mass effect. He underwent emergency decompressive craniotomy and evacuation of the hematoma, following which he recovered well, with no residual deficits. Spontaneous EDH is being increasingly reported in SCD. Possible mechanisms include skull bone infarction, altered skull bone anatomy due to extramedullary hematopoiesis, and venous congestion due to sluggish blood flow in diploic veins. In our patient, altered skull anatomy appeared to be the causative mechanism. Early identification of EDH and aggressive neurosurgical management is crucial to survival and a good prognosis.

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