Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Dr Mohan Z Mani

"Thank you very much for having published my article in record time.I would like to compliment you and your entire staff for your promptness, courtesy, and willingness to be customer friendly, which is quite unusual.I was given your reference by a colleague in pathology,and was able to directly phone your editorial office for clarifications.I would particularly like to thank the publication managers and the Assistant Editor who were following up my article. I would also like to thank you for adjusting the money I paid initially into payment for my modified article,and refunding the balance.
I wish all success to your journal and look forward to sending you any suitable similar article in future"

Dr Mohan Z Mani,
Professor & Head,
Department of Dermatolgy,
Believers Church Medical College,
Thiruvalla, Kerala
On Sep 2018

Prof. Somashekhar Nimbalkar

"Over the last few years, we have published our research regularly in Journal of Clinical and Diagnostic Research. Having published in more than 20 high impact journals over the last five years including several high impact ones and reviewing articles for even more journals across my fields of interest, we value our published work in JCDR for their high standards in publishing scientific articles. The ease of submission, the rapid reviews in under a month, the high quality of their reviewers and keen attention to the final process of proofs and publication, ensure that there are no mistakes in the final article. We have been asked clarifications on several occasions and have been happy to provide them and it exemplifies the commitment to quality of the team at JCDR."

Prof. Somashekhar Nimbalkar
Head, Department of Pediatrics, Pramukhswami Medical College, Karamsad
Chairman, Research Group, Charutar Arogya Mandal, Karamsad
National Joint Coordinator - Advanced IAP NNF NRP Program
Ex-Member, Governing Body, National Neonatology Forum, New Delhi
Ex-President - National Neonatology Forum Gujarat State Chapter
Department of Pediatrics, Pramukhswami Medical College, Karamsad, Anand, Gujarat.
On Sep 2018

Dr. Kalyani R

"Journal of Clinical and Diagnostic Research is at present a well-known Indian originated scientific journal which started with a humble beginning. I have been associated with this journal since many years. I appreciate the Editor, Dr. Hemant Jain, for his constant effort in bringing up this journal to the present status right from the scratch. The journal is multidisciplinary. It encourages in publishing the scientific articles from postgraduates and also the beginners who start their career. At the same time the journal also caters for the high quality articles from specialty and super-specialty researchers. Hence it provides a platform for the scientist and researchers to publish. The other aspect of it is, the readers get the information regarding the most recent developments in science which can be used for teaching, research, treating patients and to some extent take preventive measures against certain diseases. The journal is contributing immensely to the society at national and international level."

Dr Kalyani R
Professor and Head
Department of Pathology
Sri Devaraj Urs Medical College
Sri Devaraj Urs Academy of Higher Education and Research , Kolar, Karnataka
On Sep 2018

Dr. Saumya Navit

"As a peer-reviewed journal, the Journal of Clinical and Diagnostic Research provides an opportunity to researchers, scientists and budding professionals to explore the developments in the field of medicine and dentistry and their varied specialities, thus extending our view on biological diversities of living species in relation to medicine.
‘Knowledge is treasure of a wise man.’ The free access of this journal provides an immense scope of learning for the both the old and the young in field of medicine and dentistry as well. The multidisciplinary nature of the journal makes it a better platform to absorb all that is being researched and developed. The publication process is systematic and professional. Online submission, publication and peer reviewing makes it a user-friendly journal.
As an experienced dentist and an academician, I proudly recommend this journal to the dental fraternity as a good quality open access platform for rapid communication of their cutting-edge research progress and discovery.
I wish JCDR a great success and I hope that journal will soar higher with the passing time."

Dr Saumya Navit
Professor and Head
Department of Pediatric Dentistry
Saraswati Dental College
On Sep 2018

Dr. Arunava Biswas

"My sincere attachment with JCDR as an author as well as reviewer is a learning experience . Their systematic approach in publication of article in various categories is really praiseworthy.
Their prompt and timely response to review's query and the manner in which they have set the reviewing process helps in extracting the best possible scientific writings for publication.
It's a honour and pride to be a part of the JCDR team. My very best wishes to JCDR and hope it will sparkle up above the sky as a high indexed journal in near future."

Dr. Arunava Biswas
MD, DM (Clinical Pharmacology)
Assistant Professor
Department of Pharmacology
Calcutta National Medical College & Hospital , Kolkata

Dr. C.S. Ramesh Babu
" Journal of Clinical and Diagnostic Research (JCDR) is a multi-specialty medical and dental journal publishing high quality research articles in almost all branches of medicine. The quality of printing of figures and tables is excellent and comparable to any International journal. An added advantage is nominal publication charges and monthly issue of the journal and more chances of an article being accepted for publication. Moreover being a multi-specialty journal an article concerning a particular specialty has a wider reach of readers of other related specialties also. As an author and reviewer for several years I find this Journal most suitable and highly recommend this Journal."
Best regards,
C.S. Ramesh Babu,
Associate Professor of Anatomy,
Muzaffarnagar Medical College,
On Aug 2018

Dr. Arundhathi. S
"Journal of Clinical and Diagnostic Research (JCDR) is a reputed peer reviewed journal and is constantly involved in publishing high quality research articles related to medicine. Its been a great pleasure to be associated with this esteemed journal as a reviewer and as an author for a couple of years. The editorial board consists of many dedicated and reputed experts as its members and they are doing an appreciable work in guiding budding researchers. JCDR is doing a commendable job in scientific research by promoting excellent quality research & review articles and case reports & series. The reviewers provide appropriate suggestions that improve the quality of articles. I strongly recommend my fraternity to encourage JCDR by contributing their valuable research work in this widely accepted, user friendly journal. I hope my collaboration with JCDR will continue for a long time".

Dr. Arundhathi. S
MBBS, MD (Pathology),
Sanjay Gandhi institute of trauma and orthopedics,
On Aug 2018

Dr. Mamta Gupta,
"It gives me great pleasure to be associated with JCDR, since last 2-3 years. Since then I have authored, co-authored and reviewed about 25 articles in JCDR. I thank JCDR for giving me an opportunity to improve my own skills as an author and a reviewer.
It 's a multispecialty journal, publishing high quality articles. It gives a platform to the authors to publish their research work which can be available for everyone across the globe to read. The best thing about JCDR is that the full articles of all medical specialties are available as pdf/html for reading free of cost or without institutional subscription, which is not there for other journals. For those who have problem in writing manuscript or do statistical work, JCDR comes for their rescue.
The journal has a monthly publication and the articles are published quite fast. In time compared to other journals. The on-line first publication is also a great advantage and facility to review one's own articles before going to print. The response to any query and permission if required, is quite fast; this is quite commendable. I have a very good experience about seeking quick permission for quoting a photograph (Fig.) from a JCDR article for my chapter authored in an E book. I never thought it would be so easy. No hassles.
Reviewing articles is no less a pain staking process and requires in depth perception, knowledge about the topic for review. It requires time and concentration, yet I enjoy doing it. The JCDR website especially for the reviewers is quite user friendly. My suggestions for improving the journal is, more strict review process, so that only high quality articles are published. I find a a good number of articles in Obst. Gynae, hence, a new journal for this specialty titled JCDR-OG can be started. May be a bimonthly or quarterly publication to begin with. Only selected articles should find a place in it.
An yearly reward for the best article authored can also incentivize the authors. Though the process of finding the best article will be not be very easy. I do not know how reviewing process can be improved. If an article is being reviewed by two reviewers, then opinion of one can be communicated to the other or the final opinion of the editor can be communicated to the reviewer if requested for. This will help one’s reviewing skills.
My best wishes to Dr. Hemant Jain and all the editorial staff of JCDR for their untiring efforts to bring out this journal. I strongly recommend medical fraternity to publish their valuable research work in this esteemed journal, JCDR".

Dr. Mamta Gupta
(Ex HOD Obs &Gynae, Hindu Rao Hospital and associated NDMC Medical College, Delhi)
Aug 2018

Dr. Rajendra Kumar Ghritlaharey

"I wish to thank Dr. Hemant Jain, Editor-in-Chief Journal of Clinical and Diagnostic Research (JCDR), for asking me to write up few words.
Writing is the representation of language in a textual medium i e; into the words and sentences on paper. Quality medical manuscript writing in particular, demands not only a high-quality research, but also requires accurate and concise communication of findings and conclusions, with adherence to particular journal guidelines. In medical field whether working in teaching, private, or in corporate institution, everyone wants to excel in his / her own field and get recognised by making manuscripts publication.

Authors are the souls of any journal, and deserve much respect. To publish a journal manuscripts are needed from authors. Authors have a great responsibility for producing facts of their work in terms of number and results truthfully and an individual honesty is expected from authors in this regards. Both ways its true "No authors-No manuscripts-No journals" and "No journals–No manuscripts–No authors". Reviewing a manuscript is also a very responsible and important task of any peer-reviewed journal and to be taken seriously. It needs knowledge on the subject, sincerity, honesty and determination. Although the process of reviewing a manuscript is a time consuming task butit is expected to give one's best remarks within the time frame of the journal.
Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
Timely publication of journal: Publication of manuscripts and bringing out the issue in time is one of the positive aspects of JCDR and is possible with strong support team in terms of peer reviewers, proof reading, language check, computer operators, etc. This is one of the great reasons for authors to submit their work with JCDR. Another best part of JCDR is "Online first Publications" facilities available for the authors. This facility not only provides the prompt publications of the manuscripts but at the same time also early availability of the manuscripts for the readers.
Indexation and online availability: Indexation transforms the journal in some sense from its local ownership to the worldwide professional community and to the public.JCDR is indexed with Embase & EMbiology, Google Scholar, Index Copernicus, Chemical Abstracts Service, Journal seek Database, Indian Science Abstracts, to name few of them. Manuscriptspublished in JCDR are available on major search engines ie; google, yahoo, msn.
In the era of fast growing newer technologies, and in computer and internet friendly environment the manuscripts preparation, submission, review, revision, etc and all can be done and checked with a click from all corer of the world, at any time. Of course there is always a scope for improvement in every field and none is perfect. To progress, one needs to identify the areas of one's weakness and to strengthen them.
It is well said that "happy beginning is half done" and it fits perfectly with JCDR. It has grown considerably and I feel it has already grown up from its infancy to adolescence, achieving the status of standard online e-journal form Indian continent since its inception in Feb 2007. This had been made possible due to the efforts and the hard work put in it. The way the JCDR is improving with every new volume, with good quality original manuscripts, makes it a quality journal for readers. I must thank and congratulate Dr Hemant Jain, Editor-in-Chief JCDR and his team for their sincere efforts, dedication, and determination for making JCDR a fast growing journal.
Every one of us: authors, reviewers, editors, and publisher are responsible for enhancing the stature of the journal. I wish for a great success for JCDR."

Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
Strengths of the journal: The journal has an online first facility in which the accepted manuscripts may be published on the website before being included in a regular issue of the journal. This cuts down the time between their acceptance and the publication. The journal is indexed in many databases, though not in PubMed. The editorial board should now take steps to index the journal in PubMed. The journal has a system of notifying readers through e-mail when a new issue is released. Also, the articles are available in both the HTML and the PDF formats. I especially like the new and colorful page format of the journal. Also, the access statistics of the articles are available. The prepublication and the manuscript tracking system are also helpful for the authors.
Areas for improvement: In certain cases, I felt that the peer review process of the manuscripts was not up to international standards and that it should be strengthened. Also, the number of manuscripts in an issue is high and it may be difficult for readers to go through all of them. The journal can consider tightening of the peer review process and increasing the quality standards for the acceptance of the manuscripts. I faced occasional problems with the online manuscript submission (Pre-publishing) system, which have to be addressed.
Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Table of Contents - Year : 2020 | Month : July | Volume : 14 | Issue : 7 | Page : AB01 - AB04

Health Strategies that could Boost Industrial Productivity in India Amidst the COVID-19 Crisis AB01-AB04

Published: July 1, 2020 | DOI:

Hemant Jain, Kaushik Bharati, Aarti Garg, Sunanda Das

Dr. Hemant Jain,
No: 3, 1/9 Roop Nagar, G.T. Road, Delhi-110007, India.


The Coronavirus Disease-2019 (COVID-19) pandemic is currently wreaking havoc across the globe and has affected 213 countries and territories (1). This has led to widespread lockdowns that are having a dramatic impact on the society, which has in effect, come to a grinding halt. The livelihoods of daily wage earners and deprived and underprivileged people from the economically weaker strata of society have been particularly affected.

Job cuts have become the norm and are likely to become much worse in the near future. For example, as per the data available from the Centre for Monitoring Indian Economy (CMIE) in Mumbai, unemployment reached the highest level of 27.1% in the week that ended on 3 May 2020. The wage labourers and small businesses have been worst hit by the lockdown. A staggering 90 million people in India lost their livelihoods within a span of just one month (2).


The lockdowns have led to a complete shutdown of many industries, which could jeopardise the Indian economy. However, some industries are in the process of being reopened in a phased manner during the current Lockdown 4.0. However, an industrialist known to the authors has highlighted the problems associated with operating a factory during the current COVID-19 crisis. As per the recommendations of the Ministry of Labour and Employment, Government of India, currently the maximum limit of industrial workers who can be employed is 33% of the total workforce (3). However, he further added that the remaining 67% of employees would still need to be paid their full salary, despite the fact that they may not be working. This would greatly increase the financial burden of companies and could even lead to bankruptcy.

In order to troubleshoot these and other problems associated with reopening industries, representatives of 12 employer’s associations, including CII, FICCI and ASSOCHAM, interacted with the Labour Minister through video-conferencing to make some headway in the discussions (4).

In the meantime, Labour Law Reforms have led the Ministry of Home Affairs (MHA), Government of India to relax workplace norms, which is likely to benefit both the industries, as well as the workforce [2,5].


This editorial proposes some strategies from a health perspective to overcome some of the hurdles associated with re-opening factories and help industrialists to optimise their workflow. Some of these health strategies are discussed below.

Using Personal Protective Equipment (PPE) (6)

Personal Protective Equipment (PPE) are protective gears designed to safeguard the health of employees by minimising the exposure to biological agents. Components of PPE include coveralls, goggles, face shields, masks, gloves, and head covers.

• Coveralls: Coveralls are designed to protect the entire body of an individual from exposure to chemicals or infectious agents, such as the current Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19. Coveralls provide 360-degree protection by covering not just the torso and limbs, but also the head and feet. Hence, potentially harmful pathogens are prevented from gaining entry into the body.

Coveralls that are currently being used by medical professionals for protection against SARS-CoV-2 infection are unlikely to be suitable for industrial purposes. Firstly, medical coveralls are made of non-woven materials, such as polyester or polyethylene, which makes the wearer feel very hot. Considering the fact that factories are naturally much hotter than medical settings, the heat inside the coverall is likely to be unbearable for the wearer, thereby drastically reducing work efficiency. Secondly, since these coveralls are disposable (single-use) and cost anywhere between INR 200 and INR 1,000, these would be much too expensive and therefore infeasible for use in industrial settings (7).

An alternative solution is to use coveralls that are specifically designed for industrial use. Firstly, these are made of woven materials, usually 100% cotton fabric, thereby appreciably reducing the temperature inside the coverall. Secondly, these are washable and therefore can be re-used, without having to discard after a single use. Moreover, these are also comparatively cheaper, with an average price ranging between INR 300 and INR 800 (8). These combined factors- multiple-use and lost cost- will significantly bring down the overall running cost of the factory. Images of typical medical and industrial coveralls are presented below (Table/Fig 1).

Goggles and face shields: SARS-CoV-2 is transmitted through airborne droplets and aerosols generated by coughing or sneezing of an infected individual. When these droplets/aerosols containing the infectious virus come in contact with mucous membranes of the eyes, nose and mouth, an unaffected person becomes infected. This is how the infection spreads in the community, similar in fashion to a chain reaction. Therefore, protecting the mucous membranes of the eyes, nose and mouth by wearing goggles and face shields can effectively stop the virus from entering the body. By way of design, the frame of the goggles should be flexible and provide a tight seal with the skin around the eyes and surrounding areas of the face.

N95 respirator masks: SARS-CoV-2 and other respiratory viruses mainly infect the upper and lower respiratory tracts. Therefore, preventing the entry of infectious droplets or aerosols into the respiratory tract can prevent infection. In this regard, the role of masks is crucial for halting transmission through the respiratory route.

The N95 respirator facemasks would be most effective for industrial employees. These masks are so called because they are ‘not resistant to oil’ (hence ‘N’) and filters out 95% of airborne particles (hence ‘95’). In case of factories where employees may be exposed to oil fumes, R95 masks, which are ‘resistant to oil’ would be better suited than N95 masks.

The very high efficiency of these facemasks is capable of protecting against respiratory droplet- or aerosol-mediated transmission of the virus. These masks are designed in such a way that they are (i) close-fitting, (ii) provide good breathability due to fitted expiratory valves, (iii) possess a cup-shaped structure so that they don’t collapse against the mouth, (iv) possess nose clips to ensure a good seal, and (v) have clearly demarcated inner and outer surfaces, so that the wearer doesn’t make any mistake while putting on the mask.

Gloves: If a person touches a surface contaminated with SARS-CoV-2 from an infected person, the virus can spread by inadvertently touching the eyes, nose, or mouth. Here, gloves play a vital role in preventing viral transmission. Importantly, the gloves will not only provide protection against the virus, but also against industrial toxicants.

The type of gloves that should be used will vary according to the type of industry. Employees who perform tasks involving bulky machinery, would need to wear heavy duty gloves that are hardy and resistant to wear and tear. However, in case of tasks that require fine dexterity, close-fitting rubber gloves akin to surgical gloves would be more suitable. Ideally, these should be made of nitrile, rather than latex. Nitrile gloves are more suitable because they are resistant to chemicals, including disinfectants such as chlorine. On the other hand, the major disadvantage of latex gloves is that they can cause allergic reactions in susceptible individuals due to contact dermatitis. Moreover, non-powdered gloves are preferable than powdered gloves.

Head covers: Industrial coveralls generally don’t have a head cover. So, a separate head cover that covers the head and neck will be needed. It should be ensured that all the hair fits inside the head cover.

Practicing Personal Hygiene

Hand washing or hand sanitization: Adequate hand washing facilities and alcohol-based hand sanitizers should be made available to the employees, which should be used after taking off gloves, especially before eating. In this context, it may be mentioned that the lunchtime needs to be staggered over an extended period of time in order to prevent overcrowding of the canteen, so that social distancing measures are not compromised.

Showering: Showering facilities should be installed so that employees can take a shower before donning and after doffing PPEs, especially coveralls. Male and female employees will have separate showering areas. Personal lockers designated for each employee should be present for storing their clothes to prevent cross-contamination.

Other Strategies

Thermal scanners: Installation of thermal scanners or hand-held temperature monitors at the entry-point of the factory will play a vital role in screening employees for fever, which is a common primary symptom of COVID-19. A medical officer may be present for supervision.

Quarantining boxes containing consignments: Since COVID-19 can be transmitted by touching contaminated surfaces, it is important that the employees don’t unnecessarily touch packages. Packages and crates are generally made of cardboard and wood respectively. It has been scientifically proven that SARS-CoV-2 survives on cardboard for 24 hours and wood for up to 4 days (9). Therefore, keeping packages under quarantine for the specified time period, would ensure that they are safe to handle and also alleviate the need for sanitization by spraying disinfectants.

In-house laundry facility: Since hygiene and sanitation are of the utmost importance for tackling COVID-19, the employee’s coveralls should be scrupulously cleaned after single-use. Hence, an in-house laundry facility should be available to carry out this vital task.

An overview of how the factory workers are expected to conduct themselves within the factory premises by maintaining the highest standards of personal hygiene is depicted in the flowchart (Table/Fig 2).


Administration, communication and safety issues will be handled by staff designated for the purpose, as highlighted below:

Administrative health officer: An administrative health officer should be appointed, who will be responsible for the overall supervision and smooth running of the facility. He will oversee the activities of the workers, as well as look after their general health and wellbeing. He will also dedicate his time for properly documenting the day-to-day activities in the factory. He will maintain a log book that will contain all information, pertaining to the daily functioning of the factory in minute detail, so that nothing is missed. This record will be proof that the factory is operating as per government norms and regulations. In case of any untoward incident, he will be answerable to the higher authorities. Moreover, if any litigations are filed against the factory, the onus will lie with him to tackle the associated legal issues.

Communication intermediary: A person should be appointed to act as an intermediary between the employees and the manager, who would monitor the progress of work remotely. The intermediary will don the same PPE that medical professionals wear, thereby offering maximal protection against the virus. Additionally, he will wear a helmet fitted with a camera, headphone and mouthpiece, by means of which he will be able to transmit all audio-visual data to the manager, who would be situated within the safety of his office. The importance of the intermediary lies in the fact that it relieves the manager to do his paperwork, without having to shuttle between the factory floor and his office. Having to do this would be a logistical nightmare as it would require repeatedly donning and doffing PPE as these are mandatory on the factory floor, while at the same time, unnecessary and impractical to wear within the office. Another added advantage of having an intermediary is that the manager could monitor the factory activities remotely through video, even from the comfort of his home, given the difficulty of commuting during the lockdown.

Safety officer: A safety officer should be appointed, who will be responsible for all occupational health and safety issues. Some of the areas that he will handle include management, monitoring, advising, and reporting of all issues pertaining to the safety of all the employees. He will also be responsible for training of factory personnel through orientation programs so that they become more engaged and aware about safety issues at the workplace. Depending on the unit size and available resources, the safety officer and administrative health officer can be the same person. In this regard, one of the personnel from the Human Resource Department could take on this role.


The major impediment, as highlighted by an industrial insider, is the cost-factor involved in implementing the protective measures. However, in case of protection of employees against COVID-19, the investment will be worthwhile, as ‘all’ the employees can be employed at the same time, which would reduce running costs in the long-term. Moreover, it may be argued that industries invest heavily on fire-fighting equipment to ensure safety of its employees, then why not for COVID-19? Fire-fighting equipment doesn’t come cheap. In fact, a price analysis indicates that the cost of installation of fire sprinklers in India is approximately INR 2,500 per sq. feet. Also, fire extinguishers cost approximately INR 6,000 per piece. Besides these, there are additional costs for smoke detectors (INR 2,400 per piece) and alarm systems (INR 10,000 per piece), among other minor fire-fighting accessories (10).

With reference to COVID-19, another important health aspect needs to be kept in mind while deciding whether to invest in purchasing protective equipment. This is on the issue of rapid transmission of COVID-19. In the absence of protective gear, there is a real possibility that if a single employee becomes infected, then everyone could become infected due to working in close proximity. This could lead to closure of the factory, which would cause huge financial losses for the company.


Alleviation of the need for social distancing: By ensuring that all protective measures are in place, all the employees will be able to work in close proximity without any danger of becoming infected. Therefore, these measures will ensure that stringent social distancing protocols will no longer be mandatory within the factory.

Optimal utilisation of workforce: The suggested protective measures will enable employers to utilise the maximal workforce. This will increase output by optimising the workflow. Moreover, this will mean lesser job cuts.

Profits: In the long-run, profits are likely to rise due to increase in productivity arising from utilisation of the full strength of the workforce.

Such precautions are not only going to help ward off risk of COVID-19 but will also work against other infectious diseases (11). This will lead to a healthier workforce.


The economic and human resource costs of this strategy may be easier to bear for very large units. However, the relative marginal costs associated with these measures can be onerous for micro, small, and medium enterprises (MSME). Bathrooms and locker areas may pose problems for mid-size units (having around 50 workmen). Washing or sanitation areas may be difficult to carve out in small units with 30 or less workmen. These small and medium size units make up a large proportion of the labour and workforce and hence some innovation is required to scale these solutions down to their levels (perhaps by creating shared facilities for them or units pooling in resources to create such common complex). Government officials and regulators will need to aid the adoption of these measures and also provide incentives to smaller units for their implementation.


It is quite evident that implementation of health interventions in Indian industries is likely to benefit all stakeholders- employers, employees and the Indian economy at large. Importantly, the major employer’s associations, including CII, FICCI and ASSOCHAM have suggested that the workforce should be increased from the existing 33% to 50%, upon reopening of the factories. The authors are optimistic that by implementing the health strategies highlighted in this editorial, it would be plausible to increase the workforce well above the 50% mark- may be even as high as 100%, thereby leading to workflow optimisation, increasing productivity, as well as helping to boost the Indian economy. Hence, this will be a “win-win” situation for everyone.


The authors wish to extend their gratitude to the industrialists who kindly provided their expert opinions and insights during the preparation of the manuscript.