A STUDY TO DETERMINE THE EFFECTIVENESS OF CHILD TO CHILD PROGRAMME ON HAZARDS OF PLASTIC WASTE AND
ITS SAFE DISPOSAL AMONG SCHOOL CHILDREN IN A SELECTED SCHOOLS AT BANGALORE.
M.Sc. Nursing Dissertation Protocol submitted to
Rajiv Gandhi University of Health Sciences, Karnataka, Bangalore.
By
MS ARYA S.S
M.Sc NURSING 1ST YEAR
2011-2013
Under the Guidance of
HOD, Department of Child Health Nursing
K.T.G college of nursing
Hegganahalli Cross
Bangalore
RAJIVGANDHI UNIVERSITY OF THE HEALTH SCIENCES,KARNATAKA, BANGALORE
ANNEXURE – II
PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION 1. NAME OF THE CANDIDATE
AND ADDRESS
MS ARYA S.S
1st YEAR M.Sc NURSING
K.T.G COLLEGE OF NURSING,
BANGALORE
2 NAME OF THE INSTITUTION K.T.G COLLEGE OF NURING GANDHADAKAVALHEGGANAHALLI CROSSVISHWANEEDAM POST, MAGADI ROADBANGALORE-91
3 COURSE OF THE STUDY AND
SUBJECT
M.Sc. NURSING
(CHILD HEALTH NURSING)
4 DATE OF ADMISSION TO
COURSE
15-09-2011
5. TITLE OF THE STUDY
A STUDY TO DETERMINE THE EFFECTIVENESS OF CHILD TO
CHILD PROGRAMME ON HAZARDS OF PLASTIC WASTE AND ITS
SAFE DISPOSAL AMONG SCHOOL CHILDREN IN A SELECTED
SCHOOL AT BANGALORE.
6.0 BRIEF RESUME OF THE INTENDED WORK
INTRODUCTION
The word “plastic” comes from the Greek word “plastikos”
meaning “to form”. Plastics is any of a group of synthetic or natural organic materials that
may be shaped when soft and then hardened, including many types of resins,
resinoids,polymers, cellulose derivatives, casein materials, and proteins: used in place of other
materials, as glass, wood, and metals, in construction and decoration, for making many
articles, as coatings, and, drawn into filaments, for weaving. 1
As a result of increased production and use of chemicals, a
myriad of chemical hazards are present at homes, schools, play grounds and communities.
Chemical pollutants are released in to the environment by unregulated industries or are
emitted from heavy traffic or toxic waste sites. About 50,000 children aged 0-14 years old die
every year as a result of unintentional poisoning. 1
One among the most hazardous manufacture is the plastic.
Plastic is a group of different chemical substances, which consists of a substance having a
high molecular weight called polymers, that change from the thin consistency of plastic into
solid at the final state. 2
Polymers are large molecules that are built up by repetitive
linking of many smaller units called monomer. 3The most popular plastic polymer is
Polyvinyl Chloride (PVC), when any food material or blood is stored in the PVC plastic
containers; the chemical in it gets dissolved. The released chemical may later cause cancers,
skin diseases and other health hazards. 2
Plastic has become a part of every aspect of human living.
It is made important from birth by its use in the form of catheters, masks, sheets etc till the
grave with its multiple facets of application. It is been used for packaging, carrying, storing
and wearing, that which made the life more risky to its exposure. It has become the health and
environmental hazard. 3
The modern risk extra to basic environmental risks are
unsafe use of dangerous chemicals, inadequate disposal of toxic waste and environmental
hazards, noise, industrial, pollution, unsafe chemicals in toys and household products may
also harm children. Emerging potential environmental threats to pollutants and chemicals and
other hazards and emerging diseases. One among them is the plastic products and its use.4
Segregation of waste at the source is very important. After
segregation the material goes to a small industry for re-cycling. Decomposable and bio-
degradable is segregated from dry waste such as paper and plastic. 4
There is a great need to do more tackle environmental risks
to children’s health. The burden of disease from environmental related diseases is great and
falls disproportionately on children. In September 2002, WHO launched the healthy
environment for children initiative. It is with different groups around the world to turn their
initiative in to vibrant, global alliance which will be capable of mobilizing local support and
intervening to make children’s lives healthier where they live, learn and play. Every child has
the right to grow up in a healthy home, school and health include global climate change,
ozone depletion, contamination of persistent organic community. The future development of
our children and of their world depends on their enjoying good health now. 5
6.1
Children are more vulnerable to the illness. They are also
more capable of preventing them. The long lasting ill effects could be brought down through
an awareness and modification of the life style at the early age of their life. Use of plastic
containers, bottles and other items by children has become common. It leads to many risks in
life. However it could be only prevented rather repenting at the following stage. This could be
possible through the education given to them in the school days.5
NEED FOR STUDY In India plastic consumption trebles every decade. The impacts of
plastic can be felt across every stage of life, from fetus to adulthood. No one can ignore the
devastating consequences of plastic. In India polyvinyl chloride is commonly used to prepare
plastic materials. From slippers to the stationary used in schools, buildings and officers are
plastic. The dangers of PVC are pervasive phthalate, one of the plasticizers bond loosely with
polymer chains and can easily leach out, leading to severe consequences such as hormonal
imbalance, systemic disorders, decline in sperm count in men and also causes cancers. 6
The study on seventy one poly vinyl chloride made toys
including five from India showed a high level of phthalates. Even adults are known to be
susceptible to the effects of phthalates, especially pregnant women. It can result immature
babies, birth defects and depressed hormone response.5
Polystyrene, another commonly used polymer in plastic used to
pack food, leaches another toxic chemical namely bisphenol – A, a building block of plastic
which causes hormonal imbalance and different types of cancers. 5
Poly carbonates used for making babies bottles and water bottles
can cause severe systemic disorders in children. Other types of plastics such as poly ethylene
trephthalate (PET) is used in manufacturing cooking oil containers, low density poly ethylene
(LDPE) which is a vital component in plastic bags, poly propylene (PP) used to make caps for
containers all impact public health in various ways. 5
Bisphenol A. (BPA) a chemical in the poly carbonate plastic mimics
the hormone estrogen and causes chromosomal abnormalities 7
Plastics are the culprits in the clogging of our storm water drains,
the slow poisoning of the animals in the zoo and the cows on our streets. It also causes
chemical toxins to the subsoil of our landfills and if burnt it cause atmospheric pollution. For
anybody who cares about the future of our environment, plastic is a powerful adversary.8
Horror stories about recycled syringes, other plastic materials and
quilts packed with used surgical cotton keep pouring out of the dirty backyards of our
hospital. Segregation is the key to this waste management. Plastic bags take one million years
to degenerate. 9
The evidence from literature showed that hazards of plastic use
are highly dangerous to health and environment. Although many planned teaching programme
were developed in India on various topics, the investigator has not come across any studies on
effectiveness of a planned teaching programme on hazards of plastic use. The self-observation
of the investigator regarding the plastic use and disposal, motivated to investigate and teach
school children on hazards of plastic use.8
Health education to school children in their
formative age is the most effective method for protection and promotion of their health.
Health education in school children can be carried out in different ways and settings.
Approaching every individual in the rural area is Herculean task with poor sustainability.
Mass media and other teaching methods have their limitations. Under these circumstances
child- to –child programme offers most cost effective strategy to approach the
communities and families.7
Innovative approaches to education for health are essential to gain the
interest,support,involvement and commitment of students. The communication of health
messages is a central component of the child to child programme.This communication
occurs largely between groups where the message is transferred from a group of children
to group of respondents. This method is less stressful and more effective approach of
health education. children’s especially are vulnerable to this disease condition and through
teaching programme the mortality and morbidity rate can be controlled and prevented to a
great extent. So the investigator is very much interested in doing this topic10
REVIEW OF LITERATURE
INTRODUCTION
Review of literature is a key step in the research process. The typical purpose of
analyzing a review of existing literature is to generate questions and to identify what is known
6.2and what is unknown about the topic. The major goals of review of literature are to develop a
strong knowledge base to carry out research and non research scholalarly activity.
The review has been divided under the following headings:
1) Hazards of plastic use on human health
2) Hazards of plastic use to the environment
3) Food toxicity due to plastic chemicals.
4) Effectiveness of planned teaching programme
STUDIES RELATED TO HAZARDS OF PLASTIC USE ON HUMAN HEALTH
A study to find mortality patterns among workers exposed to styrene in
the reinforced plastic boat building industry revealed over all, 860 deaths (Standardized
Mortality Ration (SMR) 1.09, Confidence interval 1.02-1.17). The excess mortality was
accounted for esophageal cancer (n=12, SMR 2.30, CI 1.19-4.02), and prostate cancer (n=24,
SMR 1.71, CI 1.09-2.54 (Accidents (n-94, SMR 1.26, CI 1.02-1.53). Among 2.062 highly
exposed workers, urinary tract cancer (n=6 SMR 3.44, CI 1.31-4.44) rates were elevated and
urinary tract cancer SMR increased with duration of employment.11
A study on storage of serum in plastic and glass containers
may alter the serum concentration of polychlorinated biphenyls (PCBs), which is a plastic
content. The information on storage in glass (n=28) versus plastic containers (n=113) was
analyzed. Results revealed the higher PCB values (0.075 micro g/L Vs 0.45 micro g/z,
p=0.025) in the serum stored in plastic containers. The proportion of PCB detects in both
subsamples did not differ.12
A study was conducted to evaluate of the efficiency of
respiratory protective equipment based on the biological monitoring of styrene (content of
plastic). Five factories including 39 workers were investigated. Three types of respiratory
protective equipment were tested. The 20ppm which is the occupational exposure limit
recommended by the Japan society for occupational health. The result showed a significant
disparity in the efficiency of the respirator p<0.05. The site concentrations exceeded 20ppm at
10 of the 82 sampling points (12.2%) and 22 of the 39 workers (56.4%). depending on the
frequency of cartridge exchange (p<0.05). Overall study finding showed that, inspite of a half-
mask respirator used and its inhalation exchanged cartridge every half a day, the workers were
still exposed to a high styrene concentration inhalation at or over 122ppm. the study revealed
the relation of the plastic content styrene with the occupational health and personal health
when used for medical intervention.13
A cross sectional study was conducted to find the
respiratory effects of occupational poly propylene flack exposure. A total of 60 poly
propylene flocking workers were compared to a control group of 45 subjects. The result on
logistic regression analysis showed higher risk of 3.6 fold for respiratory symptoms in
polypropylene flocking workers when compared to controls. Para meters of the study group,
including percent predicted forced vital capacity ; forced expiratory volume in one second,
forced mid expiratory flow 25-75% and DL, CO, were significantly lower than in controls.
Mutlivariate analysis showed that, being polypropylene flocking worker was a predictive
factor of impairment of pulmonary function. Serum IL -8 and TNF – alpha levels were
increased in the study group compared with the controls. High resolution computed
tomography revealed peribronchial thickening and diffuse ground glass attenuation in some
subjects. The study suggested the presence of subtle or the beginning of interstitial lung
disease in these polypropylene flocking workers. 14
A comparative study on cardio toxic effect of Tinuvin 770 –
A light stabilizer of medical plastics was done in rat model. Tinuvin is a component of many
plastic materials used in medical and food industries. Investigation on cardio toxic effects of
Tinuvin 770 in vivo conducted on wistar rats by injecting intra peritoneally with increasing
doses of tinuvin 770 (1,10,100 mug and 1mg) 15 times during a 5 week period showed focal
myocytolysis and hyper contraction necrosis. Morphological results correspond the
catecholamine induced myocardial damage.15
STUDIES RELATED TO HAZARDS OF PLASTIC USE TO THE ENVIRONMENT
A study was conducted on poly chlorinated biphenyls
(PCBs) in the compost amended soil of a landfill site. The purpose was to determine if any of
the mixture of PCBs, Aroclor 1254 and Aroclor 1260 are retained in the compost amended
soil, despite atmospheric loses possible due to the peak summer (100-1170F). The method was
standardized by taking 10gm of ground soil sample in duplicate and spiked separately with
known concentration of Aroclor 1254 solution prepared in n-hexane. The maximum total
PCBs concentrations on dry wet basis were found as 1.2 ug/g. The distribution of PCBs levels
suggested an airborne mode of transport from the source. These compounds have adverse
effects on the organisms by having deposited at the top of food web including human being. 16
A study was conducted to find heavy metals
contamination in surface and ground water supply of an urbanity. The final water supply of
four treatment plants and lighty tube wells at Delhi were surveyed for cadminn chromium,
copper iron, lead, manganese, nickel, selenium and zinc. On this most of them are plasticizers.
The sample stored at room temperature and inductively. Coupled plasma atomic emission
spectrometer (ICP-AES) was used for analysis. Result showed high levels of lead, manganese,
cadmium, copper and iron compared to the Indian standard specification of 5mgL-1. Thus
study revealed the chemical toxicity to the water which cause ill effects to human health.17
A study was conducted on a cluster randomized
controlled trial evaluating the effect of hand washing promotion programme in china in
2007.87 schools were selected randomly to usual practices, slandered intervention. in control
schools, childrenexperienced a median 2 episodes of absence per 100 students per week. in
standard intervention schools ,there were a median 1.2 episodes (p=0.08) and 1.9 days
(p=0.14) of absence per 100 students weeks. Children in expanded intervention school
experienced a medium 1.2 episodes (p=0.08) and 1.9 days (p=0.14) of absence per 100
students per week. Children in expanded intervention schools experienced a medium 1.2
episodes (p=0.003) of absence per student weeks. The results showed that provision of a large
scale hand washing programme and soap was associated with significantly reduced
absenteeism.18
STUDIES RELATED TO FOOD TOXICITY DUE TO PLASTIC CHEMICALS
A comparative study of global migration levels of
recycled vs. virgin poly ethylene for packaging and storage of milk was done by using a
sample of virgin and recycled blended polyethylene films. A piece of LDPE (low density
polyethylene) was brought into contact with the stimulating solvent under the specified time
and temperature. At the end of prescribed duration, the contact liquid evaporated and the
residue was weighed for a constant weight. Analysis showed increase value of global
migration with increase percentage of recycled granules and percentage and type of activities
in film at every temperature and time combination with all extractants. The global migration
was determined by extraction method. The extractability (leaching from the LDPE) was
determined by contracting the polyethylene sample with either the food material or a range of
oily, alcoholic and aqueous extractants which stimulate various foods. 19
STUDIES RELATED TO CHILD TO CHILD PROGRAMME
A study was conducted to evaluate the effectiveness of child
to child programme on hazards of plastic waste in a selected school in Bhopal in2006.the
research approach selected was evaluative. The sampling technique was purposive and sample
size was 10 change agents and peer groups. The tool comprised of structured questionnaire.
The pre test knowledge scores range between 29.2 % to 43.3 % and post test knowledge
scores range between 65.3 % to 88.4 %.the gain in knowledge scores range between 25.6% to
4.5 %.the result showed that the post test knowledge was greater than the pre test knowledge
in every section of child to child programme. 20
A study was conducted to evaluate the effectiveness of
child to child programme in Jamaica in 2004 about the concept of Plastic disposal . A child
programme was carried out in fourth and fifth grade students of six schools.423 students and
90mothers and guardians from four of the project school were evaluated and compared with
199 children and 47 parents from 2 control schools. The project children showed higher
knowledge in the topic at the end of the year.21
A study was conducted to assess the impact of child to child
programme on knowledge,attitude,practice regarding plastic waste disposal strategies among
school children in Belgaum district in Karnataka .The subjects included sixth grade students
of primary schools. The study group and the sixth grade students as control group pre tested
pre designed questionnaire was administered to study as the Control group students to know
their knowledge, attitude and practice prior to starting of the programme.Once a week one
hour child to child session were conducted for the study group students. The result of the
study showed that child to child programme had made a significant improvement in the
knowledge, change in attitude and practice of the study group students after the intervention
when compared to control group students. 22
STATEMENT OF PROBLEM:
“A STUDY TO DETERMINE THE EFFECTIVENESS OF CHILD TO CHILD
PROGRAMME ON HAZARDS OF PLASTIC WASTE AND ITS SAFE DISPOSAL
AMONG SCHOOL CHILDREN IN A SELECTED SCHOOL AT BANGALORE “.
6.3
6.4
OBJECTIVES OF THE STUDY
The objectives of the study are:
To assess the existing knowledge of school children regarding hazards of plastic
waste and its safe disposal.
To evaluate the effect of child to child programme on knowledge regarding hazards of
plastic waste and its safe disposal.
To associate the knowledge with selected demographic variables such as age, religion,
education of the parents, type of family, area of residence.
HYPOTHESIS
The hypothesis will be tested at 0.05 level of significance.
H 1: There will be significant difference in the pre test and post test knowledge
scores of school children receiving child to child programme..
H 2: There will be significant association between knowledge of school children
and selected demographic variables such as age,religion,education.
Of the parents, type of family, area of residence.
OPERATIONAL DEFINITIONS:
DETERMINE In this study it refers to firmly decide on the effect of child to child programme
6.5
6.6
on hazards of plastic waste and its safe disposal as measured by the semi –structured
questionnaire and expressed as the post test scores of the experimental group.
EFFECTIVENESS In this study it refers to producing the desired or intended result of child to child
programme on hazards of plastic waste and its safe disposal as measured by the instrument
and shown by the post test scores of the experimental group.
CHILD TO CHILD PROGRAMME
It is an approach of health education in which a group of students are selected
according to their academic abilities, interest in participating group activities and their
communication abilities as reported by their teacher and giving health education to
these selected students regarding hazards of plastic waste and its safe disposal and these
students educate other students of the school.
KNOWLEDGE
In this study it refers to the correct responses of the students to the knowledge
part of the questionnaire of the interview schedule and expressed as knowledge scores
SCHOOL CHILDREN
Those children between 11-13 years of age, studying in 7 th standard of a selected
School.
HAZARDS
It refers to the ill effects caused by plastic on the environment and health of human
6.7
beings, in terms of physical and emotional capabilities.
DISPOSAL
It refers to safe methods of getting rid of plastic wastes.
ASSUMPTIONS
Adequate information about hazards of plastic waste and its safe disposal can be
provided through child to child programme.
Knowledge level of the students will be improved.
They will follow good plastic waste disposal strategies.
DELIMITATIONS:
The study is delimited :
To children’s
who knows kannada or English
Children between the age group of 11 to 13 years.
PROJECTED OUTCOME: The present study will help the rural school children to understand about the
6.8
6.9
7.0
hazards of plastic waste and its safe disposal
MATERIALS AND METHODS
7.1 SOURCE OF DATA
The data will be collected from school children who are studying in 7 th grade.
7.1.1 RESEARCH DESIGN
The research design adopted for this study is pre experimental study. One group pre
test and post test control group.
RESEARCH APPROACH
The research approach is evaluative.
7.1.2 SETTING:
The study will be conducted in S.V sunrise school Bangalore. It is 10 km away from
the College.
7.1.3 POPULATION
The population selected are school children who are studying in 7 th grade.
7.2 METHOD OF DATA COLLECTION
7.2.1 SAMPLING PROCEDURE
The Sampling Technique adopted for this study is purposive.
7.2.2 SAMPLE SIZE
The sample size is 60.
7.2.3 INCLUSION CRITERIA
The criteria for sample selection are mothers of under five who
Students of 7 th grade both boys and girls.
willing to participate in the study
students who are present on the day data collection.
7.2.4 EXCLUSION CRITERIA
Children who are studying in other grades.
7.2.5 INSTRUMENT INTENDED TO BE USED
SELECTION OF TOOL
This consist of three parts :
PART 1 :consist of demographic variables such as age,religion,education of the parents,
type of family, area of residence.
PART 2:Questionnaire will be used to assess the knowledge.25 Questions will be used.
SCORING PROCEDURE
For knowledge assessment
For Answers. If answer is yes 1
If answer is no 0
SCORING INTERPRETATION Good :- 75-100%
Average :- 50-75%
Poor :- Below 50%
7.2.6 DATA COLLECTION METHOD
Prior permission will be obtained from the principal of the school before conducting the study.
Self administered questionnaire will be distributed to the children and responses will be
collected . Data will be collected from 2 to 3 samples per day. The duration will be 4 weeks.
7.2.7 PILOT STUDY
6 samples will be selected and a study will be conducted to find out the feasibility.
7.2.8 DATA ANALYSIS PLAN
The data obtained from will be analyzed in view of the objectives of the study using
analytical and inferential statistics.
The plan of data analysis is as follows:-
Frequencies and percentage of distribution will be used to analyze the demographic
data.
Mean, Median and Mode , Standard Deviation is used for accessing the knowledge
score
DOES THE STUDY REQUIRE ANY INVESTIGATION OR
INTERVENTION TO BE CONDUCTED ON PATIENTS OR OTHER
HUMANS OR ANIMALS?
- No-
HAS THE ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR
INSTITUTION?
7.3
7.4
YES, Ethical clearance will be been obtained from the research committee of
K.T.G college of nursing.
Consent will be taken from the authority and permission will be taken from the
study subjects before the collection of data.
LIST OF REFERENCES
1 ) Elias, Hans-Georg ” An Introduction to Plastics”4th edition. Wiley & Weinheim
Publishers; (2003);pno 121.
2 ) Andrady, Anthony.” Plastics and the Environment” 6th edition . John Wiley & Sons;
2003); pno 222
3) Callan, Scott and Thomas.”Environmental Economics and Management ” Environmental
8.0Health Journal ; (2006) June4 (2):59.
4 )Dr.Veena SR .“Handling Hospital waste Health action “ The Indian Journal on
Medicine :2003 ;December; 16 (12): 19-21.
5) Susan Norwood.” Environmental Health Hazards and Children” The Environmental Health
Journal :2006 ;Feb. 5(25):25-29.
6 ) Richardson. E,et al.” Environment and Health”.Archives of Environmental Health
Journal :2001;May;56(3):264-70.
7) Dave G,Etal.”Environmental Health Hazards”. Science Total Environmental Journal .:
2011; August;409(18):9-24.
8 ) Gregory MR.” Effects of Plastic Burning on Environment ”. Biological Science Journal.:
2009 ; July;364(1526):2013-25.
9) Dr. Veena SR Handling Hospital waste. Health action 2003 December; 16 (12): 19-21.
10)Kalpana Sunder “Plastics a Menace”. The Indian Journal On Environmental
Health.:2009;Jan 37(3): 119-137.
11) Ruder AM. Ward EM, Dongm, Okum AH, Davis-King K. Mortality patterns among
workers exposed to styrene in the reinforced plastic boat building industry. Amj Ind Med 2004
Feb; 45 (2) 165-76.
12) Karmaus W, Rie bow jf. Storage of Serum in Plastic and Glass Containers may alter the
serum concentration of polychlorinated biphenyls. Environment Health Prospect 2004 May;
112 (b): 643-647.
13) Nakayama S, Nishide T, Horike T, Kishi Moto T, Kiras. Evaluation of the efficiency of
respiratory protective equipment based on the biological monitoring of styrene in fibre glass
reinforced plastic industries. Journal of Occupational health 2004 March; 46 (2) : 132-140.
14) Atis S, Tutluoglu B, Levent E, OZturk C, Tunacl A, Sachin K, et al. The respiratory
effects of occupational poly propylene flock exposure. Eur Respir J. 2005 Jan; 25 (1) : 110-
117.
15) Sotonyi, Peter Merkely, Bela, llubay, Marta, et al. Comparative Study on Cardiotoxic
effect of Tinuvin 770 : A light stabilizer of medical plastics in Rat Model. Toxicological
Sciences, 2004 Feb; 77 (2) : 368 – 374.
16) Thacker NP, Titus A, Pande SP. Poly chlorinated biphenyls in compost amended soil of a
land fill site. Indian Journal of Environmental Health 2002 Jan; 44 (1) : 19-23.
17) Dixit RC, Verma SR, Nitnaware V, Thacker NP. Heavy Metals contamination in surface
and ground water supply of an urban city. Indian Journal of Environmental Health 2003 April;
45 (2) : 107-112.
18) Chen X, Xi F, Geng Y,”potential environmental gains from recycling waste plastics”.
Waste Management journal: 2011; January; 31(1):168-79.
19) Upender MK, Srivastava, Sing P. Chopras. Comparative Studies of Global Migration
levels of recycled Vs. Virgin polyethylene for packaging and storage of milk. Indian Journal
of Environmental Health 2003 April; 45 (2) : 101-106.
20) Thaneja .r “use of ctc to evaluate knowledge regarding plastic disposal in selected
schools”. the Indian journal of holistic nursing 2006 14(2):12-14.
21) Jennifer knight,grantham “the effectiveness of ctc programme” the American journal of
Pediatrics;2002,6:66-68.
22) Walvekar p.r,naik v.a,wantamutte a.s.”impact of child to child programme on
knowledge,attitude and practice regarding hazards of plastic among rural school
children”.theIndian journal of public health;2006 february 31(2):45
9. SIGNATURE OF THE CANDIDATE
10. REMARKS OF THE GUIDE
11. NAME AND DESIGNATION OF
11.1 GUIDE
11.2 SIGNATURE
11.3CO-GUIDE
11.4SIGNATURE
11.5 HEAD OF DEPARTMENT
11.6 SIGNATURE
12 12.1 REMARKS OF THE PRINCIPAL
12.2 SIGNATURE