From Rickshaw to Reality

Welcome to Reality! After over forty days in India I am back home. What a whirlwind adventure it was. Just the other day I walked my beloved passive nicotine monitors to the FedEx store to ship them off to Johns Hopkins. It was difficult for me to part with them as I felt we had been through so much together. From traveling to India, the wrapping in layers of plastic bags while in the field to avoid the torrentous Mumbai monsoon rains, the questioning in the Delhi airport, and now our final goodbye in the FedEx store in Los Feliz. I must admit, I was quite reluctant to let my monitors go, they were such a part of me and my experience in India, and I feared that somehow they might be kidnapped or lost en route to Johns Hopkins where they are sent for laboratory analysis. The hipster clerk at the FedEx Store was quite amused by my indecision. Nevertheless, I put them carefully in a box and bid goodbye.

At the end of the day, after a slow start the project went as good as I could have expected. Of all the restaurants that we approached, asking to participate in our study, we had a 61.5% acceptance rate! Even the department chairs at Tata Memorial Hospital were surprised!

I will briefly describe the nature of what we accomplished:

After agreeing to participate signing the consent form, the owner briefly sat and orally completed a questionnaire which attempted to ascertain characteristics of the present restaurant. Following the questionnaire completion, the passive nicotine monitor was placed.This was the end of the initial encounter.

Within seven days from placing the passive nicotine monitor, we returned to each restaurant with a PM2.5 monitor to gauge the active concentration of particulate matter in the environment. At this time we also recorded if there was smoking or the presence of any cigarette butts or smoking paraphernalia. Additionally, we checked to see if the monitor was still in the location where it had been originally placed. Within seven to nine days following the initial placement of the monitor, we returned to the restaurant to collect the monitor.

The protocol called for seven days (although this in fact is arbitrary) but we had some unavoidable obstacles that prevented this. First- there was a Political Strike Day called by the political parties in India to protest the increase in fuel prices. It was declared unsafe to travel that day by any public or private transportation. Dozens of buses were burned and rocks thrown at other means of transport. I happened to go to the hospital because I traveled in a government + medically authorized vehicle with other medical professionals, which was exempt from the pelting stones of protesters. The political implications of the day are long, and I will discuss this in a future blog. The other difficulty was the Monsoon season. The torrentous Mumbai rains prevented collection and transport of monitors due to the impassible roads, inability to get a taxi, and risk of wetting the monitors. I would like to underline how horrific the rains in Mumbai are. As a small anecdote- my first Friday in Mumbai, I waded through waters up to my waist!!!! Yes- you can only imagine what lay in those murky waters…Yet after being stuck a few times, I began to look at it as an adventure. It just reinforces how resilient the Indians are and how little they complain even after trudging through rains up to their knees on a regular basis. Very impressive!

Returning to the study, a total of 24 monitors were used. 20 were monitors corresponding to each of the 20 restaurants where the study was performed. There were 2 monitors placed at the 2nd and 11th restaurant which served as controls. Additionally 2 monitors were used as blanks to demonstrate if there was any background nicotine recorded in the process of transport and storage. In addition to the two blanks, a total of 21 monitors (out of the 22 monitors) were retrieved. One monitor was not able to be recollected, as the owner of the restaurant stated it had gone missing during its permanence in the restaurant.

So that ends the data as we have it now. When I learn more about the analysis from Johns Hopkins I will be sure to post it. Look forward to some pictures in the near future!