Naesinee Chaiear

Sensitisation to natural rubber latex : an epidemiological study of workers exposed during tapping and glove manufacture in Thailand

OBJECTIVES To estimate the prevalence of sensitisation to natural rubber latex in latex tappers and latex glove factory workers, and to relate this to airborne exposure to latex. METHODS Five hundred workers employed in three latex glove factories, 314 tappers, and 144 college students (control group) were studied. The workers in the glove factories were classified into three exposure groups; high, moderate, and low. Personal exposures to natural rubber latex aeroallergens were measured by immunoassay. Symptom questionnaires and skin prick tests with latex allergens (Stallergènes 1:200 w/v) and other common environmental allergens were performed. The criterion for positivity was a wheal reaction at least 3 mm in diameter greater than that to a diluent control. RESULTS The geometric mean (GM) concentration of latex in air was 15.4 μg/m3for those employed in glove stripping, glove inspections, and packing of powdered gloves. The moderate exposure glove manufacturing group and the tappers had GM concentrations of 2.3 and 2.4 μg/m3respectively, compared with United Kingdom users of latex powdered gloves,who had GM concentrations of 0.5 μg/m3. The prevalence of sensitisation to latex in the tappers and latex glove factory workers was 1.3% and 1.7% respectively. No positive cases were found among the college students. Workers who showed a positive skin prick test to latex were more likely to be atopic. Work related respiratory and dermatological symptoms were found in about 20% of each population studied, but were not related to the presence of positive latex prick tests. CONCLUSIONS This study suggests that in the Thai latex industries, latex sensitisation is rare despite high concentrations of airborne exposure and is less prevalent than in the healthcare sector in Europe where skin exposure is greater.

Can workplaces be predictors for recent onset latent tuberculosis in health care workers

ObjectiveTo study the association of workplaces and recent onset latent tuberculosis (LTB) in health care workers (HCW).MethodsA case-control study was conducted at Srinagarind Hospital, Khon Kaen University, Thailand. We recruited HCW who had results of tuberculin test within 2 consecutive years from 2001–2008 and also had fixed workplaces (working hours more than 40 hours/week). Cases were subjects with tuberculin conversion, while controls were subjects with negative results of tuberculin test in two consecutive years. Tuberculin conversion was defined if a subject had a negative baseline tuberculin test and a positive tuberculin test in the next consecutive years. Baseline characteristics, workplaces (office, in-patient unit, out-patient unit, intensive care, operating room, and laboratory unit), tuberculosis related variables, and prevention strategies were studied. Multiple logistic regression analysis was used to identify predictors for tuberculin conversion.ResultsThere were 624 subjects who met the criteria and 163 subjects had tuberculin conversion (26.1%; case group). The median age and male/female ratio of both groups were 39 years old and about 1:4. The cases group had higher percentage of subjects who worked at in- and out-patient department (30.7 vs 20.2 and 17.2 vs 12.2, respectively), had history of tuberculosis exposure in the past year (32.1 vs 16.1), and had history of prevention by any method and by surgical mask (49.4 vs 37.0 and 54.3 vs 38.3, respectively). Workings at in- and out-patient unit and history of tuberculosis exposure in the past year were significant predictors for tuberculin conversion (adjusted odds ratio and [95% confidence interval] of 1.99 [1.25–3.17], 1.91 [1.10–3.17], and 2.26 [1.47–4.96], respectively).SummaryWorkplaces in health care facilities do increase risks of LTB in HCW, particularly in in- and out-patient unit. Policy development regarding tuberculosis infection control programs focused on workplace prevention in health care facilities in Thailand is needed.

Validation of the Thai Version of a Work-related Quality of Life Scale in the Nursing Profession

Background Currently available questionnaires for evaluating the quality of worklife do not fully examine every factor related to worklife in all cultures. A tool in Thai is therefore needed for the direct evaluation of the quality of worklife. Our aim was to translate the Work-related Quality of Life Scale-2 (WRQLS-2) into Thai, to assess the validity and reliability of the Thai-translated version, and to examine the tools accuracy vis-à-vis nursing in Thailand. Methods This was a descriptive correlation study. Forward and backward translations were performed to develop a Thai version of the WRQLS. Six nursing experts participated in assessing content validity and 374 registered nurses (RNs) participated in its testing. After a 2-week interval, 67 RNs were retested. Structural validity was examined using principal components analysis. The Cronbachs alpha values were calculated. The respective independent sample t test and intraclass correlation coefficient were used to analyze known-group validity and test–retest reliability. Multistate sampling was used to select 374 RNs from the In- and Outpatient Department of Srinagarind Hospital of the Khon Kaen University (Khon Kaen, Thailand). Results The content validity index of the scale was 0.97. Principal components analysis resulted in a seven-factor model, which explains 59% of the total variance. The overall Cronbachs alpha value was 0.925, whereas the subscales ranged between 0.67 and 0.82. In the assessment results, the known-group validity was established for the difference between civil servants and university employees [F (7.982, 0.005) and t (3.351; p < 0.05)]. Civil servants apparently had a better quality worklife, compared to university employees. Good test–retest reliability was observed (r = 0.892, p < 0.05). Conclusion The Thai version of a WRQLS appears to be well validated and practicable for determining the quality of the work-life among nurses in Thailand.

Preliminary Psychometric Properties of the Chinese Version of the Work-Related Quality of Life Scale-2 in the Nursing Profession

Objectives As quality of work-life (QWL) among nurses affects both patient care and institutional standards, assessment regarding QWL for the profession is important. Work-related Quality of Life Scale (WRQOLS) is a reliable QWL assessment tool for the nursing profession. To develop a Chinese version of the WRQOLS-2 and to examine its psychometric properties as an instrument to assess QWL for the nursing profession in China. Methods Forward and back translating procedures were used to develop the Chinese version of WRQOLS-2. Six nursing experts participated in content validity evaluation and 352 registered nurses (RNs) participated in the tests. After a two-week interval, 70 of the RNs were retested. Structural validity was examined by principal components analysis and the Cronbachs alphas calculated. The respective independent sample t-test and intra-class correlation coefficient were used to analyze known-group validity and test-retest reliability. Results One item was rephrased for adaptation to Chinese organizational cultures. The content validity index of the scale was 0.98. Principal components analysis resulted in a seven-factor model, accounting for 62% of total variance, with Cronbachs alphas for subscales ranging from 0.71 to 0.88. Known-group validity was established in the assessment results of the participants in permanent employment vs. contract employment (t = 2.895, p < 0.01). Good test-retest reliability was observed (r = 0.88, p < 0.01). Conclusion The translated Chinese version of the WRQOLS-2 has sufficient validity and reliability so that it can be used to evaluate the QWL among nurses in mainland China.

Exposure to wood dust and its particle size distribution in a rubberwood sawmill in Thailand.

A cross-sectional study on wood dust exposure and respiratory health effects was conducted at one of the largest rubberwood sawmills in Thailand. All workers (N = 340) from all jobs on a day shift were recruited for personal sampling. Overall, the personal inhalable dust (n = 742) and respirable dust (n = 241) of full-shift samples were collected from 27 job titles. These data were used to classify workers into high, moderate, and low exposure groups based on the concentrations found in each job. Static samples were also collected to determine the particle size distribution. Geometric means (GM) are used to present the concentrations of the rubber wood dust. Inhalable dust concentrations were clearly high, ranging between 0.2 to 59.4 mg/m3 and with GM of 4.7 mg/m3. The GM of inhalable dust in each job title enabled classification of the workers into three exposure groups: (1) high exposure; >5 mg/m3, (2) moderate exposure; 2.0–5.0 mg/m3, and (3) low exposure; 0.18–1.9 mg/m3. Among the high exposure group, the highest GM inhalable dust concentrations were found in sawing green lumber (12.8 mg/m3) and cutting dry lumber (7.3 mg/m3). The respirable dust concentrations were generally low, in the range of 0.1 to 6.0 mg/m3 with a GM of 0.5 mg/m3. The largest percentage of dust in major operations belonged to the thoracic fraction; 50% cutoff diameter was smaller than 9 μm. The size distribution of wood dust indicated a high proportion in the large particle sizes.

Prevalence and risk factors for latex allergy

Editor—We read with interest the cross sectional study of latex allergy of workers in a United Kingdom hospital.1 We have also tried to study healthcare workers in a district general hospital and have had problems with the response rate for skin prick testing and also blood taking. We have, however, used standardised and evaluated skin prick test …

Prevalence of musculoskeletal symptoms among garment workers in Kandal province, Cambodia

Prevalence of musculoskeletal symptoms among garment workers in Kandal province, Cambodia: Leap Van, et al. Department of Community Medicine, Faculty of Medicine, Khon Kaen University, Thailand

Concentrations and Size Distribution of Inhalable and Respirable Dust Among Sugar Industry Workers A Pilot Study in Khon Kaen, Thailand

There has been very limited information regarding bagasse exposure among workers in sugar industries as well as on health outcomes. The authors determined the occupational exposure of sugar industry workers in Khon Kaen to airborne bagasse dust. The size of the bagasse dust ranged from 0.08 to 9 µm with the highest size concentration of 2.1 to 4.7 µm. The most common size had a geometric mean diameter of 5.2 µm, with a mass concentration of 6.89 mg/m3/log µm. The highest mean values of inhalable and respirable dust were found to be 9.29 mg/m3 from February to April in bagasse storage, 5.12 mg/m3 from May to September, and 4.12 mg/m3 from October to January. Inhalable dust concentrations were 0.33, 0.47, and 0.41 mg/m3, respectively. Workers are likely to be exposed to high concentrations of bagasse dust and are at risk of respiratory diseases. Preventive measures, both in the form of engineering designs and personal protective devices, should be implemented.

Risk of asthma in relation to occupation: A hospital-based case-control study

BACKGROUND Asthma is a common occupational lung disease and is preventable by removing identifiable allergens. OBJECTIVES (1) To assess the relationship between occupation and asthma (2) To determine the agents associated with asthma. METHODS In this hospital-based, case-control study 153 cases from the Asthma Clinic and 306 non-asthmatic controls from Srinagarind Hospital, Thailand were interviewed. Crude odds ratios (COR), 95% confidence intervals (95% CI) and adjusted ORs (AOR) for multiple logistic regression were calculated. RESULTS Of the 153 cases, 70.6% were females with median age of 53 (IQR-14). Of the 306 controls, 62.4% were females with median age of 56 (IQR-16). The highest risk of asthma was family history of asthma and history of atopy [AOR 11.68 (95% CI 4.52, 30.24) and AOR 8.03 (95% CI 5.07, 13.60)], respectively. If only occupations were considered, healthcare workers had the highest risk [AOR 4.08 (95% CI 1.35, 12.30)], followed by textile workers [AOR 3.34 (95% CI 1.07, 10.47)] and school workers AOR 2.40 (95% CI 1.31, 4.41). When subgroups of non-atopy were considered, school workers had a significant association with asthma [COR 3.18 (95% CI 1.48, 6.83)]. When no family history of asthma was considered, school and textile workers had the most significant association with asthma [COR 3.10 (95% CI 1.87, 5.13) and COR 3.06 (95% CI 1.15, 8.13), respectively]. Inorganic dust was the agent most significantly associated with asthma COR 1.89 (95% CI 1.25, 2.82). CONCLUSION School, textile and healthcare workers have the greatest risk of asthma. Family history of asthma and being atopic would also promote asthma in relation to occupation.

0425 Validation of the Thai version of a work-related quality of life scale

Objectives Our aim was (a) to assess the content validity of a Thai translation/version of a quality of work-life evaluation tool, and (b) to examine its accuracy vis-à-vis nursing in Thailand. Method Descriptive correlation study Forward-backward translating procedures were used to develop the Thai version of the work-related quality of life scale. Six nursing experts participated in assessing content validity and 374 registered nurses (RNs) participated in its testing. After a two-week interval, 67 of the RNs were retested. Structural validity was examined using principal components analysis and the Cronbach’s alphas calculated. The respective independent sample t-test and intra-class correlation coefficient were used to analyse known-group validity and test-retest reliability. Sample group: Cluster sampling was used to select 374 registered nurses from the In- and Out-patient Departments t Srinagarind Hospital, Khon Kaen University. Results The content validity index of the scale was 0.97. Principal components analysis resulted in a seven-factor model, explaining 59% of total variance (Cronbach’s alpha for the subscales ranged between 0.65 and 0.84, while the overall Cronbach’s alpha was 0.925). The known-group validity was established in the assessment results of the difference in bureaucrats (civil servants) vs. casual employees by F (8.855,0.003) and t (3.305, p < 0.01). Apparently, government employees have a better quality of work life than the university’s casual employees. Good test-retest reliability was observed (r = 0.898, p < 0.01). Conclusions The Thai version of a work-related quality of life scale appeared to be well validated and therefore useable for determining the quality of work-life among nurses in Thailand.