Pipat Luksamijarulkul

Hepatitis B sero-prevalence and risk factors among school-age children in a low socioeconomic community, Bangkok.

A cross-sectional study of 165 school-age children who had no history of HBV vaccination was carried out in a low socioeconomic community of Din-Daeng, Bangkok. Blood specimens were collected for determination of HBV seromarkers (HBsAg, Anti-HBs and Anti-HBc) by EIA commercial kits. The results showed that the prevalence of HBV seromarkers was 24.85%, the HBsAg carrier rate was 3.64%, the anti-HBs positive rate was 15.15%, and the prevalence of only anti-HBc was 6.06%. To investigate factors associated with the positivity of HBV seromarkers, children were divided into two groups-the first group consisted of 41 children with HBV seromarkers and the second consisted of 124 children without HBV seromarkers. The study variables between the two groups were compared and analysed. The results revealed that factors associated with HBV positivity were (a) child factors: childs age, childs sex, ear piercing in female, sharing blade during haircutting, contact wound from other persons, using wares with other persons, searching things in garbage, and (b) family factors: older parent, low education in parent, low family income per month, low parents knowledge and attitude about HBV infection and vaccination, (P < 0.05). After using stepwise regression analysis, the factor of ear piercing in female was only one significant variable (P = 0.007).

Detection and characterization of hepatitis A virus in water samples in Thailand

Aims:  Outbreaks of hepatitis A in Thailand have been reported continuely and associated with water supply. However, the genetic analysis of hepatitis A virus (HAV) in water is limited. This study described the application of virus concentration method and reverse transcriptase‐nested polymerase chain reaction (RT‐nested PCR) to detect HAV RNA and analyse the genetic sequence of the virus in environmental water samples.

Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok.

OBJECTIVE To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards. METHODS This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Grams stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearsons correlation coefficient at the significant level of p<0.050. RESULTS Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively). For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively. CONCLUSION High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards.

Human Immunodeficiency Virus and Hepatitis C Virus Infections among Patients Attending Sexually Transmitted Disease Clinics, Regional 2, Thai land:

A cross-sectional study of 400 patients attending sexually transmitted disease (STD) clinics at The Venereal Diseases and AIDS Centers, Regional 2, Thailand, was conducted from January to December 1996 in order to investigate the antibody prevalence to human immunodeficiency virus (HIV) and hepatitis C virus (HCV) and to describe some epidemiological characteristics among HIV and HCV co-infected individuals. The studied patients were interviewed and their blood specimens were collected for determining anti-HIV and anti-HCV antibodies. The results revealed that the prevalence of anti-HIV among studied patients was 25%, while 7.5% were positive for anti-HCV The positivity of both antibodies present in the same individuals was 3.3% (13/400 cases). The highest prevalences of anti-HIV, anti-HCV and both antibodies were found in studied patients aged 20 years or less. Patients with primary education, or lower, had relatively higher prevalence of anti-HIV and/ or anti-HCV than those with higher level education. A relatively higher prevalence was found among commercial sex workers and labourers. Among 13 HIV and HCV co-infected individuals, there were four cases who had histories of sexual contact without condom use, but no history of parenteral contact. The rest (9/13) had histories of both parenteral contact and sexual contact without condom use. Asia Pac J Public Health 2000;12(1):41-45Occupational health services in Korea can be largely divided into periodic health examination for workers, group health care system for workers in small and medium size industries, and workplace environment measurement. Periodic health examination is composed of general and special health examination. General health examination is performed once every two years for office workers and once every year for production workers. The expenses of medical examination are covered by public medical insurance program. Special health examination is performed on workers who dealt with hazardous agents with variable durations. The employer pays the expense of special health examination. Group health care system has been established for small and medium sized industries exempt for assignment of full-time health managers (physician, nurse, hygienist). It entrusts the role of health managers to occupational health organization or clinic. Especially, entrust fee of small sized industries are paid by government. The levels of hazardous agents are measured in all workplace environment. If the measured level exceeds the permissible exposure level, the employer is enforced to improve the workplace environment with their own expense. In 1997, 684,000 workers received periodic health examination and 2,400 workers were found with occupational diseases.

Microbial Air Quality and Bacterial Surface Contamination in Ambulances During Patient Services

OBJECTIVES We sought to assess microbial air quality and bacterial surface contamination on medical instruments and the surrounding areas among 30 ambulance runs during service. METHODS We performed a cross-sectional study of 106 air samples collected from 30 ambulances before patient services and 212 air samples collected during patient services to assess the bacterial and fungal counts at the two time points. Additionally, 226 surface swab samples were collected from medical instrument surfaces and the surrounding areas before and after ambulance runs. Groups or genus of isolated bacteria and fungi were preliminarily identified by Grams stain and lactophenol cotton blue. Data were analyzed using descriptive statistics, t-test, and Pearsons correlation coefficient with a p-value of less than 0.050 considered significant. RESULTS The mean and standard deviation of bacterial and fungal counts at the start of ambulance runs were 318±485cfu/m(3) and 522±581cfu/m(3), respectively. Bacterial counts during patient services were 468±607cfu/m(3) and fungal counts were 656±612cfu/m(3). Mean bacterial and fungal counts during patient services were significantly higher than those at the start of ambulance runs, p=0.005 and p=0.030, respectively. For surface contamination, the overall bacterial counts before and after patient services were 0.8±0.7cfu/cm(2) and 1.3±1.1cfu/cm(2), respectively (p<0.001). The predominant isolated bacteria and fungi were Staphylococcus spp. and Aspergillus spp., respectively. Additionally, there was a significantly positive correlation between bacterial (r=0.3, p<0.010) and fungal counts (r=0.2, p=0.020) in air samples and bacterial counts on medical instruments and allocated areas. CONCLUSIONS This study revealed high microbial contamination (bacterial and fungal) in ambulance air during services and higher bacterial contamination on medical instrument surfaces and allocated areas after ambulance services compared to the start of ambulance runs. Additionally, bacterial and fungal counts in ambulance air showed a significantly positive correlation with the bacterial surface contamination on medical instruments and allocated areas. Further studies should be conducted to determine the optimal intervention to reduce microbial contamination in the ambulance environment.

P135 Developing a global environmental & occupational health (geohealth) hub for southeast asia

To date the Mahidol-UMass Lowell Centre for Work, Environment, Nutrition and Human Development (CWEND) GEOHealth Hub has focused on the occupational health concerns of workers in health care and in the informal sector, including agriculture. In Thailand, the informal sector accounts for about 63% of the working population. CWEND collected health questionnaires from over 630 informal sector workers. A few of the key findings are: agricultural workers reported significant exposure to ergonomic risk factors and musculoskeletal symptoms. Pesticides were widely used and farmers showed significant differences in symptoms as well as the types of pesticides and protective practices used based on the type of agricultural crop. Among the stone sculptors ∼ 12% reported an abnormal lung function or chest x-ray result due to the high silica content of the stone used. Among bird cage makers, significant differences were found for MSDs and other health effects by job type. While among salt farmers 15% reported heat cramps, 21% heat rash and 49% heat exhaustion in the past month. CWEND developed an occupational health questionnaire to collect data from 1100 health care workers in Thailand. A few of the key findings are: health care workers reported significant exposure to ergonomic risk factors and musculoskeletal symptoms, 60% of the nutrition unit experienced a sharp injury and 27% of the surgical unit experienced a needle stick in the past 3 months, while workers in patient care units were more likely to report awareness of a hospital health and safety program, receive training and be provided PPE than non-patient care workers. Our current focus is on expanding the CWEND-GEOHealth Hub network to other countries and, through our training program, expanding research capacity and initiating research projects that will support data driven policy changes to improve occupational health in the ASEAN region.

Occupational Hazards in the Thai Healthcare Sector

Healthcare personnel work in vulnerable conditions that can adversely impact physical and/or mental health. This paper aims to synthesize the state of knowledge on work-related illnesses, injuries, and risks experienced by Thai healthcare workers. We found that Thai healthcare personnel, like others worldwide, are at risk for injury related to needle sticks and sharp instruments; infectious diseases due to biological hazards exposure such as airborne pathogens and patient secretions; muscle pain due to workload and long duration of work; and psychological disorders related to stressful working conditions. Because detailed surveillance data are limited for the Thai healthcare workforce, we recommend that additional surveillance data on Thai healthcare workers’ health outcomes be collected. Future research efforts should also focus on evidence-based interventions in order to develop methods to prevent and treat occupational health injuries and illnesses acquired in the workplace for Thai healthcare sector workers.

Predictive Factors of Legionella pneumophila Contamination in Cooling Tower Water

A cross-sectional study of 160 water samples collected from 72 cooling towers in 4 hospitals, 7 department stores, and 3 hotels in Bangkok was carried out to investigate Legionella pneumophila contamination and its predictive factors. All water samples were cultured for Legionella spp. and tested for L. pneumophila by real-time polymerase chain reaction (PCR). Some cooling tower parameters were measured and recorded. Data were analyzed using χ 2 -test, odds ratio and stepwise logistic regression analysis at the significant level of α = 0.05. Results revealed that the Legionella spp. contamination was 20.0% (32/160) and for L. pneumophila was 61.3% (98/160). The sensitivity of real-time PCR was higher than that of the culture. Factors significantly associated with L. pneumophila contamination by χ 2 -test were: the cooling tower model, size, use duration, pH, water temperature, use of ozone, and residual free chlorine (95% CI of OR > 1.0, P < 0.05). After stepwise logistic regression analysis, four predictive factors remained. These included the cooling tower model being a cross-flow type (adjusted OR = 3.1, 95% CI = 1.2-7.8, P = 0.017), use duration >5 years (adjusted OR = 3.6, 95% CI = 1.3-10.1, P = 0.016), water temperature <29.4°C (adjusted OR = 7.9, 95% CI = 2.1-29.6, P = 0.002), and residual free chlorine <0.2 ppm (adjusted OR = 8.5, 95% CI = 2.1-34.9, P = 0.003). Additionally, the risk probability for L. pneumophila contamination was estimated to be 13.9-97.1%, depending on the combination of predictive factors.