Teerasak Phajan

Work-related musculoskeletal disorders among sugarcane farmers in north-eastern Thailand.

This cross-sectional analytical study aimed to identify prevalence and factors associated with work-related musculoskeletal disorders (WMSDs) among sugarcane farmers. Cluster random sampling was used to select 540 sugarcane farmers from 3 provinces in North-Eastern Thailand. Three related questionnaires, plus assessments by 2 expert physiotherapists, were used to check for factors associated with WMSDs and prevalence of WMSDs. Data were analyzed using descriptive statistics and multiple logistic regressions. The results indicated the prevalence of WMSDs among sugarcane farmers in the 7 days before the interview and looking back over the previous 12 months were 82.96% and 88.70%, respectively. Factors significantly associated with reporting WMSDs (P value < .05) during past 12 months were (a) repetitive motions (adjusted odds ratio [OR] = 1.90; 95% confidence interval [CI] = 1.05-3.43), (b) working in awkward postures (adjusted OR = 1.95; 95% CI = 1.01-3.77), (c) forceful exertions (adjusted OR = 2.78; 95% CI = 1.54-5.02), and (d) stress about future income (adjusted OR = 1.80; 95% CI = 1.02-3.16). Recommendations are made for risk prevention strategies.

Factors associated with blood zinc, chromium, and lead concentrations in residents of the Nam Pong River in Thailand

ABSTRACT This cross-sectional analytical study aimed to determine the blood levels of zinc (B-Zn), chromium (B-Cr), and lead (B-Pb) and to identify the factors influencing these levels in the blood of residents of the Nam Pong River. Quantitative data collection was utilized, and systematic random sampling was conducted to obtain 420 samples for measuring serum heavy metals, including B-Zn, B-Cr, and B-Pb. Multiple regression analysis was used to identify factors influencing the accumulation of heavy metals in the population, reported mean differences, 95% confidence intervals, and p values. The average levels of heavy metals were 74.38 ± 14.00 µg/dL (95% confidence interval [CI]: 73.03–75.72) for zinc, 0.28 ± 0.23 µg/L (95% CI: 0.26–0.30) for chromium, and 2.80 ± 1.60 µg/dL (95% CI: 2.64–2.95) for lead, which all were within normal limits. Factors influencing zinc levels included occupational exposure (batteries) (mean diff = 11.56; 95% CI: 1.81–21.32, p value = 0.02) and consumption of fish from the river exceeding 300 grams/meal or three times/week (mean diff = 4.68; 95% CI: 0.09–9.45, p value = 0.05). Factors influencing chromium levels included a history of past illness (mean diff = 0.19; 95% CI: 0.05–0.34, p value = 0.01) and dust/chemical exposure from industry (mean diff = 0.05; 95% CI: 0.00–0.11, p value = 0.05). Factors influencing lead concentrations included gender (mean diff = 1.82; 95% CI: 0.26–1.98, p value = 0.001), smoking (mean diff = 1.03; 95% CI: 0.60–1.45, p value < 0.001), and occupational exposure (garage) (mean diff = 1.11; 95% CI: 0.27–1.94, p value = 0.01).

Developing primary care occupational health services for informal sector workers in Thailand

This study demonstrates action research’s emancipatory traditions in enabling community stakeholders in rural Thai settings to increase self-reliance and collaboration in improving primary care occupational health services. Most of the Thai workforce are informal sector workers outside Thai labor law protections, health and safety regulatory frameworks, and without specific occupational health services to provide for work-related health needs. This project brought together community leader teams, village health volunteers and informal workers themselves to collaboratively develop community services for this underserved group. Significant changes were effected at community team level, with improvements in networking and community nurses’ health care for the workers and in their oversight and supervision of village health volunteers (VHVs) in the community. Most notably, VHVs’ self-confidence improved at providing illness prevention and health promotion support in workers’ homes and work settings congruent with their daily lifestyle and work schedules. Informal workers’ health self-care behaviors improved.

Using Action Research to prevent work-related illness among rubber farmers in Northeastern Thailand

OBJECTIVES This research aimed to enhance self-care among rubber farmers for preventing work-related illness. DESIGN AND SAMPLE The project used Action Researchs four phase iterative process: fact-finding to understand the problems, action planning, action plan implementation, and evaluation and reflection on action plan impacts. Sixty-six participants (46 rubber farmers and 20 community stakeholders) were purposively recruited from two villages in the top 10 rubber producing provinces in Northeastern Thailand. MEASURES Demographic and work-related illness data were collected in face-to-face structured interviews, Focus group interviews and participant observations were used to collect data in each project phase. Night group meetings were held throughout the research phases. The intervention included training workshops and establishing a community health education team for ongoing farmer support. RESULTS Results showed improved farmer self-care behaviors and establishment of a community health education team to encourage farmers to care for themselves properly. CONCLUSION Community nurses, other health personnel, and the Thai government can build on initiatives like this to strengthen occupational health and safety practices and services policy for rubber farmers.

Socioeconomic disparities and chronic respiratory diseases in Thailand: The National Socioeconomics Survey

ABSTRACT This study aimed to determine the association between socioeconomic determinants and Chronic Respiratory Diseases (CRDs) in Thailand. The data were used from the National Socioeconomics Survey (NSS), a cross-sectional study conducted by the National Statistical Office (NSO), in 2010 and 2012. The survey used stratified two-stage sampling to select a nationally representative sample to respond to a structured questionnaire. A total of 17,040 and 16,905 individuals in 2010 and 2012, respectively, were included in this analysis. Multiple logistic regressions were used to identify the association between socioeconomic factors while controlling for other covariates. The prevalence of CRDs was 3.81% and 2.79% in 2010 and 2012, respectively. The bivariate analysis indicated that gender, family size, geographic location, fuels used for cooking and smoking were significantly associated with CRDs in 2010, whereas education, family size, occupation, region, geographic location, and smoking were significantly associated with CRDs in 2012. Both in 2010 and 2012, the multiple logistic regression indicated that the odds of having CRDs were significantly higher among those who lived in urban areas, females, those aged ≥41–50 or ≥61 yr old, and smokers when controlling for other covariates. However, fuels used for cooking, wood and gas, are associated with CRDs in 2010.

Development and validation of a work-related low back pain risk-assessment tool for sugarcane farmers

This cross sectional study developed and validated a LBP risk-factor screening scale for use with sugarcane farmers. The scale was developed from a synthesis of LBP risk factors, pretested with 30 sugarcane farmers and administered to five hundred and forty sugarcane farmers to test its psychometric properties. Results indicated construct validity for three factors; physical factors (19 items) with factor loadings of 0.406 to 0.881 and communalities between 0.471 and 0.991; psychological factors (7 items) with factor loadings of 0.635 to 0.821 and communalities between 0.444 and 0.714, and third, working environment factors (2 items), with factor loadings between 0.345 and 0.347 and communalities between 0.946 and 0.953. The content validity index was 0.90 with reliability index of 0.87. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy were 82.02%, 30.49%, 62.65% and 54.40% respectively. The area under the receiver operating characteristic was 0.56. The scale’s high specificity and sensitivity and comprehensive three risk-factor dimensions should make it a very useful screening tool in primary health care for early detection of LBP and for LBP risk-reduction and prevention advice. Future studies could focus on confirming content and predictive validity in other settings to assess generality of its usage.

Dust exposure and lung function of workers in the brick and clay pottery factories in the Northeast of Thailand

Abstract This study aimed to determine the particulate matter concentrations (PM10) in workplace air and personal dust, and their effects on the respiratory health of exposed workers. The lung function of 449 exposed workers was examined. The concentration of PM10 in workplace air and personal dust exposure was measured. Spirometry was used to evaluate the lung function capacity included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), forced expiratory volume ratio (FEV%) and peak expiratory flow rate (PEF). The forced expiratory flow at 25% to 75% of the FVC (FEF 25-75%) was determined. The PM10 concentration in workplace air (6 study sites) and personal dust (4 study sites) exceeded the standard (REL) of 0.12 mg/m3. The results of this study showed a decrease in the mean values and percent predicted value of FVC, FEV1, FEV1%, PEF and FEF 25-75%. The lung capacity of participants revealed that 24.50%, 4.45% and 7.13% had mildly, moderately restrictive and small airway disease. The respiratory symptoms were dyspnoea (22.49%), wheezing (10.69%), chest pain (10.69%) and chronic cough (2.90%). Factors influencing lung capacity included mask usage (Adj.OR: 0.44 CI: 0.25-0.79 p-value: 0.006) and chest pain (Adj.OR: 2.68 CI: 1.14-6.30 p-value: 0.024).

Socioeconomic disparities in income, education and geographic location for hypertension among Thai adults: Results from the National Socioeconomic Survey

Background: Hypertension (HT) has been one of the leading global risk factors for health and the leading cause of death in Thailand for decades. The influence of socioeconomic factors on HT has been varied and inconclusive. The aim of this study was to determine the association between socioeconomic determinants and HT in Thailand. Methods: This study used data from the National Socioeconomic Survey, a cross-sectional study that was conducted by the National Statistical Office of Thailand in the years 2005, 2006 and 2007. In our analysis, data were collected on gender, age, marital status, smoking status, education, status of work, occupation, current liability (short-term debt), household monthly income, residential area, region and previously diagnosed HT by a physician. Results: The odds of having HT were significantly higher among those who had household monthly income, education, residential area and region. The participants who had monthly income of <10001 baht (2005: AOR = 3.19, 95%CI:1.47 - 6.92; 2006: AOR 2.53, 95%CI:1.37 - 4.69; 2007: AOR = 3.35, 95%CI: 1.97 - 7.00), were living in Bangkok compared with the Northeast region (2005: AOR = 1.72, 95%CI:1.37 - 2.17; 2006: AOR = 2.44, 95%CI: 1.89 - 3.13; 2007: AOR = 2.63, 95%CI 2.08 - 3.45), lived as an urban resident (2005: AOR= 1.32, 95%CI: 1.12 - 1.56; 2006: AOR= 1.21, 95%CI: 1.02 - 1.43; 2007: AOR= 1.47, 95%CI: 1.18 - 1.62), and finished primary education (2005: AOR =1.21, 95%CI: 1.03 - 1.43; 2006: AOR= 1.23, 95%CI: 1.04 - 1.46; 2007: AOR= 1.18, 95%CI: 1.01 - 1.38) when controlling for other covariates. Conclusion: This study indicated that socioeconomic disparity has an influence on HT. Those with low educational attainment, low income, lived in urban regions, and were metropolitan residents (Bangkok) were vulnerable to HT.

THE RELATIONSHIP BETWEEN EXPOSURE TO ANTISMOKING CAMPAIGN, KNOWLEDGE, FAMILY SUPPORT, AND SMOKING HABIT, AMONG MALE WORKERS IN EAST BORNEO, INDONESIA

BACKGROUND: Indonesia has the highest (46.16%) prevalence of smokers among the ASEAN countries. Some anti-smoking measures had been implemented. However, little was known for their effect. This study aimed to determine the prevalence of smoking, and the relationship between exposure to anti-smoking campaign, knowledge, family support, and smoking habit, among male workers in East Borneo, Indonesia. SUBJECT AND METHODS: This was a cross sectional study conducted in Samarinda, East Borneo, Indonesia. A sample of 311 male workers was selected at random from 10 subdistrics in Samarinda. The dependent variable was smoking behavior. The independent variable included exposure the anti-smoking campaign, knowledge about the damaging effect of tobacco smoking, and family support. A structured questionnare was developed to collect the data. A logistic regresion was used to analyze the data. RESULTS: The prevalence of smokers was 45.6% (95%CI=40.09 to 51.23). Un-exposure to anti-smoking campaign (OR=2.24, 95%CI= 1.10 to 4.68; p=0.032), lacking in knowledge of the health damaging effect of tobacco smoking such as mouth and throat cancers (OR=2.43; 95%CI=1.16 to 5.06; p=0.018), and weak family support (OR= 2.07; 95%CI=1.09 to 4.50; p=0.006), were all associated with an increased probability of smoking. CONCLUSION: Nearly half of the Indonesian male workers living in Samarinda were smokers. Un-exposure to anti-smoking campaign, lacking in knowledge of the health damaging effect of tobacco smoking such as mouth and throat cancers, and weak family support, were all associated with an increased probability of smoking. The government should increase the frequency of anti-smoking campaign and improve its access.

FACTORS ASSOCIATED WITH CHEMICAL PESTICIDE USE AMONG FARMERS IN EASTERN PART OF CAMBODIA

BACKGROUND: Chemical pesticides are known to have adverse impact on human health. However, little is known about the magnitude and factors influencing chemical pesticide use in Cambodia. The study aimed to describe and determine factors influencing chemical pesticide use among farmers in the Eastern part of Cambodia. SUBJECT AND METHODS: This was a cross-sectional study. A total of 287 farmers were selected by multistage random sampling proportional to size of the population from 8 communes in the Eastern part of Cambodia. The questionnaire was developed to measure variables under study. A multiple logistic regression was applied to estimate the factors influencing chemical pesticide use. RESULTS: 53.66% of the sample was female. Mean age= 41.01, and SD= 10.8 years old. The average monthly income was 460,000 Riel (112 US