Implementation of a health education program in Asia, comparing Thailand, Indonesia, and Japan.

BACKGROUND: The global community is faced with aging societies, which will result in increased health care costs. we have been introducing our International Organization for Standardization (ISO)-certified health education system in Thailand and Indonesia. OBJECTIVE: The purpose of this study was to collect data on the effects of this ISO-certified health education system, to extend the healthy life expectancy and to study the feasibility of implementing this program and in new social contexts. METHODS: We implemented the health education program recruiting 43, 114 and 119 participants, respectively, in Japan, Thailand and Indonesia. The participants' conditions before and after the program were determined through anthropometry, physical fitness tests, blood chemistry tests, brain function tests and pedometry. RESULTS: Regarding pedometry, the Japanese participants took the highest number of daily steps on average, followed by the Indonesian and Thai participants. In the 10-m obstacle walk, the Thai and Indonesian participants had significantly increased times. Furthermore, the differentiation reaction time, reverse differentiation reaction time, total number of "misses", total number of "mistakes" and total number of errors significantly improved. CONCLUSION: It is possible to implement a program of an ISO-certified health education system, but how to develop exercise habits is important.

Risk factors associated with heat-related illness among sugarcane farmers in Thailand.

Heatstroke is defined as severe symptoms of heat-related illness, which could lead to death. Sugarcane farmers are at high risk of heatstroke under extremely hot outdoor working conditions. We explored the prevalence of heat-related illness symptoms and risk factors related to heat-related illness among sugarcane farmers working in the summer. We conducted a cross-sectional study using questionnaire interviews among 200 sugarcane farmers in Kamphaeng Phet Province, Thailand. The questionnaire addressed demographics, heat-related symptoms experienced during summer at work, and occupational factors. Bioelectrical impedance analysis was used to assess body mass index and body fat percentage. Watson formula equations were used to estimate total body water. The prevalence of heat-related illness symptoms was 48%; symptoms included heavy sweating, weakness/fatigue, dizziness, muscle cramps, headache, and vertigo. Factors associated with heat-related illness included women and clothing. Sugarcane farmers wearing two-layer shirts had a higher risk of heat-related illness. Farmers with fluid intake 3.1-5.0 liters per day had a 79% lower risk of heat-related illness. Our findings demonstrated that sugarcane farmers are at risk of heat-related illness. We confirmed that working conditions, including wearing proper clothing and water-drinking habits, can reduce this risk.

Cold-related pain in the face, upper limbs, and lower body among Thai chicken industry workers: a cross-sectional study.

OBJECTIVE: There is limited information on cold-related pain (CRP) in various parts of the body among workers employed in cold environments. We, therefore, determined the prevalence of CRP among Thai chicken industry workers and attempted to identify vulnerable subgroups. METHODS: Four hundred and twenty-two workers in four chicken meat factories in Thailand were asked about CRP in the face, upper limbs, and lower body. The results were expressed as adjusted prevalence and prevalence differences [PD; in percentage points (pp)] and their 95% confidence intervals (CI). RESULTS: Overall, 80% of the subjects suffered from CRP in at least one site on the body: 66% in the upper limbs, 65% in the lower body, and 44% in the face. In most sites, CRP increased from the lowest to the highest educational level, notably in the nose with a PD of 36 pp [95% CI 23, 49]. Forklift drivers experienced knee pain [PD 21 pp (0, 41)], and manufacturing [PD 27 pp (15, 38)] and storage workers [PD 24 pp (10, 37)] experienced thigh pain more often than office workers, while office workers reported CRP in the cheeks, ears, wrists, and fingers more often than other workers. Women had more CRP than men in several body sites. CONCLUSIONS: The majority of workers suffered from CRP. Intensified protective measures should be targeted not only for forklift drivers and storage and manufacturing workers, but also for the highly educated as well as the office staff who showed excessive prevalence of CRP in several body sites.

Cold-related symptoms and performance degradation among Thai poultry industry workers with reference to vulnerable groups: a cross-sectional study.

BACKGROUND: Few studies have examined cold-related symptoms among cold workplace workers in Thailand. This study aimed to determine the prevalence of cold-related cardiorespiratory, circulatory, and general symptoms and performance degradation among Thai chicken industry workers and identify vulnerable groups. METHODS: Overall, 422 workers aged from 18 to 57 years at four chicken meat factories in Thailand were interviewed for cold-related symptoms and complaints. The results were expressed in terms of model-based adjusted prevalence and prevalence differences (PDs) in percentage points (pp) with 95% confidence intervals (CIs). RESULTS: In total, 76.1% of the respondents reported cold-related respiratory symptoms, 24.6% reported cardiac symptoms, 68.6% reported circulatory symptoms, and 72.1% reported general symptoms. In addition, 82.7% of the respondents reported performance degradation. Cold-related respiratory symptoms increased by PD 29.0 pp. (95% CI 23.4-34.6) from the lowest to the highest educational group, with a similar pattern observed in performance degradation. Forklift drivers and storage and manufacturing workers complained of cold-related respiratory symptoms more than office staff (PD 22.1 pp., 95% CI 12.8-31.3; 12.0 pp., 95% CI 2.4-21.6; and 17.5 pp., 95% CI 11.5-23.6, respectively); they also reported more performance degradation (PD 24.1 pp., 95% CI 17.0-31.2; 19.8 pp., 95% CI 14.1-25.6; and 14.8 pp., 95% CI 8.0-22.6, respectively). Weekly alcohol consumers reported more performance problems owing to cold (PD 18.2 pp., 95% CI 13.9-22.6) than non-consumers of alcohol. Cardiac and circulation symptoms were more common in women than men (PD 10.0 pp., 95% CI 1.1-18.9; and 8.4 pp., 95% CI 0.5-16.4, respectively). The age trend in performance issues was curved, with the highest prevalence among those aged 35-44 years, while the oldest workers (45-57 years) perceived less cold-related symptoms, particularly thirst. CONCLUSIONS: Cold-related symptoms and performance degradation were found to be common in this industry, with vulnerable groups comprising of highly educated workers, forklift drivers, storage and manufacturing workers, weekly alcohol consumers, aging workers, and women. The results demonstrate a need for further research on the adequacy of protection provided against the cold, particularly given that global warming will increase the contrast between cold workplaces and outdoor heat.

Prevalence of cold-related symptoms among Thai chicken meat industry workers: association with workplace temperature and thermal insulation of clothing.

This study determined the association of cold-related symptoms with workplace temperature and thermal insulation of clothing among Thai chicken industry workers. Three hundred workers were interviewed regarding cold-related symptoms, which were regressed on worksite temperature and protective clothing. In total, 80% of workers reported respiratory symptoms; 23%, cardiac symptoms; 62%, circulation disturbances; 42%, thirst; 56%, drying of the mouth; and 82%, degradation of their performance. When adjusted for personal characteristics, respiratory symptoms were 1.1‒2.2 times more prevalent at -22‒10°C than at 10‒23°C. At -22‒10°C, cardiac symptoms increased by 45%, chest pain by 91%, peripheral circulation disturbances by 25%, and drying of the mouth by 57%. Wearing protective clothing with at least 1.1 clo units was associated with marked reductions in symptom prevalence. Therefore, temperatures lower than 10°C increased prevalence of cold-related symptoms, which are largely preventable by appropriate clothing use.

Effects of triple-treatment trunk stretching on physical fitness and curvature of the spine.

BACKGROUND: Research on the effectiveness of treatment for low back disorders has been made, however yet no established method has been found. Therefore, we devised a triple-treatment trunk stretching program comprising the following three trunk stretching exercises: stretching using an unstable flex chair; stretching using a stretching bench; and stretching using a stretch pad. Our three-treatment trunk stretching program is based on the principles of static muscular stabilization of the spine and uses well-known physiological strength-training principles. In this study, we investigated the effects of triple-treatment trunk stretching on physical fitness levels and curvature of the spine measured by X-ray photographs. METHODS: Thirteen healthy male subjects (mean age, 26.3 ± 4.0 years; height, 173.5 ± 4.9 cm; weight, 64.9 ± 5.7 kg; BMI 21.6 ± 1.7) were enrolled in this study. In consideration of safety and simplicity, we applied the physical fitness test introduced by the Ministry of Education, Culture, Sports, Science and Technology of Japan for 65- to 79-year-olds. RESULTS: Triple-treatment trunk stretching led to significant improvements in sit-and-reach flexibility, 10-m obstacle course walking time, standing forward flexion, thoracolumbar extension and horizontal flexion. Significant improvements were also observed in the neutral angle of the curvature of the lower thoracic spine and the neutral angle of the curvature of the lower lumbar spine. CONCLUSIONS: Significant improvements were evident in the neutral angles of both the curvature of the lower thoracic spine and the curvature of the lower lumbar spine after triple-treatment trunk stretching. This suggests that triple-treatment trunk stretching can help improve the curvature of the spine and physical fitness.

The effectiveness of a Japanese style health program: comparison between Minowa, Japan and Rayong, Thailand.

AIM: This study aimed to appropriately establish a Japanese style healthcare program under the ISO9001:2008 (ISO: International Organization for Standardization) in Minowa, Japan and Rayong, Thailand to improve problem areas and inspect its effectiveness. Furthermore, we want to make this health promotion through ISO widely available in Asian countries and to make an international contribution. METHOD: We implemented a 6-month health program in the c Rayong city, Thailand, and a 12 month health program in the Minowa town, Japan. This study assessed findings from pedometry, anthropometry and blood pressure measurements, physical fitness, blood chemistry, and brain function tests. RESULTS: The comparisons were made using interaction effects between the participants in Rayong and Minowa. They showed significant differences in the 10-m obstacle walk, the 6-minute walk, HDL, the reverse and reverse differentiation time, the total number of forgets, the total number of mistakes, and the total number of brain function errors. CONCLUSIONS: To improve the brain function in participants from Rayong through this health education program, measures such as increasing the number of steps, adding muscular strength/stretching exercises, and home training every day is suggested.

The Effect of Multifactorial Intervention Programs on Health Behavior and Symptom Control Among Community-Dwelling Overweight Older Adults With Knee Osteoarthritis.

BACKGROUND: Osteoarthritis of the knee (OA knee), especially in older adults, is the most common chronic illness and a major public health problem. Overweight older adults are at a high risk of developing OA knee and suffering from OA knee symptoms, which cause older adults to become disabled and have functional limitations. The reduction of knee pain and the maintenance of physical functions of overweight older adults with OA knee are critical. PURPOSE: To examine the effect of multifactorial intervention programs (MUFIPs) on health behavior and symptoms control in overweight older Thais with knee osteoarthritis. METHODS: Eighty overweight older Thais with knee osteoarthritis living in communities were randomly assigned into experimental and control groups. The experimental group received MUFIPs, including health education, a weight-reduction/control program, a quadriceps exercise training class followed by a home-based exercise program, and a home visit program. The control group did not receive the MUFIPs. Changes in the study variables were assessed at baseline and 8- week follow-ups. Data were analyzed by using descriptive and independent t test analyses. RESULTS: The experimental group had significant improvement in osteoarthritis knowledge, illness representation, health behavior, movement ability, and joint range of motion, and had reduction in knee pain and body weight. All these variables were observed to have significant differences between experimental and control groups. CONCLUSION: The MUFIPs can break down the progression of the disease among overweight older Thais with knee osteoarthritis.