Situations of work-related diseases and injuries among agriculturists in the upper northeast regions of Thailand.

Background: Agriculturists exposed to health hazards are affected by increased occupational disease. This retrospective study aimed to investigate situations of work-related diseases and injuries among agriculturists in upper northeast Thailand. Methods: The secondary data of international classification of diseases 10 th revision (ICD-10) case reports of occupational disease among farmers, from the database of the Health Data Center (HDC), were used. The registered farmers data was collected as a dataset from the provincial agricultural office and the data of ICD-10 code utilised from the hospital information system (HIS) of healthcare services in Udon Thani and Roi-Et provinces, which was extracted for cases of work-related diseases and injuries of registered agriculturists. The annual morbidity rate of occupational diseases was analysed and presented at a rate per 100,000 farmers. Results: Among farmers in the HDC database, lung disease, which was not reported as occupational disease of the HDC database, was the highest ranking of all diseases, followed by work-related musculoskeletal disorders (WMSDs), noise- and heat-related diseases, and pesticide toxicity, respectively, while the injury rate was as high as that of WMSDs. Those morbidity rates of Roi-Et and Udon Thani provinces were representative of the morbidity ranking of diseases of the nation and had increasing trends from 2014 to 2016. The number of farmers in the HDC database did not consistently reflect the number of registered farmers in the agricultural database. Conclusions: Situations of work-related diseases and injuries discovered among registered farmers reflect the health problems of Thai agriculturists, and the underestimation in the reported disease rate in the health database is explained by big data analysis, which showed that work-related cases with an identifying code of Y96 had rarely been reported among agriculturists. Therefore, Thai agriculturists should be supported in registration with occupational diseases and injuries surveillance as holistic healthcare.

Biomatrix of health risk assessment of benzene-exposed workers at Thai gasoline stations.

OBJECTIVE: This study assessed the health risk of benzene exposure among Thai gasoline station workers through biomarker detection and experience of adverse symptoms. METHODS: Trans, trans-muconic acid (tt-MA) metabolites of benzene were analyzed from spot urine sampled among gasoline station workers after shift work using HPLC-UV. Air benzene monitoring was done with an active sampler connected to a charcoal sorbent tube, and analyzed by GC-FID. The health risk was calculated by using the biomatrix of the likelihood of benzene exposure and the severity of adverse symptoms. RESULTS: The tt-MA concentration, among 235 workers, ranged from less than 10-2159 µg/g Cr, which corresponded to the air benzene concentration range of <0.1 to 65.8 ppb. In total, 32.3% of workers had a higher than acceptable risk level and there was a significant association between gasoline station work zones and the likelihood of benzene exposure as well as the health risk of workers. The health risk levels estimated from the biomarker monitoring were consistent with the risk matrix of air benzene monitoring. CONCLUSION: This tt-MA biomarker monitoring and biomatrix of health risk assessment is suggested as useful for health surveillance of gasoline station workers exposed to benzene.

Factors Affecting Adverse Health Effects of Gasoline Station Workers.

This cross-sectional study examined the risk factors affecting adverse health effects from benzene exposure among gasoline station workers in Khon Kean province, Thailand. An interview questionnaire of adverse symptoms relating to benzene toxicity was administered to 151 workers. Area samplings for benzene concentration and spot urine for tt-muconic acid (tt-MA), a biomarker of benzene exposure, were collected. The factors associated with adverse symptoms were analysed by using multiple logistic regression. It was found that these symptoms mostly affected fuelling workers (77.5%), and the detected air benzene reached an action level or higher than 50% of NIOSH REL (>50 ppb). The top five adverse symptoms, i.e., fatigue, headache, dizziness, nasal congestion, and runny nose, were reported among workers exposed to benzene. More specific symptoms of benzene toxicity were chest pain, bleeding/epistaxis, and anaemia. The detected tt-MA of workers was 506.7 ug/g Cr (IQR), which was a value above the BEI and higher than that of asymptomatic workers. Risk factors significantly associated with adverse symptoms, included having no safety training experience (ORadj = 5.22; 95% CI: 2.16-12.58) and eating during work hours (ORadj = 16.08; 95% CI: 1.96-131.74). This study urges the tightening of health and safety standards at gasoline stations to include training and eating restrictions while working in hazardous areas.

Incidence and risk factors associated with lower back pain among university office workers.

This prospective cohort study investigated the incidence of lower back pain (LBP) and the risk factors for LBP among university-based office workers. Participants were 159 office workers in one Thailand university who met the inclusion criteria of the cohort group. Data were collected using a follow-up interview questionnaire and measurements of physical fitness and lighting intensity. Results showed that the incidence of LBP during 12-month follow-up was 83.0%. Physical fitness tests showed that the back, leg and hand grip strengths were significantly lower in LBP cases than in non-cases. Multiple logistic regression analysis indicated that the risk factors associated with LBP were body mass index ≤ 25 (adjusted relative risk [RRadj] = 3.49, 95% confidence interval [CI] [1.27, 9.55]), poor back-pain preventive behavior (RRadj = 3.44, 95% CI [1.08, 10.98]) and inappropriate workstation width (RRadj = 5.72, 95% CI [1.44, 22.70]). In conclusion, most workstations (91.8%) had a lighting intensity lower than the standard requirement (400-500 lx). The results indicate the nature of hazards affecting LBP in office workers in the academic workplace. In order to prevent LBP in this group of office workers, ergonomics education and the better design of workspace, improved lighting and greater emphasis on the physical fitness of staff are needed.

Fire risk assessment in fire hazardous zones of gasoline stations.

OBJECTIVE: This cross-sectional study aimed to assess fire risk in fire hazardous zones (FHZ) at the dispenser areas of gasoline stations. METHODS: There were 47 stations chosen for fire risk assessment and two zones around the dispenser area of each station were assessed. The assessments were carried out by applying the matrix (3 × 4) of fire risk assessment by multipliers of opportunities level of hazard occurrence and the subsequent severity of the incident. RESULTS: Across the 47 gasoline stations studied, there was an average of 23 ± 12 nozzles and none had vapor recovery systems (VRS) on dispenser nozzles. The average daily amount of gasoline sold was 3382 L. Each gasoline station had an average of 10 ± 5 workers/station; they all worked within a 1.5 meter radius of the dispenser (FHZ-I); and they used cellphones >4 hours/day. The average level of flammable gas was in the range 1.3%-7.4% LEL-UEL (6.2% ± 5.2%). The fire risk was found to be an intolerable risk in FHZ-I at 40 stations (85.1%) and FHZ-II at 10 stations (21.3%). A total of 18 stations were ranked as having a substantial risk, whereas 19 stations also had a moderate risk in FHZ-II; those levels correlated with the station locations and the quantity of fuel sold. CONCLUSION: It suggests that high risk must be controlled by using preventive and safety actions: eliminating fire ignition sources, such as by cellphone prohibition, and inspection of electrostatic discharges, engineering control with grounding when refuelling, signposting of hazardous zones, and VRS installation on dispenser nozzles.

Low Back Pain (LBP) Incidence, Ergonomics Risk and Workers' Characteristics in Relations to LBP in Electronics Assembly Manufacturing.

AIMS: Electronics industry workers might have increased the risk of low back pain (LPB). This cohort study aimed to investigate LBP incidence and provide a baseline of ergonomic factors and workers' characteristics associated with LBP. METHODS: A six-month monitoring phase was designed using 196 electronic workers to identify LBP incidence. Baseline data were collected for ergonomic risk by RULA and lighting intensity measurement. Personal factors and work stress were surveyed by job content questionnaires (JCQ). RESULTS: Ergonomic risk related to sitting posture was indicated at inspection with lamp (66.7%; change needed). High risk was shown among standing workers at punching and E-check processes. The lighting intensity did not meet the recommended standard in the arm range zone 2 of inspection and E-check stations. Dissatisfaction was reported due to work stress, workload, work rhythm, and job control. The six-month LBP incidence was 52.5%. Work experience less than three years (RR = 1.41; 95% CI: 1.031.90) and chronic diseases (RR = 1.41; 95% CI: 1.091.82) were significantly correlated with LBP incidence. CONCLUSIONS: Ergonomic and lighting conditions at E-check and inspection should be improved, and the promotion of short break exercise during shiftwork period is suggested. LBP should be closely surveilled in workers who had less job experience and underlying diseases.

Factors Affecting Urinary tt-Muconic Acid Detection among Benzene Exposed Workers at Gasoline Stations.

Trans, trans-muconic acid (tt-MA) is a metabolite that is widely used as a biomarker to identify low exposure to benzene, a human carcinogen. This study aimed to investigate occupational factors related to the urinary tt-MA detection of benzene exposed workers in gasoline stations. Spot urine samples were collected and analyzed for tt-MA using a high performance liquid chromatography. Additional data were collected via subject interviews using a structured questionnaire. The personal benzene concentration was measured and analyzed by gas chromatography with a flame ionization detector. Results showed that, among the 170 workers, tt-MA was detected in 24.7% of workers and the concentration ranged from 23.0 to 1127.8 µg/g creatinine. Over 25% of those detections possessing tt-MA exceeding the recommended 500 µg/g creatinine was safe. A multiple logistic regression analysis identified that factors significantly associated with the detectable tt-MA were having no other part-time jobs (ORadj = 4.2), personal benzene concentrations of 0.05 ppm or higher (ORadj = 10.3), close to fuel nozzle during refuelling (ORadj = 93.7), and no job training (ORadj = 2.74). Safety training is recommended for those tt-MA detected workers or under a reference benzene concentration of 0.05 ppm or higher. The proposed reference of occupational action level to benzene exposure is 0.05 ppm and compliance could be assessed tt-MA for biomonitoring of those benzene exposed workers.

Risk Assessment on Benzene Exposure among Gasoline Station Workers.

Benzene is a human carcinogen presented in gasoline (1% by volume). It is also found in vehicle exhaust. The aim of this study was to assess the health risk of inhalation exposure to benzene among gasoline station workers. The ambient benzene concentration was measured by personal sampling from 150 gasoline station workers (137 fueling workers and 13 cashiers). Additional data of working characteristics were collected by interviews and on-site observations. All workers were non-smokers and passive smoking was limited. Risk assessment of inhalation exposure was determined using the United State Environmental Protection Agency (USEPA),and showed a high risk of adverse health effect (Hazard Quotients (HQ) >1) in 51.33% of workers. The cancer risk was increased from 1.35 × 10-8 to 1.52 × 10-4, and 70.67% of the workers had a lifetime cancer risk (>Inhalation Unit Risk (IUR): 2.2 × 10-6). A significantly higher risk was found in fueling workers compared to cashiers, and in workers at gasoline stations in inner-city zones (suburban and urban), compared to rural zones. All risk estimations were based upon a single measurement in an eight hour working period, which was assumed to be the average shift length for all working days in a year (250 days). The increased health risk suggests that there should be health surveillance for workers in order to protect them from exposure to benzene. In addition to benzene, the volatile organic compounds (VOCs) present in gasoline may influence health outcomes.

Factors affecting delay in seeking treatment among malaria patients along Thailand-Myanmar border in Tak Province, Thailand.

BACKGROUND: Malaria is a major health problem in Thailand, especially in areas adjacent to the borders of Myanmar. Delay in seeking treatment is an important factor in the development of severe complications, death and the transmission of the disease. This study aimed to investigate factors affecting delays in seeking treatment of malaria patients. METHODS: A cross-sectional analytic study was conducted in 456 malaria patients along the Thailand-Myanmar border. Patients were selected by stratified sampling from 11 malaria clinics and five public hospitals in Tak Province, Thailand. Data were collected by the use of a structured interview questionnaire and from patient's medical records. RESULTS: The majority of patients were categorized with an ethnicity of 'hill tribe' (65.8%), followed by Thai (34.2%). Seventy-nine per cent of patients delayed seeking treatment. A simple logistic regression identified significant factors affecting delays in seeking treatment: people of "hill tribe" ethnicity; plasmodium species; self-treatment; visiting sub-district health promotion hospital/malaria post before visiting a malaria clinic or public hospital; and low to medium social support. After being subjected to multivariate analysis, factors significantly associated with the delay were "hill tribe" ethnicity (ORadj = 2.32, 95% CI: 1.34-4.04); infection with P.vivax (ORadj=2.02, 95% CI: 1.19-3.41; self-treatment (ORadj = 1.73, 95% CI: 1.04-2.85); and receiving a low degree of social support (ORadj = 2.58, 95% CI: 1.24-5.35). CONCLUSIONS: Emphasis should be placed on need for early diagnosis and treatment in malaria patients as well as on ensuring the first facility for detection and treatment of malaria is a malaria clinic or public hospital, and the promotion of social support. These are especially important issues for the health of hill tribe people.

Risk factors for repetitive strain injuries among school teachers in Thailand.

Prolonged posture, static works and repetition are previously reported as the cause of repetitive strain injuries (RSIs) among workers including teachers. This cross-sectional analytic study aimed to investigate the prevalence and risk factors of RSIs among school teachers. Participants were 452 full-time school teachers in Thailand. Data were collected by the structural questionnaires, illuminance measurements and the physical fitness tests. Descriptive statistics and inferential statistics which were Chi-square test and multiple logistic regression analysis were used. Most teachers in this study were females (57.3%), the mean years of work experience was 22.6 ± 10.4 years. The six-month prevalence of RSIs was 73.7%. The univariate analysis identified the related risk factors to RSIs which were chronic disease (OR=1.8; 95% CI = 1.16-2.73), history of trauma (OR=2.0; 95% CI = 1.02-4.01), member of family had RSIs (OR=2.0; 95% CI = 1.02- 4.01), stretch to write on board (OR=1.7; 95% CI = 1.06-1.70) and high heel shoe >2 inch (OR=1.6; 95% CI = 1.03-2.51). Multiple logistic regression analysis showed that chronic diseases and high heel shoe >2 inch significantly related to developing of RSIs. The poor grip strength and back muscle flexibility significantly affected RSIs of teachers. In conclusions, RSIs were highly prevalent in school teachers that they should be aware of health promotion to prevent RSIs.