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.

Self-Assessed Threshold Temperature for Cold among Poultry Industry Workers in Thailand.

The self-assessed threshold temperature for cold in the workplace is not well known. We asked 392 chicken industry workers in Thailand what they regard as the cold threshold (CT) and compared subgroups of workers using linear and quantile regressions by CT sextiles (percentiles P17, P33, P50, P67, and P83, from warmest to coldest). The variables of interest were sex, office work, and sedentary work, with age, clothing thermal insulation, and alcohol consumption as adjustment factors. The mean CT was 14.6 °C. Office workers had a 6.8 °C higher mean CT than other workers, but the difference ranged from 3.8 °C to 10.0 °C from P17 to P83. Sedentary workers had a 2.0 °C higher mean CT than others, but the difference increased from 0.5 °C to 3.0 °C through P17-P83. The mean CT did not differ between sexes, but men had a 1.6-5.0 °C higher CT at P17-P50 (>20 °C) and a 5.0 °C lower CT at P83 (<10 °C). The CT was relatively high at warm (≥10 °C), dry (relative humidity <41%), and drafty (air velocity > 0.35 m/s) worksites. We conclude that office, sedentary, and female workers and those working at warm, dry, and draughty sites are sensitive to the coldest temperatures, whereas male workers are sensitive even to moderate temperatures.

The risk of pig and chicken farming for carriage and transmission of Escherichia coli containing extended-spectrum beta-lactamase (ESBL) and mobile colistin resistance (mcr) genes in Thailand.

South-East Asian countries report a high prevalence of extended-spectrum cephalosporin- (ESC-) and colistin-resistant Escherichia coli (Col-R-Ec). However, there are still few studies describing the molecular mechanisms and transmission dynamics of ESC-R-Ec and, especially, Col-R-Ec. This study aimed to evaluate the prevalence and transmission dynamics of Ec containing extended spectrum beta-lactamases (ESBL) and mobile colistin resistance (mcr) genes using a 'One Health' design in Thailand. The ESC-R-Ec and Col-R-Ec isolates of human stool samples (69 pig farmers, 155 chicken farmers, and 61 non-farmers), rectal swabs from animals (269 pigs and 318 chickens), and the intestinal contents of 196 rodents were investigated. Resistance mechanisms and transmission dynamics of Ec isolates (n=638) were studied using short and long read sequencing. We found higher rates of ESBL-Ec isolates among pig farmers (n=36; 52.2%) than among chicken farmers (n=58; 37.4 %; P<0.05) and the control group (n=61; 31.1 %; P<0.05). Ec with co-occurring ESBL and mcr genes were found in 17 (6.0 %), 50 (18.6 %) and 15 (4.7 %) samples from humans, pigs and chickens, respectively. We also identified 39 (13.7 %) human samples with non-identical Ec containing ESBL and mcr. We found higher rates of ESBL-Ec, in particular CTX-M-55, isolates among pig farmers than among non-pig farmers (P<0.01). 'Clonal' animal-human transmission of ESBL-Ec and Ec with mcr genes was identified but rare as we overall found a heterogenous population structure of Ec. The Col-R-Ec from human and animal samples often carried mcr-1.1 on conjugative IncX4 plasmids. The latter has been identified in Ec of many different clonal backgrounds.

One Health Surveillance of Antimicrobial Resistance Phenotypes in Selected Communities in Thailand.

Integrated surveillance of antimicrobial resistance (AMR) using the One Health approach that includes humans, animals, food, and the environment has been recommended by responsible international organizations. The objective of this study was to determine the prevalence of AMR phenotypes in Escherichia coli and Klebsiella species isolated from humans, pigs, chickens, and wild rodents in five communities in northern Thailand. Rectal swabs from 269 pigs and 318 chickens; intestinal contents of 196 wild rodents; and stool samples from 69 pig farmers, 155 chicken farmers, and 61 non-farmers were cultured for E. coli and Klebsiella species, which were then tested for resistance to ceftriaxone, colistin, and meropenem. The prevalence of ceftriaxone-resistant E. coli and Klebsiella species in pigs, chickens, rodents, pig farmers, chicken farmers, and non-farmers was 64.3%, 12.9%, 4.1%, 55.1%, 38.7%, and 36.1%, respectively. Colistin resistance in pigs, chickens, rodents, pig farmers, chicken farmers, and non-farmers was 41.3%, 9.8%, 4.6%, 34.8%, 31.6%, and 24.6%, respectively. Meropenem resistance was not detected. The observed high prevalence of AMR, especially colistin resistance, in study food animals/humans is worrisome. Further studies to identify factors that contribute to AMR, strengthened reinforcement of existing regulations on antimicrobial use, and more appropriate interventions to minimize AMR in communities are urgently needed.

Estimating Occupational Exposure to VOCs, SVOCs, Particles and Participant Survey Reported Symptoms in Central Thailand Rice Farmers Using Multiple Sampling Techniques.

Thailand is known for its agricultural productivity and rice exportation. Most farms use small machines and manual labor, creating potential exposure to multiple health hazards. A cross-sectional study was conducted to measure pollutants liberated during preparation, pesticide application, and harvesting. Thirty rice farmers, mostly males from 41 to 50 years old, participated. The participant survey data showed that 53.3% of the respondents spent >2 h per crop on preparation, <1 h on pesticide application, and about 1-2 h harvesting; 86.7% of the respondents maintained and stored mechanical applicators at home, suggesting possible after-work exposures. Gloves, fabric masks, boots, and hats were worn during all activities, and >90% wore long sleeved shirts and pants. VOCs and SVOCs were collected using charcoal tubes and solid phase micro sample extraction (SPME). An analysis of the charcoal and SPME samplers found that 30 compounds were detected overall and that 10 were in both the charcoal tubes and SPME samplers. The chemicals most often detected were 1, 1, 1 Trichloro ethane and xylene. Additionally, farmers experienced the highest exposure to particulates during harvesting. These results demonstrated that farmers experience multiple exposures while farming and that risk communication with education or training programs may mitigate exposure.

Workplace Cold and Perceived Work Ability: Paradoxically Greater Disadvantage for More vs. Less-Educated Poultry Industry Workers in Thailand.

The association between worksite temperature and perceived work ability (WA) in various educational classes remains unknown. Therefore, we interviewed 286 poultry industry workers in Thailand about their WA and linked their responses to worksite temperature. WA was based on the self-assessment of current work ability compared with their lifetime best ability (scores 0-10). Education was classified as high (university or vocational school) or low (less education). Temperature was classified as cold (-22-10°C) or warm (10-23°C). WA and the occurrence of a low WA were regressed on worksite temperature, education, and their interaction with the adjustment for sex, age, job category, physical work strain, moving between cold and warm sites, thermal insulation of clothing, relative humidity, and air velocity. The average worksite temperature was 10°C for high- and 1°C for low-educated workers. The average WA score was 8.32 (SD, 1.33; range, 4-10) and classified as low (<8) in 23% of the workers. In highly-educated workers, the adjusted mean WA decreased from 9.11 in the warm areas to 8.02 in the cold areas and the prevalence of a low WA increased from 11 to 30%, while no significant change was observed in less-educated workers. The WA score was estimated to decline by 10% more (95% CI, 4-16%) in the cold areas for the more vs. less-educated workers and the prevalence of a poor WA was estimated to increase 3.09 times (95% CI, 1.43-5.45) more. Highly-educated workers in this industry are a risk group that should be given customized advice.

Climate Warming and Occupational Heat and Hot Environment Standards in Thailand.

BACKGROUND: During the period 2001 to 2016, the maximum temperatures in Thailand rose from 38-41oC to 42-44oC. The current occupational heat exposure standard of Thailand issued in 2006 is based on wet bulb globe temperature (WBGT) defined for three workload levels without a work-rest regimen. This study examined whether the present standard still protects most workers. METHODS: The sample comprised 168 heat acclimatized workers (90 in construction sites, 78 in foundries). Heart rate and auditory canal temperature were recorded continuously for 2 hours. Workplace WBGT, relative humidity, and wind velocity were monitored, and the participants' workloads were estimated. Heat-related symptoms and signs were collected by a questionnaire. RESULTS: Only 55% of the participants worked in workplaces complying with the heat standard. Of them, 79% had auditory canal temperature ≤ 38.5oC, compared with only 58% in noncompliant workplaces. 18% and 43% of the workers in compliant and noncompliant workplaces, respectively, had symptoms from heat stress, the trend being similar across all workload levels. An increase of one degree (C) in WBGT was associated with a 1.85-fold increase (95% confidence interval: 1.44-2.48) in odds for having symptoms. CONCLUSION: Compliance with the current occupational heat standard protects 4/5 of the workers, whereas noncompliance reduces this proportion to one half. The reasons for noncompliance include the gaps and ambiguities in the law. The law should specify work/rest schedules; outdoor work should be identified as an occupational heat hazard; and the staff should include occupational personnel to manage heat stress in establishments involving heat exposure.

A One Health approach to assessing occupational exposure to antimicrobial resistance in Thailand: The FarmResist project.

This Southeast Asia-Europe research project will use a One Health approach to identify the major parameters responsible for the presence of animal-associated antimicrobial resistant bacteria in animal production facilities in Thailand and the risk of their transmission from animals to humans. We will focus on traditional, small, extensive pig and poultry farms where information on antibiotic use is scarce and animals live in close contact with humans. This cross-sectional study will be based on the epidemiological analysis of the antimicrobial resistance (AMR) present in fecal samples from animals and humans. Extended spectrum beta-lactamase producing Enterobacteriaceae (ESBL-E) and Enterobacteriaceae resistant to colistin will be actively searched in the feces of farm animals (pigs and poultry), small wild rodents and farmers. Phenotypic (selective plating) and genotypic (multilocus seuquence typing and sequencing) methods will be used for the detection of AMR, the identification of antibiotic resistance genes (ARGs) and the characterization of strains carrying resistance genes. Questionnaires will be administered to investigate the effects of antibiotic use, farm characteristics and biosecurity measures on the occurrence of AMR in animals. Subsequently, the fecal carriage of AMR and ARGs in farmers will be compared to a control population with no occupational contacts with animals, thus enabling an estimation of the risk of transmission of AMR/ARGs from animals to farmers.

Overview of Legal Measures for Managing Workplace COVID-19 Infection Risk in Several Asia-Pacific Countries.

BACKGROUND: Despite the lack of official COVID-19 statistics, various workplaces and occupations have been at the center of COVID-19 outbreaks. We aimed to compare legal measures and governance established for managing COVID-19 infection risks at workplaces in nine Asia and Pacific countries and to recommend key administrative measures. METHODS: We collected information on legal measures and governance from both general citizens and workers regarding infection risks such as COVID-19 from industrial hygiene professionals in nine countries (Indonesia, India, Japan, Malaysia, New Zealand, Republic of the Philippines, Republic of Korea, Taiwan, and Thailand) using a structured questionnaire. RESULTS: A governmental body overseeing public health and welfare was in charge of containing the spread and occurrence of infectious diseases under an infectious disease control and prevention act or another special act, although the name of the pertinent organizations and legislation vary among countries. Unlike in the case of other traditional hazards, there have been no specific articles or clauses describing the means of mitigating virus risk in the workplace that are legally required of employers, making it difficult to define the responsibilities of the employer. Each country maintains own legal systems regarding access to the duration, administration, and financing of paid sick leave. Many workers may not have access to paid sick leave even if it is legally guaranteed. CONCLUSION: Specific legal measures to manage infectious disease risks, such as providing proper personal protective equipment, education, engineering control measures, and paid sick leave are recommended to be stipulated in Industrial safety and health-related acts.

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.

Respiratory and skin health among glass microfiber production workers: a cross-sectional study.

BACKGROUND: Only a few studies have investigated non-malignant respiratory effects of glass microfibers and these have provided inconsistent results. Our objective was to assess the effects of exposure to glass microfibers on respiratory and skin symptoms, asthma and lung function. METHODS: A cross-sectional study of 102 workers from a microfiber factory (response rate 100%) and 76 office workers (73%) from four factories in Thailand was conducted. They answered a questionnaire on respiratory health, occupational exposures, and lifestyle factors, and performed spirometry. Measurements of respirable dust were available from 2004 and 2005. RESULTS: Workers exposed to glass microfibers experienced increased risk of cough (adjusted OR 2.04), wheezing (adjOR 2.20), breathlessness (adjOR 4.46), nasal (adjOR 2.13) and skin symptoms (adjOR 3.89) and ever asthma (adjOR 3.51), the risks of breathlessness (95%CI 1.68-11.86) and skin symptoms (1.70-8.90) remaining statistically significant after adjustment for confounders. There was an exposure-response relation between the risk of breathlessness and skin symptoms and increasing level of microfiber exposure. Workers exposed to sensitizing chemicals, including phenol-formaldehyde resin, experienced increased risk of cough (3.43, 1.20-9.87) and nasal symptoms (3.07, 1.05-9.00). CONCLUSION: This study provides evidence that exposure to glass microfibers increases the risk of respiratory and skin symptoms, and has an exposure-response relation with breathlessness and skin symptoms. Exposure to sensitizing chemicals increased the risk of cough and nasal symptoms. The results suggest that occupational exposure to glass microfibers is related to non-malignant adverse health effects, and that implementing exposure control measures in these industries could protect the health of employees.

Health risk among asbestos cement sheet manufacturing workers in Thailand.

OBJECTIVE: To assess asbestos exposure and calculate the relative risks of lung cancer among asbestos cement roof sheet workers and to predict the incidence rate of lung cancer caused by asbestos in Thailand. MATERIAL AND METHOD: A cross-sectional study was conducted in four asbestos cement roof factories. Both area and personal air samples were collected and analyzed employing NIOSH method # 7400 and counting rule A for all procesess and activities. The time weight average exposures were calculated for each studied task using average area concentrations of the mill and personal concentrations. Then, cumulative exposures were estimated based on the past nation-wide air sampling concentrations and those from the present study. The relative risk (RR) of lung cancer among asbestos cement sheet workers was calculated and the number of asbestos related lung cancer case was estimated. RESULTS: The roof fitting polishers had the highest exposure to airborne asbestos fiber (0.73 fiber/ml). The highest average area concentration was at the conveyor to the de-bagger areas (0.02 fiber/ml). The estimated cumulative exposure for the workers performed studied-tasks ranged in between 90.13-115.65 fiber-years/ml while the relative risk of lung cancer calculated using US. EPA's model were 5.37-5.96. Based on the obtained RR, lung cancer among AC sheet in Thailand would be 2 case/year. CONCLUSION: In case that AC sheet will not be prohibited from being manufactured, even though only chrysotile is allowed, the surveillance system should be further developed and more seriously implemented. The better control measures for all processes must be implemented. Furthermore, due to the environmental persistence of asbestos fiber, its life cycle analysis should be conducted in order to control environmental exposure of general population.

Case study of occupational mercury exposure during decontamination of turnaround in refinery plant.

Decontamination during turnaround (TA) can lead to high exposure to toxic chemicals among workers. The decontamination process in refinery plants usually comprises two types, i.e. steam and chemical decontamination. No matter the method used, concentrations of toxic chemicals must be measured using the direct reading instrument at the end of each decontamination cycle, which maybe repeated several times until the readings are in acceptable level. To evaluate mercury exposure of decontamination workers during decontamination procedure in comprehensive turnaround of a refinery plant. Thirty personal and 16 area air samples were collected using passive dosimeters and absorbent tubes, respectively, during 8 days of the decontamination in comprehensive turnaround. All samples were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). Good practices and standard procedures for air sampling and analysis were performed. The TWA concentrations were calculated and compared between steam and chemical decontamination workers. All area samples were well below TLV (ND - 0.0016 mg/m3) while 5 of 14 samples collected at the steam team and 1 of 16 samples taken from the chemical team exceeded the TLV. The geometric mean (GSD) of TWA concentration of the steam team was 0.0057(10.4906) mg/m3, which is about twice as high as that of the chemical team, 0.0031(6.9422) mg/m3. The highest mercury concentration, 0.1037 mg/m3, was collected from a steam decontamination worker. According to the activities and observation, the steam team may have high exposure while reading the chemical concentrations at the end of the decontamination cycle.

Development of a combined air sampling and quantitative real-time PCR method for detection of Legionella spp.

The objective of this study was to develop and optimize the combined methods of air sampling and real time polymerase chain reaction (real-time PCR) for quantifying aerosol Legionella spp. Primers and TaqMan hydrolysis probe based on 5S rRNA gene specific for Legionella spp were used to amplify a specific DNA product of 84 bp. The impinger air sampler plus T-100 sampling pump was used to collect aerosol Legionella and as low as 10 fg of Legionella DNA per reaction could detected. Preliminary studies demonstrated that the developed method could detect aerosol Legionella spp 1.5-185 organisms /500 l of air within 5 hours, in contrast to culture method, that required a minimum of 7-10 days.

Asbestos Exposure among Mitering Workers.

The objectives are to compare the airborne asbestos concentrations resulted from mitering of abestos cement roof sheets by a high-speed motor and a hand saw, and to monitor whether other workers near the test sites are vulnerable to the fibers exceeding the occupational exposure limit. Four test cases were carried out and altogether 7 personal and 4 area air samples were collected. The NIOSH method 7400 was employed for the air samplings and analysis. Using the phase contrast microscopy, fiber counting was conducted under Rule A. The study showed that the fiber concentration medians for personal air samples gathered from the two tools were 4.11 fibers/cc (ranged: 1.33-12.41 fibers/cc) and 0.13 fibers/cc (ranged: 0.01-5.00 fibers/cc) respectively. The median for the area samples was 0.59 fibers/cc (ranged: 0.14-3.32 fibers/cc). Comparing each study case, the concentration level caused by the high-speed motor saw was more than twice that of the hand saw. According to the area samples, the workers nearby the test site are at risk from high exposure to asbestos.