Development of an ergonomics risk assessment tool for repetitive task assessment (RTRA).

BACKGROUND: Most ergonomics assessment tools for repetitive task have been used in industries which are mainly focused on assessing the biomechanical risk factors that affect musculoskeletal disorders (MSDs) rather than the psychosocial and work environment risk factors. OBJECTIVE: To develop a tool for Repetitive Task Risk Assessment (RTRA) and Rapid Upper Limb Assessment (RULA) that can identify biomechanical, physical stress and psychosocial risk factors, prioritize risk reduction action and systematic record keeping. METHODS: The study consisted of 2 phases; tool development and evaluation of the contents of risk factors by 7 ergonomic experts and intra-rater and inter-rater reliability and validity tests of the tool by 1 researcher and 9 Thai practitioners to assess 30 repetitive tasks. RESULTS: RULA was modified by adding more biomechanical risk, combining psychosocial and work environment risk factors lead to MSD become the first prototype of RTRA. The Item-Objective Congruence Index (IOC) validated 20 items on usability of each step of the RTRA ranged between 0.64 and 0.93. The examination of the overall intra-rater reliability was 0.932 (95% CI: 0.862-0.967) and the overall inter-rater was 0.956 (95% CI: 0.909-0.978). CONCLUSION: The tool has high test-retest reliability. There is a suggestion for researchers to understand more on the identification of multiple risk factors in one assessment tool and consider a risk-level rating and scoring for prioritizing risk reduction.

Informal Workers in Thailand: Occupational Health and Social Security Disparities.

Informal workers in Thailand lack employee status as defined under the Labor Protection Act (LPA). Typically, they do not work at an employer's premise; they work at home and may be self-employed or temporary workers. They account for 62.6 percent of the Thai workforce and have a workplace accident rate ten times higher than formal workers. Most Thai Labor laws apply only to formal workers, but some protect informal workers in the domestic, home work, and agricultural sectors. Laws that protect informal workers lack practical enforcement mechanisms and are generally ineffective because informal workers lack employment contracts and awareness of their legal rights. Thai social security laws fail to provide informal workers with treatment of work-related accidents, diseases, and injuries; unemployment and retirement insurance; and workers' compensation. The article summarizes the differences in protections available for formal and informal sector workers and measures needed to decrease these disparities in coverage.

A program for thai rubber tappers to improve the cost of occupational health and safety.

The purposes of this research were to determine the cost of occupational health and safety and work-related health problems, accidents, injuries and illnesses in rubber tappers by implementing a program in which rubber tappers were provided training on self-care in order to reduce and prevent work-related accidents, injuries and illnesses. Data on costs for healthcare, the prevention and the treatment of work-related accidents, injuries and illnesses were collected by interview using a questionnaire. The findings revealed that there was no relationship between what was spent on healthcare and the prevention of work-related accidents, injuries and illnesses and that spent on the treatment of work-related accidents, injuries and illnesses. The proportion of the injured subjects after the program implementation was significantly less than that before the program implementation (p<0.001). The level of pain after the program implementation was significantly less than that before the program implementation (p<0.05). The treatment costs incurred after the program implementation were significantly less than those incurred before the program implementation (p<0.001). It was demonstrated that this program raised the health awareness of rubber tappers. It strongly empowered the leadership in health promotion for the community.

Prevalence and management of diabetes and associated risk factors by regions of Thailand: Third National Health Examination Survey 2004.

OBJECTIVE: The aim of this study was to determine the prevalence of diabetes and impaired fasting glucose (IFG) and their association with cardiovascular risk factors and to evaluate the management of blood glucose, blood pressure, and cholesterol in individuals with diabetes by geographical regions of Thailand. RESEARCH DESIGN AND METHODS: With the use of a stratified, multistage sampling design, data from a nationally representative sample of 37,138 individuals aged > or = 15 years were collected using questionnaires, physical examination, and blood samples. RESULTS: The prevalence of diabetes and IFG weighted to the national 2004 population was 6.7% (6.0% in men and 7.4% in women) and 12.5% (14.7% in men and 10.4% in women), respectively. Diabetes was more common in urban than in rural men but otherwise prevalence was relatively uniform across geographical regions. In more than one-half of those with diabetes, the disease had not been previously diagnosed, although the majority of those with diabetes were treated with oral antiglycemic agents or insulin. The prevalence of associated risk factors was high among individuals with diabetes as well as those with IFG. Two-thirds of those with diabetes and concomitant high blood pressure (> or = 130/80 mmHg) were not aware that they had high blood pressure, and > 70% of those with diabetes and concomitant high cholesterol (total cholesterol > or = 6.2 mmol/l) were not aware that they had high cholesterol. CONCLUSIONS: The prevalences of diabetes and IFG were uniformly high in all regions. Improvements in prevention, diagnosis, and treatment of diabetes and associated risk factors are required if the health burden of diabetes in Thailand is to be averted.

A study of melatonin levels and stress in female shift workers.

The aim of this study was to determine the relationship between saliva melatonin and stress levels in Thai female shift workers. Five older (38.4 +/- 1.82) and five younger (21.4 +/- 0.55) female workers voluntarily participated in this study. All participants worked both morning and night shifts at a glass manufacturing factory. Saliva was collected every three hours at the workplace and at the subjects' houses to examine melatonin profiles. The Mann-Whitney U test and the Wilcoxon signed ranks test were used. There was a significant (p < 0.05) difference between melatonin levels in younger and older subjects when measured during the night shift at 19:00. Differences between melatonin levels during the morning and night shifts in the older group were significant at 07:00 and at 19:00 in younger subjects (p < 0.05). Normal stress and mild stress were found. No significant differences in melatonin levels were found between workers with normal and mild stress levels. The onset time of increasing saliva melatonin was at 19:00, both in women working the morning shift and in those working the night shift. Peak melatonin production occurred at 22:00 for the night shift in both groups. During the morning shifts, the peak times were at 04:00 and 01:00 (in the younger and older groups, respectively), usually between 02:00 and 04:00. These findings show that melatonin levels in female shift workers adapted according to the shift worked, especially in the older group. Health surveillance programs should therefore be established to prevent further negative health effects for female shift workers.