Risk Factors Related to Perceived Hot Conditions on Outdoor Farms Among Thai Elderly Farmers With Chronic Diseases.

Working on outdoor farms affects elderly farmers' health, especially those who have chronic diseases. This study aims to identify the risk factors related to perceived hot conditions on outdoor farms among elderly Thai farmers aged 60 years and older with chronic diseases. A cross-sectional study was conducted on 352 elderly farmers in nine sub-districts of Nong Suea District, Pathum Thani Province, Thailand via convenience sampling. Questionnaires were used as instruments to gather data about demographic and working factors. The risk factors associated with elderly Thai farmers' perceptions of hot conditions on outdoor farms were identified by using binary logistic regression. The most common chronic illnesses were hypertension (35.8%), heart disease (34.4%), and diabetes mellitus (24.5%). More than 60.5% of the participants perceived their hot conditions to be high. The results of binary logistic regression show that low income and work duration ≤8.0 hours per day were risk factors related to perceived hot conditions on outdoor farms (P value < 0.05). These findings may be used by relevant authorities to support elderly farmers by emphasizing the importance of individual and work-related factors. Relevant government agencies should consider formulating working standards in hot conditions specifically for elderly farm workers.

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.

Comparison of musculoskeletal load using two devices for manual height adjustment of the hospital bed.

Objectives. Patient manual handling in bed causes lower back pain (LBP) among Thai nurses. This study aims to develop an extension device for manual height adjustment of the hospital bed, and to evaluate its efficiency in preventing LBP among Thai nurses. Methods. Eleven participants were enrolled for electromyography measurement in eight right muscles. Subsequently, 56 volunteer nurses were recruited by convenience sampling for observational risk assessment by rapid entire body assessment (REBA) and satisfaction evaluation. The characteristics of the participants, percentage of maximum voluntary contraction (%MVC) of each muscle, REBA scores and satisfaction in using the device were analyzed by descriptive statistics, multivariate analysis of variance, paired t test and Wilcoxon signed-rank test, respectively. Results. %MVC values of the six muscles, i.e., biceps brachii, deltoideus, trapezius, latissimus dorsi, erector spinae and hamstring, were found to have a 4-18% decrease. The REBA scores decreased for both left and right when using the extension device, and all participants were more satisfied with the extension device than the hand crank of the hospital bed. Conclusions. The use of the extension device for manual height adjustment of the hospital bed developed from this study helps to prevent LBP among healthcare workers across settings.

Agricultural Risk Factors Related Musculoskeletal Disorders among Older Farmers in Pathum Thani Province, Thailand.

Background Agriculture is one of the most hazardous jobs in terms of occupational illness, especially musculoskeletal disorders (MSDs). This paper is a cross-sectional study designed to identify agricultural risk factors related to MSDs among older farmers.Methods A convenience sampling method was used to select 481 older farmers from the Nong Suea district in Pathum Thani province. A three-part questionnaire generated data that included demographics, work conditions, and environment, and self-reported MSDs. Multiple logistic regression analysis was used to identify the risk factors for MSDs.Results The results indicated the prevalence of musculoskeletal symptoms in the past 7 days and 12 months were 87.9% and 88.9%, respectively. The three body parts with highest prevalence rates of MSDs were lower extremities (65.4%), lower back (42.6%), and shoulders (29.9%). Factors significantly associated with reporting MSDs during the past 12 months (p value <.05) were women (adjusted odds ratio = 2.52: 95% CI; 1.19-5.36), using agricultural tools (adjusted odds ratio = 4.40: 95% CI; 1.18-13.79), prolonged static postures (adjusted odds ratio = 3.81: 95% CI; 1.05-13.82), and lifting >10 kg (adjusted odds ratio = 2.87: 95% CI; 1.22-6.82).Conclusions Study results revealed older farmers had high prevalence of MSDs and various related risk factors. Occupational ergonomic issues for promoting safety awareness of agricultural risk factors among elderly farmers should be considered.

Determinants Of Patients' Satisfaction Level Reporting Chronic Kidney Disease Clinics Established In Thailand.

BACKGROUND: Patients' satisfaction is considered to be major predictor used for the assessment of the overall quality of the healthcare services. The current study aims to evaluate the patient's level of satisfaction reporting Chronic Kidney Disease clinics (CKDC) under the Policy of the Ministry of Public Health, Thailand providing the care for Chronic Kidney Disease (CKD) patients in the public hospitals by a multidisciplinary health professional team. METHODS: A cross sectional study was conducted from January-December 2017. A two-stage sampling technique was adopted. A validated and reliable questionnaire was administered to 258 CKD patients during their visit to the CKD clinic from 134 public hospitals in 12 regional service providers in Thailand to elicit their satisfaction level. The satisfaction was scored and described into four aspects: services, place and facilities, health professional staff, and medical equipment and supplies. Data was analysed using frequency, mean, standard deviation, and Mann-Whitney U test and Kruskal-Wallis test were used to determine whether there was a significant difference among the variables in terms of patients' satisfaction. This study was ethically approved from the Ethics Review Committee of Thammasat University, Thailand (COA. No. 254/2560). RESULTS: Most of the respondents 53.9% were female ranging from 21-88 years with a mean age of 64.69 years SD 13.14. The mean score of satisfaction for all CKD patients was 3.11±0.44 (out of 4) categorized in a good satisfaction level. The satisfaction level of the service aspect was least in comparison to others. Among all the variables a significant difference in satisfaction level was found in terms of duration of the disease (χ2 =10.52, p=0.03*). CONCLUSION: This study has demonstrated levels of satisfaction with the CKD clinic that could tailor for the significant implications and challenges in improving healthcare service policy further.

Visual problems among electronic and jewelry workers in Thailand.

In the processes of electronic and jewelry manufacturing, workers are employed to use their skill in tiny visual tasks (1-3 mm) and near visual distances (<35 cm) that cause visual strain. This study consisted of 3 phases: 1) a survey of workers visual health status and factors affecting their visual strain; 2) the development and implementation of guidelines in the selected factories; and 3) a resurvey to document the change. The baseline survey was conducted in Samutprakan Province during October to December, 2003. Ninety-five percent of the sampled workers were female with an average age of 26.2 yr. Fifty-two percent of the workers had at least one kind of vision problem that might have affected their work performance, and 48.3% of the work sites had substandard illumination levels. The intervention included improvement of lighting conditions, the introduction of short breaks, and correction of visual performance problems. After the intervention, the inadequate lighting problem went down to 24.5%. All factories took a rest break and 20.5% of the workers with inadequate visual performance had corrected their vision in the intervention period. Comparing pre-intervention status with the end of the program, the Critical Fusion Frequency (CFF) at one hour and two hours of work were improved with statistical significance among the electronic but not the jewelry workers. In conclusion, visual problems among vision intensive industrial workers are common. Intervention programs partially but significantly improved the situation.

Upper extremities musculoskeletal disorders: prevalence and associated ergonomic factors in an electronic assembly factory.

OBJECTIVES: To determine the magnitude, distribution and associated ergonomic factors of upper extremities musculoskeletal disorders (UEMSD) among workers of electronic assembly in Thailand. MATERIAL AND METHODS: This was a cross-sectional study. 591 of 853 workers in an electronic and electrical appliance assembly factory in Bangkok, Thailand, participated in this study. A self-administered questionnaire consisting of demographic data and ergonomic factors was collected from October 2010 to January 2011. Clinical examination of each worker was performed by an occupational physician. The criteria for diagnosis of UEMSD came as a result of a consensus reached by a group of orthopedists. The associated factors were analyzed using a multiple logistic regression. RESULTS: The point prevalence of clinically diagnosed UEMSD was as follows: radial styloid tenosynovitis - 13.03% (95% CI: 10.31-15.75), trigger finger - 9.48% (95% CI: 7.11-11.84), carpal tunnel syndrome - 8.12% (95% CI: 5.91-10.33), lateral epicondylitis - 3.38% (95% CI: 1.92-4.85), and medial epicondylitis - 1.69% (95% CI: 0.65-2.73), respectively. The adjusted odds ratio with statistical significance associated with UEMSD was as follows: high force of wrist - 1.78 (95% CI: 1.06-2.99), awkward posture of wrist - 2.37 (95% CI: 1.28-4.37) and contact stress at wrists - 1.75 (95% CI: 1.02-3.00) to develop radial styloid tenosynovitis. For trigger finger, the ratios were awkward posture of fingers - 2.09 (95% CI: 1.12-3.90) and contact stress on finger - 1.86 (95% CI: 1.04-3.34). For medial epicondylitis, it was an awkward posture of using elbows - 3.14 (95% CI: 1.10-8.95). However, this study did not find any associations between repetitive motion and any UEMSD. CONCLUSIONS: UEMSD are most commonly found in electronic assembly workers. The relevant parties should provide comprehensive ergonomic resolution for these workers.

Safety and health in the petrochemical industry in Map Ta Phut, Thailand.

BACKGROUND: Petrochemical industries are known as sources of many toxic chemicals. Safety and health risks of the petrochemical workers employed at Map Ta Phut Industrial Estate, located in Rayong, Thailand, are potentially high. METHODS: The research materials consisted of documents emanating from statutory reports on safety in working with toxic chemicals and the results of interviews by questionnaire among 457 petrochemical workers regarding occupational health and safety issues. RESULTS: Most of workers who were working with toxic chemicals had knowledge and awareness of health risks and chemical hazards at work. We found that safe behavior at work through read the safety information among operational workers less than non-operational workers around 10%. Most of workers had perceived occupational health and safety management in their companies. Some companies revealed that they had not been performing biological monitoring of blood or urine for their health examination reports and that workplace exposure monitoring had not correlated well with health examination of workers. CONCLUSIONS: Our study suggested that occupational health and safety for petrochemical industries requires standards and guidelines for workers' health surveillance aimed at protection of workers.

Health impact of climate change on occupational health and productivity in Thailand.

BACKGROUND: The rise in global temperature is well documented. Changes in temperature lead to increases in heat exposure, which may impact health ranging from mild heat rashes to deadly heat stroke. Heat exposure can also aggravate several chronic diseases including cardiovascular and respiratory disease. OBJECTIVE: This study examined the relationship between climate condition and health status and productivity in two main categories of the occupational setting - where one setting involves heat generated from the industry and the other with heat in a natural setting. DESIGN: This cross-sectional study included four industrial sites (pottery industry, power plant, knife industry, and construction site) and one agricultural site in the Pathumthani and Ayutthaya provinces. Exposure data were comprised of meteorological data and heat exposure including relative humidity (RH) measured by Wet Bulb Globe Temperature (WBGT) monitor. Heat index was calculated to measure the effects of heat exposure on the study population, which consisted of 21 workers at five worksites; a questionnaire was also used to collect data on workers. RESULTS: Among the five workplaces, the outdoor WBGT was found to be highest at 34.6°C during 12:00 and 1:00 PM at the agricultural site. It was found that four out of five study sites had heat indices in the 'extreme caution,' where heat cramp and exhaustion may be possible and one site showed a value of 41°C that falls into the category of 'danger,' where sunstroke and heat exhaustion are likely and prolonged exposure may lead to heatstroke. Productivity as perceived by the workers revealed that only the construction and pottery industry workers had a loss of productivity ranged from 10 to 60 %. CONCLUSIONS: Climate conditions in Thailand potentially affect both the health and productivity in occupational settings.