Risk of asthma in relation to occupation: A hospital-based case-control study.

BACKGROUND: Asthma is a common occupational lung disease and is preventable by removing identifiable allergens. OBJECTIVES: (1) To assess the relationship between occupation and asthma (2) To determine the agents associated with asthma. METHODS: In this hospital-based, case-control study 153 cases from the Asthma Clinic and 306 non-asthmatic controls from Srinagarind Hospital, Thailand were interviewed. Crude odds ratios (COR), 95% confidence intervals (95% CI) and adjusted ORs (AOR) for multiple logistic regression were calculated. RESULTS: Of the 153 cases, 70.6% were females with median age of 53 (IQR-14). Of the 306 controls, 62.4% were females with median age of 56 (IQR-16). The highest risk of asthma was family history of asthma and history of atopy [AOR 11.68 (95% CI 4.52, 30.24) and AOR 8.03 (95% CI 5.07, 13.60)], respectively. If only occupations were considered, healthcare workers had the highest risk [AOR 4.08 (95% CI 1.35, 12.30)], followed by textile workers [AOR 3.34 (95% CI 1.07, 10.47)] and school workers AOR 2.40 (95% CI 1.31, 4.41). When subgroups of non-atopy were considered, school workers had a significant association with asthma [COR 3.18 (95% CI 1.48, 6.83)]. When no family history of asthma was considered, school and textile workers had the most significant association with asthma [COR 3.10 (95% CI 1.87, 5.13) and COR 3.06 (95% CI 1.15, 8.13), respectively]. Inorganic dust was the agent most significantly associated with asthma COR 1.89 (95% CI 1.25, 2.82). CONCLUSION: School, textile and healthcare workers have the greatest risk of asthma. Family history of asthma and being atopic would also promote asthma in relation to occupation.

Work-Related Quality of Life among Medical Residents at a University Hospital in Northeastern Thailand.

OBJECTIVE: 1) To assess work-related quality of life (WRQOL) among medical residents at a university hospital in northeast Thailand. 2) To determine the strength of the association between personal and working condition components and WRQOL among medical residents. MATERIAL AND METHOD: A descriptive study was used to describe the WRQOL among medical residents. The study population comprised of all 375 residents affiliated with the university hospital. The Thai version of a self-administered work-related quality of life scale-2 was used for data collection. RESULTS: Testing the reliability revealed a Cronbach's alpha of 0.908. Questionnaires were completed by 259 of 375 (68.3%). The study found that the mean rating by residents for overall WRQOL was 113.8 out of 170 (SD 14.8). Most rated WRQOL as moderate (76.6%). The seven sub-factors were rated as moderate to high for employee engagement and control at work, moderate for home/work interface, general well-being and working conditions, high-moderate for job career satisfaction, and low-moderate for stress at work. Relationships between the personal and working condition components and WRQOL were analyzed using binary logistic regression. Residents in minor specialties had a higher WRQOL than those in major specialties (OR 2.522, 95% CI: 1.37, 4.63). Residents who had less than eight duty shifts/week had a higher WRQOL than those with more than eight duty shifts/week (OR 2.263, 95% CI: 1.16, 4.41). Similarly, residents working with less than 80 hours/week had a higher WRQOL than those working more than 80 hours/week (OR 2.344, 95% CI: 1.17, 4.72). A subgroup analyzes of those working in minor specialties showed the trend that working less than eight shifts/month and working less than 80 hours/week had the potential association with good quality of work-life (QWL). This phenomenon is presented in the subgroup analyses of those working in major specialties. Therefore, working hours and number of shifts might have played important role in contributing good QWL. CONCLUSION: To increase QWL, the residents and institutions should be better managed to have the appropriate number of working hours and to increase work-life balance, working condition, general well-being, and job-career satisfaction. On the other hand, stress at work must be reduced.

Which alternative well-fit masks can be used in medical procedures?

BACKGROUND: During the COVID-19 pandemic, the WHO and CDC recommended that healthcare personnel (HCPs) performing non-aerosol-generating procedures (AGPs) don a properly fitted mask. We aimed to evaluate the fit factors (FFs) of eight alternative well-fit masks (AWMs) used by Thai HCPs. METHODS: This comparative descriptive study was conducted on 33 HCPs between October and November 2022, categorized into three facial sizes: small, medium, and large. Each participant wore eight types of AWMs in random order: medical mask under adjustable ear-loop (AEL)-KF94 (MK), medical mask under AEL-KN95 with a hook (MN), medical mask under fabric mask (MF), AEL- KF94 (KF94), AEL-KF94 under fabric masks (KF), AEL-KF94 with a hook (KF94H), AEL-KN95 with a hook (KN95), and AEL-KN95 with a hook under fabric mask (NF). FFs were measured using a quantitative fit test. RESULTS: The respective number of HCPs wearing small, medium, and large was 12, 12, and 9, and the mean±SD of face width and length was 132.98 ± 10.49 and 114.92 ± 10.10 mm. The highest respective median of FF was KN95 = 200, NF= 200, MN= 185, and KF94H = 171, and the respective passing fit-test rate was 97%, 84.8%, 63.6%, and 60.6%. There was no difference in FFs between the N95 and KN95 (p=0.72), the N95 and NF (p=0.202), and the three face sizes. Moreover, KF94H pass rates were significantly higher for females compared to males (OR = 13.3; p = 0.001) and for small facial sizes compared to either medium or large sizes (OR = 14.7; p = 0.009). CONCLUSION: The AEL-KN95 with hook and sponge at the nosepiece is an effective respirator for use by HCPs in non-AGPs, as the FF and fit test pass rates were comparable to those of N95, and there were no differences in FFs between facial sizes. However, the female who had a small face size may use a KF94H as an alternative PPE.

Reduced protein levels in latex gloves may play an alternative approach to lowering latex sensitization risks among health workers; a cross-sectional analytical study.

BACKGROUND: Latex gloves are essential for protecting healthcare workers from biological hazards but pose a risk of latex allergy, particularly due to powdered, protein, and allergen content. Recent advancements in latex glove manufacturing have led to reduced levels of extractable proteins, a known factor triggering allergenic reaction. This study aimed to compare latex sensitization between nursing staff using low-protein and high-protein latex gloves at a tertiary university hospital in Thailand. METHODS: A cross-sectional analytical study categorized participants into two groups based on glove exposure: the low extractable protein group (only exposed to non-powdered latex gloves with extractable protein levels below 50 µg/g) and the high extractable protein group (exposed to powdered latex gloves with levels above 50 µg/g). The sample size comprised 163 individuals in the low protein group and 318 in the high protein group (1:2). Latex allergy symptoms and sensitization were assessed using a self-administered questionnaire and latex-specific IgE measurement (ImmunoCAP), respectively. Data analysis involved descriptive and inferential statistics, including odds ratios and 95%CI. RESULTS: Demographic data was mostly similar in both exposure groups except for age. No significant differences in latex sensitization between the low and high protein groups were found via latex-specific IgE measurement (crude OR 1.90, 95%CI: 0.5, 7.18), potentially attributed to lower extractable protein levels in powdered latex gloves compared to previous studies. In contrast, the low protein group exhibited significantly fewer current latex allergy symptoms in both bivariate (crude OR 0.24, 95%CI: 0.06, 0.74) and multiple variable analysis (adjusted OR 0.18, 95%CI: 0.04, 0.86). Moreover, there was a significant reduction in latex allergy symptoms among the low protein group, decreasing from 9.8% who reported experiencing symptoms (when powdered latex gloves were used) to 1.2% who still reported current symptoms (OR 0.11, 95%CI: 0.02, 0.44). CONCLUSIONS: This study underscores the importance of using non-powdered and low-protein latex gloves to reduce latex allergy symptoms while emphasizing the need for further investigation into the relationship between extractable protein levels in addition to the attempt of the major allergen removal and latex sensitization amid evolving glove manufacturing practices.

Residues of organophosphate pesticides used in vegetable cultivation in ambient air, surface water and soil in Bueng Niam Subdistrict, Khon Kaen, Thailand.

Agricultural pesticide utilization is one of the important problems in rural and urban crop-cultivated areas, with the majority of pollutants dispersing via ambient air, water and other natural pathways. This study was therefore conducted in a specially selected village which is known to be a leading vegetable growing area in Khon Kaen Province. The aim of the study was to assess pesticide residues, and measure the seasonal fluctuations in organophosphate concentrations during 2010 in the environment of a risk area. Samples from selected sites were collected in two phases: Phase I was in summer (during March to May) and Phase II was in winter (during October to December). A total of 150 samples were analyzed using gas chromatography with flame photometric detection. The results showed that dicrotophos, chlorpyrifos, profenofos and ethion were found at the highest concentrations in soil and at the lowest concentrations in ambient air (p<0.001). The highest mean concentration of a pesticide in ambient air samples was 0.2580 +/- 0.2686 mg/m(3) for chlorpyrifos in summer and 0.1003 +/- 0.0449 mg/m(3) for chlorpyrifos in winter. In surface water samples, the highest mean concentration of a pesticide was 1.3757 +/- 0.5014 mg/l for dicrotophos in summer and 0.3629 +/- 0.4338 mg/l for ethion in winter. The highest mean concentration of a pesticide in soil samples was 42.2893 +/- 39.0711 mg/kg ethion in summer and 90.0000 +/- 24.1644 mg/kg of ethion in winter.

Latex anaphylaxis in healthcare worker and the occupational health management perspective: A case report.

Latex allergy is a critical occupational health problem in healthcare settings. Exposure to latex can lead to severe allergic reactions, including anaphylaxis. However, in epidemiological studies, occupational anaphylaxis due to natural rubber latex is relatively rare. For this reason, allergic reactions from latex exposure in the workplace may not be well aware and, therefore, lead to delayed appropriate management. We reported a female physician who sought occupational health program counseling for her latex allergic reaction following occupational exposure and her two episodes of latex anaphylaxis during medical-surgical procedures. An occupational health management program (e.g. glove replacement and a bracelet with latex allergy labeling) was established. After the intervention, she rarely experienced any allergic symptoms. Given these points, anaphylaxis can be triggered by occupational exposure to latex; thus, occupational health management is key to preventing and managing latex allergies in the workplace.

Enterprise-Based Participatory Action Research in the Development of a Basic Occupational Health Service Model in Thailand.

Various basic occupational health services (BOHS) are provided, particularly in-plant BOHS; however, it might be necessary to start expanding BOHS. The current study focuses on BOHS model development using participatory action research (PAR) at a large-sized enterprise in northeastern Thailand. The PAR began with a situation analysis using ILO Convention C161, problem and cause analysis, the development of an action plan, observation and action, evaluation, and replanning. The research tools included interviews, focus group discussions (FGDs), and participant observations. The participants included managers, human resource staff, safety officers, and workers. Both inductive and deductive thematic analyses were undertaken. The results showed that (1) education and learning experience led to the workers detecting work-related diseases early by themselves and the implementation of medical surveillance programs; (2) the workers' occupational health needs led to return-to-work assessments and first aid room system development; (3) the employer's experience led to appropriate fit-for-work examinations and emergency preparedness; and (4) the feedback from BOHS providers led to a hospital-to-in-plant return-to-work conversion. The study concluded that the enterprise could develop fit-for-work and return-to-work assessments as per the ILO Convention C161 under the policy; however, medical surveillance and the first aid room system need to be developed through counseling at the hospital's occupational medicine clinic.

The Proportion of Occupationally Related Cholangiocarcinoma: A Tertiary Hospital Study in Northeastern Thailand.

Northeastern Thailand registers the highest worldwide incidence of cholangiocarcinoma (CCA). Most of the cases are associated with liver flukes, while unknown causes comprise approximately 10-30% of cases, and these could be due to occupational exposures. Our aim was to determine the magnitude of occupational causes of CCA in a tertiary hospital in northeastern Thailand. We conducted a cross-sectional study with a sample of 220 patients between March and November 2021. Descriptive statistics were used to analyze the findings. Clinical information and telephone interviews were used to explore significant occupational histories. An occupational consensus meeting was held with two occupational physicians, an industrial hygienist, and a hepatobiliary surgeon to decide on the final diagnosis. The response rate was 90.9% (200/220). Based on the medical records and telephone interviews, researchers found that 11 participants had significant exposure. After occupational consensus, it was agreed that the eleven had possible occupational causes, 5.5% (11/200)-54.5% (6/11) being due to asbestos fibers, 45.5% (5/11) due to dichloromethane, and 9.1% (1/11) due to 1,2-dichloropropane. Only 4% (8/200) had occupational histories collected by their treating physicians. Taken together, occupationally related CCA appears to have been underestimated, so improving occupational history taking is needed to properly identify and classify work-related CCA-both for patient treatment and occupational hazard prevention.

Cholangiocarcinoma Attributed to Occupation: A Systematic Reviews.

BACKGROUND: The occurrence of a cluster of occupational cholangiocarcinoma(CCA) cases among Japanese workers at a small offset printing plant led to the hypotheses that occupational exposure was the root cause of this cancer. Numerous workplace carcinogens can be found at various jobs sites and are integral to various industrial processes. Therefore, a systematic evaluation of potential occupationally-related CCA and likely exposure types is needed. OBJECTIVE: To conduct a systematic review on the cause of CCA in relation to occupation. METHODS: The systematic review included papers published between 1980 and 2020. Databases included PubMed, Science Direct, CINAHL, ProQuest Medical Library, Springer, Wiley online library, and the Cochrane library. The review focused on CCA, intrahepatic CCA(as distinct from other types of liver cancer), and extrahepatic CCA(not including the gallbladder). While some occupations involve an expected risk of exposure to carcinogens, this study sought both primary reports on specific carcinogens or surrogates by occupation or industry title. Of the 65 English version abstracts, 18 studies were selected for in-depth review according to the eligibility criteria. Two occupational physicians independently assessed the relevance to the study objectives, data extractability, and data quality as per the Newcastle-Ottawa Scale. RESULTS: The review revealed that ten observational studies met the eligibility criteria. There was heterogeneity of occupational exposure assessment and the reported results. The possible carcinogens statistical significantly related to the incidence or mortality of CCA risk included 1,2-dichloropropane (the highest RR = 32.40, 95%CI=6.40-163.90), asbestos (the highest OR=4.81, 95 % CI =1.73-13.33), endocrine-disrupting compounds (the highest OR =2.00, 95% CI=1.10-3.70), and rotating shift work (the highest HR =1.97, 95%CI=1.02-3.79). These carcinogens are classified as IARC class 1 and 2A. CONCLUSIONS: Despite the limited number of studies reviewed, the hypothesis of occupational risk for CCA was supported. Occupational health and safety measures may decrease exposure to these carcinogens, and surveillance in high-risk occupations or industries is urgently needed to prevent and control CCA.

Effect of Latex Purification and Accelerator Types on Rubber Allergens Prevalent in Sulphur Prevulcanized Natural Rubber Latex: Potential Application for Allergy-Free Natural Rubber Gloves.

Natural rubber (NR) gloves manufactured from NR latex are widely utilized in various applications as a personal protective device due to their exceptional barrier characteristics in infection control. However, the use of NR gloves was associated with concerns on NR protein allergy. With comprehensive leaching procedures now a common practice in NR latex glove factories to eliminate latent rubber proteins and chemical allergens, occurrences and complaints of protein allergy from medical glove users have decreased drastically over the past two decades. The present work aims to eliminate further the residual rubber allergens in NR latex through effective purification of the NR latex and compounding the thus purified latex with an established formulation for allergy-free NR for glove applications. NR latex was purified by deproteinization and saponification, respectively. Several analytical techniques were used to verify rubber allergens eliminated in the purified latexes. Saponified NR (SPNR) latex was the purified NR latex of choice since it is devoid of allergenic proteins and poses the lowest risk of Type I allergy. The purified NR latex was compounded with zinc diethyldithiocarbamate (ZDEC), zinc dibutyldithiocarbamate (ZDBC), and zinc 2-mercaptobenzothiazole (ZMBT), respectively, for glove dipping. Among the investigated accelerators, only ZDBC was not detected in the artificial sweat that came into contact with the dipped articles. Thus, it is deduced that ZDBC poses the lowest risk of Type IV allergy to consumers. Additionally, the morphological and physical properties of dipped articles were assessed. It was revealed that the dipped film from the SPNR latex compounded with ZDBC provided thinner and less yellow products with a more uniform internal structure and a tensile strength comparable to those of commercial NR gloves.

Which Shiftwork Pattern Is the Strongest Predictor for Poor Sleep Quality in Nurses?

Shiftwork is related to an increased risk of several diseases, including gastric ulcers, myocardial infarction, and diabetes. Several shiftwork patterns are related to poor sleep quality, such as a quick returns or extended shifts. This study aimed to find the shiftwork patterns strongly associated with poor sleep quality amongst nurses. A cross-sectional analytical study was conducted among nurses working for at least one month. The sub-groups were the good sleep quality group (n = 150) and the poor sleep quality group (n = 472). Eligible participants were asked to complete a self-reported questionnaire comprising personal characteristics, job characteristics, shiftwork characteristics, and sleep quality. Factors associated with poor sleep quality were determined using logistic regression analysis. Two factors associated with poor sleep quality remained in the final model: viz., depression and backward rotational shift. The only independent factor for poor sleep quality was a backward rotational shift with an adjusted odds ratio (95% CI) of 1.946 (1.344, 2.871). In conclusion, compared with other shift patterns, backward shiftwork was the most significant factor associated with poor sleep quality and should be avoided.

Validity and Reliability of Self-Assessment Tool for Risk Prioritization Following Exposure to Tuberculosis in a Hospital Setting.

The Modified Self-Assessment (MSA) and Present Self-Assessment (PSA) forms are questionnaires used to prioritize the risk of infection of health workers exposed to tuberculosis (TB) in Srinagarind Hospital in Thailand. As MSA was developed from PSA, the validity and reliability of MSA need to be assessed. The research aim is to examine the content validity of MSA and to assess the respective reliability of MSA and PSA vis-à-vis expert opinion. Seven experts determined the content validity index (CVI) of MSA. MSA and PSA were used to prioritize the TB contact of 108 subjects, and we compared the result with the risk assessed by the experts. The respective Kappa agreements between MSA and PSA and the experts were used to assess reliability. The result of the content validity index revealed that MSA had I-CVI > 0.83 for all questions and an S-CVI/Ave above 0.90 for all factors. The Kappa agreement of contact priority between MSA and the experts was 0.80; it was 0.58 between PSA and the experts. MSA can, thus, be used to prioritize contact with tuberculosis in Srinagarind Hospital. MSA is a valid risk communication tool for aerosol-generating procedures. Further study should be conducted in other hospitals, and the number of participants should be increased in order to come to a concrete result.

A Lung Granuloma Case Possibly Associated with a Working Environment: A Case Report.

Lung granulomas are uncommon in Thailand. The disease typically develops from an occupational environment and is mostly caused by infection. Herein is a case report of a female patient, aged 48, working as a nurse in an Accident and Emergency Department at a hospital. Eighteen years prior to admission the patient was diagnosed with myasthenia gravis and pulmonary tuberculosis. The chest X-ray and CT scans showed a solitary pulmonary nodule in the lower left lung. The patient received an open thoracotomy with a left lobectomy. Granulomatous and nonseptate hyphae were found in the pathology diagnosis. The patient was thus diagnosed as having a lung granuloma. The galactomannan antigen test was positive. The solitary pulmonary nodule-found from the use of a Polymerase Chain Reaction (PCR) test-was an Aspergillus spp. The fungus culture was collected from air samples. The air samples were collected by the impaction technique using a microbial air sampler. Three types of Aspergillus spp. were found as well as Penicillium spp. and Monilia sitophila. The Aspergillus spp. was a match for the patient's disease. The patient was diagnosed as having a lung granuloma possibly Aspergillus nodule which was caused by airborne Aspergillus spp. from the occupational environment.

Validation of the Brief Thai Version of the Work-Related Quality of Life Scale (Brief THWRQLS).

The Work-Related Quality of Life Scale (WRQLS) was developed by Van Laar et al. The Thai version was developed and could be completed in 13.4 min on average with some items having a factor loading of less than 0.4. The aims of this study were (a) to develop a brief Thai version of the WRQLS (brief THWRQLS), and (b) to assess its validity and reliability. A descriptive correlation study was performed with the components of THWRQLS selected based on statistical and judgmental criteria. The statistical criteria were developed using secondary data from 320 physicians identifying discrimination, internal consistency and exploratory factor analysis (EFA). The judgmental criteria included content validity and agreement by five experts. The web-based brief THWRQLS was then used by 250 health personnel, and confirmatory factor analysis (CFA) was conducted and internal consistency assessed. The brief THWRQLS consisted of seven dimensions, encompassing 25 of the original 32 items. The CFA revealed that most of the standardized factor loadings were greater than 0.5. The 2goodness of fit was 268.772 (p < 0.01), the comparative fit index was 0.971, the root mean square error of approximation was 0.039, and the standardized root mean square residual was 0.049. The Cronbach's alpha coefficient of the scale was 0.94, and almost all dimensions were greater than 0.7 except for that of "stress at work," which was 0.53. In conclusion, the brief THWRQLS appeared to be valid, and the reliability was acceptable, except in the dimension of "stress at work."

Factors Associated with Latent Tuberculosis Infection among the Hospital Employees in a Tertiary Hospital of Northeastern Thailand.

Latent tuberculosis infection (LTBI) can develop into tuberculosis (TB). The WHO requires the discovery and management of LTBI among high-risk groups. Health care workers (HCWs) constitute a high-risk group. Factors associated with LTBI among HCWs in Thailand need further study. The current study aimed to explore the factors related to LTBI among Thai HCWs. A hospital-based, matched case-control study was conducted. All cases and controls were HCWs at a tertiary hospital in northeastern Thailand. Between 2017 and 2019, a total of 85 cases of interferon-γ release assays (IGRAs)-proven LTBI, and 170 control subjects were selected from a hospital (two controls per case). The two recruited controls were individually matched with LTBI cases by sex and age (±5 years). Secondary data were obtained from the occupational health and safety office. Case HCWs had a higher proportion of significant factors than control HCWs (i.e., working closely with pulmonary TB-94.1% vs. 88.8%, and working in the area of aerosol-generating procedures (AGPs) 81.2% vs. 69.4%). The bivariate conditional logistic regression showed that the occurrence of LTBI in HCWs was statistically significant (p-value < 0.05), particularly with respect to: workplaces of AGPs (crude OR = 1.90, 95% CI: 1.01-3.58, p = 0.041); among HCWs performing AGPs (crude OR = 2.04, 95% CI: 1.20, 3.48, p = 0.007); and, absent Bacille Calmette-Guérin (BCG) scar (crude OR = 2.59, 95% CI: 1.50-4.47, p = 0.001). Based on the multivariable conditional logistics analysis, HCWs who performed AGPs while contacting TB cases had a statistically significant association with LTBI (adjusted OR = 1.82, 95% CI: 1.04-3.20, p = 0.035). HCWs who reported the absence of a BCG scar had a statistically significant association with LTBI (adjusted OR = 2.49, 95% CI: 1.65-5.36, p = 0.001), whereas other factors including close contact with TB (adjusted OR = 2.44, 95% CI: 0.74, 8.09, p = 0.123) were not significantly associated with LTBI. In conclusion, HCWs who performed AGPs and were absent a BCG scar had a significant association with LTBI, while other factors played a less critical role.

Work-Related Tuberculosis among Health Workers Employed in a Tertiary Hospital in Northeastern Thailand: A Report of Nine Cases.

Between October 2016 and September 2018, fifteen health workers were diagnosed with tuberculosis (TB) at a tertiary hospital in northeastern Thailand. However, the cases could not be diagnosed as occupational TB according to international standards because of hospital limitations. The use of occupational epidemiological information provides a more effective work-related TB diagnosis. This study aims to provide a report of work-related TB using individual case investigation methods. We collected secondary data from the Occupational Health and Safety Office of the hospital in question, including baseline characteristics for the health workers, occupational history, source of TB infection and occupational exposure, and working environmental measurements. We found that nine of the fifteen cases were diagnosable as work-related TB due to two important factors: daily prolonged exposure time to an infected TB patient, and aerosol-generating procedures without adequate respiratory protection. The other six cases were not diagnosable as work-related TB because of inadequate evidence of activities related to the TB infection. The diagnosis of work-related TB thus requires occupational epidemiological information in order to complete the differentiation process.

Exposure to wood dust and its particle size distribution in a rubberwood sawmill in Thailand.

A cross-sectional study on wood dust exposure and respiratory health effects was conducted at one of the largest rubberwood sawmills in Thailand. All workers (N = 340) from all jobs on a day shift were recruited for personal sampling. Overall, the personal inhalable dust (n = 742) and respirable dust (n = 241) of full-shift samples were collected from 27 job titles. These data were used to classify workers into high, moderate, and low exposure groups based on the concentrations found in each job. Static samples were also collected to determine the particle size distribution. Geometric means (GM) are used to present the concentrations of the rubber wood dust. Inhalable dust concentrations were clearly high, ranging between 0.2 to 59.4 mg/m3 and with GM of 4.7 mg/m3. The GM of inhalable dust in each job title enabled classification of the workers into three exposure groups: (1) high exposure; >5 mg/m3, (2) moderate exposure; 2.0-5.0 mg/m3, and (3) low exposure; 0.18-1.9 mg/m3. Among the high exposure group, the highest GM inhalable dust concentrations were found in sawing green lumber (12.8 mg/m3) and cutting dry lumber (7.3 mg/m3). The respirable dust concentrations were generally low, in the range of 0.1 to 6.0 mg/m3 with a GM of 0.5 mg/m3. The largest percentage of dust in major operations belonged to the thoracic fraction; 50% cutoff diameter was smaller than 9 mum. The size distribution of wood dust indicated a high proportion in the large particle sizes.

Prevalence of musculoskeletal symptoms among garment workers in Kandal province, Cambodia.

OBJECTIVES: The main objectives of this cross-sectional descriptive study were to identify the prevalence of musculoskeletal symptoms and workstation biomechanical risk levels for garment workers in Kandal Province, Cambodia. METHODS: This cross-sectional descriptive study used multistage sampling techniques to select 714 workers from three garment factories among 22 medium-size factories (250-1,000 workers). Face-to-face interviews and direct observation using the rapid upper limb assessment scale (RULA) were used to collect data. RESULTS: The response rate was 98.3% (702/714), and the majority (89.3%) of the respondents were female. Ninety-two percent (95% CI=90.0-94.0) of the workers reported musculoskeletal symptoms in at least one body region in the previous 12 months and 89.0% (95% CI=86.7-91.3) of the workers reported such symptoms in the past seven-day period. The neck, shoulder, and lower back were the most affected body regions. In addition, the RULA data showed that 81.2% of the workers' postures were rated as action level 3, indicating that investigation and change were required soon, and that 7.5% their postures were rated as action level 4, indicating that investigation and change were required immediately. CONCLUSIONS: Cambodian garment workers reported a high prevalence of musculoskeletal symptoms in upper body regions, and their workplaces were rated as high risk ergonomically.

Health status of health care workers at Srinagarind Hospital: experience from the Annual Health Check-up Program.

The authors conducted this study to evaluate the efficacy of a health check-up program and the health status of health care workers at Srinagarind Hospital, Faculty of Medicine, Khon Kaen University. The authors reviewed all yearly-check up charts of personnel who worked at Srinagarind Hospital from 2002 to 2003 including history taking, physical examination, and laboratory testings. There were 606 office workers and 1,024 nursing staff enrolled The mean ages of both groups were 38.9 and 36.5 years old, respectively. The office workers visited physicians significantly more often than the nursing staff (553 of 606 vs 271 of 1,024; p-value = 0.00). Obesity was found much more in office workers (127 of 472 versus 129 of 749). There were significant differences between the groups on impaired fasting plasma glucose, DM, HT, high cholesterol level, high triglyceride level, and significant elevation of ALT or AST (all p-value = 0.00). In the obese group, there was also a significantly higher number of cases who had high blood pressure, defined as IFG or DM, high cholesterol level, and high triglyceride level (p-value = 0.00) except the significant elevation of ALT or AST level. Cases of obesity with significant elevation of hepatic enzyme had many atherosclerotic risk factors. Therefore, metabolic derangements are the important problem for health care workers.

Validation of the Thai Version of a Work-related Quality of Life Scale in the Nursing Profession.

BACKGROUND: Currently available questionnaires for evaluating the quality of worklife do not fully examine every factor related to worklife in all cultures. A tool in Thai is therefore needed for the direct evaluation of the quality of worklife. Our aim was to translate the Work-related Quality of Life Scale-2 (WRQLS-2) into Thai, to assess the validity and reliability of the Thai-translated version, and to examine the tool's accuracy vis-à-vis nursing in Thailand. METHODS: This was a descriptive correlation study. Forward and backward translations were performed to develop a Thai version of the WRQLS. Six nursing experts participated in assessing content validity and 374 registered nurses (RNs) participated in its testing. After a 2-week interval, 67 RNs were retested. Structural validity was examined using principal components analysis. The Cronbach's alpha values were calculated. The respective independent sample t test and intraclass correlation coefficient were used to analyze known-group validity and test-retest reliability. Multistate sampling was used to select 374 RNs from the In- and Outpatient Department of Srinagarind Hospital of the Khon Kaen University (Khon Kaen, Thailand). RESULTS: The content validity index of the scale was 0.97. Principal components analysis resulted in a seven-factor model, which explains 59% of the total variance. The overall Cronbach's alpha value was 0.925, whereas the subscales ranged between 0.67 and 0.82. In the assessment results, the known-group validity was established for the difference between civil servants and university employees [F (7.982, 0.005) and t (3.351; p < 0.05)]. Civil servants apparently had a better quality worklife, compared to university employees. Good test-retest reliability was observed (r = 0.892, p < 0.05). CONCLUSION: The Thai version of a WRQLS appears to be well validated and practicable for determining the quality of the work-life among nurses in Thailand.