Association of high sensitivity C-reactive protein concentrations and metabolic syndrome among Thai adults.

Background: Limited information is available regarding associations of metabolic syndrome with C-reactive protein (CRP) concentrations among Asian populations. Objective: Investigate the association of high sensitivity CRP (hsCRP) concentrations and metabolic syndrome among Thai adults. Methods: This cross-sectional study was comprised of 467 Thai participants (209 men and 258 women) receiving annual health check-up. Spearman’s rank correlation coefficients were used to assess the associations between metabolic parameters (age, waist circumference, blood pressure, triglycerides, HDL-C, fasting plasma glucose, fasting insulin and uric acid) with hsCRP concentrations for men and women, respectively. Multivariable logistic regression procedures were used to estimate the risk (odds ratios (OR), and 95% confidence intervals (CI) of metabolic syndrome according to low, moderate, and high hsCRP concentrations (<1.0, 1.0-3.0, and >3.0 mg/L, respectively). Results: Measures of adiposity and fasting insulin were positively and significantly correlated with hsCRP concentrations among women with and without metabolic syndrome. Similar associations were observed among men without metabolic syndrome. After controlling for confounders, moderately elevated hsCRP concentrations were associated with a 2.38-fold increased risk of metabolic syndrome (OR=2.38, 95%CI=1.20-4.72) among men. Men with high hsCRP concentrations had a 5.45-fold increased risk of metabolic syndrome (OR=5.45, 95%CI=2.24- 13.27) when compared with those who had low hsCRP concentrations. The corresponding OR for women with moderately elevated and high hsCRP concentrations were 4.92 (OR=4.92, 95%CI=2.34-10.35) and 11.93 (OR=11.93, 95%CI=5.54-25.72), respectively. Conclusions: These findings are consistent with the literature suggesting a role of hsCRP as a biomarker for metabolic syndrome.

Nosocomial tuberculosis risk assessment and management recommendation for an emergency department in a university hospital.

OBJECTIVES: To assess the nosocomial TB risk and recommend appropriate risk management procedure for the trauma ward of the emergency department at a university hospital in Bangkok. MATERIAL AND METHOD: The risk assessment procedure includes: (1) estimating the number of healthcare visits of the TB patients at the trauma ward of emergency department in 2004; (2) determining the TB incidence rate among the healthcare workers (HCWs) of the trauma ward during 2004-2005; and (3) surveying the indoor environment (particularly concerning the ventilation condition) of the targeting ward. Appropriate risk management procedures were then recommended based on the guidelines provided by The World Health Organization (WHO) and The Centers for Disease Control and Prevention (CDC) of the United States. RESULTS: The estimated number of healthcare visits of the TB patient at the trauma ward in 2004 was 20. During 2004-2005, there were 4 out of 57 HCWs at the trauma ward who developed tuberculosis; among these were two registered nurses and two nursing auxiliaries. The TB incidence rates among these HCWs were 3,509 per 100,000 person-year overall (or 2,632 per 100, 000 person-year for confirmed TB cases only) and 3,333 (or 1,667 for confirmed TB cases only) and 4,761 per 100, 000 person-year for registered nurse and nursing auxiliary. The ventilation in the trauma inpatient ward had 1.43 air changes per hour, which was below the recommended standard value. Turbulence pattern of airflow, which promotes airborne TB spreading in this area, was also detected. CONCLUSION: The risk assessment results showed that the trauma ward of the emergency department at this university hospital has a high risk for nosocomial tuberculosis. Appropriate risk management procedures, which are in accord with the standard guidelines, should be urgently implemented.

Occupational exposures among nurses and housekeeping personnel in King Chulalongkorn Memorial Hospital.

OBJECTIVES: To determine the incidence and related factors of blood and body fluid exposure (BBFE)among nurses and housekeeping personnel in King Chulalongkorn Memorial Hospital, Bangkok, Thailand MATERIAL AND METHOD: A retrospective survey of BBFE among 858 nurses and housekeeping personnel who were working in the year 2004 was done. Data were collected by a self-administered questionnaire RESULTS: The annual incidence rate of BBFE was 31.9% (by person) and 45.5 exposures per 100 persons (by event). The highest incidence rate was observed in percutaneous exposure. Graduated nurses had the greatest risk of all exposures, but housekeeping personnel had the highest rate ofpercutaneous exposure. The highest incidence of BBFE was observed in the emergency room. Most BBFE occurred after using a medical instrument. 76.9% of BBFE were not reported. CONCLUSION: The incidence of BBFE among nurses and housekeeping personnel in King Chulalongkorn Memorial Hospital was high. Systematic control measures and good organization of the work and workplace should be urgently implemented.

Incidence and predictors of type 2 diabetes among professional and office workers in Bangkok, Thailand.

OBJECTIVES: To determine the incidence rates of type 2 diabetes and associated factors among professional and office workers in Bangkok. MATERIAL AND METHOD: Data on fasting glucose measurements and physical examination were obtained from a cohort of 6,924 workers in 43 establishments in Bangkok during 1999-2003. Impaired fasting glucose and diabetes were defined according to the American Diabetes Association criteria. The type 2 diabetes incidence rates were calculated based on the person-time of follow-up period. RESULTS: A total of 136 individuals developed type 2 diabetes during 11,581 person-years (py) of follow-up. The incidence rates of type 2 diabetes in individuals aged 35-60 years was 11.4 per 1000 py Men had a higher incidence rate than women (17.8 vs 9.2 per 1,000 py). The incidence rates increased with age. Factors associated with development of diabetes included baseline fasting plasma glucose (FPG) level, overweight and obesity status. Adjusted incidence rate ratios (IRR, 95%CI) for FPG of 93-99 mg/dl and 100-125 mg/dl were 3.2 [1.1-9.9] and 31.5 [11.4-86.8] respectively, compared to those with FPG < 93 mg/dl. The IRRs for those with BMI of 23-27.5 and > 27.5 kg/m2 were 1.5 [0.9-2.5] and 2.7 [1.6-4.5] respectively, compared to those with BMI < 23 kg/m2. CONCLUSION: Findings from the present study could serve as the first marking post for estimating the risk and magnitude of type 2 diabetes in other adult populations in Thailand.

The influence of indoor environment quality on psychosocial work climate among office workers.

BACKGROUND: There is increasing concern about psychosocial problem in workplaces and indoor environmental quality (IEQ) is alleged to be among the major causes of this problem. PURPOSE: To investigate the influence of indoor environmental problems on psychosocial effect among office workers in Bangkok, Thailand. STUDY DESIGN: Cross-sectional descriptive study. METHOD: Study subjects were 1,262 office workers selected by cluster random sampling from 5 air-conditioned buildings in Bangkok. The data were collected by self-administered questionnaires during February 2004. RESULTS: Office workers in an unhealthy climate group were significantly younger, had longer weekly working hours and higher educational levels. The prevalence rates of all categories of IEQ complaints were higher in the unhealthy climate group. In crude analyses, the odds ratios of having an unhealthy psychosocial work climate were significantly associated with the number of IEQ complaints in a dose-response manner After adjusting for a set of confounding factors (sex, age groups, education, job category and working hours), temperature, noise and dust are the aspects of IEQ complaints significantly associated with having an unhealthy psychosocial work climate. CONCLUSION: Good workplace IEQ would have beneficial effects on psychological well-being of employees.