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.

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 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-a-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.

Preliminary Psychometric Properties of the Chinese Version of the Work-Related Quality of Life Scale-2 in the Nursing Profession

OBJECTIVES: As quality of work-life (QWL) among nurses affects both patient care and institutional standards, assessment regarding QWL for the profession is important. Work-related Quality of Life Scale (WRQOLS) is a reliable QWL assessment tool for the nursing profession. To develop a Chinese version of the WRQOLS-2 and to examine its psychometric properties as an instrument to assess QWL for the nursing profession in China. METHODS: Forward and back translating procedures were used to develop the Chinese version of WRQOLS-2. Six nursing experts participated in content validity evaluation and 352 registered nurses (RNs) participated in the tests. After a two-week interval, 70 of the RNs were retested. Structural validity was examined by principal components analysis and the Cronbach's alphas calculated. The respective independent sample t-test and intra-class correlation coefficient were used to analyze known-group validity and test-retest reliability. RESULTS: One item was rephrased for adaptation to Chinese organizational cultures. The content validity index of the scale was 0.98. Principal components analysis resulted in a seven-factor model, accounting for 62% of total variance, with Cronbach's alphas for subscales ranging from 0.71 to 0.88. Known-group validity was established in the assessment results of the participants in permanent employment vs. contract employment (t = 2.895, p < 0.01). Good test-retest reliability was observed (r = 0.88, p < 0.01). CONCLUSION: The translated Chinese version of the WRQOLS-2 has sufficient validity and reliability so that it can be used to evaluate the QWL among nurses in mainland China.

Health related behaviors survey of the medical organization, Srinagarind hospital, Faculty of Medicine, Khon Kaen University

Background: Physicians and dentists are the health personnel that need high investment and long production process. The life expectancy of medical doctors was varied between 61.1 and 86.5 years old and dentists was varied between 51.3 and 75.4 years old. Health related behavior might play an important role to health status and life expectancy.  Objective: To study health related behavior of physicians and dentists who are the member of the medical organization, and work at  Srinagarind hospital. Study design: A cross-sectional descriptive  studySetting: Srinagarind hospitalMethod: The physicians and dentists who are the members of the medical organization, and work at Srinagarind hospital were given a self-administrated questionnaire during June 31st- Oct 30th, 2004. The questionnaire had 5 compartments as follows: general information, occupational history, health status data, life style pattern and occupation-related hazards.Result: Two hundred and six  out of 519 numbers (39.7%) Completed the questionaires. The male: female ratio was nearly 1:1. The mean age of responder was 38.1 + 8.6 years old.  Sixty  five percent were highly pleased with their own occupation. The mean monthly income of physicians was 72,483.00 baht (median 30,000 Baht). The average working hour was 42.5 + 24.8 hours per week. Most of the cases slept 6-8 hours per day. The four most common diseases were allergy (19.6%), hypertension (5.4%), heart disease (1.6%) and Diabetes Millitus(1.1%), respectively. 8.2% of the respondents  noticed history of doze during driving while 7.1% experienced traffic accident. Regarding personal behaviors; 20.0% had history of alcohol drinking, 2.7% presented cigarette smoking and 10.2% had ever played government raffle. Most of the cases (80.6%) took care themselves while having ill. However, only 52.2% of respondents attended annual health check-up program. In addition, half of cases 48.9%  exercised less than 2 days per week. In cases of stress management, 36% watched television, while 30% read  books. Subgroup analysis of 22 dentists revealed that 72.7% of them were highly pleased with their own occupation. The mean monthly income of dentists was 58,500.00 Baht. The average working hour was 34.9 + 5.7  hours per week. Most of the cases slept 6-8 hours per day. The three most common diseases were allergic disease (13.6%), hypertension (4.5%), and diabetes mellitus (4.5%), respectively.  9.1% of the respondents  noticed history of doze during driving while 4.5% experienced traffic accidents. Regarding personal behaviors, 13.6% had history of alcohol drinking, 9.1% presented cigarette smoking. Most of the cases (40.9%) took care themselves in terms of illness. However, 3 in 4 of responders attended annual health check-up program. In addition, one-third of cases (36.4%) exercised less than 2 days per week. In cases of stress management, 40.9% watched television, while 27.3% read  books.   Conclusion:  The physicians and dentists who are the members of the medical organization and work at Srinagarind hospital were highly satisfied with their own profession. The average earning was good. The health statuses were similar to the physicians and the dentists in the other part of Thailand. However, the attitude in health promotion was low. 

The Variability of the Prevalence of Latex Sensitisation

       Latex gloves are widely used for non-invasive procedures since increased public awareness of acquired immune deficiency syndrome (AIDS). A number of allergic reactions have been reported to the latex protein and some of the other components in the gloves. The clinical symptoms include: contact dermatitis, localised urticaria, allergic rhinoconjunctivitis, angioedema, generalised urticaria, asthma and even anaphylaxis.

Sickness Absence among Nursing Staff of Srinagarind Hospital

Rationale : There are several potential harmful exposures in hospital, for example chemical reagents, radiation, virus, bacteria, nosocomial agents, etc.  These exposures may be the major causes of absence due to sickness among nursing staff.  Furthermore exposure to job strain could also causes absence.  Absence due to sickness among nursing staff not only causes an increase of work burden and job strain on other colleagues but also causes both direct and indirect cost lost to the system. Therefore, the magnitude and causes of this problem should be explored in order to gather information to plan for appropriate occupational health intervention to prevent or minimize this problem.Objectives: The objectives of this study are (1) to estimate the rate of absence due to sickness, (2) to estimate the average duration of absence, (3) to estimate extra wages dude to absence.Method: It was a descriptive study.  The population in this study was nursing staff who took sick leave during the period from January 1 to December 31, 2000.  Information was collected from sick leave form.  Data was analyzed by SPSS-PC program.  The results are presented by descriptive statistics.Results : There were 759 out of 1445 nursing staff taking sick leave during the period from January 1 to December 31 ,2000.  There were 1373 sick leave forms.  The rate of sickness absence was estimated to be 0.95 time/person/year or 6 persons/day.  The average duration of absence was estimated to be 1.7 days/person/year.  The top three causes of sickness absence were having a headache or fever (21.0%), common cold (18.8%) and diarrhea (10.8%).  Among those taking sick-leave for more than 3 days/time, the top causes of sickness absence were undergoing an ovarian operation or breast operation, and threaten abortion.  The extra wages due to absence was estimated to be 34,284 Bath/month.Conclusion: The rate of sickness absence was not high, however, the top three causes of sickness absence are due to preventable symptoms.  It should be further investigate as to whether the tip causes of sickness absence among those taking sick-leave of more than 3 days/time are related to workplace exposure or not.Keywords : absenteeism, healthcare workers, nurse, occupational health

Sufficient Exercise and Exercise Behavior Among Employees and Lecturers at the Faculty of Medicine, Khon Kaen University (KKU), Thailand

Background:  Exercise is apart of health promotion. Sufficient exercise is continuous less than 3 times /week. Exercise should be intense so as to increase the pulse rate, cause sweating and result in fatigue. The benefits of exercise include improved health, better social life and mental health. The sample group consisted of employees at the Faculty of Medicine. The data regarding exercise within this group was insufficient so a new study was undertaken.Objective: The purpose of this research was to monitor and measure employees and lecturers at the Faculty of Medicine Khon Kaen University (KKU)Study design: Decriptive studySetting: Faculty of Medicine, KKUPopulation and Samples: The population of the study consisted of 3,401 subjects at the Faculty of Medicine KKU. A stratified random sample of 1,671 subjects consisted of 965 (shift workers) and 706 (day workers).Research tool and data collection: Self-administered questionnaires were developed which included information in relation to demographics, exercise data and recommended exercise data. The researchers sent the questionnaires to the sample of 1,671 and waited for the returned questionnaires.Analysis of data: The data analysis used the ready made computer program SPSS-PC version 11 to calculate descriptive statistic frequency, percentage, mean, standard deviation to within 95 %confidence interval (CI).Results: The response rate of the returned questionnaire was 68%. This consisted of 648 shift workers (67%) and non-shift workers 488 (69%). 75.2% of the subjects were females. The sample aged between 18 and 60. The average age being 38.1 years (SD=8.5). The results showed that 64.4% (95%CI: 59.4, 65.2) of the subjects exercised regularly. However sufficient exercise within the subject group was only 6.2 % (95%CI 4.9, 7.7). In this group the data showed that running and jogging as a form of exercise was (57.7%) followed by aerobic dance (32.4%) and bicycling at 25.2 % respectively. 81% of the subjects said they like to exercise in the evening including near their residence (46.5%) and the exercise grounds in KKU (41.2 %). 42.2% of the subjects preferred to exercise alone. The top three reasons respondents said they like to exercise was for good health (88.5%), relaxation (65.0%), and diet (49.7%). The top three reasons given for not exercising were; no time (81.1%), tired from work (72.5%) and unsuitable plac to exercise (24.8%).Conclusion: Of the sample subjects who took part in sufficient exercise the top three types of exercise included running, jogging, followed by bicycling and aerobic dance. Most respondents liked to exercise in the evening. The research findings also found that subjects usually like to exercise near their accommodations. 

Undergraduate students’ knowledge and understand of occupational medicine at Khon Kaen University

Background: Occupational medicine and occupational health were taught in 20 hours through out our whole 6 years curriculum. From a survey done in the year 2001, our 6th year medical students had low confidence when diagnosing occupational diseases. Since the year 2002, a teaching session at a factory setting was added for the 5th year medical students.Objective: To assess the knowledge and understanding of occupational medicine among 6th medical school students in the year 2004.Study design: Descriptive studyMethod: The 6th year medical students were given a self-administrated questionnaire. The data collected were general information and specific knowledge and understanding about occupational medicine.Result: There was 62% response rate. 86% of the respondents understood the role of doctor toward occupational medicine at an average level. 63% were not confident about the diagnosis of occupational disease. 70% emphasized on history taking for the diagnosis of occupational disease. 52% do not know the correct funding source for the workers’ compensation however they knew better than the study done in 2002. 84% knew that doctors were required to write a sick leave certificate only. 53% of the students knew the correct procedure for writing a medical opinion for the claim form. Nevertheless, some thought that doctor should evaluate the workplace as well. In addition the students are aware of the occupational health and safety principles while working at hospitals.Conclusion: When compare with the previous study, our students’ understanding about the doctors’ role in occupational medicine remain the same as compared with the earlier study. However, the student had more ability to emphasize on the history taking for the diagnosis.