Home as a new physical workplace: a causal model for understanding the inextricable link between home environment, work productivity, and well-being.

The home has become a new physical workplace, and can therefore influence the work, health, and life of workers. This cross-sectional study aimed to evaluate the chronology of the effects of work hazards at home on factors such as workers' health, productivity, and well-being (WB). Information on novice working-from-home (WFH) workers was derived from the "Occupational health of WFH" project. The selected variables in the hypothesis model comprised problems such as perceived indoor environmental quality (IEQ), working conditions (WC), sick house syndrome (SHS), occupational stress (OS), work productivity (WP), and WB. The relationship between these variables was analyzed using a structural equation model. The group analysis results showed the following significant indirect path effects from work environment through WP: IEQ-> SHS->OS->WP. A non-significant direct effect was observed between IEQ and WP. While WC problems could also have a significant direct effect on WP, or be mediated by OS, WP is a significant consequence and a direct effect of WB. In conclusion, the WFH model's causal impact between home environment, WP, and WB is a physiopsychological pathway. Therefore, creating a healthy home environment and WC, along with OS management, comprise important issues for improving productivity and WB for this new work style.

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.

In Vitro Activity of Ceftolozane-Tazobactam and Other Antibiotics against Pseudomonas aeruginosa Infection-Isolates from an Academic Medical Center in Thailand.

(1) Background: Resistant Pseudomonas aeruginosa (PA) infections have limited treatment options. Data on the activity of ceftolozane-tazobactam (C-T) against PA in Thailand are limited. Objectives: The objective of this study was to identify the in vitro activity of C-T against general and resistant PA isolates from patients with real clinical infections from the HRH Princess Maha Chakri Sirindhorn Medical Center (MSMC) compared to other antibiotics and to study the resistant molecular patterns of those PA strains which were resistant to C-T. (2) Materials and Methods: This was an in vitro susceptibility study of 100 PA isolates plus an additional seven resistant PA isolates collected from MSMC patients. All PA isolates were tested with susceptibility broth (Sensititre™) and C-T minimal inhibitory concentration (MIC) test strips (Liofilchem, Roseto degli, Abruzzi, Italy). The C-T-resistant PA isolates were analyzed for six ß-lactamase genes (blaCTX-M, blaNDM, blaIMP, blaVIM, blaOXA-23 and blaOXA-48) and the mcr-1 gene. (3) Results: A total of 100 PA isolates were collected between January 2020 and January 2021 and between February 2021 and September 2021 for the additional 7 resistant isolates. There were 18 resistant PA isolates (6 MDR, 11 XDR and 1 pan-drug resistant isolate). The overall susceptibility of the initial 100 PA isolates and the 18 resistant PA isolates was 94% and 44.5%, respectively, for C-T. The C-T susceptibility rates for isolates non-susceptible to ceftazidime, piperacillin-tazobactam, carbapenems and antipseudomonal ß-lactams were 65.5%, 69.7%, 50% and 44.5%, respectively. Among the 10 isolates which were resistant to C-T, there were only 3 isolates found to have the resistant gene, which included 1 for blaIMP, 1 for blaVIM and 1 for blaNDM. (4) Conclusions: Although C-T was the best susceptibility antibiotic overall for PA isolates and MDR PA isolates at the MSMC, most of the XDR PA isolates and the PDR PA isolate were not susceptible to C-T. The mechanisms for C-T resistance involved multiple factors including the presence of blaIMP, blaVIM and blaNDM.

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.

Social Intelligence Counseling Intervention to Reduce Bullying Behaviors Among Thai Lower Secondary School Students: A Mixed-method Study.

OBJECTIVES: To develop and investigate the effectiveness of an integrative counseling intervention for enhancing social intelligence and reducing bullying behaviors among lower secondary school students in Bangkok, Thailand. METHODS: An interventional mixed-method design was employed in 2 phases. Phase 1 involved the development of a qualitative method-based integrative counseling program from key informants using the eclecticism technique. In phase 2, a randomized controlled trial with a wait-list control was conducted and qualitative research was performed with students who demonstrated bullying behaviors. Demographic data, Social Intelligence Scale (SIS) scores, and Bullying-Behavior Scale (BBS) scores were collected at baseline. Changes in SIS scores and qualitative findings obtained from in-depth interviews were examined after counseling ended, and BBS scores were collected again 1 month later. RESULTS: The developed social intelligence counseling program included eight 1-hour weekly sessions consisting of 3 components: (1) social awareness, (2) social information processing, and (3) social skills. After receiving this intervention, scores for the SIS overall (p<0.001) and all of its components (p<0.05) were significantly enhanced in the experimental group compared to the control group. Moreover, the mean BBS scores in the experimental group significantly decreased 1 month after counseling (p=0.001). With regard to the qualitative research results, the experimental students demonstrated improvements in all components of social intelligence. CONCLUSIONS: The results indicated that a preventive counseling program may enhance social intelligence, decrease bullying behaviors among lower secondary school students, and prevent further incidents of school violence. However, further studies in various population subgroups should also be performed.

Occupational Health Problems and Lifestyle Changes Among Novice Working-From-Home Workers Amid the COVID-19 Pandemic.

BACKGROUND: Social distancing by working-from-home is an effective measure to decrease the spread of COVID-19. However, this new work pattern could also affect the well-being of workers. Therefore, the aim of the study was to study the magnitude of occupational health problems and lifestyle changes among workers who have only recently started working from home. METHODS: A cross-sectional study was conducted using online self-administered questionnaires during the coronavirus disease 2019 pandemic in the Bangkok metropolitan area, Thailand. The participants were from any organization that allowed working from home. The demographic data including the analysis of the characteristics of working from home, the occurrence of occupational health problems, and the lifestyle changes caused by working from home were analyzed. RESULTS: A total of 869 workers were included as study participants. The highest prevalence of physical health problems among all workers was identified to be weight gain at a rate of 40.97% (95% confidence interval = 37.69-44.24), and the highest prevalence of psychosocial problems was identified to be cabin fever at a rate of 31.28% (95% confidence interval = 26.66-35.90%) among full-time working-from-home workers. The health effects that were significantly related to the intensity of working from home (p for trends <0.05), either positively or negatively, included body weight changes, ergonomic problems, indoor environmental problems, and psychosocial problems. Meanwhile, the lifestyle changes related to work intensity included eating pattern, sleep habits, and exercise. CONCLUSIONS: Working from home can affect workers' well-being in various aspects. Hence, occupational health providers must prepare for risk prevention and health promotion in this "new normal" working life pattern and for future pandemics.

Cancer Incidence among Healthcare Workers in Cancer Centers: A 14-Year Retrospective Cohort Study in Thailand.

OBJECTIVE: To identify the situation and possible work-related cancer risks among healthcare workers in cancer centers. METHODS: This research was a 14-year retrospective cohort study of 2,331 healthcare workers at the National Cancer Institute and 7 regional cancer centers in Thailand. The study period consisted of a total of 18,939 person-years of observation. The demographic data, such as occupation and work area were collected by self-administered questionnaires or by use of a proxy. The cases were identified by the diagnoses of physicians. The incidence rates for each type of cancer, occupation and work area among the population of this study were compared with the general working population, based on national cancer statistics. The results were reported in terms of Standard Incidence Ratio (SIR) and a 95% confidence interval (CI), using Fisher's exact method. FINDINGS: There were 12 different types of cancer identified in 35 cases during the 14 years of the study and breast cancer was found to be at the highest number. The overall cancer incidence rates were 221.04 and 173.43 per 100,000 person-years, in males and females, respectively. Leukemia showed statistically significant levels of high SIR among the female healthcare staffs (SIR = 11.54; 95% CI = 2.38-33.72). With regard to occupation, only the male physicians showed significant SIR = 6.02; 95% CI = 1.41-19.93, while this study did not identify significant SIR levels in any of the work areas. CONCLUSIONS: This study found that the risk of leukemia was higher than expected among healthcare workers and that physicians may have an increased risk of cancer compared to the general working population, which may be a work-related reflex. However, interpretations should be made with caution due to the small number of cases.

Impact of Tobacco Control Campaigns on Smoking Behaviors in Thai Medical Schools.

Objective: To explore the changes in the prevalence of smoking behavior, attitudes, and cessation training among medical students after the establishment of the Thai Health Professional Alliance against Tobacco (ThaiPAT) and its major campaigns by using the nationwide Global Health Professions Student Surveys (GHPSS). Material and Method: Multiple cross-sectional studies were conducted after three major campaigns were launched between 2007 and 2011, the Deans' Summit on Tobacco Control, implemented tobacco control into the medical curriculum, and 100% smoke-free hospitals and medical schools. The results of two rounds of GHPSS among third year medical students across the nation in 2006 and 2011 were compared. Results: Overall prevalence of active cigarette smoking remained unchanged at 2.6%. Passive cigarette smoke exposure in public areas appeared to decrease slightly over time. In the most recent national survey, the prevalence of passive smoke exposure was 53.7%. Moreover, the number of student that agreed with the smoking ban in pubs, bars, and nightclubs increased significantly from 80.8 to 90.5%. There was significant improvement in the cessation training among medical students (p<0.001). A significant increase in the number of student that agreed that healthcare personnel needed specific training in cessation techniques (p = 0.004) and should always advise their patients to quit smoking (p<0.001). Conclusion: Nationwide tobacco control campaigns in Thai medical schools significantly improved the attitudes toward smoking cessation and cessation training among their students, although overall prevalence of active and passive cigarette smoking was unchanged.

Semi-quantitative exposure assessment of occupational exposure to wood dust and nasopharyngeal cancer risk.

Occupational exposure to wood dust is one cause of nasopharyngeal cancer (NPC); however, assessing this exposure remains problematic. Therefore, the objective of this study was to develop a semi-quantitative exposure assessment method and then utilize it to evaluate the association between occupational exposure to wood dust and the development of NPC. In addition, variations in risk by histology were examined. A case-control study was conducted with 327 newly diagnosed cases of NPC at the National Cancer Institute and regional cancer centers in Thailand with 1:1 controls matched for age, gender and geographical residence. Occupational information was obtained through personal interviews. The potential probability, frequency and intensity of exposure to wood dust were assessed on a job-by-job basis by experienced experts. Analysis was performed by conditional logistic regression and presented in odds ratio (ORs) estimates and 95% confidence intervals (CI). Overall, a non significant relationship between occupational wood dust exposure and NPC risk for all subjects was observed (ORs=1.61, 95%CI 0.99-2.59); however, the risk became significant when analyses focused on types 2 and 3 of NPC (ORs=1.62, 95%CI 1.03-2.74). The significant association was stronger for those exposed to wood dust for >10 year (ORs=2.26, 95%CI 1.10-4.63), for those with first-time exposure at age>25 year (ORs=2.07, 95%CI 1.08-3.94), and for those who had a high cumulative exposure (ORs=2.17, 95%CI 1.03-4.58) when compared with those considered unexposed. In conclusion, wood dust is likely to be associated with an increased risk of type 2 or 3 NPC in the Thai population. The results of this study show that semi-quantitative exposure assessment is suitable for occupational exposure assessment in a case control study and complements the information from self-reporting.

Occupational Risk Factors of Lymphohematopoietic Cancer in Rayong Province, Thailand.

BACKGROUND: The Lymphohematopoietic Cancer (LHC) incidence rate in Thailand has been rising over the past decade with unknown etiology, including Rayong province. One hypothesis of LHC risks is exposure to occupational carcinogens. OBJECTIVE: To determine the association of occupational exposure and LHC risks in Rayong province, Thailand. MATERIAL AND METHOD: This matched hospital-based case-control study was conducted in a Rayong provincial hospital from September 2009 to January 2013. One LHC case was matched with four controls in gender and age, ±5 years. Demographic data, residential factors, behavioral factors, and occupational exposure-including chemical exposure-were obtained by interviews and collected by occupational health care officers. The risk factor was analyzed by conditional logistic regression and reported in odds ratio with 95% confidence interval. RESULTS: This study found 105 LHC cases which met the inclusion criteria and were included in the study, yielding a 66% cover rate of cases reported in the database. The histology of LHC were 51 leukemia cases (47.7%), 43 lymphoma cases (42.0%), and 11 multiple myeloma cases (10.3%). The results revealed that occupational exposure to pesticide and smoke were statistically significantly associated with LHC with adjusted ORs 2.26 (95% CI 1.30-3.91) and 1.99 (95% CI = 1.13-3.51), respectively. When stratified to histological subtype of LHC by WHO 2000, leukemia was statistically significantly associated with occupational exposure to smoke, adjusted ORs 2.43 (95% CI 1.11-5.36), with occupational pesticide exposure a significant risk of lymphoma, adjusted ORs 4.69 (95% CI 2.01-10.96). However, neither fumes, wood dust, working outdoors, cleaners, contact with animals, petroleum products and chlorine; nor occupational exposure to volatile organic compounds (VOCs) such as benzene or organic solvents, were statistically significant risk factors of LHC. In addition, there were no significant risks in the demographic data, residential factors, and behavioral factors. CONCLUSION: Occupational exposure to pesticides and smoke were important occupational risks in developing LHC in Rayong province. However, the ability or power to detect this problem due to the small sample size and recall bias from the study design could not be excluded.

Tobacco smoke exposure and breast cancer risk in Thai urban females.

The incidence of urban female breast cancer has been continuously increasing over the past decade with unknown etiology. One hypothesis for this increase is carcinogen exposure from tobacco. Therefore, the objective of this study was to investigate the risk of urban female breast cancer from tobacco smoke exposure. The matched case control study was conducted among Thai females, aged 17-76 years and living in Bangkok or its surrounding areas. A total of 444 pairs of cases and controls were recruited from the Thai National Cancer Institute. Cases were newly diagnosed and histologically confirmed as breast cancer while controls were selected from healthy women who visited a patient, matched by age ± 5 years. After obtaining informed consent, tobacco smoke exposure data and information on other potential risk factors were collected by interview. The analysis was performed by conditional logistic regression, and presented with odds ratio (ORs) and 95% confidence intervals(CI). From all subjects, 3.8% of cases and 3.4% of controls were active smokers while 11.0% of cases and 6.1% of controls were passive smokers. The highest to lowest sources of passive tobacco smoke were from spouses (40.8%), the workplace (36.8%) and public areas (26.3%), respectively. After adjusting for other potential risk factors or confounders, females with frequent low-dose passive smoke exposure (≤ 7 hours per week) from a spouse or workplace had adjusted odds ratio 3.77 (95%CI=1.11-12.82) and 4.02 (95%CI=1.04-15.50) higher risk of breast cancer compared with non-smokers, respectively. However, this study did not find any association of breast cancer risk in high dose passive tobacco smoke exposure, or a dose response relationship in cumulative passive tobacco smoke exposure per week, or in the active smoker group. In conclusion, passive smoke exposure may be one important risk factor of urban female breast cancer, particularly, from a spouse or workplace. This risk factor highlights the importance of avoiding tobacco smoke exposure as a key measure for breast cancer prevention and control.

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.

Overweight/Obesity and related factors among thai medical students.

This study was conducted to assess the prevalence of overweight/obesity and the related demographic data and health behaviors of Thai medical students. A cross-sectional study of 5441 medical students from all the 13 medical schools in Thailand was conducted in 2006 by means of a self-administered questionnaire. Demographic data, health behaviors, and self-reported body weight and height were recorded. The results revealed that Thai medical students have a lower prevalence of overweight/obesity than the general population of the same age group. The multiple logistic regression analysis showed that higher academic year was associated with being overweight or obesity in males, having improper dietary habits were associated with being overweight or obesity in both genders, whereas alcohol consumption was associated with being overweight in male only. Therefore, medical curricula should place an emphasis not only on knowledge but also on attitudes and behaviors for healthy lifestyles.

Factors associated with seropositive antibodies to Brucella melitensis in the Nakhon Nayok, Thailand.

BACKGROUND: Human brucellosis is a re-emerging disease in Thailand. In 2006, Her Royal Highness Princess Maha Chakri Sirindhorn Medical Center Nakorn Nayok province had diagnosed three cases of brucellosis which have never been reported in this area. OBJECTIVE: To conduct an epidemiologic study with the aim of evaluating the sero-prevalence and factors associated with seropositive antibodies to Brucella melitensis among residents who live in the same sub-district of the first index case. MATERIAL AND METHOD: In 2007, a study was conducted in Chumpon sub-district, Ongkharak district, Nakhon Nayok province, Thailand where the outbreak took place in the previous year. The 86 subjects were selected from three villages in the present study area. Blood specimens were collected and tested for antibodies for Brucella melitensis using a serum agglutination test. A structural interview questionnaire was used to detect any possible risk factors. A binary logistic regression was utilized for analyzing the statistical data. RESULTS: Of all participants in the present study, 45.35% (95% CI; 34.61-56.08%) had seropositive antibodies to Brucella melitensis. Multivariate analysis indicated that factors associated with seropositive titers were highly related to contact with labored or aborted goats, adjusted odds ratio = 27.16 (95% CI = 1.02-721.53) and the consumption of raw goat products, adjusted odds ratio = 6.27 (95% CI = 1.25-31.36). CONCLUSION: High seropositive prevalence of Brucella melitenis after the 2006 outbreak was found in the present study. The associated factors of infection are direct contact with infected animals and this is similar with the other outbreak areas in Thailand and the endemic countries. Therefore, local authorities should not only provide the communities with health education, but also conduct continued surveillance in order to help control and prevent the epidemic.

Efficacy of fresh lime for smoking cessation.

OBJECTIVE: To determine the efficacy of fresh lime as a smoking cessation aid compared with nicotine gum. MATERIAL AND METHOD: A randomized, controlled trial was conducted between March 2009 and September 2009. Only regular smokers aged 18 or older who were willing to quit were randomized to receive either fresh lime (n = 47) or nicotine gum (n = 53). Smokers were excluded if they were using other smoking cessation aids, allergic to citrus, or had dental problems. Exhaled carbon monoxide (CO)-confirmed continuous abstinence rate (CAR) during week 9-12 was measured as the primary outcomes. To grade the severity of craving, a 100-mm visual analogue scale (VAS) was used. RESULTS: There was no significant difference in CO-confirmed CAR between the fresh lime group and the nicotine gum group during weeks 9-12 (61.7% vs. 66.0%; p = 0.65), although 7-day point prevalence abstinence at week 4 of the fresh lime users was statistically significant lower than those using nicotine gum (38.3% vs. 58.5%; p = 0.04). Cravings did not differ significantly between the groups, although fresh lime users tend to report more cravings intensity. CONCLUSION: Fresh lime can be used effectively as a smoking cessation aid, although not as good as nicotine gum in reducing cravings.

Evaluation of non-viral risk factors for nasopharyngeal carcinoma in Thailand: results from a case-control study.

Nasopharyngeal cancer (NPC) is rare in most populations but common in Southern China and Southeast Asia. To understand the role of environmental exposures on risk of NPC, a case-control study was conducted among 327 newly diagnosed case of NPC and 327 controls matched to case on sex, age and geographic residence. Information was collected by interviewer about demographic variables, cigarette smoking, alcohol drinking, eating habits, past history of disease, family history of cancer and a lifetime history of every job that was held for one year or longer. The result indicates that cigarette smoking was associated with an increased risk of NPC (OR=2.41, 95% CI 1.61-3.6). There was indication of increased risk with a history chronic ear or nose disease (OR=2.71, 95% CI 1.45-5.06). Occupational exposure to wood dust was also associated with a higher risk (OR=1.63, 95% CI 1.02-2.61). Furthermore, lower education was found to be positively associated with NPC (OR=2.71, 95% CI 1.45-5.06). There was no association between NPC and salted fish intake (OR=1.38, 95% CI 0.84-2.25) or alcohol consumption (OR=0.88, 95% CI 0.58-1.33). Our results suggest that cigarette smoking, past history of ear or nose disease and occupational exposure to wood dust may play a role in the development of NPC in the Thai population.

Case-control study of occupational categories and breast cancer risk in Thailand.

Breast cancer is common malignancy in Thai female. Although there are well established risk factors, many environmental agents with an impact are still unknown especially with reference to occupation. The objective of this study was to investigate the risk of female breast cancer among different occupational categories in Thailand. A frequency-matched case-control study was conducted among Thai women aged 17-79. A total of 516 pairs of cases and controls were recruited at the Thai National Cancer Institute, Khon Kaen University Hospital and Khon Kaen Provincial Hospital during 2002-2004. Cases were newly diagnosed with histological confirmed breast cancers while controls were selected from healthy women matched by age (± 5 years) and geographical area. After informed consent was signed, information was obtained on occupation and other risk factors from each subject using an interviewer-administered and structured questionnaire. The International Standard Classification of Occupations version 1968 (ISCO-68) was used to code for occupational categories. The relation between occupational categories and breast cancer risk was evaluated by unconditional logistic regression analysis. The mean age of cases and controls were 46.9 ± 10.6 and 47.8 ± 9.9 years, respectively. Fifty-five percent of cases were pre-menopausal women. After adjusting for confounding factors by multiple logistic regression analysis, the results showed that occupational category as production and related workers, transport equipment operators and labourers was associated with an increased risk of breast cancer (OR=1.41 95% CI=1.01-1.97) and this finding was also supported by a statistically significant positive trend for duration of employment (p=0.01). A significantly decreased breast cancer risk was observed in clerks (OR=0.59, 95% CI=0.37-0.96). In conclusion, this study revealed that women who have lifetime occupation in an industrial setting may have higher risk to develop breast cancer. Further studies are needed to assess occupational exposure in specific occupations.

Etiological investigation of unintentional solvent exposure among university hospital staffs.

AIM: This study was done to investigate unintentional solvent exposure in Srinakharinwirot university hospital staffs with unknown etiology. MATERIAL AND METHODS: A multidisciplinary investigation was conducted. Total volatile organic compounds (TVOCs) in working environments were measured. Biomarkers of exposure and self-administered questionnaires about clinical symptoms were collected, during and after the incidence, from the affected workers. RESULTS: The reason behind this event was found to be renovation of the 15(th) floor. TVOCs contaminated the air hanging unit of the lower 5th floor via space of the pipeline system of the building. The average TVOC value in the complaint area, on the date of notification, was 9.5 ppm. The symptoms and level of hippuric acid, collected during the incidence, were significantly higher than those collected after the problems were solved. CONCLUSIONS: The solvent from the renovation site was a potential source of health hazards for hospital staffs. The relevant authorities should be concerned about implementing a policy for the prevention of indoor pollution in the hospital.

Effect of nicotine polyestex gum on smoking cessation and quality of life.

OBJECTIVE: To determine the effectiveness and safety of the novel nicotine polyestex gum for smoking cessation, along with its impact on the quality of life (QOL). MATERIAL AND METHOD: A double-blind, placebo-controlled, randomized clinical trial was conducted on 43 smokers. All of them received either nicotine gum or placebo. Only those who could quit completely and continuously by the end of 3 months were considered total abstinence. QOL was also measured using WHO questionnaires. RESULTS: Treatment with nicotine polyestex gum resulted in significantly greater abstinence rate at 3 months compared with placebo (50% vs. 9%; p = 0.003). Adverse events were modest and not encountered more often than those seen in the placebo group. QOL at 3-months improved in both groups, but there was no statistically significant difference between the groups. CONCLUSION: Nicotine polyestex gum is effective and safe for smoking cessation. It is also associated with significant improvement in the QOL.

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.