HEALTH STATUS, ENVIRONMENTAL LIVING CONDITIONS AND MICROBIAL INDOOR AIR QUALITY AMONG MIGRANT WORKER HOUSEHOLDS IN THAILAND.

A large number of migrants have move to cities in Thailand seeking employment. These people may be at increased risk for environmental health problems. We studied the health status, environmental living conditions and microbial indoor air quality (IAQ) among selected groups of migrant workers and their households in Mueang District, Samut Sakhon, central Thailand. We conducted a cross sectional study of 240 migrant workers and their households randomly selected by multistage sampling. The person responsible for hygiene at each studied household was interviewed using a structured questionnaire. Two indoor air samples were taken from each household (480 indoor air samples) to determine bacterial and fungal counts using a Millipore air tester; 240 outdoor air samples were collected for comparison. Ninety-nine point six percent of study subjects were Myanmar, 74.2% were aged 21-40 years, 91.7% had a primary school level education or lower and 53.7% had stayed in Thailand less than 5 years. Eight point three percent had a history of an underlying disease, 20.8% had a recent history of pulmonary tuberculosis in a family member within the previous year. Forty-three point eight percent had a current illness related to IAQ during a previous month. Twenty-one point three were current cigarette smokers, 15.0% were current alcohol consumers, and 5.0% exercises ≥3 times per week. Forty-nine point two percent never opened the windows of their bedrooms or living rooms for ventilation, 45% never cleaned their window screens, and 38.3% never put their pillows or mattresses in the sunlight. The mean(±SD) air bacterial count was 230(±229) CFU/m3 (outdoor air = 128±82 CFU/ m3), and the mean fungal count was 630(±842) CFU/m3 (outdoor air = 138±94 CFU/ m3). When the bacterial and fungal counts were compared with the guidelines of the American Conference of Governmental Industrial Hygienists, the bacterial counts in 6.5% of houses surveyed and the fungal counts in 28.8% of house surveyed were higher than the recommended levels (<500 CFU/m3). Bacterial and fungal counts in the sample households were not significantly correlated with household hygiene practice scores (p>0.05). There was a positive correlation between bacterial counts and fungal counts in household air samples, r=0.28, p<0.001.

Occupational risk towards blood-borne infections among ambulance personnel in a provincial hospital network in Thailand.

Health-care personnel working in an ambulance may be at risk for work-related infections, especially blood-borne infections. This cross-sectional study was conducted to assess occupational risks and their preventive practices for blood-borne infections among ambulance personnel working in a provincial hospital network. One hundred sixty-one personnel who voluntarily participated were interviewed using a structured questionnaire. The one-month history of risk exposures to blood-borne infections was collected. In order to cover the real situation of patient care practices among ambulance personnel during working, 30 ambulance runs were observed. Data from the questionnaire and field observation were analyzed and presented by descriptive statistics. The results indicated that 82% had a history of contact with jaundiced patients, and 95% had a history of contact with AIDS patients. Approximately, 63.4% had a history of contact with patients' blood through injuries; of these, 64.7% had needle stick injuries, and 24.5% had sharp injuries. Data for blood-borne preventive practices from interviews reported 82.6% wore disposaiole gloves when doing a blood puncture or giving intravenous fluid/blood. Only 54% broke off drug vials with a clean cloth or cotton wool to protect from an injury, in contradiction to recommended procedure. The mean score of preventive practices was 7.6±2.2; a score classified at a moderate level. However, data from field observations demonstrated only 30.3% of observed personnel (3/9) used aprons and goggles when contacting a large amount of blood, and only 11.1% (1/9) broke off drug vials with a clean cloths to protect from an injury. Continuous education and training, as well as the improvement of safety equipment are needed to better protect ambulance personnel from occupational risks.

Microbial Contamination on Used Surgical Masks among Hospital Personnel and Microbial Air Quality in their Working Wards: A Hospital in Bangkok.

OBJECTIVE: To assess the relationship of bacterial and fungal contamination on used surgical masks worn by the hospital personnel and microbial air quality in their working wards. METHODS: This is a cross-sectional study of 230 used surgical masks collected from 214 hospital personnel, and 215 indoor air samples collected from their working wards to culture for bacterial and fungal counts. This study was carried out at the hospital in Bangkok. Group or genus of isolated bacteria and fungi were preliminarily identified by Gram's stain and lacto-phenol cotton blue. Data were analyzed using paired t-test and Pearson's correlation coefficient at the significant level of p<0.050. RESULTS: Means and standard deviation of bacterial and fungal contamination on inside area of the used masks were 47 ± 56 and 15 ± 9 cfu/ml/piece, and on outside area were 166 ± 199 and 34 ± 18 cfu/ml/piece, respectively, p<0.001. The bacterial and fungal contamination on used masks from hospital personnel working in the male and female medical wards and out-patient department, as well as the bacterial and fungal counts of the indoor air sample collected from the same area were relatively higher than the other wards. The predominant isolated bacteria and fungi contaminated on inside and outside areas of the used masks and air samples were similar (Staphylococcus spp. and Aspergillus spp.; respectively). For its relationship, results found that bacterial and fungal counts in air samples showed significantly positive correlation with the bacterial contamination load on outside area of the used masks, r=0.16, p=0.018 and r=0.21, p=0.003, respectively. CONCLUSION: High bacterial contamination on outside area of the used masks was demonstrated, and it showed a significant correlation with microbial air quality of working wards.

Microbial counts and particulate matter levels in indoor air samples collected from a child home-care center in Bangkok, Thailand.

OBJECTIVE: To assess the microbial count (bacteria and fungi) and particulate matter with sizes less than 10 microm (PM10) level in indoor air of a child home-care center in Bangkok. MATERIAL AND METHOD: A total of 287 air samples were collected from the indoor air of twenty households which were part of a child home-care center to assess bacterial and fungal counts (212 samples) and PM10 levels (66 samples). Additionally, fifty-two and twenty-six outdoor air samples were collected to compare microbial count and PMo10 levels. RESULTS: It was found that means + standard deviation (SD) for bacterial and fungal counts in the child home-care center were 527.8 +/- 230.9 cfu/m3 and 514.6 +/- 256.7 cfu/m3, respectively (those in outdoor air samples were 264.6 +/- 179.7 cfu/m3 and 308.7 +/- 217.3 cfu/m3, respectively). The mean +/- SD of PM10, level was 125.1 + 48.0 pg/m3 (that in outdoor air samples was 120.1 +/- 66.9 microg/m3). When compared with the levelfor the indoor air quality guideline, 47.2% and 47.6% of total air samples had bacterial and fungal counts higher than the recommended levels and 47.0% of total air samples had PM10 levels higher than the recommended level. CONCLUSION: The present study found that about 47% of total air samples collected from the child home-care center had bacterial and fungal counts and PM10 levels higher than the recommended levels. These results may affect the health of a child who spends most of his/her time in this center Some intervention or preventive endeavors should be undertaken, including periodic cleaning and maintenance of the ventilation systems and adoption of a regular schedule for room cleaning should be implemented.

Sero-epidemiological study of hepatitis A virus infection among hill-tribe youth and household environmental sanitation, a hill-tribe community in northern Thailand.

A cross-sectional analytic study of 190 hill-tribe youth in a community in the north of Thailand was conducted to investigate the sero-prevalence of HAV and factors related to positive anti-HAV antibody. The studied youth, whose ages ranged from 15 to 24 years, were interviewed about socio-economic status and personal hygiene. Blood specimens were collected to detect anti-HAV by ELISA commercial kit. Household environmental sanitation conditions were observed and drinking water samples were screened for bacterial contamination using SI2 medium. Following the anti-HAV assay, the studied youth were divided into two groups: anti-HAV positive, and anti-HAV negative. The studied variables of the two groups were analyzed by chi2 test to find factors related to anti-HAV positivity. The results revealed that 87% of the studied youth were positive for anti-HAV. There was no statistically significant difference between age group/gender and anti-HAV positivity, p = 0.46 and 0.16, respectively. Approximately 35.79 to 45.79% washed their hands with soap before preparing food, before eating and after using the latrine. About 88% did not improve the potability of their drinking water. The results of screening for bacterial contamination in drinking water samples found that 73.53% were contaminated with coliform bacteria. Factors related to positive anti-HAV antibody included monthly income, number of household members, use of latrine, hand-washing with soap after using latrine, household refuse management and control of insects and rodents; p = 0.04, 0.007, 0.013, 0.008, <0.001 and <0.001, respectively. The findings suggested that appropriate household environmental management should be improved in this community to reduce HAV transmission.