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ABSTRACT: The purpose of this study was to conduct a health impact assessment (HIA) in a community where an old slaughterhouse was to be renovated. The authors conducted a cross-sectional study in March, 2011. Questionnaires were used to collect data and focus group discussions were conducted to solicit the community concerns and recommendations regarding the project. The results reveal positive impacts in 4 aspects of health: physical, mental, social, and spiritual. The current substandard slaughterhouse was perceived negatively by the surrounding community. They were happy the slaughterhouse would be renovated, and some preferred it moved elsewhere. This HIA had 2 positive results: first, we tested our HIA tool in a real situation and found it practical on a small scale; second, the municipality obtained the community's opinions and concerns and the community knew their opinions reached the municipality, so they were more positive about the municipality.
The Southeast Asian journal of tropical medicine and public health 01/2012; 43(1):229-35. · 0.60 Impact Factor
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ABSTRACT: The purpose of this study was to assess a health impact assessment (HIA) tool to determine the perceived health impact by the public of a public park. The authors conducted a cross-sectional study from March to April, 2011, using this HIA questionnaire to collect data and through focus group discussions. We also assessed community concerns about the park and obtained recommendations of how to mitigate possible negative aspects of the parks. Four aspects were listed as possible benefits of the park: physical, mental, social, and spiritual health. The negative aspects mentioned by participants were that a park could be a potential place of assembly for teenagers, a place for theft and crime and accidents among children. The HIA tool used for this research seemed appropriate. The next challenge is to use this tool to assess a more controversial project.
The Southeast Asian journal of tropical medicine and public health 01/2012; 43(1):236-42. · 0.60 Impact Factor
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ABSTRACT: 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.
Asia-Pacific Journal of Public Health 12/2011; · 1.06 Impact Factor
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ABSTRACT: This study explored community concerns about the impact of a healthcare‐waste (HCW) incinerator site in Yala Province, Thailand. A structured questionnaire was used to gather data from 300 respondents twice: before and after the incinerator commenced operation. The Chi‐square test was used to identify changes in concerns and the impact of distance. The results showed high levels of concern regarding the environment and health, and the nuisance related to HCW and the incinerator. The impacts associated with distance were air pollution, adverse health effects, and nuisance related to waste vehicles. In addition, the HCW incinerator site affected sources of drinking water and resulted in road damage. Location of incinerator site, people’s low education level, lack of public participation, trust in the project vendor, acceptability of incinerator technology, and job benefits might be enabling factors for the success of an HCW‐incineration site.
Journal of Risk Research 08/2011; 14(7):847-858. · 0.88 Impact Factor
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ABSTRACT: This evaluative research study aimed to assess the effects of the central healthcare incinerator project on waste management in Yala Province. The study data were collected twice: at baseline and during the operational phase. A combination of structured interview and observation were used during data collection. The study covered 127 healthcare facilities: government hospitals, healthcare centres, and private clinics. The results showed 63% of healthcare risk waste (HCRW) handlers attended the HCRW management training. Improvements in each stage of the HCRW management system were observed in all groups of facilities. The total cost of the HCRW management system did not change, however; the costs for hospitals decreased, whereas those for clinics increased significantly. It was concluded that the central healthcare waste incinerator project positively affected HCRW management in the area, although the costs of management might increase for a particular group. However, the benefits of changing to a more appropriately managed HCRW system will outweigh the increased costs.
Waste management & research : the journal of the International Solid Wastes and Public Cleansing Association, ISWA. 06/2011; 29(10 Suppl):91-6.
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ABSTRACT: The purpose of this research was to develop tools applicable to the Health Impact Assessment (HIA) in Environmental Impact Assessment (EIA) in a Thai context. The relevant documents and articles were extensively reviewed, analyzed, and drafted. The first draft was presented to a research advisory committee for their review, and the recommended changes were subsequently made. The second draft was then presented to respondents from 6 groups of key stakeholders-expert review committees under the Office of Natural Resources and Environmental Policy and Planning (ONREPP), EIA registered consulting firms, non-government organizations, members of the ONREPP, local government organizations, and government organizations responsible for issuing permission to the proposed projects. Their commentary and recommendation were considered, and modifications were made as necessary. The third draft was finally reviewed by the research advisory committee before the tryout step. The final revised version is presented in this paper.
Acta medica Okayama 04/2011; 65(2):123-8. · 0.84 Impact Factor
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ABSTRACT: To compare the health between type 2 diabetic patients doing day work and shift work.
Two hundred and forty workers (120 day workers, 120 shift workers) aged 30-60 years were selected from the Social Security Clinic in five hospitals in Bangkok and its vicinity. All participants in the present study filled out the questionnaires that included questions for detecting hypoglycemic symptoms, Thai GHQ--12 questionnaires, and Suanprung Stress Test--20 questionnaires. Fasting blood glucose during the last six months, blood pressure during the last six months, and body mass index (BMI) were collected from the patient's medical records. All results were collected and compared between day workers and shift workers.
Good glycemic control was significantly higher in day workers versus shift workers (28.3% vs. 15.8%). A higher proportion of shift workers had hypoglycemic symptoms and abnormal mental health compared to day workers.
Shift work may have a negative effect on type 2 diabetic patients' health. Consequently, type 2 diabetic shift-worker needs more attention from physicians and employers at their work place.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 08/2008; 91(7):1093-6.
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ABSTRACT: Develop performance indicators reflecting the quality of trauma-patient-care in the emergency room and hospitalization within the first 48 hours.
A two-round Delphi technique was conducted. A panel of 11 expert surgeons experienced in the fields of trauma care was consulted. The panel was initially asked to rate performance indicators that reflected the quality of trauma care given in the emergency department setting and hospitalization in the first 48 hours using a 5-point on visual analogue scale. The statement of indicators that was collected from the first round was analyzed and necessary changes were before resending to the same experts. Each indicator statement was considered consensus if the expert's opinion rating was 4 or 5 for more than 70% (8 out of 11 experts).
Fifty-three performance indicators were proposed in four domains of trauma care in emergency room and four domains of trauma care in hospitalization within 48 hours. Altogether 35 indicators reached consensus reflecting quality of trauma performance after two rounds. Twenty-one of these were trauma care indicators in emergency room and 14 were trauma care indicators in hospitalization within 48 hours.
Twenty-one indicators of quality of trauma care in the emergency room and 14 in the hospitalization within 48 hours have been developed. They will be used as the tool by specialist for quality evaluation in the next phase.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 02/2008; 91(1):99-103.
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ABSTRACT: This is Phase 2 of the authors study on long-lived Thai physicians. After obtaining quantitative data from Phase 1, the authors approached 11 male and 5 female physicians whose ages were older than general population's life expectancy. The authors conducted an in-depth interview using semi-structured questions asking about their life, work, lifestyle, and relevant factors. Then the authors synthesized the factors influencing longevity. The authors found that they are genetic, financial stability/security, trying to be disease-free by increasing positive lifestyle (such as exercise) and decrease negative lifestyle (such as drug addict, alcohol consumption), mind-set to be non-attachment (either doing nothing or busy doing everything), and being mentally ready to die. The authors also proposed policy implications for Thai physicians and people accordingly.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2005; 88(9):1257-60.
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ABSTRACT: This survey was aimed at obtaining a screening survey on mental health status of Thai physicians. We systematically sampled to obtain 440 Thai physicians from the directory of Thai Center for Continuing Medical Education (CCME). Then, we obtained their mental health status by mailing a questionnaire containing Thai GHQ-28 and asking them to reply, later we obtained through telephone interview. The response rate was 86.3 percent, and 60.3 percent of them were male. The result revealed that 15 male and 13 female physicians had abnormal mental health status. The overall prevalence rate of abnormal mental health status was 7.4 percent. We also found a significant negative association between mental health status and career satisfaction and the use of sedatives in the past 6 months. This study pointed out that mental health of some Thai physicians was to be concerned. These problems, along with their physical health problems, should be tackled systematically and preventatively in order to have the majority of Thai physicians in good health and able to serve the population more effectively.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S9-13.
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ABSTRACT: The objectives of this study were to explore characteristics of the long-lived Thai physicians. We sent 983 posted questionnaires to 840 male and 143 female physicians. We obtained 327 of them back after 2 rounds of mailing, yielding a response rate of 33.3 percents. The response rate of male physicians was 32.4 percents and that of female physicians was 38.5 percents. Their ages were between 68-93 years (75.1 +/- 4.86 years on average). The majority were married, implying that their spouses were also long-lived. Around half of them still did some clinical work, one-fourth did some charity work, one-fourth did various voluntary works, one-fifth did some business, one-fifth did some academic work, and some did more than one type of work. Most long-lived physicians were not obese, with BMI of 16.53-34.16 (average 23.97 +/- 2.80). Only 8 had BMI higher than 30. BMIs were not different between male and female physicians. However, four-fifths of them had diseases that required treatment, and some of them had more than one disease. The five most frequent diseases were hypertension, diabetes, ischemic heart disease, dyslipidemia, and benign prostate hypertrophy, respectively. Most long-lived physicians did exercise (87.8%), and some did more than one method. The most frequent one was walking (52.3%). Most did not drink alcohol or drank occasionally, only 9.0% drank regularly. Most of them slept 3-9 hours per night (average 6.75 +/- 1.06). Most (78.3%) took some medication regularly; of most were medicine for their diseases. Most did not eat macrobiotic food, vegetarian food, or fast food regularly. Most long-lived physicians practiced some religious activities by praying, paying respect to Buddha, giving food to monks, practicing meditation, and listening to monks' teaching. They also used Buddhist practice and guidelines for their daily living and work, and also recommended these to their younger colleagues. Their recreational activities were playing musical instruments (15%), singing (27%), doing hobbies (64.0%), and others (51.8%). Most did not reply on question whether they achieved their self-actualization target of their lives, this might result from the fact that this was rather an abstract question. Our first part study revealed some characteristics of long-lived Thai physicians that seem to be in agreement with other studies indicating that physicians compared favorably with the general population in mortality from physical illness. This may result from several factors: the medical student selective process leading to "healthy worker effect", knowledge in medicine, access to care, and their healthy behaviors (such as nutrition, exercise, religious activities which help improve their spiritual well-being).
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S23-32.
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ABSTRACT: Physicians often conduct research on other occupations' health or general populations' health, but their health has hardly been studied systematically. The authors conducted a cross-sectional descriptive survey on 440 physicians systematically selected from their medical license numbers. The response rate was 86.4% (380 out of 440). Two-hundred and twenty-nine were male, and 151 were female. Their average age was 40.8 years (range: 22-74). Most of them were Buddhists (93.9%), specialists (64.2%), married only once and still lived with their spouses (59.5%), and concurrently practiced medicine (95.5%). Their overall satisfaction as physicians was 60.2% high, and 37.2% moderate. Their average sleep time was 6-8 hours per night for 58.9%. Most had eye problems (74.9%) and most were refractive errors such as myopia. Most (63.8%) of them did not have any prevalent diseases. Whereas those who had diseases had (in order) allergy, hypertension, asthma, diabetes, and cancer. Their current illnesses included respiratory tract infection. Most physicians did not smoke (94.2%) nor drink alcohol (70.5%). Most of them were not vegetarians (60.4%), did not eat fast food (99.2%). Interestingly, 41.4% of them were accounted for spending less than twice per week for exercise. As expected, 23.7% of them were exposed to blood, 14.5% to respiratory tract secretion, and 13.7% to pus/secretion from wounds. This study serves as a basis for health promotion approach to medical community and does create awareness of health among Thai physicians.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S1-4.
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ABSTRACT: To investigate the risk factors for suicide in Thai physicians.
The study focused on 18 doctors who had committed suicide before January 2002, identified by death certificates and the reported data from Thai Medical Council. Consensus case reports were assembled by using the psychological autopsy method. Study methods included semi-structured and in-depth interviews of next of kin and interviews of classmates, colleagues and medical or mental health services workers who had treated the suicide victims.
The sample consisted of 18 subjects (17 males, one female). The age range was 30-49 years old. Most victims were specialists (11 out of 18; 3 gynecologists, 2 psychiatrists, 2 pediatricians, 2 surgeons and 1 internist, 1 radiologist). The methods of suicide were 6 hanging, 5 gun shots, 5 intravenous injections, 1 jumping and 1 drug over-dose. Psychiatric disorders were found in 11 out of 18 cases, and depressive disorder was the most common disorder. Interpersonal conflict and/or loss were the most common factors leading to suicide (6 out of 18), the second factor was psychiatric illness and the third factor was work problems.
In assessing suicidal risk, a history of interpersonal conflicts and loss and the presence of co-morbid psychiatric disorders are particularly important. The important strategies for suicide prevention in Thai physicians are early detection and proper management of psychiatric illness especially depressive disorder and recognition the significance of family support.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S14-8.
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ABSTRACT: The purposes of this cross-sectional study were to collect data regarding satisfaction and influencing factors related to satisfaction of Thai Physicians. The survey was conducted during October 2002 to March 2003. Study subjects were 440 physicians obtained by systematic random sampling. They were asked to reply posted questionnaire and telephone interviewed later if they did not reply the mailed questionnaire. The authors could obtain data from 380 out of 440 cases (86.3%), 60.3% were male and 39.7% were female. Their average age was 43.9 and 37.7 years, respectively, with an overall average of 40.9 years. The level of career satisfaction of Thai Physicians was high (60.2%), moderate (37.2%) and low (2.6%). Conclusively the factors which influenced or predicted satisfaction of Thai physicians were age, exercise and accident. The author make some recommendations for improving Thai physicians' satisfaction.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S5-8.
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ABSTRACT: Previous report suggested early age at death of Thai physicians; the estimate however was not a comparable measurement with general Thai population. This information created a concern on the health status of Thai population. This study was therefore aimed to calculate life expectancy of Thai physicians and to compare with Thai population. Information on year of birth of all registered physicians and year of death of physicians who died during 1998-2002 was retrieved from the database of the Thai Medical Council and the Centre for Continuing Medical Education of Thailand. Age-specific mortality rates were computed for ages of 23-24, 25-29, and then 5-year intervals until 70 years or more. These age-specific mortality rates were used for calculation of life expectancy by using the method of abridged life table. During the year 1998-2002, there were 655 deaths among 25,501 Thai physicians. According to life table calculation, life expectancy at age 23 for Thai physicians was 63.5 years or they could live until age of 86.5 years when they started their career and those figures for Thai general population were 53.2 and 76.2 respectively. The differences between these two populations were declined in older age groups. Increased life expectancy among physicians compared to general population was also reported in other countries. A longer life span of physicians might be a result of higher socioeconomic status and low prevalence of health risk behavior.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 10/2004; 87 Suppl 4:S19-22.
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ABSTRACT: This study was a result of the second phase of a two-phase research project. In the previous phase, the draft of healthy workplace indicators was developed by means of literature review and soliciting of expert opinion. There were 46 indicators divided into 6 different groups. This phase of the project was a quantitative cross-sectional descriptive study which aimed at exploring the opinion of employers and occupational health officers (OHOs) of the enterprises towards the pilot set of healthy workplace indicators. The field data collection was conducted by means of a postal survey. Questionnaires were sent to 180 workplaces in Samutprakarn province. The response rates of employers and OHOs were 66.7 per cent (n = 120) and 68.3 per cent (n = 123), respectively. It was found that the majority of the enterprises had a workplace health promotion policy (59.3%), had health promotion activities (60.2%), did not have designated personnel responsible for health promotion (69.1%), had a health promotion budget (53.7%), were large scale enterprises (61.0%), and did not have a mother enterprise in foreign country (81.3%). In general, the mean scores of the opinions of employers and OHOs toward indicators in the appropriateness aspect were high. For the achievability aspect, there were 9 indicators which less than half of the employers thought they could achieve, and 10 indicators that less than half of the OHOs thought they could achieve. The opinion of employers and OHOs differed significantly in 4 indicators in the appropriateness aspect and 1 indicator in the achievability aspect. In conclusion, both the employers and OHOs considered most of these indicators appropriate for the enterprises and most indicators were achievable and useful as a guideline and evaluation tool for workplace health promotion.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 07/2003; 86 Suppl 2:S271-83.
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ABSTRACT: The objective of this study was to analyze the current situation of laboratory accreditation (LA) in Thailand, especially on occupational and environmental health. The study integrated both quantitative and qualitative approaches. The response rate of the quantitative questionnaires was 54.5% (226/415). The majority of the responders was environmental laboratories located outside hospital and did not have proficiency testing. The majority used ISO 9000, ISO/IEC 17025 or ISO/ EEC Guide 25, and hospital accreditation (HA) as their quality system. However, only 30 laboratories were currently accredited by one of these systems. Qualitative research revealed that international standard for laboratory accreditation for both testing laboratory and calibration laboratory was ISO/IEC Guide 25, which has been currently revised to be ISO/IEC 17025. The National Accreditation Council (NAC) has authorized 2 organizations as Accreditation Bodies (ABs) for LA: Thai Industrial Standards Institute, Ministry of Industry, and Bureau of Laboratory Quality Standards, Department of Medical Sciences, Ministry of Public Health. Regarding LA in HA, HA considered clinical laboratory as only 1 of 31 items for accreditation. Obtaining HA might satisfy the hospital director and his management team, and hence might actually be one of the obstacles for the hospital to further improve their laboratory quality system and apply for ISO/IEC 17025 which was more technically oriented. On the other hand, HA may be viewed as a good start or even a pre-requisite for laboratories in the hospitals to further improve their quality towards ISO/IEC 17025. Interviewing the director of NAC and some key men in some large laboratories revealed several major problems of Thailand's LA. Both Thai Industrial Standards Institute and Bureau of Laboratory Quality Standards did not yet obtain Mutual Recognition Agreement (MRA) with other international ABs. Several governmental bodies had their own standards and accreditation systems, and did not accept other bodies' standards and systems. This put a burden to private laboratories because they had to apply and get accredited from several governmental bodies, but still had to apply and get accredited from international ABs especially for those dealing with exports. There were only few calibration laboratories, not enough for supporting the calibration required for the equipment in testing laboratories' LA. Purchasing proficiency testing specimens from abroad was very expensive, and often got into troubles with the customs duty procedures. The authors recommend some strategies and activities to improve laboratory accreditation in Thailand. Improvement in occupational and environmental health laboratories would essentially be beneficial to laboratory accreditation of other areas such as clinical laboratory.
The Southeast Asian journal of tropical medicine and public health 07/2002; 33(2):400-9. · 0.60 Impact Factor
