Journal of Preventive Medicine and Public Health

Original Articles

Environmental Health Literacy Regarding Fine Particulate Matter and Related Factors Among Village Health Volunteers in Upper Northern Thailand: Nattapon Pansakun, Warangkana Naksen, Waraporn Boonchieng, Parichat Ong-artborirak, Tippawan Prapamontol; J Prev Med Public Health. 2024;57(2):138-147. Published online February 10, 2024; DOI: https://doi.org/10.3961/jpmph.23.434

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Abstract PDF: Objectives
Fine particulate matter pollution has emerged as a significant life-threatening issue in Thailand. Recognizing the importance of environmental health literacy (EHL) in disease prevention is crucial for protecting public health. This study investigated EHL levels and aimed to identify associated factors among village health volunteers (VHVs) in the upper northern region of Thailand.
Methods
A cross-sectional study was conducted to collect data from 710 VHVs using the EHL assessment tool developed by the Department of Health, Thailand.
Results
The overall EHL score was moderate (mean, 3.28 out of a possible 5.0), with the highest and lowest domain-specific mean score for the ability to make decisions (3.52) and the ability to access (3.03). Multiple linear regression revealed that the factors associated with EHL score were area of residence (urban areas in Chiang Mai: B=0.254; urban areas in Lampang: B=0.274; and rural areas in Lampang: B=0.250 compared to rural areas in Chiang Mai), higher education levels (senior high school: B=0.212; diploma/high vocational certificate: B=0.350; bachelor’s degree or above: B=0.528 compared to elementary school or lower), having annual health checkups compared to not having annual health check-ups (B=0.142), monthly family income (B=0.004), and individuals frequently facing air pollution issues around their residence (B=0.199) compared to those who reported no such issues.
Conclusions
The VHVs exhibited moderate EHL associated with residence area, education, health check-ups, family income, and residential air pollution. Considering these factors is vital for enhancing VHVs’ EHL through strategic interventions.; Summary

Alleviation of PM_2.5-associated Risk of Daily Influenza Hospitalization by COVID-19 Lockdown Measures: A Time-series Study in Northeastern Thailand: Benjawan Roudreo, Sitthichok Puangthongthub; J Prev Med Public Health. 2024;57(2):108-119. Published online January 19, 2024; DOI: https://doi.org/10.3961/jpmph.23.349

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Abstract Summary PDF Supplementary Material: Objectives
Abrupt changes in air pollution levels associated with the coronavirus disease 2019 (COVID-19) outbreak present a unique opportunity to evaluate the effects of air pollution on influenza risk, at a time when emission sources were less active and personal hygiene practices were more rigorous.
Methods
This time-series study examined the relationship between influenza cases (n=22 874) and air pollutant concentrations from 2018 to 2021, comparing the timeframes before and during the COVID-19 pandemic in and around Thailand’s Khon Kaen province. Poisson generalized additive modeling was employed to estimate the relative risk of hospitalization for influenza associated with air pollutant levels.
Results
Before the COVID-19 outbreak, both the average daily number of influenza hospitalizations and particulate matter with an aerodynamic diameter of 2.5 μm or less (PM_2.5) concentration exceeded those later observed during the pandemic (p<0.001). In single-pollutant models, a 10 μg/m³ increase in PM_2.5 before COVID-19 was significantly associated with increased influenza risk upon exposure to cumulative-day lags, specifically lags 0-5 and 0-6 (p<0.01). After adjustment for co-pollutants, PM_2.5 demonstrated the strongest effects at lags 0 and 4, with elevated risk found across all cumulative-day lags (0-1, 0-2, 0-3, 0-4, 0-5, and 0-6) and significantly greater risk in the winter and summer at lag 0-5 (p<0.01). However, the PM_2.5 level was not significantly associated with influenza risk during the COVID-19 outbreak.
Conclusions
Lockdown measures implemented during the COVID-19 pandemic could mitigate the risk of PM_2.5-induced influenza. Effective regulatory actions in the context of COVID-19 may decrease PM_2.5 emissions and improve hygiene practices, thereby reducing influenza hospitalizations.; Summary

Key Message
In the present research, both single- and multi-pollutant models indicated that the level of PM2.5 was significantly related to the daily number of influenza cases in Khon Kaen, Thailand, prior to the COVID-19 outbreak. Additionally, a significant risk difference was observed between the pre-outbreak and the pandemic periods due to the reduction in air pollutant concentrations because of lockdown measures to control the spread of COVID-19. These findings could be useful for developing environmental policies and strategies accordingly to mitigate respiratory health issues.

Sleep Quality and Associated Factors Among Firefighters in Bangkok, Thailand: A Cross-sectional Study: Nunnapat Piyachaiseth, Pornchai Sithisarankul, Jate Ratanachina; J Prev Med Public Health. 2024;57(1):83-90. Published online December 9, 2023; DOI: https://doi.org/10.3961/jpmph.23.305

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Abstract Summary PDF Supplementary Material: Objectives
Professional firefighters face various health hazards and are required to maintain both physical and mental fitness to effectively mitigate crises and respond to emergencies. Moreover, the long working hours and shift work of this profession impact sleep quality. This study investigated the quality of sleep and its associated factors among firefighters in Bangkok, Thailand.
Methods
This was a cross-sectional study of firefighters affiliated with the Bangkok Fire and Rescue Department, Bangkok Metropolitan Administration, Thailand between January 2023 and March 2023. A cluster random sampling technique was utilized to distribute 600 questionnaires to firefighters in 15 fire stations. The questionnaire addressed demographic, work-related, and environmental factors. Sleep quality was assessed using the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Data analysis involved both descriptive and inferential statistics. Bivariate and multiple logistic regressions were performed.
Results
The response rate was 78.7% (n=472), and 44.1% of the firefighters reported poor sleep quality (PSQI score >5). Sleep quality was statistically associated with conflicting family relationships (odds ratio [OR], 1.8; 95% confidence interval [CI], 1.1 to 2.9), additional part-time jobs (daytime, OR, 2.4; 95% CI, 1.3 to 4.4; or nighttime, OR, 4.3; 95% CI, 1.1 to 16.7), noisy sleeping areas (OR, 1.7; 95% CI, 1.1 to 2.8), and the availability of adequate bedding (OR, 3.0; 95% CI, 1.8 to 4.9).
Conclusions
Poor sleep quality among firefighters was associated with various personal, work-related, and environmental factors. Organizations should promote policies that improve sleep quality through good sleep hygiene practices and facilities.; Summary

Key Message
This cross-sectional study aimed to investigate sleep quality among firefighters in Bangkok, Thailand its associated factors. 44.1% of the firefighters reported poor sleep quality (the Pittsburgh Sleep Quality Index: PSQI score >5). Sleep quality was statistically associated with conflicting family relationships, additional part-time jobs (daytime or nighttime), noisy sleeping areas, and the availability of adequate bedding.

Protection Motivation Theory and Rabies Protective Behaviors Among School Students in Chonburi Province, Thailand: Mayurin Laorujisawat, Aimutcha Wattanaburanon, Pajaree Abdullakasim, Nipa Maharachpong; J Prev Med Public Health. 2021;54(6):431-440. Published online November 16, 2021; DOI: https://doi.org/10.3961/jpmph.21.457

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Abstract PDF

Objectives
The aim of this study was to predict rabies protective behaviors (RPB) based on protection motivation theory (PMT) among fourth-grade students at schools in Chonburi Province, Thailand.
Methods
This cross-sectional study was conducted from December 2020 to February 2021. A multistage sampling technique was used for sample selection. The questionnaire was divided into socio-demographic data and questions related to PMT and RPB. Descriptive statistical analysis was conducted using the EpiData program and inferential statistics, and the results were tested using the partial least squares model with a significance level of less than 5%.
Results
In total, 287 subjects were included, of whom 62.4% were girls and 40.4% reported that YouTube was their favorite media platform. Most participants had good perceived vulnerability, response efficacy, and self efficacy levels related to rabies (43.9, 68.6, and 73.2%, respectively). However, 54.5% had only fair perceived severity levels related to rabies. Significant positive correlations were found between RPB and the PMT constructs related to rabies (β, 0.298; p<0.001), and the school variable (S4) was also a predictor of RPB (β, -0.228; p<0.001). Among the PMT constructs, self efficacy was the strongest predictor of RPB (β, 0.741; p<0.001).
Conclusions
PMT is a useful framework for predicting RPB. Future RPB or prevention/protection intervention studies based on PMT should focus on improving self efficacy and response efficacy, with a particular focus on teaching students not to intervene with fighting animals. The most influential PMT constructs can be used for designing tools and implementing and evaluating future educational interventions to prevent rabies in children.

Summary

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Screening Intention Prediction of Colorectal Cancer among Urban Chinese Based on the Protection Motivation Theory
Wenshuang Wei, Miao Zhang, Dan Zuo, Qinmei Li, Min Zhang, Xinguang Chen, Bin Yu, Qing Liu
International Journal of Environmental Research and Public Health.2022; 19(7): 4203. CrossRef
Career resilience of the tourism and hospitality workforce in the COVID-19: The protection motivation theory perspective
Diep Ngoc Su, Thi Minh Truong, Tuan Trong Luu, Hanh My Thi Huynh, Barry O'Mahony
Tourism Management Perspectives.2022; 44: 101039. CrossRef

Identification of Unmet Healthcare Needs: A National Survey in Thailand: Sukanya Chongthawonsatid; J Prev Med Public Health. 2021;54(2):129-136. Published online March 4, 2021; DOI: https://doi.org/10.3961/jpmph.20.318

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Abstract PDF Supplementary Material

Objectives
This study examined demographic factors hampering access to healthcare at hospitals and suggests policy approaches to improve healthcare management in Thailand.
Methods
The data for the study were drawn from a health and welfare survey conducted by the National Statistical Office of Thailand in 2017. The population-based health and welfare survey was systematically carried out by skilled interviewers, who polled 21 519 384 individuals. The independent variables related to demographic data (age, sex, religion, marital status, education, occupation, and area of residence), chronic diseases, and health insurance coverage. The dependent variable was the degree of access to healthcare. Multiple logistic regression analysis was subsequently performed on the variables found to be significant in the univariate analysis.
Results
Only 2.5% of the population did not visit a hospital when necessary for outpatient-department treatment, hospitalization, or the provision of oral care. The primary reasons people gave for not availing themselves of the services offered by government hospitals when they were ill were—in descending order of frequency—insufficient time to seek care, long hospital queues, travel inconvenience, a lack of hospital beds, unavailability of a dentist, not having someone to accompany them, and being unable to pay for the transportation costs. Multiple logistic regression analysis showed that failure to access the health services provided at hospitals was associated with demographic, educational, occupational, health welfare, and geographic factors.
Conclusions
Accessibility depends not only on health and welfare benefit coverage, but also on socioeconomic factors and the degree of convenience associated with visiting a hospital.

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Factors associated with poor self-rated health among chronic kidney disease patients and their health care utilization: Insights from LASI wave-1, 2017-18
Swetalina Nayak, Soumya Ranjan Nayak, Alice Alice, Debadutta Sahoo, Srikanta Kanungo, Tanveer Rehman, Sanghamitra Pati, Subrat Kumar Palo
Frontiers in Nephrology.2023;[Epub] CrossRef
The association between health costs and physical inactivity; analysis from the Physical Activity at Work study in Thailand
Katika Akksilp, Wanrudee Isaranuwatchai, Yot Teerawattananon, Cynthia Chen
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Unmet Healthcare Needs among the Elderly Korean Population: Before and during the COVID-19 Pandemic
Hyo Lyun Roh, Sang Dol Kim
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The association of physical activity and sedentary behaviour on health-related quality of life: a cross-sectional study from the physical activity at work (PAW) trial
Katika Akksilp, Falk Müller-Riemenschneider, Yot Teerawattananon, Cynthia Chen
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Soroush Moallef, Travis Salway, Nittaya Phanuphak, Katri Kivioja, Suparnee Pongruengphant, Kanna Hayashi
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The impact of the Syrian Refugee Crisis on the health access in Turkiye: A synthetic control analysis
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Effects of the Short Foot Exercise With Neuromuscular Electrical Stimulation on Navicular Height in Flexible Flatfoot in Thailand: A Randomized Controlled Trial: Juntip Namsawang, Wichai Eungpinichpong, Ratana Vichiansiri, Somchai Rattanathongkom; J Prev Med Public Health. 2019;52(4):250-257. Published online July 14, 2019; DOI: https://doi.org/10.3961/jpmph.19.072

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Abstract PDF

Objectives
Flatfoot, or low medial longitudinal arch, contributes to back and lower extremity injuries and is caused by weak abductor hallucis (AbdH) muscles. The purpose of this study was to investigate the effects of short foot exercise (SFE) alone or with neuromuscular electrical stimulation (NMES) on navicular height, the cross-sectional area (CSA) of the AbdH muscle, and AbdH muscle activity in flexible flatfoot.
Methods
Thirty-six otherwise healthy people with flexible flatfoot were randomly assigned to a group that received SFE with placebo NMES treatment (the control group) or a group that received both SFE and NMES treatment (the experimental group). Each group received 4 weeks of treatment (SFE alone or SFE with NMES). Navicular height, the CSA of the AbdH muscle, and AbdH muscle activity were assessed before and after the intervention.
Results
No significant differences were found in navicular height or the CSA of the AbdH muscle between the control and experimental groups, while AbdH muscle activity showed a statistically significant difference between the groups (SFE=73.9±11.0% of maximal voluntary isometric contraction [MVIC]; SFE with NMES=81.4±8.3% of MVIC; p<0.05). Moreover, the CSA of the AbdH muscle showed a statistically significant increase after treatment in the SFE with NMES group (pre-treatment=218.6±53.2 mm²; post-treatment=256.9±70.5 mm2; p<0.05).
Conclusions
SFE with NMES was more effective than SFE alone in increasing AbdH muscle activity. Therefore, SFE with NMES should be recommended to correct or prevent abnormalities in people with flexible flatfoot by a physiotherapist or medical care team.

Summary

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Effect of Arch Height Flexibility in Individuals With Flatfoot on Abductor Hallucis Muscle Activity and Medial Longitudinal Arch Angle During Short Foot Exercises
Haruki Ishiyama, Tomoya Takabayashi, Shiori Hiratsuka, Wataru Ito, Takanori Kikumoto, Masayoshi Kubo
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Anushri R Patil, Swapna Jawade, Kamya J Somaiya, Manali A Boob
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Luis Enrique Carranza García, Ricardo López-García, Jose Omar Lagunes-Carrasco, Perla Lizeth Hernández-Cortés, María Cristina Enríquez-Reyna, Ricardo Navarro-Orocio
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Regimen-related Mortality Risk in Patients Undergoing Peritoneal Dialysis Using Hypertonic Glucose Solution: A Retrospective Cohort Study: Chinakorn Sujimongkol, Cholatip Pongskul, Supannee Promthet; J Prev Med Public Health. 2018;51(4):205-212. Published online June 19, 2018; DOI: https://doi.org/10.3961/jpmph.18.066

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Abstract PDF

Objectives
The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution.
Methods
A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders.
Results
Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome.
Conclusions
Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.

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Associations of Glucometabolic Indices with Aortic Stiffness in Patients Undergoing Peritoneal Dialysis with and without Diabetes Mellitus
Chi-Chong Tang, Jen-Pi Tsai, Yi-Hsin Chen, Szu-Chun Hung, Yu-Li Lin, Bang-Gee Hsu
International Journal of Molecular Sciences.2023; 24(23): 17094. CrossRef

Urinary Mercury Levels Among Workers in E-waste Shops in Nakhon Si Thammarat Province, Thailand: Somsiri Decharat; J Prev Med Public Health. 2018;51(4):196-204. Published online June 19, 2018; DOI: https://doi.org/10.3961/jpmph.18.049

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Abstract PDF

Objectives
To determine urinary mercury levels in e-waste workers in Southern Thailand and the airborne mercury levels in the e-waste shops where they worked, to describe the associations between urinary and airborne mercury levels, and to evaluate the prevalence of mercury exposure-related health effects among e-waste workers.
Methods
A cross-sectional study was conducted by interviewing 79 workers in 25 e-waste shops who lived in Nakhon Si Thammarat Province, Thailand. Information on general and occupational characteristics, personal protective equipment use, and personal hygiene was collected by questionnaire. Urine samples were collected to determine mercury levels using a cold-vapor atomic absorption spectrometer mercury analyzer.
Results
The e-waste workers’ urinary mercury levels were 11.60±5.23 μg/g creatinine (range, 2.00 to 26.00 μg/g creatinine) and the mean airborne mercury levels were 17.00±0.50 μg/m3 (range, 3.00 to 29.00 μg/m3). The urinary and airborne mercury levels were significantly correlated (r=0.552, p<0.001). The prevalence of self-reported symptoms was 46.8% for insomnia, 36.7% for muscle atrophy, 24.1% for weakness, and 20.3% for headaches.
Conclusions
Personal hygiene was found to be an important protective factor, and should therefore be stressed in educational programs. Employers should implement engineering measures to reduce urinary mercury levels and the prevalence of associated health symptoms among e-waste workers.

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Gengze Liao, Feng Wang, Shaoyou Lu, Yanny Hoi Kuen Yu, Victoria H. Arrandale, Alan Hoi-shou Chan, Lap Ah Tse
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Associations of the Neighborhood Environment With Substance Use: A Cross-sectional Investigation Among Patients in Compulsory Drug Detention Centers in Thailand: Suneerat Yangyuen, Manop Kanato, Udomsak Mahaweerawat; J Prev Med Public Health. 2018;51(1):23-32. Published online January 4, 2018; DOI: https://doi.org/10.3961/jpmph.17.141

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Objectives
To identify the associations of characteristics of the neighborhood environment with substance abuse among clients receiving treatment for drug abuse in Thailand.
Methods
A cross-sectional study was conducted of 1128 drug addicts from 28 neighborhoods who were receiving treatment at all 7 compulsory drug detention centers in Thailand. A trained interviewer conducted structured interviews with the subjects about substance use and the perceived neighborhood environment in their community. A multilevel logistic regression model was applied to estimate the effects of the neighborhood environment on substance use.
Results
The majority of participants, 53.8% only used methamphetamine pills, 31.3% used other illicit drugs as well as methamphetamine pills, and 14.9% used an illicit drug other than methamphetamine. Three neighborhood characteristics were associated with substance use. A 1-unit increase in the perceived neighborhood cohesion score was associated with a 15% reduction in methamphetamine pill use and an 11% reduction of the use of both methamphetamine pills and another illicit drug. Conversely, a 1-unit increase in perceived neighborhood crime predicted 19 and 14% increases in the use of methamphetamine pills and the use of both methamphetamine pills and another illicit drug, respectively. In addition, a 1-unit increase in the scores for stigma surrounding addiction corresponded to a 25% increase of the use of methamphetamine pills and a 12% increase in the use of both methamphetamine pills and another illicit drug.
Conclusions
Substance use among drug addicts was influenced by characteristics of the neighborhood environment. Therefore, prevention and intervention strategies should be designed based on a consideration of the impact of neighborhood context on substance use behaviors.

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Holly Horan, Alyssa Thompson, Kendall Willard, Emmily Mobley, Justin McDaniel, Ellen Robertson, Shanna McIntosh, David L. Albright
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