Occupational Tasks Influencing Lung Function and Respiratory Symptoms Among Charcoal-Production Workers: A Time-Series Study

Pramchoo, Walaiporn,Geater, Alan F.,Jamulitrat, Silom,Geater, Sarayut L.,Tangtrakulwanich, Boonsin Occupational Safety and Health Research Institute 2017 Safety and health at work Vol.8 No.3

Background: Tasks involved in traditional charcoal production expose workers to various levels of charcoal dust and wood smoke. This study aimed to identify specific tasks influencing lung function and respiratory symptoms. Methods: Interviews, direct observation, and task/symptom checklists were used to collect data from 50 charcoal-production workers on 3 nonwork days followed by 11 workdays. The peak expiratory flow rate (PEFR) was measured four times per day. Results: The PEFR was reduced and the prevalence of respiratory symptoms increased over the first 6-7 workdays. The PEFR increased until evening on nonwork days but not on workdays. Loading the kiln and collecting charcoal from within the kiln markedly reduced the PEFR and increased the odds of respiratory symptoms. Conclusion: Tasks involving entry into the kiln were strongly associated with a short-term drop in the PEFR and the occurrence of respiratory symptoms, suggesting a need for the use of protective equipment and/or the operation of an effective kiln ventilation system.

Occupational Tasks Influencing Lung Function and Respiratory Symptoms Among Charcoal-Production Workers: A Time-Series Study

Walaiporn Pramchoo,Alan F. Geater,Silom Jamulitrat,Sarayut L. Geater,Boonsin Tangtrakulwanich 한국산업안전보건공단 산업안전보건연구원 2017 Safety and health at work Vol.8 No.3

Background: Tasks involved in traditional charcoal production expose workers to various levels of charcoal dust and wood smoke. This study aimed to identify specific tasks influencing lung function and respiratory symptoms. Methods: Interviews, direct observation, and task/symptom checklists were used to collect data from 50 charcoal-production workers on 3 nonwork days followed by 11 workdays. The peak expiratory flow rate (PEFR) was measured four times per day. Results: The PEFR was reduced and the prevalence of respiratory symptoms increased over the first 6e7 workdays. The PEFR increased until evening on nonwork days but not on workdays. Loading the kiln and collecting charcoal from within the kiln markedly reduced the PEFR and increased the odds of respiratory symptoms. Conclusion: Tasks involving entry into the kiln were strongly associated with a short-term drop in the PEFR and the occurrence of respiratory symptoms, suggesting a need for the use of protective equipment and/or the operation of an effective kiln ventilation system.

Reproductive Variables and Risk of Breast Malignant and Benign Tumours in Yunnan Province, China

Yanhua, Che,Geater, Alan,You, Jing,Li, Li,Shaoqiang, Zhou,Chongsuvivatwong, Virasakdi,Sriplung, Hutcha Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.5

Introduction and aim: To compare reproductive factor influence on patients with pathological diagnosed malignant and benign tumor in the Breast Department, The First Peoples' Hospital of Kunming in Yunnan province, China. Methods: A hospital-based case-control study was conducted on 263 breast cancer (BC) cases and 457 non-breast cancer controls from 2009 to 2011. The cases and controls information on demographics, medical history, and reproductive characteristics variables were collected using a self-administered questionnaire and routine medical records. Histology of breast cancer tissue and benign breast lesion were documented by pathology reports. Since some variables in data analysis had zero count in at least one category, binomial-response GLM using the bias-reduction method was applied to estimate OR's and their 95% confidence intervals (95% CI). To adjust for age and menopause status, a compound variable comprising age and menopausal status was retained in the statistical models. Results: multivariate model analysis revealed significant independent positive associations of BC with short menstrual cycle, old age at first live birth, never breastfeeding, history of oral contraception experience, increased number of abortion, postmenopausal status, and nulliparity. Categorised by age and menopausal status, perimenopausal women had about 3-fold and postmenopausal women had more than 5-fold increased risk of BC compared to premenopausal women. Discussion and Conclusion: This study has confirmed the significant association of BC and estrogen related risk factors of breast cancer including longer menstrual cycle, older age of first live birth, never breastfeeding, nulliparity, and number of abortions more than one. The findings suggest that female hormonal factors, especially the trend of menopause status play a significant role in the development of BC in Yunnan women.

Low-Oxygen Atmosphere and its Predictors among Agricultural Shallow Wells in Northern Thailand

Wuthichotwanichgij, Gobchok,Geater, Alan F. Occupational Safety and Health Research Institute 2015 Safety and health at work Vol.6 No.1

Background: In 2006, three farmers died at the bottom of an agricultural shallow well where the atmosphere contained only 6% oxygen. This study aimed to document the variability of levels of oxygen and selected hazardous gases in the atmosphere of wells, and to identify ambient conditions associated with the low-oxygen situation. Methods: A cross-sectional survey, conducted in June 2007 and July 2007, measured the levels of oxygen, carbon monoxide, hydrogen sulfide, and explosive gas (percentage of lower explosive limit) at different depths of the atmosphere inside 253 wells in Kamphaengphet and Phitsanulok provinces. Ambient conditions and well use by farmers were recorded. Carbon dioxide was measured in a subset of wells. Variables independently associated with low-oxygen condition (<19.5%) were identified using multivariate logistic regression. Results: One in five agricultural shallow wells had a low-oxygen status, with oxygen concentration decreasing with increasing depth within the well. The deepest-depth oxygen reading ranged from 0.0% to 20.9%. Low levels of other hazardous gases were detected in a small number of wells. The low-oxygen status was independently associated with the depth of the atmosphere column to the water surface [odds ratio (OR) = 13.5 for 8-11 m vs. <6 m], depth of water (OR = 0.17 for 3-<8 m vs. 0-1 m), well cover (OR = 3.95), time elapsed since the last rainfall (OR = 7.44 for >2 days vs. <1 day), and location of well in sandy soil (OR = 3.72). Among 11 wells tested, carbon dioxide was detected in high concentration (>25,000 ppm) in seven wells with a low oxygen level. Conclusion: Oxygen concentrations in the wells vary widely even within a small area and decrease with increasing depth.

Preferences and Acceptance of Colorectal Cancer Screening in Thailand

Saengow, Udomsak,Chongsuwiwatvong, Virasakdi,Geater, Alan,Birch, Stephen Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.6

Colorectal cancer (CRC) is now common in Thailand with an increase in incidence over time. Health authorities are planning to implement a nationwide CRC screening program using fecal immunochemical test (FIT) as a primary screening tool. This study aimed to estimate preferences and acceptance of FIT and colonoscopy, explore factors influencing the acceptance, and investigate reasons behind choosing and rejecting to screen before the program was implemented. Patients aged 50-69, visiting the primary care unit during the study period, were invited to join this study. Patients with a history of cancer or past CRC screening were excluded. Face-to-face interviews were conducted. Subjects were informed about CRC and the screening tests: FIT and colonoscopy. Then, they were asked for their opinions regarding the screening. The total number of subjects was 437 (86.7% response rate). Fifty-eight percent were females. The median age was 58 years. FIT was accepted by 74.1% of subjects compared to 55.6% for colonoscopy. The acceptance of colonoscopy was associated with perceived susceptibility to CRC and family history of cancer. No symptoms, unwilling to screen, healthy, too busy and anxious about diagnosis were reasons for refusing to screen. FIT was preferred for its simplicity and non-invasiveness compared with colonoscopy. Those rejecting FIT expressed a strong preference for colonoscopy. Subjects chose colonoscopy because of its accuracy; it was refused for the process and complications. If the screening program is implemented for the entire target population in Thailand, we estimate that 106,546 will have a positive FIT, between 8,618 and 12,749 identified with advanced adenoma and between 2,645 and 3,912 identified with CRC in the first round of the program.

Low-Oxygen Atmosphere and its Predictors among Agricultural Shallow Wells in Northern Thailand

Gobchok Wuthichotwanichgij,Alan F. Geater 한국산업안전보건공단 산업안전보건연구원 2015 Safety and health at work Vol.6 No.1

Background: In 2006, three farmers died at the bottom of an agricultural shallow well where the atmospherecontained only 6% oxygen. This study aimed to document the variability of levels of oxygenand selected hazardous gases in the atmosphere of wells, and to identify ambient conditions associatedwith the low-oxygen situation. Methods: A cross-sectional survey, conducted in June 2007 and July 2007, measured the levels of oxygen,carbon monoxide, hydrogen sulfide, and explosive gas (percentage of lower explosive limit) at differentdepths of the atmosphere inside 253 wells in Kamphaengphet and Phitsanulok provinces. Ambientconditions and well use by farmers were recorded. Carbon dioxide was measured in a subset of wells. Variables independently associated with low-oxygen condition (<19.5%) were identified using multivariatelogistic regression. Results: One in five agricultural shallow wells had a low-oxygen status, with oxygen concentrationdecreasing with increasing depth within the well. The deepest-depth oxygen reading ranged from 0.0%to 20.9%. Low levels of other hazardous gases were detected in a small number of wells. The low-oxygenstatus was independently associated with the depth of the atmosphere column to the water surface[odds ratio (OR) ¼ 13.5 for 8e11 m vs. <6 m], depth of water (OR ¼ 0.17 for 3e<8 m vs. 0e1 m), wellcover (OR ¼ 3.95), time elapsed since the last rainfall (OR ¼ 7.44 for >2 days vs. <1 day), and location ofwell in sandy soil (OR ¼ 3.72). Among 11 wells tested, carbon dioxide was detected in high concentration(>25,000 ppm) in seven wells with a low oxygen level. Conclusion: Oxygen concentrations in the wells vary widely even within a small area and decrease withincreasing depth.

Fear of cancer recurrence and its predictors among cervical cancer survivors

Jitti Hanprasertpong,Alan Geater,Ingporn Jiamset,Laaong Padungkul,Phongchawee Hirunkajonpan,Nartya Songhong 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.6

Objective: To identify the characteristics of fear of cancer recurrence (FCR) in cervical cancer survivors (CCSs) and investigate the relationship of FCR with demographic and medical characteristics, level of quality of life (QOL), and psychological distress. We also aimed to determine the predictors of FCR. Methods: The short version of the Fear of Progression Questionnaire (FoP-Q-SF), the Hospital Anxiety and Depression Scale (HADS), and the Functional Assessment of Cancer Therapy-Cervical (FACT-Cx) questionnaire were administered to 699 CCSs who had complete treatment at Songklanagarind Hospital between 2006 and 2016. Analysis was performed to determine potential predictors associated with FCR. Results: Among the 12 items of the FoP-Q-SF, the 3 greatest fears were 1) worrying about what would happen to their family; 2) being afraid of pain; and 3) fear of disease progression. The prevalences of anxiety and depression disorder were 20.46% and 9.44%, respectively. CCSs who had FCR at the 5th quintile were more likely to have medical co-morbidities, low FACT-Cx scores in all domains and a high HADS scores (anxiety and depression disorder). Multivariate analysis showed that only anxiety disorder (odds ratio [OR]=4.99; p<0.001) and low FACT-Cx score (total) (OR=6.14; p<0.001) were identified as independent predictors for FCR at the 5th quintile. Conclusion: FCR is an important problem in cervical cancer which should be addressed during post-treatment care. Only anxiety disorder and low QOL were independently associated with high FCR

Differences in Cancer Incidence among Predominantly Muslim and Buddhist Subpopulations in Songkhla

Sriplung, Hutcha,Bilheem, Surichai,Kuntipundee, Tirada,Geater, Sarayut Lucian Asian Pacific Journal of Cancer Prevention 2014 Asian Pacific journal of cancer prevention Vol.15 No.22

Background: The population of Songkhla, a province in Southern Thailand, can be divided into a predominantly Muslim subpopulation (PMSP, approximately 70% Muslim) and a predominantly Buddhist subpopulation (PBSP, around 14% Muslim). Objectives: This study was conducted to 1) describe the incidence of various cancers in both PMSP and PBSP, and 2) compare the incidence of various cancers between the two subpopulations. Materials and Methods: Cancer cases diagnosed between 1990 and 2010 were drawn from the database of Songkhla Cancer Registry. Population denominators were estimated from the 3 population censuses surveyed by the National Statistical Office of Thailand in 1990, 2000, and 2010. Results: The age-standardized incidence rates (ASR) of the 5 commonest male cancers among both subpopulations were calculated. In females, a lower incidence of cancers of the cervix and breast in PMSP compared to PBSP, with odds ratios of 0.54 (95% CI: 0.45-0.64) and 0.51 (95% CI: 0.43-0.60) respectively, was observed. In males, the incidence of cancers of the lung, liver, colon-rectum, and some other cancers were significantly different between the two populations in the past, but only prostate cancer showed a lower incidence among males in PMSP in recent years. Independent of sex and year of diagnosis, the incidence of lung, liver, NHL, and colorectal cancers was lower in MPSP compared to BPSP, with odds ratios of 0.75 (95% CI: 0.65-0.85), 0.74 (95% CI: 0.62-0.88), 0.74 (95% CI: 0.60-0.91), and 0.67 (95% CI: 0.56-0.78) respectively. Conclusions: The differences in incidence of some cancers and religionrelated culture between the two subpopulations need 2 sets of cancer-control plans and goals to fit the unique population context in deep Southern Thailand. This plan can be used in the 3 southernmost provinces of Thailand where the percentage of Muslims is over 85%.

Impact of time interval between radical hysterectomy with pelvic node dissection and initial adjuvant therapy on oncological outcomes of early stage cervical cancer

Jitti Hanprasertpong,Ingporn Jiamset,Alan Geater,Kittinun Leetanaporn,Thanarpan Peerawong 대한부인종양학회 2017 Journal of Gynecologic Oncology Vol.28 No.4

Objective: To determine the impact of time interval (TI) from radical hysterectomy with pelvicnode dissection (RHND) to adjuvant therapy on oncological outcomes in cervical cancer. Methods: The study included 110 stage IA2–IB1 cervical cancer patients who underwentRHND and adjuvant therapy. The patients were divided into 2 groups based on the cut-offpoints of TI of 4 and 6 weeks, respectively. The associations of TI and clinicopathologic factorswith oncological outcomes were evaluated using Cox proportional-hazards regression. Results: The median TI was 4.5 weeks. There were no statistical differences in 5-yearrecurrence-free survival (RFS) (89.2% vs. 81.0%, and 83.2% vs. 100.0%) or 5-year overallsurvival (OS) rates (90.9% vs. 97.2%, and 93.2% vs. 100.0%) between patients accordingto TI (≤4 vs. >4, and ≤6 vs. >6 weeks, respectively). Deep stromal invasion (p=0.037), andparametrial involvement (PI) (p=0.002) were identified as independent prognostic factorsfor RFS, together with the interaction between TI and squamous cell carcinoma histology(p<0.001). In patients with squamous cell carcinoma, a TI longer than 4 weeks wassignificantly associated with a worse RFS (hazard ratio [HR]=15.8; 95% confidence interval[CI]=1.4–173.9; p=0.024). Univariate analysis showed that only tumor size (p=0.023), and PI(p=0.003) were significantly associated with OS. Conclusion: Delay in administering adjuvant therapy more than 4 weeks after RHND in earlystage squamous cell cervical cancer results in poorer RFS.

Single Nucleotide Polymorphisms in the Gc Gene for Vitamin D Binding Protein in Common Cancers in Thailand

Maneechay, Wanwisa,Boonpipattanapong, Teeranut,Kanngurn, Samornmas,Puttawibul, Puttisak,Geater, Sarayut Lucien,Sangkhathat, Surasak Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.8

Background: This case-control study aimed to determine if there were any associations between the two single nucleotide polymorphisms (SNPs) in Gc, rs7041 (Asp416Glu) and rs4588 (Thr420Lys) and 3 common cancers (breast, lung and colorectal) in Thai patients. Materials and Methods: Two hundred and eighty two colorectal, 101 breast and 113 lung cancer patients were recruited from one institute during 2011-2013. The controls were age-matched volunteers who had a negative history of index cancers. In addition, vitamin D levels were compared among different genotypes in the 2 SNPs. Results: The minor allele frequencies of rs7041 (G) and rs4588 (A) were 0.32 and 0.24, respectively. Under the dominant model, the study found significant associations between minor-allele genotypes of the SNP rs7041 (TG/GG) and lung cancer (odds ratio [OR] 1.78, 95% CI 1.05-3.03). When subgroup analysis was performed according to sex and age at diagnosis, the study found that the minor-allele genotypes of rs7041 (TG/GG) were significantly associated with colorectal cancer in patients whose age at diagnosis was more than 60 years (OR 1.67, 95%CI 1.06-2.61) and the minor-allele genotypes of rs4588 (CA/AA) were significantly associated with colorectal cancer in males aged 60 years or less (OR 2.34, 95%CI 1.25-4.37). When SNP combinations (rs7041-rs4588) were examined, the TT-CA combination had a significant protective association with lung cancer (OR 0.44, 95% CI 0.22-0.85). On evaluation of serum 25(OH)D levels in 205 individuals without cancer (males 144, females 61), the proportion of subjects with low serum vitamin D (< 20 ng/ml) in those harboring CA or AA genotypes of rs4588 (41.7%) was significantly higher than the CC genotype (15.5%, p-value < 0.01). Conclusions: Genetic polymorphisms in Gc were associated with lung and colorectal cancers in Thai patients. Lower serum 25(OH)D in minor variants of rs4588 may explain this association.