Long-term air pollution exposure and self-reported morbidity: A longitudinal analysis from the Thai cohort study (TCS)

[Background] Several studies have shown the health effects of air pollutants, especially in China, North American and Western European countries. But longitudinal cohort studies focused on health effects of long-term air pollution exposure are still limited in Southeast Asian countries where sources of air pollution, weather conditions, and demographic characteristics are different. The present study examined the association between long-term exposure to air pollution and self-reported morbidities in participants of the Thai cohort study (TCS) in Bangkok metropolitan region (BMR), Thailand. [Methods] This longitudinal cohort study was conducted for 9 years from 2005 to 2013. Self-reported morbidities in this study included high blood pressure, high blood cholesterol, and diabetes. Air pollution data were obtained from the Thai government Pollution Control Department (PCD). Particles with diameters ≤10 μm (PM₁₀), sulfur dioxide (SO₂), nitrogen dioxide (NO₂), ozone (O₃), and carbon monoxide (CO) exposures were estimated with ordinary kriging method using 22 background and 7 traffic monitoring stations in BMR during 2005–2013. Long-term exposure periods to air pollution for each subject was averaged as the same period of person-time. Cox proportional hazards models were used to examine the association between long-term air pollution exposure with self-reported high blood pressure, high blood cholesterol, diabetes. Results of self-reported morbidity were presented as hazard ratios (HRs) per interquartile range (IQR) increase in PM₁₀, O₃, NO₂, SO₂, and CO. [Results] After controlling for potential confounders, we found that an IQR increase in PM₁₀ was significantly associated with self-reported high blood pressure (HR = 1.13, 95% CI: 1.04, 1.23) and high blood cholesterol (HR = 1.07, 95%CI: 1.02, 1.12), but not with diabetes (HR = 1.05, 95%CI: 0.91, 1.21). SO₂ was also positively associated with self-reported high blood pressure (HR = 1.22, 95%CI: 1.08, 1.38), high blood cholesterol (HR = 1.20, 95%CI: 1.11, 1.30), and diabetes (HR = 1.21, 95%CI: 0.92, 1.60). Moreover, we observed a positive association between CO and self-reported high blood pressure (HR = 1.07, 95%CI: 1.00, 1.15), but not for other diseases. However, self-reported morbidities were not associated with O₃ and NO₂. [Conclusions] Long-term exposure to air pollution, especially for PM₁₀ and SO₂ was associated with self-reported high blood pressure, high blood cholesterol, and diabetes in subjects of TCS. Our study supports that exposure to air pollution increases cardiovascular disease risk factors for younger population

AC: Happiness, mental health, and socio-demographic associations among a national cohort of Thai adults

Abstract Research on happiness has been of interest in many parts of the world. Here we provide evidence from developing countries; this is the first analysis of happiness among a cohort of Thai distance learning adults residing throughout the country (n = 60,569 in 2009). To measure happiness, we tested use of the short format Thai Mental Health Indicators (TMHI), correlating each domain with two direct measures of happiness and life satisfaction. Several TMHI domains correlated strongly with happiness. We found the mental state and the social support domains moderately or strongly correlated with happiness by either measure (correlation coefficients 0.24-0.56). The other two TMHI domains (mental capacity and mental quality) were not correlated with happiness. Analysis of socio-demographic attributes and happiness revealed little effect of age and sex but marital status (divorced or widowed), low household income, and no paid work all had strong adverse effects. Our findings provide Thai benchmarks for measuring happiness and associated socio-demographic attributes. We also provide evidence that the TMHI can measure happiness in the Thai population. Furthermore, the results among Thai cohort members can be monitored over time and could be useful for comparison with other Southeast Asian countries

Reporting of lifetime fractures : methodological considerations and results from the Thai Cohort Study

Objectives: To provide estimates of fracture incidence among young adults in Thailand. Design: Cross-sectional analysis of a large national cohort. Setting: Thailand. Participants: A total of 60 569 study participants residing nationwide responded to the 2009 follow-up survey; 55% were women and median age was 34 years (range 19-92). Outcome measures: Self-reported lifetime fractures, along with age at fracture. Fracture incidence rates per person-year were then compared using lifetime fracture reports, and again selecting only fractures reported for the last year. Incidence rates were compared by age and sex. Results: 18 010 lifetime fractures were reported; 11 645(65%) by men. Lifetime fracture prevalence was 30% for men and 15% for women. Lifetime incidence per 10 000 person-years was 83; analysing only fractures from the last year yielded a corresponding incidence rate of 187. For ages 21-30, fractures per 10 000 person-years were more common among men than women (283 (95% CI 244 to 326) and 150 (130 to 173), respectively); with increasing age, rates decreased among men and increased among women (for ages 51-60, 97 (58 to 151) and 286 (189 to 417), respectively). Conclusions: Large-scale surveys provide a feasible method for establishing relative fracture incidence among informative subgroups in a population. Limiting analyses to fractures reported to have occurred recently minimises bias due to poor recall. The pattern of self-reported fracture incidence among Thais aged 20-60 was similar to that reported for Western countries: high falling rates in young men and high rising rates in older women