Mandarin farmers' knowledge, attitudes, and practices related to antibiotic use in mandarin orchards and the presence of antibiotic-resistant bacteria in mandarin orchard workers in Fang district, Chiang Mai province, Thailand

Background and Aim: Inappropriate antibiotic use in the agricultural sector is a crucial driver of antibiotic resistance which is a global public health concern. Although there are many studies on antibiotic use in livestock production, studies on antibiotic use in crop production are relatively scarce. This study aimed to determine farmers' knowledge, attitudes, and practices (KAP) toward antibiotic use in Mandarin orchard and investigate their associations with the antibiotic susceptibility patterns among Mandarin orchard farmers in Fang District, Chiang Mai Province, Thailand. Materials and Methods: This cross-sectional study was conducted in Fang District between November and December 2021. The participants in this study were 151 farmers (farm owners and farm workers) in ten Mandarin orchards. All participants completed face-to-face interviews using a structured questionnaire. Nasal swabs were collected from 100 participants. The disk diffusion and staphylococcal chromosome cassette mec typing methods were used to test the antibiotic susceptibility of the isolates. Results: All farmers involved in the activities related to antibiotic exposure, 39.7% prepared or mixed antibiotics, and 82.8% injected antibiotics into Mandarin trees. Overall, farmers in this study had moderate levels of knowledge and attitudes and good antibiotic use practices. There was a significant association between attitudes and practices (r = 0.312, p < 0.001). In the analysis of drug resistance of the bacterial isolates, Staphylococcus aureus was detected in 16 of 100 nasal swab samples, with resistance to penicillin (16/16), methicillin (cefoxitin) (1/16), and tetracycline (6/16). Conclusion: This is the first report on farmers' and farm workers' KAP and antibiotic use in crop production, specifically Mandarin production. The findings of this research will help in developing plans and strategies to encourage the appropriate use of antibiotics and prevent antibiotic resistance or microbial resistance in plant production

Environmental Health Literacy Regarding Fine Particulate Matter and Related Factors Among Village Health Volunteers in Upper Northern Thailand

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

The relationship between prenatal exposure to organophosphate insecticides and neurodevelopmental integrity of infants at 5-weeks of age

IntroductionOrganophosphate (OP) insecticides are among the most abundantly used insecticides worldwide. Thailand ranked third among 15 Asian countries in its use of pesticides per unit hectare and fourth in annual pesticide use. More than 40% of Thai women of childbearing age work on farms where pesticides are applied. Thus, the potential for pregnant women and their fetuses to be exposed to pesticides is significant. This study investigated the relationship between early, mid, and late pregnancy maternal urine concentrations of OP metabolites and infant neural integrity at 5 weeks of age.MethodWe enrolled women employed on farms from two antenatal clinics in the Chiang Mai province of northern Thailand. We collected urine samples monthly during pregnancy, composited them by early, mid and late pregnancy and analyzed the composited samples for dialkylphosphate (DAP) metabolites of OP insecticides. At 5 weeks after birth, nurses certified in use of the NICU Network Neurobehavioral Scale (NNNS) completed the evaluation of 320 healthy infants. We employed generalized linear regression, logistic and Poisson models to determine the association between NNNS outcomes and DAP concentrations. All analyses were adjusted for confounders and included creatinine as an independent variable.ResultsWe did not observe trimester specific associations between DAP concentrations and NNNS outcomes. Instead, we observed statistically significant inverse associations between NNNS arousal (β = −0.10; CI: −0.17, −0.002; p = 0.0091) and excitability [0.79 (0.68, 0.92; p = 0.0026)] among participants with higher average prenatal DAP concentrations across pregnancy. We identified 3 NNNS profiles by latent profile analysis. Higher prenatal maternal DAP concentrations were associated with higher odds of being classified in a profile indicative of greater self-regulation and attention, but arousal and excitability scores below the 50th percentile relative to US normative samples [OR = 1.47 (CI: 1.05, 2.06; p = 0.03)]. Similar findings are also observed among infants with prenatal exposure to substances of abuse (e.g., methamphetamine).DiscussionOverall, the associations between prenatal DAP concentrations and NNNS summary scores were not significant. Further evaluations are warranted to determine the implications of low arousal and excitability for neurodevelopmental outcomes of attention and memory and whether these results are transitory or imply inadequate responsivity to stimulation among children as they develop

Secondhand smoke prevention through the perceptions of pregnant women with smoking family members: a Thailand study

Purpose Pregnant women with smoking family members are at risk of exposure to second-hand smoke, which leads to adverse pregnancy outcomes. Second-hand smoke prevention is thus important but remains less understood based on pregnant women’s perceptions. This study aimed to describe the perceptions of pregnant women on second-hand smoke prevention. Methods This study employed a qualitative descriptive approach. Data collection was performed between July and August 2023 through in-depth interviews with 17 pregnant women purposively selected from a province in central Thailand. The verbatim transcribed data were analysed using thematic analysis. Results Five themes emerged: unclear understanding of second-hand smoke; influences shaping perceptions related to second-hand smoke; attempt to prevent second-hand smoke exposure; barriers to prevention of second-hand smoke exposure; and needs related to prevention of second-hand smoke exposure. Conclusion The findings provide insights into second-hand smoke prevention from the perception of pregnant women with smoking family members. Healthcare professionals need to design interventions tailored to pregnant women’s needs and involve smoking family members. It is necessary to develop and incorporate clinical guidelines into standard prenatal care to support healthcare personnel in identifying, assessing, educating, and mitigating the issue of second-hand smoking exposure

The Hematological and Biochemical Effects from Pesticide Exposure on Thai Vegetable Farmers

Pesticide-related health concerns are a global public health issue. Few studies in Thailand have explored the hematological and biochemical effects of occupational pesticide exposure. The goal of this study was to investigate the effects of pesticides on the hematology, hepatic, and renal function of Thai vegetable farmers. A cross-sectional study was carried out in Chiang Mai, northern Thailand. A total of 124 apparently healthy vegetable farmers were interviewed about their lifetime exposure to agricultural pesticides. Blood samples were collected via venipuncture to be tested for complete blood count (CBC), liver function, and kidney function. Approximately 46% of the farmers were pesticide users who reported a history of pesticide use for their crops, while 54% were non-pesticide users. In the male farmers, the activities of aspartate aminotransferase (AST), mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly higher in the pesticide users compared to the non-pesticide users, while the estimated glomerular filtration rate (eGFR), hematocrit (HCT), and red blood cells (RBC) were significantly lower (p p < 0.05). Pesticide use among Thai vegetable farmers may cause hematological alterations and increase the risk of hepatic and renal dysfunction. Some hematological and biochemical parameters may be used for monitoring to protect them from the adverse health effects of occupational exposure to pesticides

Indoor air quality assessment to design a model for indoor air quality management and health impact assessment in Northern Thailand

Indoor air quality (IAQ) has become an important area of concern these days and tends to be more serious to human health as well as resident convenience, especially in smoke haze season (February - April) in Upper Northern Thailand (UNT). Indoor air monitoring and model development for controlling the air quality indoors is necessary for all buildings, particularly in urban areas and polluted areas. This study aims i) to study indoor air quality, ii) to assess health impacts and factors related to indoor air quality, and iii) to develop an effective model for controlling indoor air quality in Sub-district Health Promoting Hospital (HP) and Early Childhood Development Center (ED). Temperature, relative humidity, air movement, PM2.5, PM10, Carbon Dioxide (CO2), Carbon Monoxide (CO), Ozone (O3), Formaldehyde (CH2O), Total Volatile Organic Compound (TVOC), Total bacterial and fungal were used to evaluate indoor air quality. It was found that PM2.5 and PM10 concentrations in all buildings exceeded indoor air quality standards. Moreover, CO2 concentration was higher than recommended levels, especially during the daytime. HP and ED found high values of total bacteria and total fungi, which were higher than recommended level. The indoor air quality management model of a clean room that involved with the calculation of total airflow in cubic feet per hour was created and a specific size of air cleaner for the room was selected. The results showed that PM2.5 and PM10 concentrations including other parameters of the selected rooms were reduced to the recommended levels after implementing the rooms. This result indicated the effectiveness of developing an indoor air quality management model. Thus, this model can be used as a successful study case for other HP and ED, leading to a positive impact on building occupant health

Fractional exhaled nitric oxide (FeNO) in students in Northern Thailand : associations with respiratory symptoms, diagnosed allergy and the home environment

Objective: There are few studies on fractional exhaled nitric oxide (FeNO) among children in subtropical areas. We studied associations between FeNO and respiratory symptoms, reported diagnosed allergies and indoor and outdoor environmental factors in first grade junior high school students (N = 270) in upper northern Thailand. Methods: Data on demographics, health and home environment were collected by a questionnaire distributed in dry season (February-March 2018). FeNO was measured when the research team visited the school. Daily outdoor pollution data (PM10 and ozone) were collected from the nearest monitoring station 3 days (lag 3) and 7 days (lag 7) before the FeNO measurements. Two-level (student, school) linear mixed models were used to analyze associations, adjusting for gender and family education level. Results: In total, 29.6% had elevated FeNO level (&gt;20 ppb) and 7.8% reported any allergy diagnosed by a doctor. Male gender (p = 0.02), diagnosed allergy (p = 0.001), especially to cat (p = 0.001) and house dust mite (HDM) allergies (p = 0.001) were associated with FeNO. Eye symptoms (p = 0.01), rhinitis symptoms (p = 0.03) and dyspnea (p = 0.05) in the last 3 days were associated with FeNO. Household indoor mold (p = 0.03), gas cooking (p = 0.03) and PM10 (lag 3 and lag 7) were negatively (protective) associated with FeNO. Conclusions: Diagnosed allergy, especially to cat and HDM, can be associated with increased FeNO. Indoor mold and gas cooking can be associated with lower FeNO. Ocular, nasal and dyspnea symptoms reported by students in dry season in northern Thailand can be associated with FeNO, a biomarker of Th2 driven airway inflammation

Respiratory infections among junior high school students in upper northern Thailand : The role of building dampness and mould, biomass burning and outdoor relative air humidity (RH)

Background: Few studies exist on environmental risk factors for respiratory infections in Thai school children. Aim: To study associations between home and outdoor environment and respiratory infections among school children in Northern Thailand in dry and wet season. Methods: A repeated questionnaire survey among the children (N = 1159). Data on ambient temperature and relative air humidity (RH) and PM10 and ozone was collected from nearby monitoring stations. We used logistic regression to calculate odds ratios (OR). Results: 14.1% had current respiratory infections (last 7 days), 32.1% had any respiratory infection last 3 months, and 26.1% had any respiratory infection last 12 months with antibiotic treatment. Students with diagnosed allergy (7.7%) and diagnosed asthma (4.7%) had more often respiratory infections (ORs 1.40-5.40; p &lt; 0.05). Current respiratory infections were more common in dry (18.1%) than in wet season (10.4%) (p &lt; 0.001) and was associated with indoor mould (OR 2.16; p = 0.024) and outdoor RH (OR 1.34 per 10% RH; p = 0.004.) in the total material. In wet season, mould (OR 2.32; p = 0.016), window pane condensation (OR 1.79; p = 0.050), water leakage (OR 1.82; p = 0.018), environmental tobacco smoke (ETS) (OR 2.34; p = 0.003) and outdoor RH (OR 2.70 per 10% RH; p = 0.01) were risk factors for current respiratory infections. In dry season, mould (OR 2.64; p = 0.004) and outdoor RH (OR 1.34 per 10% RH; p = 0.046) were associated with current respiratory infections. Irrespectively of season, biomass burning inside or outside the home was a risk factor for respiratory infections (ORs 1.32-2.34; p &lt; 0.05). Living in a wooden house decreased the risk of respiratory infections (OR 0.56: p = 0.006). Conclusions: Dry season, high outdoor RH, household dampness, indoor mould and ETS can increase childhood respiratory infections. Living in a traditional wooden house can reduce respiratory infections, possibly due to better natural ventilation. Smoke from biomass burning can increase childhood respiratory infections in northern Thailand

Associations between indoor environment in residential buildings in wet and dry seasons and health of students in upper northern Thailand

We performed a repeated questionnaire study on home environment and health (six medical symptoms) in 1159 junior high school students (age 12.8 ± 0.7 years) in upper northern Thailand in wet and dry seasons. Data on outdoor temperature, relative humidity (RH), and air pollution were collected from nearest monitoring station. Odds ratios (OR) were calculated by multi-level logistic regression. Most common symptoms were rhinitis (62.5%), headache (49.8%), throat (42.8%), and ocular symptoms (42.5%). Ocular symptoms were more common at lower RH and rhinitis more common in dry season. Water leakage (28.2%), indoor mold (7.1%), mold odor (4.1%), and windowpane condensation (13.6%) were associated with all six symptoms (ORs: 1.3-3.5). Other risk factors included cat keeping, environmental tobacco smoke (ETS), other odor than mold odor, gas cooking, and cooking with biomass fire. Biomass burning inside and outside the home for other reasons than cooking was associated with all six symptoms (ORs: 1.5-2.6). Associations between home environment exposure and rhinitis were stronger in wet season. In conclusion, dampness-related exposure, windowpane condensation, cat keeping, ETS, gas cooking, and biomass burning can impair adolescent health in upper northern Thailand. In subtropical areas, environmental health effects should be investigated in wet and dry seasons

Asthma and rhinitis in wet and dry season among students in upper Northern Thailand : the role of building dampness and household air pollution

We investigated associations between domestic exposure and respiratory health in students inNorthern Thailand in wet and dry season (1159 participants), calculating odds ratios (OR) with 95% confidence intervals (CI) by multilevel logistic regression. Totally 6.0% had wheeze, 23.0% dyspnoea, 4.0% current asthma, 54.6% rhinitis and 31.5% rhinoconjunctivitis. Girls had less wheeze (OR 0.66; 95% CI 0.43-1.00) and current asthma (OR 0.32; 95% CI 0.19-0.54). Water leakage was associated with wheeze (OR 2.35; 95% CI 1.09-5.06), dyspnea (OR 2.00; 95% CI 1.24-3.23) and rhinoconjunctivitis (OR 1.62; 95% CI 1.11-2.38). Mould was associated with rhinitis (OR 1.89; 95% CI 1.06-3.38). Window pane condensation was associated with wheeze (OR 2.60; 95% CI 1.13-5.98) and rhinoconjunctivitis (OR 1.70; 95% CI 1.08-2.67). Biomass burning was associated with wheeze, dyspnoea, rhinitis and rhinoconjunctivitis. In conclusion, household dampness and pollution from domestic biomass burning can increase asthma symptoms and rhinitis symptoms in students in northern Thailand