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OBJECTIVE: To investigate factors associated with indoor formaldehyde levels in office settings within an academic medical institute. METHODS: This cross-sectional study was conducted in 25 offices (261 workers) at a medical university in Thailand. Questionnaires gathered data on demographics, work patterns, and office equipment usage (printers, photocopiers, air fresheners, liquid paper, glue, cleaning agents and marker pens). The building environment was assessed by a multidisciplinary team. Formaldehyde levels and relevant parameters (temperature and relative humidity) were measured in each room both indoors and outdoors. A multiple linear regression model investigated the relationship between formaldehyde and office factors, controlling for room conditions. RESULTS: Median office formaldehyde levels were 442.1 µg/m3 (IQR: 343.8-908.7 µg/m3), exceeding World Health Organization and Thai guidelines. Photocopier use was significantly associated with higher levels of indoor formaldehyde (ß = 0.20, 95%CI: 0.30-0.37, p = 0.02). Air freshener use also showed a significant association (ß = 0.56, 95%CI: 0.30-0.81, p < 0.001). No correlation was found between the use of liquid paper, glue, printers, cleaning agents, or marker pens and indoor formaldehyde levels. CONCLUSIONS: Indoor formaldehyde levels in these offices exceeded the established guidelines. Use of photocopiers and air fresheners were associated with increased formaldehyde levels. Implementing interventions such as improved ventilation and regular screening is essential for creating healthier office environments.

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Background and Objectives: Presenteeism, when employees continue to work despite being sick, may have increased among intern physicians during the COVID-19 pandemic due to the necessity of performing unfamiliar tasks. This study aimed to investigate the prevalence of presenteeism among intern physicians (IPs) in Thailand, its associated factors, and outcomes. Material and Methods: A total of 254 IPs participated in this cross-sectional study conducted from June to July 2022. Participants completed a nationwide online questionnaire including demographics, financial status, underlying diseases, hospital location and affiliation, department, resource problems, manpower shortage, workload intensity, presenteeism, and its outcomes. IPs were recruited via various social media platforms. Statistical analysis was performed using multivariable zero-inflated Poisson regression and multivariable linear regression. Results: The average age of IPs was 25.5 years (SD 1.9), and 57.5% were female. The majority of IPs reported dealing with resource problems (74.8%), insufficient manpower (94.9%), and intense workload (83.5%). Presenteeism was prevalent among 63.8% of IPs, with the most common of the diseases being allergic rhinitis (31.3%). IPs with underlying diseases had an increased rate of presenteeism (adjusted odds ratio (aOR) 2.50, 95% confidence interval (CI) 1.33-4.55). IPs working in community hospitals during their rotations exhibited a lower rate of presenteeism (aOR 0.39, 95% CI 0.16-0.94) compared to other departments within general or regional hospitals. The IPs frequently exposed to insufficient manpower had an increased rate of presenteeism (aOR 4.35, 95% CI 1.02-20.00) compared to those not exposed. Additionally, IPs with presenteeism had more exhaustion (ß 1.40, 95% CI 0.33 to 2.46), lower perceived well-being (ß -0.65, 95% CI -1.26 to -0.03), and job satisfaction (ß -0.33, 95% CI -0.63 to -0.03). Conclusions: During COVID-19, intern physicians in Thailand often exhibit presenteeism due to physical conditions, resource scarcity, and personnel shortages, impacting exhaustion, well-being, and job satisfaction. Recommendations include assessing healthcare workforces, allocating resources more effectively, enforcing policies to promote responsible use of sick leave, and implementing sick leave systems.

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Physicians are exposed to occupational stress and burnout, which have been identified as contributing to a decrease in the quality of work life (QWL). Thailand's medical education program, consisting of a six-year curriculum with government tuition support followed by three years of internships, provides the context for this investigation. This study aimed to assess the QWL among intern physicians (IPs) in public hospitals and investigated the association between burnout and QWL. A cross-sectional study was conducted among 241 IPs in public hospitals in Thailand utilizing an online self-administered questionnaire. The questionnaire included a Thai version of a 25-item QWL scale and the Maslach Burnout Inventory-Human Services Survey for Medical Personnel. Data analysis was performed using multivariable logistic regression. A significant proportion of IPs experienced low to moderate QWL (72.6%), with low levels of home-work interface (39.4%) and employee engagement (38.6%). In the exploratory model, after adjusting for sex and age, IPs with high depersonalization and low personal accomplishment demonstrated an association with low QWL (adjusted OR, aOR 2.08, 95% CI 1.01 to 4.31; aOR 2.74, 95% CI 1.40 to 5.39). Healthcare organizations should regularly assess intern physicians' QWL and burnout, prioritizing interventions; ensure reasonable work hours, schedule adjustments, and open communication; and develop support systems for cost-effective interventions. Further research on the dynamic relationship between burnout and QWL is crucial for targeted and culturally sensitive interventions.

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Wildland firefighting is a high-risk occupation. The level of cardiopulmonary fitness can indicate whether wildland firefighters are ready to perform their job duties. This study's objective was to determine wildland firefighters' cardiopulmonary fitness using practical methods. This cross-sectional descriptive study aimed to enroll all 610 active wildland firefighters in Chiang Mai. The participants' cardiopulmonary fitness was assessed using an EKG, a chest X-ray, a spirometry test, a global physical activity questionnaire, and the Thai score-based cardiovascular risk assessment. The NFPA 1582 was used to determine "fitness" and "job restriction". Fisher's exact and Wilcoxon rank-sum tests were used to compare cardiopulmonary parameters. With a response rate of 10.16%, only eight wildland firefighters met the cardiopulmonary fitness requirements. Eighty-seven percent of participants were in the job-restriction group. An aerobic threshold of eight METs, an abnormal EKG, an intermediate CV risk, and an abnormal CXR were the causes of restriction. The job-restriction group had a higher 10-year CV risk and higher systolic blood pressure, although these differences were not statistically significant. The wildland firefighters were unfit for their task requirements and were more at risk of cardiovascular health compared to the estimated risk of the general Thai population. To improve the health and safety of wildland firefighters, pre-placement exams and health surveillance are urgently needed.

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Sick building syndrome (SBS) is the term used to describe the medical condition in which people in a building suffer from symptoms of illnesses for no apparent reason. SBS was found to be associated with indoor air quality (IAQ) but there are a variety of determinants (buildings, in particular). Identifying and controlling factors related to SBS is crucial for improving worker health and efficiency. A cross-sectional study was conducted to investigate (1) the prevalence of respiratory symptoms and skin SBS and (2) their associations with IAQ among office workers in administrative offices in an academic medical institute. A self-reporting questionnaire assessing the worker's characteristics, working conditions, and perception of working environments was used. The building assessment was via a walk-through survey and IAQ measurement. Of 290 office workers, 261 (90%) in 25 offices of 11 buildings took part in the survey. The highest prevalence of SBS was nasal symptoms (25.3%). We found that to reduce the risk of SBS, optimal air temperature levels in air-conditioned offices should be lower than 23 °C, with relative humidity between 60% and 70%. Lowering indoor CO2 levels below 700 ppm may be indicative of adequate ventilation to prevent SBS by reducing worker discomfort and indoor contaminants (e.g., formaldehyde).

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During the COVID-19 pandemic, N95 respirators were commonly used in many situations. Respiratory problems from prolonged use of respirators were discussed in many studies, which show varied results. From the inconclusive results, the current systematic review and meta-analysis discerned the effects of the N95 respirator by assessing the oxygen and carbon dioxide changes in both high- and low-to-moderate-intensity physical activities in a healthy population. Thirteen studies were identified for inclusion in the study. In high-intensity physical activities, our meta-analysis showed borderline lower oxygen saturation and higher carbon dioxide partial pressure, but oxygen saturation did not change in low-to-moderate physical activity. The use of N95 respirators could statistically affect the physiologic changes of carbon dioxide and oxygen in high-intensity physical activity among healthy participants, but this may not be clinically significant. Some users who have certain health conditions, such as respiratory problems, should be informed of the clinical symptoms related to hypercarbia and hypoxia for the early detection of adverse effects of N95 respirators.

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BACKGROUND: COVID-19 pandemic is a worldwide problem. Vaccination as primary prevention is necessary. Thailand is in the initial phase of the vaccination program. However, the demand for this vaccine among Thais and expatriates living in Thailand is still unknown. This study aims to assess acceptance, attitude, and determinants for COVID-19 vaccination among Thai people and expatriates living in Thailand. METHODS: This was a cross-sectional study conducted in Thailand during May 2021. An online survey (REDcap) was distributed through online social media platforms. Adult (>18 years old) Thai and expatriates living in Thailand were invited. Any person who already received any COVID-19 vaccine was excluded from this study. RESULT: One thousand sixty-six responses were collected in this survey. A total of 959 were available for analysis. Six hundred thirty-seven 637 responses were from Thais and 322 responses from expatriates living in Thailand. The acceptance rate was significantly higher among expatriates than local people (57.8% vs 41.8%, p-value < 0.001). The acceptance rate increased up to 89.0-91.3% if they could select the vaccine brand, and 80.7-83.2% when they were recommended by the health care professionals. Both groups had a similar mean attitude score toward COVID-19 vaccination. Being Thai, health care worker, good compliance to social distancing, accepting serious side effects at level 1 per 100,000, and having a good attitude toward COVID-19 vaccination were associated with vaccine acceptance. CONCLUSION: Thailand's COVID-19 vaccination program could improve the acceptance rate by informing the public about vaccine efficacy, vaccine benefit, and vaccine safety. Moreover, supplying free of charge high efficacy alternative vaccines and letting all people living in Thailand make their own vaccine choices could increase the acceptance rate.

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