Silpasuwan Pimpan, Sujirarat Dusit, Kongtip Pornpimol, Inbamrung Sukhontatip, Woskie Susan
Faculty of Public Health, Mahidol University, Bangkok, Thailand.
Department of social medicine, Samutsakorn Hospital, Samutsakorn Province, Thailand.
Sumer J Med Healthc. 2019;2(10):125-133.
Unsafe environments and occupational hazards have been documented and are contributing to health risks for salt farm workers in Thailand. Whether exposures with various health hazards and outcomes affect work ability among these workers is uncertain. This study aimed to examine the effects of hazard exposures with health risks and outcomes, including accidents, for work ability among salt farm workers.
A cross-sectional study was completed with 120 salt farm workers recruited from the largest salt farm company in Samutsakorn Province during January and February 2014. Face to face interviews were conducted using a structured questionnaire comprised of worker characteristics, working conditions, safety and health problems related to work, and a work ability index (questionnaire reliability =0.84) through a worksite visit. The MIMIC model was used to determine direct and indirect causal effects of work-related health hazards and outcomes on work ability.
Among 120 salt farmers, 61% were female and 77% had primary educations. Average age and work experience was 49.5 years (SD = 13.7) and 23.7 years (SD = 13.5), respectively. 66% worked more than 5 days per week and 21.3% had at least one accident in the past 3 months. The results of structure equation analysis revealed that healthy skin was related to heat exposure (β=.35, p=.01) and directly influenced work ability (β=.37, p=.01), Eye irritation was influenced by length of work time (β=.24, p=.05), and harmonized the predictive value of the model at a high level (χ=94.51, df=73, p-value =0.05, χ/df=1.29. RMSEA= 0.066).
Results for the MIMIC model indicate that two factors, bright sunlight and strong wind exposure over an extended work period, could be having crucial impacts on skin and eye health of salt farm workers. These factors might be protected against using PPE and health examinations with positive health outcomes directly improving work ability. Substantial governmental action with community leadership is needed immediately so action plans are instituted to improve occupational safety and health.
不安全的环境和职业危害已被记录在案，并且正在增加泰国盐场工人的健康风险。各种健康危害及其后果的暴露是否会影响这些工人的工作能力尚不确定。本研究旨在探讨具有健康风险和后果（包括事故）的危害暴露对盐场工人工作能力的影响。
2014年1月至2月期间，对从巴蜀府最大的盐场公司招募的120名盐场工人进行了一项横断面研究。通过现场访问，使用一份结构化问卷进行面对面访谈，问卷包括工人特征、工作条件、与工作相关的安全和健康问题以及工作能力指数（问卷信度=0.84）。采用MIMIC模型确定与工作相关的健康危害及其后果对工作能力的直接和间接因果效应。
在120名盐农中，61%为女性，77%接受过小学教育。平均年龄和工作经验分别为49.5岁（标准差=13.7）和23.7岁（标准差=13.5）。66%的人每周工作超过5天，21.3%的人在过去3个月内至少发生过一次事故。结构方程分析结果显示，健康皮肤与热暴露有关（β=0.35，p=0.01），并直接影响工作能力（β=0.37，p=0.01），眼睛刺激受工作时间长度影响（β=0.24，p=0.05），并在较高水平上协调了模型的预测价值（χ=94.51，自由度=73，p值=0.05，χ/自由度=1.29，RMSEA=0.066）。
MIMIC模型的结果表明，在较长的工作期间，强烈阳光照射和强风这两个因素可能对盐场工人的皮肤和眼睛健康产生关键影响。可以通过使用个人防护装备和进行健康检查来预防这些因素，积极的健康结果可直接提高工作能力。立即需要政府采取实质性行动并发挥社区领导作用，以便制定行动计划来改善职业安全与健康。
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