PREVALENCE OF AND FACTORS ASSOCIATED WITH OCCUPATIONAL HEALTH PROBLEMS AMONG HILL FARMERS IN THAILAND

Abstract

Hill farmers, those who work on land that is partly or completely hilly, may be at increased risk for occupational health problems. In this study, we aimed to determine the prevalence of and factors associated with occupational health complaints among hill farmers in northern Thailand. Participants were recruited from hill farmers using convenience random sampling. These subjects included ethnic Thais and Karen. Inclusion criteria for study subjects were: any farmer who worked on partially or completely hilly land for more than 6 months, being aged >18 years and being able to communicate with the researchers. The exclusion criterion was having a congenital physical disability. Study subjects were interviewed following a structured questionnaire containing 4 sections: 1) socioeconomic characteristics, 2) work characteristics, 3) occupational hazard exposures in the previous six months and 4) occupational health problems in the previous six months. We used univariate and multivariate binary logistic regression analysis to determine factors associated with occupational health problems. A total of 600 subjects were included in the study; 55% male. The mean (±standard deviation (SD)) age of subjects was 45.6 (±12.8) (range: 18-85) years; 51% were aged 30-49 years. Sixty-three percent of subjects self-identified as being ethnic Karen. The mean (±SD) number of years the subjects worked in agriculture were 23.8 (±14.8) years. Seven percent of subjects stated they worked on land that was completely hilly and the other 93% worked on land that was only partially hilly. The most prevalent occupational health problems were: low back pain (79%), shoulder and neck pain (78%) and heat exhaustion (74%). On multivariate analysis factors significantly associated with low back pain were: having to bend or twist during their work (adjusted odds ratio (aOR) = 7.3, 95% confidence interval (CI): 4.2-12.7; p<0.001) and work on a completely hill farming terrain (aOR = 4.0, 95%CI: 1.2-13.9; p=0.027). The factor significantly associated with shoulder and neck pain was: having to lift heavy loads (aOR = 3.2, 95%CI: 1.8-5.6; p<0.001). The factors significantly associated with heat exhaustion was: expose to heat from working outdoors (aOR = 11.4, 95%CI: 4.9-26.9; p<0.001). In summary, the prevalences of back pain, shoulder and neck pain and heat exhaustion in our study population were high. The factors significantly associated with these complaints were working in a bent or twisted posture, work on a completely hilly farm, lift heavy loads and being exposed to heat working outdoors. We conclude there is need to develop methods to reduce these symptoms and apply them in this study population. Further studies are needed to determine if these developed interventions can reduce these symptoms in this study population.