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Songklanakarin Journal of Science and Technology SJST-2019-0180.R3 Chaiklieng Work-related Diseases among Agriculturists in Thailand: A Systematic Review Journal: Songklanakarin Journal of Science and Technology Manuscript ID SJST-2019-0180.R3 Manuscript Type:ForReview Review Article Only Date Submitted by the 25-Apr-2020 Author: Complete List of Authors: Chaiklieng, Sunisa; Khon Kaen University, Department of Environmental Health, Occupational Health and Safety, Faculty of Public Health Poochada, Worawan; Khon Kaen University Faculty of Public Health, Environmental Health, Occupational Health and Safety Suggaravetsiri, Pornnapa; Khon Kaen University, Faculty of Public Health Keyword: agriculture, health effect, hazard, injuries, meta-analysis For Proof Read only Songklanakarin Journal of Science and Technology SJST-2019-0180.R3 Chaiklieng Page 2 of 26 1 2 3 4 Review Article 5 6 7 Work-related Diseases among Agriculturists in Thailand: 8 9 A Systematic Review 10 11 12 13 14 Sunisa Chaiklieng1* Worawan Poochada1 Pornnapa Suggaravetsiri2 15 16 17 18 19 1Department of Environmental Health, Occupational Health and Safety, Faculty of 20 For Review Only 21 Public Health, Khon Kaen University, Khon Kaen 40002, Thailand 22 23 2 24 Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon 25 26 Kaen University, Khon Kaen, 40002, Thailand 27 28 *Corresponding author, Email address csunis@kku ac th 29 : . 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 For Proof Read only Page 3 of 26 Songklanakarin Journal of Science and Technology SJST-2019-0180.R3 Chaiklieng 1 2 3 4 Abstract 5 6 7 This systematic review aimed to summarize the prevalence of work-related 8 9 diseases among agriculturists in Thailand. A meta-analysis was done in prespecified 10 11 subgroups of health hazards and effects from primary studies. The articles were searched 12 13 14 for by using the following electronic databases: PubMed, TCI, and ThaiLIS published 15 16 between 2007 and 2017. Heterogeneity between studies was assessed by using the I2 and 17 18 Chi-square test. Data from 34 articles were analyzed using STATA and a comprehensive 19 20 meta-analysis on the prevalence of diseases. The highest estimated pooled prevalence 21 For Review Only 22 23 (random effects model) was that of musculoskeletal disorders (MSDs) at 67.8% (95%CI 24 25 66.3-69.3), followed by those of chemical hazard at 52.8% (95%CI 50.5-55.1), and other 26 27 health effects, including heat effects, skin irritation and injuries, at 53.1% (95%CI 51.7- 28 29 30 54.4). This review shows that a health surveillance program using big data management 31 32 to show work-related diseases and Thai government support in strategic planning to 33 34 decrease prevalence of MSDs and pesticide exposure among agriculturists are a priority. 35 36 37 Keywords: agriculture, health effect, hazard, occupational disease, injuries, meta- 38 39 analysis 40 41 42 43 1. Introduction 44 45 46 The National Statistical Office (NSO) of Thailand collected informal employment 47 48 data in 2017. It was revealed that 55.6% of the 38.3 million workforce were informally 49 50 employed (NSO, 2017). The agricultural sector had a majority of informal workers and 51 52 53 almost all of them were engaged in crops (NSO, 2013). They lacked employee status as 54 55 defined under the Labor Protection Act (LPA). Typically, they were not working in the 56 57 status of an employee; they were working at home or maybe self-employed, or were 58 59 60 For Proof Read only Songklanakarin Journal of Science and Technology SJST-2019-0180.R3 Chaiklieng Page 4 of 26 1 2 3 4 temporary workers. Epidemiological studies of adverse health effects among 5 6 7 agriculturists have been reported with regard to health risk and risk factors of exposure to 8 9 health hazards, and injuries caused by agricultural activities (Suggaravetsiri & 10 11 Chaiklieng, 2017; Veerast, Suggaravetsiri & Chaiklieng, 2013). 12 13 14 According to a global report on work-related diseases, the highest prevalence of 15 16 the work-related diseases of agriculturists was work-related musculoskeletal disorders 17 18 (MSDs) at 43.2% to 91.3% (Yee, Tamrin, Yik, Yusoff, & Mori, 2014; Jo et al., 2016; 19 20 Osborne et al., 2010; Kearney, Allen, Balanay, & Barry, 2016; McMillan, Trask, 21 For Review Only 22 23 Dosman, Hagel, & Pickett, 2015; Dong, Li, & Yu, 2012), followed by skin irritation at 24 25 86.0% (Oesterlund et al., 2014) to 87.3% (Kim et al., 2013), injuries caused by all kinds 26 27 of accidents at 26.3% to 60.0% (Kim, Lee, & Räsänen, 2016; Mayrhofer, Quendler, & 28 29 30 Boxberger, 2014; Browning, Westneat, & Reed, 2016; Prasanna & Dewangan, 2009), 31 32 heat-related illness at 4.0% (Banerjee, 1993) to 50.0% (Sahu, Sett, & Kjellstrom, 2013), 33 34 toxicity from pesticide at 10% (Kamel et al., 2007) to 22.5% (Zare et al., 2015), infectious 35 36 37 diseases at 0.7% to 28.6% (Dahal et al., 2016; Adesiyun et al., 2010; Fiecek, 38 39 Grochowalska, Chmielewski, & Tylewska-Wierzbanowska, 2012), and lower respiratory 40 41 tract complaints at 2.7% to 26.0% (Kim et al., 2013; Hoppin et al., 2008; 2009), 42 43 respectively. 44 45 46 In Thailand, occupational and environmental diseases among the Thai population 47 48 visiting public hospitals are reported to the Health Data Center (HDC). It was reported 49 50 between 2013 and 2016 that the highest prevalence among agriculturists was injuries 51 52 53 (0.6%), followed by MSDs (0.3%), hearing loss and diseases caused by heat (0.2%), and 54 55 pesticide toxicity (0.1%) (Health Data Center, 2017). The statistics were compiled from 56 57 diagnosed cases of the passive surveillance report in Thailand and largely contradicted 58 59 60 For Proof Read only Page 5 of 26 Songklanakarin Journal of Science and Technology SJST-2019-0180.R3 Chaiklieng 1 2 3 4 the global statistics mentioned in the research, which were mostly based on the complaints 5 6 7 or health screening data reports of the study participants. Some work-related diseases 8 9 were indicated in the previous studies, but there was no general report from the HDC on 10 11 cases as occupational diseases, such as skin diseases and infectious diseases. One cross- 12 13 14 sectional study indicated the prevalence of skin diseases, calculated from the self-reported 15 16 symptoms of the agriculturists, at 71.5% (Lueangektin & Wongvigitsuk, 2010); this was 17 18 19 much higher than the incidence rate calculated from diagnosed cases of skin diseases 20 21 (6.2%) and infectiousFor diseases Review (3.5%) in a retrospective Only cohort study of agriculturists 22 23 (Phuengsangpaen & Chaiklieng, 2017). There was a higher incidence of MSDs (39.2%) 24 25 and pesticide toxicity (0.4%) among the agriculturists of the previous study report 26 27 28 (Phuengsangpaen & Chaiklieng, 2017) when compared to those reports from the passive 29 30 surveillance database of HDC. Although there have been studies about the prevalence of 31 32 work-related diseases, they are not representative of the national prevalence of 33 34 35 occupational diseases of agriculturists according to the surveillance report of health data 36 37 and its studies. Therefore, the aim of this meta-analysis was to summarize the prevalence 38 39 of work-related diseases among agriculturists in Thailand. 40 41 42 43 44 2. Materials and Methods 45 46 2.1 Search Strategy 47 48 This review was carried out by searching the following electronic databases for 49 50 51 primary studies: PubMed, TCI (Thai Journal Citation Index Centre), and ThaiLIS 52 53 (Thailand Library Integrated System), published between January 2007 and September 54 55 2017. The search strategy included incorporation of the following terms: agriculture, 56 57 58 59 60 For Proof Read only Songklanakarin Journal of Science and Technology SJST-2019-0180.R3 Chaiklieng Page 6 of 26 1 2 3 4 agriculturist, farmers, planter, grower, prevalence, injuries, work-related, occupational 5 6 7 diseases, health hazard, health effect, and Thailand. 8 9 2.2 Study Selection 10 11 The search strategy aimed to identify all the available publications in Thai or 12 13 14 English language that reported data on the prevalence of work-related diseases, including 15 16 injuries among agriculturists in Thailand. Two reviewers independently reviewed titles 17 18 and abstracts to identify acceptable studies from all sources which met the inclusion 19 20 criteria: 1) there was a full-text article available, 2) the type of agriculture was presented 21 For Review Only 22 23 and located in Thailand, and 3) the sample size of agriculturists and the prevalence of 24 25 disease were identifiable enough to be classified according to health hazard, MSDs and 26 27 other health effects groups. 28 29 30 2.3 Data Extraction 31 32 Two reviewers independently extracted data from the acceptable studies. Any 33 34 differences of opinion were discussed and the cases of disagreement were resolved by a 35 36 37 third reviewer, who was an epidemiologist to meet the eligibility criteria of a cross- 38 39 sectional study designed for agriculturists. The data was extracted from 34 acceptable 40 41 studies of a cross-sectional study, which included the names of the authors and the year 42 43 of article publication. The recorded parameters were province of study (from the 44 45 46 following regions of Thailand: North, Northeast, Central, East and South) or locality, 47 48 survey year, number of participants, type of agriculture, type of health hazard or health 49 50 effects of exposure, and prevalence of work-related diseases and injuries according to the 51 52 53 complaints or health screening data of the participants.
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