Journal of disease and health hazard Eastern Region Thailand (JDH)

Study of Styrene Exposure Levels in Individuals Affected by a Fire at a Furniture Factory in Bangkok

Nuttapong Leamun — 2026-08-31

A fire at a furniture factory generated air pollution that could affect response personnel and residents in the surrounding area. This study aimed to assess styrene exposure after the fire by measuring airborne styrene and urinary mandelic acid plus phenylglyoxylic acid (MA+PGA) levels, and to examine the association between distance from the fire site and urinary MA+PGA levels. This analytical cross-sectional study collected urine samples from 101 participants within 24 hours after the incident, of whom 94 had interpretable MA+PGA results; 27 of these participants underwent repeat testing two months later. Air-quality monitoring and health interviews were also conducted. Airborne styrene was detected during the early phase of the incident but was not detected during subsequent monitoring. Among the 94 participants with interpretable results within 24 hours, 48 (51.06%) had MA+PGA concentrations ≥150 mg/g Cr. Among the 27 participants with results available at both time points, the median MA+PGA concentration decreased from 327.27 mg/g Cr (IQR: 233.76–518.36) to 12.60 mg/g Cr (IQR: 2.50–119.23), representing a statistically significant difference (p < 0.001). Participants located <300 m and ≥300 m from the fire site had median MA+PGA concentrations of 188.11 and 108.39 mg/g Cr, respectively, with no statistically significant difference between the groups (p = 0.799). These findings suggest that urinary MA+PGA testing may provide supplementary information for individual exposure assessment when used alongside airborne styrene monitoring and post-fire health surveillance.

Development of a Clinical Nursing Care Model for Patients with Acute Myocardial Infarction in the Emergency and Outpatient Departments of Pattaya BhattamaKun Hospital, Chonburi Province

Udomluk Trakulmeenak — 2026-08-31

Acute myocardial infarction is a medical emergency that requires prompt diagnosis and treatment. This research and development study aimed to assess existing problems, develop and implement a nursing care model, compare outcomes between groups, and evaluate registered nurses’ satisfaction with the developed model. The study was conducted from October 2024 to May 2026 at Pattaya Patmakhun Hospital, Chonburi Province, Thailand. The patient sample consisted of 40 patients with ST-segment elevation myocardial infarction (STEMI), including 20 patients in the historical control group who received conventional care before implementation of the developed model and 20 patients in the intervention group who received care according to the developed nursing care model. In addition, 40 registered nurses participated in the satisfaction evaluation. The research instruments included a clinical outcome record form, the developed nursing care model, and a satisfaction questionnaire. Data were analyzed using descriptive statistics and Fisher’s exact test. The developed nursing care model comprised patient triage guidelines, a checklist for assessing risk symptoms, patient care protocols, and a systematic referral coordination process. Correct triage was achieved in 100% of patients in the intervention group compared with 75% in the historical control group (p = 0.024). Electrocardiography (ECG) within 10 minutes was achieved in 100% and 80% of patients in the intervention and historical control groups, respectively (p = 0.053). Percutaneous coronary intervention (PCI) within 120 minutes after STEMI diagnosis was achieved in 100% and 75% of patients, respectively (p = 0.024). Registered nurses reported the highest level of satisfaction with the developed model (mean = 4.53, SD = 0.58). In conclusion, the developed nursing care model provided a clear and structured approach to the triage and care of patients with STEMI, and the intervention group demonstrated better care-process outcomes than the historical control group for selected indicators.

Evaluation of Thermal Foggers of Public Health Network Agencies, Vector-Borne Disease Control Center 6.5 Chanthaburi Province

Maneerat Sukjan — 2026-08-31

Aedes mosquito control can be implemented through various approaches; however, during outbreaks, space spraying of adulticides remains an important measure for reducing disease transmission. This descriptive study aimed to evaluate thermal fogger standards, compare chemical droplet quality according to fogger characteristics, and describe the characteristics of foggers that failed the Volume Median Diameter (VMD) criterion. A total of 131 thermal foggers submitted for evaluation at Vector-Borne Disease Control Center 6.5, Chanthaburi Province, between February and May 2026 were included. The proportions of foggers meeting the VMD criterion (≤30 μm) were 86.21% in Chanthaburi and 81.82% in Prachinburi. All foggers in both provinces met the droplet uniformity criterion (Span < 2.0). The proportions meeting the chemical flow-rate criterion were 71.26% and 70.45%, while those meeting the nozzle-temperature criterion were 96.55% and 100%, respectively. The Kruskal–Wallis test showed that VMD differed significantly across fogger brands (H = 15.99, df = 8, p = 0.043); however, Bonferroni-adjusted pairwise comparisons showed no significant differences between individual brands. VMD also differed significantly according to nozzle size (p = 0.003), with 1.4-mm and 1.2-mm nozzles differing significantly from foggers without a fixed nozzle. Service life and frequency of use were not significantly associated with differences in VMD or Span. Among the 20 foggers that failed the VMD criterion, 55.00% had been in service for ≥10 years, 55.00% were used 1–9 times per year, and 50.00% had below-standard flow rates. Therefore, flow rates and VMD should be routinely assessed, foggers should undergo standard evaluation before the outbreak season, and regular maintenance should be performed.

Selected Environmental Drivers of Cardiovascular Disease: A Narrative Review of Mechanisms and Implications for Population and Public Health

Sirawish Akkawattananukul — 2026-08-31

Cardiovascular disease (CVD) remains a leading cause of morbidity and mortality worldwide. Environmental exposures may contribute to cardiovascular risk beyond established clinical and behavioural risk factors. This review aimed to synthesise evidence on environmental exposures associated with cardiovascular risk, including shared biological pathways, interactions between exposures, population vulnerability, and implications for prevention, public-health policy, and environmental justice.A narrative review informed by a structured literature search was conducted using PubMed, Scopus, and Web of Science for publications from January 2000 to December 2024. Reference lists and selected institutional and technical sources were also examined. Of 642 records identified, 231 duplicates were removed, leaving 411 records for screening; 92 full-text publications were assessed for eligibility. 22 sources met the eligibility criteria and were included in the principal narrative synthesis. Evidence was interpreted according to methodological limitations, consistency across studies, exposure–response relationships, biological plausibility, and convergence between epidemiological and mechanistic evidence. PM_2.5 had the strongest and most consistent evidence of cardiovascular harm. Extreme heat and transportation noise showed substantial but context-dependent associations, whereas evidence concerning artificial light at night, persistent chemical pollutants, and microplastics and nano plastics remained heterogeneous or emerging. Shared biological pathways included oxidative stress, systemic inflammation, endothelial dysfunction, autonomic and circadian dysregulation, metabolic dysregulation, and thrombosis. Co-exposures may have additive or interactive effects, although evidence for synergistic effects remains exposure-specific. In Thailand, a modelling study using 2009 exposure data estimated a population-attributable fraction of approximately 14.6% for cardiovascular mortality associated with ambient PM_2.5 exposure. Supplementary contextual evidence indicated increasing attention to PM_2.5; however, evidence concerning cardiovascular risk awareness, policy effectiveness, health outcomes, and equity remains limited. Cardiovascular prevention in Thailand should consider environmental exposure assessment, protection of vulnerable populations, source-specific exposure reduction, and evaluation of policy effects using cardiovascular and equity outcomes.

Factors Associated with Rabies Prevention Behaviors among Residents of Chonburi Province, Thailand, 2025

Tawinan Suksai — 2026-08-31

This cross-sectional analytical study aimed to identify factors associated with rabies preventive behaviors among people who owned dogs and/or cats or had a history of potential exposure to rabies. A total of 130 participants were recruited from four districts in Chon Buri Province, Thailand Bang Lamung, Si Racha, Sattahip, and Ban Bueng which had reported confirmed human rabies deaths during 2021–2025. Participants were consecutively recruited from eligible individuals who met the inclusion criteria and received services at subdistrict health-promoting hospitals in the study areas. Data were collected from April 1 to July 31, 2025, using a structured questionnaire. The mean content validity index was 0.93. The knowledge test demonstrated a KR-20 coefficient of 0.58, while the rating-scale measures showed Cronbach’s alpha coefficients ranging from 0.73 to 0.92. Data were analyzed using descriptive statistics, the chi-square test, and Pearson’s correlation coefficient. The majority of participants were female (66.2%), and the largest age group was 51–60 years (27.7%). Knowledge (r = 0.278), attitudes (r = 0.506), access to rabies vaccination (r = 0.389), and local government organization efforts in rabies prevention and control (r = 0.382) were positively and significantly correlated with rabies preventive behaviors (p < 0.05). In contrast, sex, age, income, educational level, occupation, and duration of animal ownership were not significantly associated with preventive behaviors. These findings highlight the importance of strengthening rabies-related knowledge and fostering positive attitudes, improving access to rabies vaccination services, and enhancing the implementation of rabies prevention and control measures by local government organizations. An integrated approach involving communities, health services, and local authorities, consistent with the One Health approach, may contribute to strengthening rabies prevention and control and support Thailand’s efforts toward the global goal of Zero by 30.