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

Health Literacy for Preventing Health Effects Associated with Particulate Matter Less Than 2.5 Micrometers (PM2.5) Exposure Among High-Risk Occupational Groups in Ban Chang District, Rayong Province

Natthida Suwanpuchai — 2026-01-30

Particulate matter with a diameter of 2.5 micrometers or less (PM_2.5) is a critical environmental and public health concern, particularly among outdoor workers. This study aimed to examine the level of health literacy related to self-protection against PM_2.5 exposure and to identify factors associated with health literacy among a high-risk occupational group in Ban Chang District, Rayong Province, Thailand. An analytical cross-sectional study was conducted among 56 street sweepers. Data were collected using a structured questionnaire between April and June 2025. Descriptive statistics, including percentages, means, and standard deviations, were used to summarize the data.Independent samples t-tests were applied to compare differences in health literacy levels, and logistic regression analysis was performed to identify associated factors. The results showed that the overall level of health literacy was moderate (mean = 2.86, S.D. = 0.99). All domains of health literacy, including access to information, cognitive understanding, communication skills, self-management, media literacy, and decision-making skills, were also at a moderate level. Age and educational level were significantly associated with health literacy (p < 0.05). Participants aged 20 - 40 years and those with at least secondary education had higher odds of having a higher level of health literacy compared with those in the older age group and those with lower educational attainment.In conclusion, street sweepers demonstrated a moderate level of health literacy regarding self-protection against PM_2.5 exposure, indicating a need for targeted health literacy promotion to enhance effective self-protective behaviors among high-risk occupational groups.

Surveillance, Prevention and Control of Legionnaires’disease in hotels, Banglamung District, Chonburi Province

Artorn Niakul — 2026-01-30

This study aimed to examine the operational situation, identify obstacles, and synthesize guidelines for the surveillance, prevention, and control of Legionnaires'disease among hotels in Banglamung District, Chonburi Province. This qualitative research utilized in-depth interviews for data collection. The key informants consisted of 17 individuals,
including hotel managers, chief engineers, and executive housekeepers from 6 hotels. These establishments participated in the "3C Clean Hotel Project" (Regional Medical Sciences Center 6 Chonburi, 2025) and the "Development of Surveillance and Control Models for Legionnaires' Disease in Tourist City Hotels" (Bureau of Environmental Health, Department of Health, 2025), all of which had reported Legionella contamination levels of 10,000 CFU/L or higher. Data were analyzed using content analysis.
The results revealed that while most hotels had assigned responsible personnel and implemented surveillance measures to some extent, compliance with Department of Health guidelines remained incomplete. Major gaps included irregular laboratory testing for Legionella, inconsistent monitoring and recording of residual chlorine and water temperature, and a lack of sustainable, continuous surveillance systems.
To improve operations, the study recommends focusing on the capacity building of key informants, including hotel managers, chief engineers, and executive housekeepers. Furthermore, it suggests establishing concrete water management and surveillance systems with structured oversight from public health officials, fostering collaborative
networks with health agencies, and enhancing awareness regarding relevant laws and standards.

Factors Associated with Blood Lead Levels Among Informal Electronic Waste Workers in Prachinburi Province

Ratchaya Jirapong — 2026-01-30

This cross-sectional study aimed to examine factors associated with blood lead levels among informal electronic waste sorting workers in Sri Maha Phot District, Prachinburi Province, Thailand.
The study sample consisted of 89 participants from 19 establishments. Data were collected using a questionnaire on lead-related diseases and lead exposure behaviors,which was validated by experts (Index of Item-Objective Congruence [IOC] = 0.9) and demonstrated good reliability (Cronbach’s alpha = 0.8). Data collection was conducted between January and July 2025 through face-to-face interviews and blood lead level testing. Data were analyzed using descriptive statistics (percentage, mean, and standard deviation) and inferential statistics (Chi-square test and Fisher’s exact test). The results showed that 19.1% of participants had blood lead levels ≥ 5 μg/dL, which is considered a level requiring health surveillance. Factors significantly associated with blood lead levels (p < 0.05) included wearing a dust-protective mask or face covering (p = 0.028)
and changing clothes before returning home (p = 0.045). These findings indicate that personal hygiene behaviors play an important role in preventing lead exposure.Policy implications include promoting proactive health screening among electronic waste workers, enhancing occupational health literacy with emphasis on personal hygiene behaviors that reduce lead exposure such as wearing dust-protective masks
and changing clothes before returning home and supporting workplaces in providing appropriate personal protective equipment.

Factors Influencing Outcomes of Performance of NCD Clinic Plus in Hospitals in Health Region 6

Naphatsinee Nongpraow — 2026-02-04

This retrospective evaluation study was designed to examine the performance and analyze factors influencing the outcomes of NCD Clinic Plus implementation among hospitals in Health Region 6. The study sample comprised 73 hospitals under the Ministry of Public Health that participated in the NCD Clinic Plus Online assessment in the fiscal year 2024. The research instrument was the standard NCD Clinic Plus assessment form, which consists of four parts: (1) general information of the health care facility, (2) quality development processes across six components, (3) service outcome indicators comprising 13 indicators, and (4) continuous quality improvement (CQI). Data were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation, as well as inferential statistics using multiple linear regression analysis. The results showed that most hospitals (67.13%) met the assessment criteria, with small hospitals having the highest passing proportion (82.9%). The analysis identified ten significant predictors explaining 87.3% of the variance in performance outcomes (Adjusted R² = 0.873, p < 0.05). These predictors included self-management support systems, decision-support systems, key screening and control indicators for diabetes and hypertension (KPI2, KPI3, KPI8–KPI10, KPI13), quality improvement outcomes (CQI2), and hospital size (SIZE_HPT). The findings indicate that effective implementation of NCD Clinic Plus requires an integrated care system that emphasizes both process and outcome dimensions. Strengthening patient self-management, data-driven clinical decision-making, and continuous quality improvement are essential strategies for enhancing service quality and achieving sustainable population health outcomes.

Investigation of a Scarlet Fever Outbreak in a Primary School, Samut Prakan Province, Thailand, January – March 2025

Waritnun Anupat — 2026-01-30

Scarlet fever, a highly contagious infection caused by Streptococcus pyogenes, poses a significant risk in school settings. On February 27, 2025, a suspected outbreak was reported at a school in Samut Prakan, Thailand, prompting an epidemiological investigation. This investigation aimed to confirm the outbreak, describe its epidemiological characteristics, identify risk factors, and propose effective control measures. A descriptive epidemiological study was conducted. Data were collected from medical records, interviews, and active case finding, analyzing distribution by person, time, and place. An environmental survey, along with throat swab cultures for β-hemolytic Streptococcus pyogenes (group A) and antimicrobial susceptibility testing, was performed. A total of 93 cases were identified (overall attack rate: 5.1%), with the highest rate in 3rd-grade students (13.0%). Key symptoms included fever (86.0%), sore throat (80.4%), and rash (76.3%). Laboratory tests confirmed 7 of 11 cases (63.6%), with the pathogen susceptible to penicillin but resistant to macrolides.
The investigation revealed a propagated source pattern and identified significant environmental risk factors, including classroom overcrowding (0.95 m²/person) and inadequate ventilation. The outbreak was confirmed, driven by person-to-person transmission exacerbated by overcrowding and poor ventilation. Implemented control measures, including patient screening, isolation, health education, and environmental cleaning, successfully stopped the transmission, with no new cases found during follow-up surveillance.