Fluoride exposure from natural, agricultural, and industrial sources has harmed people living in fluoride-affected areas. Fluoride accumulates in the human body after being exposed to it through the food chain. The population consisted of 371 community health volunteers who were surveyed and chosen based on personal fluoride information. Only 39 residents were chosen to be interviewed and take part in the trial, which involved drinking fluoride-containing groundwater (>1.5 part per million: ppm) and urine testing that revealed urine fluoride level (>0.7 ppm). In addition, 47 biological samples and eight commercially bottled water specimens were examined. The information was gathered in four ways: (1) a questionnaire-based survey of fluoride knowledge, (2) food consumption behavior with locally grown vegetables, fruits, poultry, and meat, and commercially bottled water produced by groundwater in fluoride-affected areas, (3) a semi-food frequency questionnaire, and (4) fluoride content measurements using an ion-selective electrode. According to the analyses, the participants ranged in age from 51 to 60 years, with approximately 60.38% of them female and born and raised in polluted areas. The majority of subjects had a low level of fluoride knowledge (65.23%). The respondents’ primary source of drinking water (100.00%) was commercially bottled water; they chewed camellia sinensis 11.56% of the time (1 to 5 years) and they drank tea 9.16% of the time (during 1 to 5 years). Sus scrofa domesticus was responsible for the intake of vegetables and fruits, whereas Brassica chinensis, Jusl var para-chinensis (Bailey), and Tsen and Lee were responsible for the intake of poultry and animal flesh. They were all purchased at a local farm. The hazard quotient was greater than one, and the fluoride concentration (ppm) ranged between 75.00% (0.29–5.20), 57.14% (0.01–0.46), 88.89% (0.07–0.91), 100.00% (0.43–3.07), 100.00% (0.58–0.77), 42.86% (0.12–0.62 ppm.), 60.00% (0.11–1.44), and 33.33% (0.10–0.80) in drinking water, fruit, young and mature plants. Fluoride ingestion may pose a health concern. Under the 95th percentile condition, 74.47% consumed water with a high fluoride level, vegetables and fruits, and poultry and meats.

This study aims to encourage innovative participation in the management of medical waste by bedridden patients in the research region of Khon Sawan, Chaiaphum Province, through research and development. The steps were as follows: Phase 1: Study of bedridden patient waste management situations using the amount of waste generated through innovation with relatives, non-relatives, village health volunteers (VHVs), and community leaders. Phase 2: Developing creative waste management engagement requires two steps: (1) analyzing the problem or its cause and generating management alternatives through collaborative brainstorming with a community member and (2) gathering the thoughts and suggestions of a number of agency specialists. The outcome is a novel model of participation in waste management by bedridden patients termed “Four Joins of Power,” which includes (1) participatory activities and enhancing community knowledge and attitudes, and (2) providing information on the management of each type of waste. (3) cooperation in waste management (analytical thinking, planning, execution, etc.) and regulation by mutually agreed-upon rules. (4) joint expansion of the waste management network: Phase 3 is the innovation trial, and Phase 4 is the innovation assessment. The paired t-test was used to compare pre-and post-development knowledge and attitudes, and to conduct qualitative data analysis. In Phase 3, after implementing collaborative innovations, the average knowledge (X¯ = 13.23) and attitudes (X¯ = 4.14) regarding waste management increased considerably (p < 0.05), and in Phase 4, waste management behavior comprising sorting, storage, and disposal was observed. There were progressively substantial gains (X¯ = 4.25 and X¯ = 4.27). Among the most collaborative participants, 93.50% were satisfied. To reduce the amount of waste that must be sorted and collected, it is necessary to emphasize the participation of people and networks from all sectors in the area through joint thinking, planning, and comprehensive analysis, to ensure the sustainability of waste management in the community.

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Fluoride naturally occurs in the Earth’s crust and is widely dispersed in groundwater. The high consumption of fluoride can inhibit iodine metabolism in the human body, especially in the thyroid gland. This study assessed iodine knowledge, iodine consumption behavior, urinary iodine (UI), thyroid stimulating hormone (serum TSH), and free triiodothyronine3 (serum FT3) and examined the connection between fluoride exposure and UI and thyroid function as serum concentrations of TSH and FT3 in pregnant women dwelling in an area of endemic fluorosis. This was a cross-sectional study. The population included 152 pregnant women within the 1st trimester of pregnancy, during which they were provided antenatal care (ANC) in seven public community hospitals in Phayao province, Thailand. The study consisted of two components. First, the study consisted of a questionnaire in which we evaluated the iodine knowledge and iodine consumptive behaviors in subjects. Second, biochemical data were investigated to evaluate thyroid function in the subjects. The gestational age of most subjects was 8–12 weeks. The study population has lived in fluoride-contaminated areas since birth (76.97%). The iodine and iodine consumption levels were moderate (50.00%). Their food iodine consumption was 3–4 days/week, and the top five consumption ranks were iodized salt, cooked pork, eggs, sticky rice, and iodine fish sauce. In terms of biochemical parameters, 63.16% of respondents had UI levels below 150.00 g/L, which is below the normal reference range of 150.00–249.00 g/L. 89.47% of the risk of hypothyroidism was associated with serum TSH levels below 2.50 g/L. In 38.16% of the samples, normal levels of serum FT3 (2.00–4.40 pg/L) were identified in the subjects. In addition, 61.84% of the samples had FT3 concentrations greater than 4.40 pg/L (high intake of iodine). The approved association between positive serum FT3 data and serum TSH was positive (r = 260 and p  < 0.05). These studies imply that these elevated levels of TSH and FT3 place pregnant women in their first trimester at risk for hypothyroidism.