This study aimed to assess paraquat concentrations in the urine of women at 28 weeks of pregnancy, delivery and 2 months postpartum and in the meconium of neonates. In all, 79 pregnant women were recruited from three hospitals located in agricultural areas in Thailand. The subjects were interviewed about personal characteristics, agricultural activities and pesticide use patterns. Paraquat was analyzed in urine and meconium using high performance liquid chromatography equipped with a fluorescence detector. The geometric mean (GSD) of urinary paraquat concentrations at 28 weeks of pregnancy, delivery and 2 months postpartum were 2.04 (4.22), 2.06 (5.04) and 2.42 (5.33) ng/mL, respectively. The urinary paraquat concentrations at 28 weeks of pregnancy, delivery and 2 months postpartum between agriculturist and non-agriculturist were not significantly different (p = 0.632, p = 0.915, p = 0.57, respectively). The geometric mean (GSD) of paraquat concentration in the meconium was 33.31 (4.59) ng/g. The factors predicting paraquat exposures among pregnant women and neonates included working outside, living near farmland, having family members who work on a farm, drinking well water and using herbicides or paraquat.

Vegetable farmers applying the herbicide alachlor may be highly exposed through dermal contact when spraying. Dermal patches were attached to 10 locations on the farmers' skin when they mixed and applied alachlor in vegetable farming areas in Thailand. Measurements were made on farmers using either a backpack sprayer with a 2 stroke gasoline motor and fan or a battery operated pump. Forty-seven vegetable farmers in Bungphra subdistrict of Thailand participated in this study. Both motorized and battery pump backpack sprayers wearing long-sleeve shirts had significantly lower alachlor concentrations on the dermal patches under their long-sleeve shirts compared to those who wore only short-sleeve shirts, regardless of the sprayer type. Moreover, sprayers wearing long pants had significantly lower alachlor concentrations on dermal patches placed under the pants on the lower legs than those wearing short pants, regardless of the sprayer type. The highest estimated alachlor exposures were found on the upper legs (median = 9.29 µg/h) for those using a 2 stroke engine/fan backpack sprayer and on the lower legs (2.87 µg/h) for those using the battery operated pump backpack sprayer. The estimated total body alachlor exposures of applicators using the 2 stroke engine/fan backpack sprayer (219.48 µg/h) were significantly higher than those using the battery operated pump backpack sprayer (15.50 µg/h). Using long-sleeve shirts as personal protection reduced alachlor exposures for the arms 97-99% and wearing long pants reduced alachlor exposure to the legs for 81-99%. Thus, training about the protection provided by clothing choices would be one step in improving the health and safety of Thai farmers.

Thai agriculturists heavily used paraquat in agricultural areas to control weed and grasses. This study determined paraquat exposure among backpack sprayers in Thailand and identified determinants of occupational exposure. Breathing zone air and dermal samples were collected from 57 backpack sprayers while spraying. Spot urine samples were collected on the day before spraying, end of spraying event and the next day after spraying. The subjects were interviewed about general demographics, agricultural activities, pesticide application and personal protective equipment used while applying paraquat. Paraquat concentrations in urine samples, air samples and dermal samples were determined by HPLC with a fluorescence detector. The median IQR of urinary paraquat concentrations on the day before spraying, end of spraying event, the next day after spraying were 2. 51 (0.81-5.59), 8.23 (3.3-13.73) and 3.48 (1.03-8.19) μg/g creatinine, respectively. Concentrations of air samples and total dermal exposures were 5.15 (2.28-10.12) μg/m 3 and 92.66 (34.37-1647.46) μg/hr, respectively. Use of battery powered backpack sprayer and standing upwind effectively reduced inhalation exposures. Wearing a long sleeve shirt, long pants, boots, latex gloves and balaclava could reduce paraquat concentration on dermal exposure among backpack sprayers.

Introduction: Diabetic Nephropathy (DN) is one of the most serious long-term complications of patients with type 2 diabetes and the leading cause of end-stage kidney failure. Early detection and risk reduction measures can prevent DN. However, data showing the survival time and factors associated with DN development among Thai patients with type 2 diabetes is currently not available. Aim: This study aims to explore the survival time and examine the risk factors associated with the development of DN among Thai patients with type 2 diabetes. Materials and Methods: This cross-sectional retrospective study was conducted during 1st January, 2002 to 3rd December, 2017 to performed and to explore the survival time and examine the risk factors associated with the development of DN among 1,540 patients with type 2 diabetes who received treatment at the Diabetes Mellitus (DM) clinic in Mahachanachai Hospital, Yasothon Province, Thailand. Data was collected from the Hospital Experience (HOSxP) program and medical records from 2002 to 2017. Kaplan-Meier and Cox’s regressions were used for data analysis. Results: From those 15 years, out of 1,540 cases 306 eligible patients with type 2 DM were selected for survival analysis. The results showed that 274 patients met the criteria for DN (89.50%) and 32 patients (10.50%) did not meet the criteria for DN. The median of DN survival time was five years. Multivariate Cox’s regression analysis confirmed that systolic blood pressure had a statistically significant association with the development of DN among hospitalised type 2 diabetic patients. Conclusion: Duration of Diabetes and Systolic blood pressure are associated with the development of DN. The application of future prevention and control measures are highly recommended to control systolic blood pressure for DN protection.

Background: The rate of adolescent pregnancy has steadily increased in Thailand over the years and depression is considered an important psychological problem in many pregnant adolescents. The aims of this study were to determine the proportion of pregnant adolescents with depressive symptoms and to identify a predictive statistical model for the factors related to prenatal depression among adolescents at antenatal care clinics in 10 community health centers in Maha Sarakham Province. Methods: A cross-sectional study was conducted in 230 randomly selected participants who were pregnant adolescents who volunteered to participate in the research, those aged ≤19 years, and had an estimated gestational age of ≤18 weeks. Those with severe obstetrics complications or a psychiatric disorder were excluded. The subjects were asked to complete a demographic questionnaire and the Thai version of the Edinburgh Postnatal Depression Scale. The mean age of participants was 17.0 (±1.4) years. Results: Overall, 43.9% of the adolescents had a cut off score of ≥11, suggestive of prenatal depressive symptoms. Multivariate analysis identified that pregnant adolescents at a primary school education level were 6.5 times more likely to experience depression symptoms than those with a diploma. Those who were emotionally supported by their husband or partner compared to relatives had a five times higher chance of presenting depressive symptoms, and those with a perceived bad relationship with their husband or partner had seven times higher. The model was well-calibrated (goodness-of-fit test, p = 0.675) and had high discriminative power (ROC curve = 0.73 (95%CI = 0.67 to 0.79). Conclusions: More attention is needed to reduce the known problems with pregnant adolescents and to ensure they continue with their education.  Lastly, public education to support mental health initiatives for individuals and families should be encouraged.