Abstract
This study explored health status, risk factors, and health promotion via occupational health nursing practice concepts, and explored knowledge about noise-induced hearing loss and silicosis, and the practice of using personal protective equipment. This part was a quasi-experiment, with pre- and postparticipatory group process. This study was conducted between March and August 2008. Study subjects
were 47 workers in a granite-processing factory in Muang District, Rayong Province. Data were collected by a walk-through survey form, area air sampling to measure silica dust, sound level meter type I, a health and health behavior interview form, measurement of weight and height, pulmonary function test, audiometer, chest X-ray, questionnaire on knowledge, observation form for health protection behavior, occupational health nursing practice, and participatory group process. Data were analyzed descriptively by number and percentage and inferentially by t-test.
The results revealed major health risks: silica dust above the standard in the gang-saw section (%SiO2 = 7.648) and polishing section (%SiO2 = 6.622); and noise above standard of 90 dB(A) in 4 out of 15 points in the gearing and trimming section (2 points: 97.4 and 102.3 dB(A)) and polishing section (2 points: 91.1 and 99 dB(A)). The results on health status showed that most (78.7%) had abnormal audiograms – reduced high tone hearing (37/47), threshold shift 8.5 percent (4 /47); restrictive lung 6.7 percent (3/47); abnormal chest X-ray requiring surveillance 10.6 percent (5/47), physician observation 2.13 percent (1/47); but none were compatible with silicosis. Regarding health protection behavior, 83.0 percent of workers used ear plugs (39/47), with mean duration being 6.3 hours per day; and nasal masks 55.3 percent (26/47), with mean duration of 6.26 hours per day. Health promotion and counseling were done via participatory group process, demonstration, health education on noise-induced hearing loss, silicosis, and prevention. Before the group process, only 15.38 percent of the workers wore ear plugs correctly (6/39); this increased to 100 percent (39/39) after the group process. Before the group process, workers had knowledge score of 6.52 (SD = 2.12) which increased to 9.81 (SD = 2.60), and the difference was significant (p <0.01).
Silica dust was above standard, but no case of silicosis was detected yet. Audiograms revealed those with abnormality, i.e. 87.23 percent of the total and some areas had noise above the safety threshold. The factory should therefore establish a surveillance program on health and environment and continuing education, especially for new workers. Group process should be deployed to enhance employers’ and employees’ participation.
