University of Oulu

Auttanate, N., Chotiphan, C., Maruo, S.J. et al. Cold-related symptoms and performance degradation among Thai poultry industry workers with reference to vulnerable groups: a cross-sectional study. BMC Public Health 20, 1357 (2020).

Cold-related symptoms and performance degradation among Thai poultry industry workers with reference to vulnerable groups : a cross-sectional study

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Author: Auttanate, Nipaporn1; Chotiphan, Chotirot1; Maruo, Suchinda Jarupat1;
Organizations: 1Department of Occupational Health, Faculty of Public Health, Mahidol University, Bangkok, Thailand
2Center for Environmental and Respiratory Health Research, University of Oulu, P.O. Box 5000, FI-90014, Oulu, Finland
3Finnish Institute of Occupational Health, Työterveyslaitos, FI-90032, Helsinki, Finland
4School of Public Health, Physiotherapy and Sports Science, University College Dublin, Belfield, Dublin, DB4, Ireland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.7 MB)
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Language: English
Published: Springer Nature, 2020
Publish Date: 2020-09-17


Background: Few studies have examined cold-related symptoms among cold workplace workers in Thailand. This study aimed to determine the prevalence of cold-related cardiorespiratory, circulatory, and general symptoms and performance degradation among Thai chicken industry workers and identify vulnerable groups.

Methods: Overall, 422 workers aged from 18 to 57 years at four chicken meat factories in Thailand were interviewed for cold-related symptoms and complaints. The results were expressed in terms of model-based adjusted prevalence and prevalence differences (PDs) in percentage points (pp) with 95% confidence intervals (CIs).

Results: In total, 76.1% of the respondents reported cold-related respiratory symptoms, 24.6% reported cardiac symptoms, 68.6% reported circulatory symptoms, and 72.1% reported general symptoms. In addition, 82.7% of the respondents reported performance degradation. Cold-related respiratory symptoms increased by PD 29.0 pp. (95% CI 23.4–34.6) from the lowest to the highest educational group, with a similar pattern observed in performance degradation. Forklift drivers and storage and manufacturing workers complained of cold-related respiratory symptoms more than office staff (PD 22.1 pp., 95% CI 12.8–31.3; 12.0 pp., 95% CI 2.4–21.6; and 17.5 pp., 95% CI 11.5–23.6, respectively); they also reported more performance degradation (PD 24.1 pp., 95% CI 17.0–31.2; 19.8 pp., 95% CI 14.1–25.6; and 14.8 pp., 95% CI 8.0–22.6, respectively). Weekly alcohol consumers reported more performance problems owing to cold (PD 18.2 pp., 95% CI 13.9–22.6) than non-consumers of alcohol. Cardiac and circulation symptoms were more common in women than men (PD 10.0 pp., 95% CI 1.1–18.9; and 8.4 pp., 95% CI 0.5–16.4, respectively). The age trend in performance issues was curved, with the highest prevalence among those aged 35–44 years, while the oldest workers (45–57 years) perceived less cold-related symptoms, particularly thirst.

Conclusions: Cold-related symptoms and performance degradation were found to be common in this industry, with vulnerable groups comprising of highly educated workers, forklift drivers, storage and manufacturing workers, weekly alcohol consumers, aging workers, and women. The results demonstrate a need for further research on the adequacy of protection provided against the cold, particularly given that global warming will increase the contrast between cold workplaces and outdoor heat.

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Series: BMC public health
ISSN: 1471-2458
ISSN-E: 1471-2458
ISSN-L: 1471-2458
Volume: 20
Article number: 1357
DOI: 10.1186/s12889-020-09272-6
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Copyright information: © The Author(s). 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.