Estimating of the costs of nonfatal occupational injuries and illnesses in agricultural works in Thailand
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Estimating of the costs of nonfatal occupational injuries and illnesses in agricultural works in Thailand Densak Yogyorn1 · Craig Slatin2 · Somkiat Siriruttanapruk3 · Susan Woskie2 · Thanawadee Chantian3 · Pusanisa Chaladlerd3 · Pornpimol Kongtip1
© The Author(s) 2020
Abstract Thailand lacks occupational injury and illness (OII) surveillance for its agricultural sector, a sector that comprises 34% of the total Thai workforce but is not covered by the workers compensation system. This study used data from Thailand’s Universal Health Care System to estimate the medical costs of OIIs from agricultural work in Thailand. In 2017, OII medical costs totaled $47 million (USD), about ~ 0.2% of the gross domestic product produced by the Thai agricultural sector. We recommend that some of the national funds currently used for medical treatment of OIIs be used instead to develop and implement prevention programs in agriculture. This would improve not only worker health and safety, but also productivity. Availability of data on working conditions, injuries and illnesses, and especially lost time, lost income and productivity, and OII-related costs for the workers and their dependents might enable better public health policy formulation. Keywords Agricultural · Occupational injury and illness (OII) · Costs
Introduction In recent years, the importance of Thailand’s agricultural sector to the national GDP has declined from 10.5% in 2014 to 8.6% in 2018 [1]. Agriculture remains part of Thailand’s economic growth, having expanded by 5.0% in 2018, and employing over 13 million workers (34%) [2] in 2018. These agricultural workers constitute 40% of those below the poverty line (~ $3 per day) in Thailand [3]. * Densak Yogyorn [email protected] 1
Department of Occupational Health and Safety, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
2
Department of Public Health, University of Massachusetts Lowell, Lowell, MA, USA
3
Bureau of Occupational and Environmental Disease, Ministry of Public Health, Nonthaburi, Thailand
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Thailand’s Labor Protection Act covers workers in the private sector but does not apply to informal sector agricultural workers [4]. Agricultural workers are exposed to physical hazards such as heat stress due to the equatorial climate, biological hazards such as insect-borne diseases and parasites, chemical hazards such as pesticides and herbicides [5]. They also face safety hazards due to the use of hand tools, poorly guarded machinery, repetitive and awkward postures, and inadequate use of personal protective equipment. These common hazards, present in the many and frequent agricultural tasks, put farmers at risk of occupational injuries and illnesses [6]. Farmers often seek medical treatment at local primary healthcare units (PCUs), also called health-promoting hospitals, or at district or provincial hospitals for more intensive levels of care. Thailand’s Universal Health Coverage Scheme (UHCS) is a tax-financed scheme that provides free
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