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.
Highlights
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]
We calculated the medical costs of treating job-related injuries and illnesses among informal sector agricultural workers covered by the Universal Health Coverage Scheme (UHCS) system. (We report all costs in United States (US) dollars.) We estimate the expenditures shifted to the UHCS system, so that policy makers can consider re-allocation of funds from medical treatment to occupational injury and illness (OII) prevention programs
Animal producers suffer more expensive injuries compared to other farmers, largely from handling livestock. If their medical costs were not absorbed by the UCHS, they would have had to spend an average of 7% of their annual income for medical treatment of OIIs. This is the first report on the number and medical treatment costs of occupational injuries and illnesses in the Thai agricultural sector
Summary
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. 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 face safety hazards due to the use of hand tools, poorly guarded machinery, repetitive and awkward postures, and inadequate use of personal protective equipment. Farmers often seek medical treatment at local primary healthcare units (PCUs), called health-promoting hospitals, or at district or provincial hospitals for more intensive levels of care
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