Fitness to Work Assessment for Working in Confined Space: A Study in Occupational Medicine Clinic, Tertiary Hospital, Nakhon Ratchasima Province

Abstract

This study was a descriptive retrospective study. The objectives are to describe the proportion of workers who have health conditions that fit to work in confined space and to characterize the health conditions of workers classified as either unfit or fit with restrictions for confined space work. The data were collected by reviewing the patient’s medical records from 1^st January 2020 to 31^st December 2022 at the occupational medicine clinic in tertiary hospital, Nakhon Ratchasima Province. Using secondary data from records, including general information, work characteristics, physical examination, laboratory data, and analyzing the data with descriptive statistics. The study consisted of 50 workers with a median age of 33 years. 96.00 % of confined space workers were male and 10.00 % had underlying disease. The majority of tasks involved entry into water tanks using clawing methods, with 78.00 % of the work processes involving metal welding and activities that could potentially produce ignition. All workers worked under safety measures including safety training, warning signal, entrance – exit supervisor and the use of personal protective equipment. Air-purifying masks were used, with half-face masks for 38.00 % and full-face masks for 2.00 %.  The result revealed that the proportion of workers with health conditions deemed fit and unfit for confined space work was 74.00 and 26.00 %, respectively. Unfit conditions were attributed to various factors, including hypertension 12 %, abnormal visual acuity 8.00 %, BMI ≥ 35 kg/m² 2.00 %, abnormal EKG with symptoms 2.00 %, and abnormal spirometry 2.00 %. Some medical conditions are treatable; therefore, workers should undergo reassessment after appropriate management. Workers with abnormal EKG results should be referred to a cardiologist for further assessment. Minor abnormalities in other body systems might not necessarily preclude individuals from working in confined spaces.