title: Lack of safety systems in agricultural settings in rural Thailand: a report of three worker death.
abstract: BACKGROUND
  Three farm workers lost consciousness within a few minutes after entering a silo pit on a farm located in a rural Thai village. All victims died later in the hospital.
  
  
  OBJECTIVE
  To identify the cause of unconsciousness in these victims and to determine safety systems for agricultural enterprises containing silos.
  
  
  METHODS
  Medical records of the three decedents were reviewed for demographic characteristics, clinical manifestations, and the cause of deaths. Co-workers of the decedents were interviewed to obtain details of the victims' work on the farm during the incident. Concentrations of oxygen and other potentially hazardous gases were measured in the pit where the victims collapsed. All agricultural enterprises that have silos in the district were identified and investigated for safety systems.
  
  
  RESULTS
  Of the three decedents, two died in a rescue attempt. They all developed metabolic acidosis and died 1-3 days following admission. Oxygen concentration at the top of the pit was 20.9% and decreased to 0.8% at a depth of 1 meter and to 0.0% at the bottom of the three-meter pit. Carbon dioxide, which is heavier than air, was the major asphyxiant displacing oxygen in this confined space. Lack of safety systems were detected on this farm and in all settings containing silos in the district.
  
  
  CONCLUSIONS
  Asphyxiation due to oxygen depletion was the cause of all deaths. It is essential to install safety systems for work in confined spaces in agricultural settings.
authors.affiliation: Department of Community and Social Medicine, Mae Sot General Hospital, Tak, Thailand. swaddi@hotmail.com
authors.forename: Witaya
authors.initials: W
authors.lastname: Swaddiwudhipong
authors.forename: Pranee
authors.initials: P
authors.lastname: Mahasakpan
authors.forename: Winai
authors.initials: W
authors.lastname: Thongchub
authors.forename: Thippawan
authors.initials: T
authors.lastname: Funkhiew
authors.forename: Settha
authors.initials: S
authors.lastname: Suthapreeda
mesh_terms: D000062:Accidents, Occupational; D000383:Agriculture; D001237:Asphyxia / Q000209:etiology*; D002423:Cause of Death; D020378:Confined Spaces; D017809:Fatal Outcome; D006801:Humans; D008297:Male; D016273:Occupational Exposure; D012424:Rural Population; D012449:Safety; D013785:Thailand