title: Risk factors for saddle-related skin lesions on elephants used in the tourism industry in Thailand.
abstract: BACKGROUND
  Lesions related to working conditions and improper saddle design are a concern for a variety of working animals including elephants. The objectives of the present study were to determine the prevalence of cutaneous lesions in anatomic regions (i.e., neck, girth, back, tail) in contact with saddle-related equipment among elephants in Thailand working in the tourism industry, and to identify potential risk factors associated with these lesions. Data for this cross-sectional study were collected between May 2007 and July 2007 on 194 elephants from 18 tourism camps across Thailand.
  
  
  RESULTS
  There was a high prevalence (64.4 %; 95 % CI 57.3 - 71.2) of active lesions, most often located on the back region. Using multilevel multivariable logistic regression modelling containing a random intercept for camp we identified the following risk factors: increasing elephant age, the use of rice sacks as padding material in contact with the skin, and the provision of a break for the elephants. Working hours had a quadratic relationship with the log odds of an active lesion where the probability of an active lesion initially increased with the number of working hours per day and then declined possibly reflecting a "healthy worker" bias where only animals without lesions continue to be able to work these longer hours.
  
  
  CONCLUSIONS
  While we recognize that the cross-sectional nature of the study posed some inferential limitations, our results offer several potential intervention points for the prevention of these lesions. Specifically, we recommend the following until longitudinal studies can be conducted: increased monitoring of older elephants and the back region of all elephants, working less than 6 hours per day, and the avoidance of rice sacks as padding material in contact with skin.
authors.affiliation: Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada. scarlett.magda@gmail.com.
authors.forename: Scarlett
authors.initials: S
authors.lastname: Magda
authors.affiliation: Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada. ospohn@uoguelph.ca.
authors.forename: Olivia
authors.initials: O
authors.lastname: Spohn
authors.affiliation: The National Elephant Institute, Hangchart, Lampang, Thailand. taweepoke@gmail.com.
authors.forename: Taweepoke
authors.initials: T
authors.lastname: Angkawanish
authors.affiliation: Department of Pathobiology, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada. dalesmit@uoguelph.ca.
authors.forename: Dale A
authors.initials: DA
authors.lastname: Smith
authors.affiliation: Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, ON, N1G 2W1, Canada. dpearl@uoguelph.ca.
authors.forename: David L
authors.initials: DL
authors.lastname: Pearl
mesh_terms: D000818:Animals; D004606:Elephants; D011998:Recreation; D012307:Risk Factors; D012867:Skin / Q000293:injuries* / Q000473:pathology; D013785:Thailand; D014947:Wounds and Injuries / Q000473:pathology / Q000662:veterinary