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Background: Type 2 diabetes mellitus (T2DM) is increasingly prevalent in countries undergoing rapid development, including Thailand. We assessed T2DM incidence over an 8-year period in a nationwide cohort of Thai adults.Methods: Thai Cohort Study participants were surveyed in 2005, 2009 and 2013. The analysed cohort members were aged (15–88), did not have diabetes in 2005 and were followed up by questionnaire in 2013 (n=39 507). T2DM was ascertained using self-report, which has been validated using physician interviews. We calculated the 8-year cumulative incidence of T2DM. Multivariable logistic regression assessed associations between potential risk factors and T2DM incidence.Results: 8-year cumulative incidence of T2DM (2005 to 2013) was 177 per 10 000 (95% CI 164 to 190). Crude and age-standardised cumulative incidences of T2DM by sex were 249 per 10 000 (95% CI 226 to 272) and 222 per 10 000 (95% CI 219 to 225) for men; and 119 per 10 000 (95% CI 105 to 133) and 96 per 10 000 (95% CI 94 to 98) for women, respectively. T2DM increased significantly for both sexes with increasing age and body mass index (BMI) (p trend Conclusions: This study found that the sociodemographic and lifestyle changes that have accompanied Thailand's economic development are associated with T2DM risk in a large cohort of Thai adults. Our findings highlight the need to address these transitions to prevent a further increase in the national incidence of T2DM, particularly among Thai men.

Background Height trends can be useful indicators of population health but, despite Thailand9s rapid socioeconomic development since the 1950s, few studies have examined accompanying secular changes in adult height or the effects of the transition on the heights of rural versus urban populations. This study therefore sought to document average heights in different age groups of rural and urban Thais and to investigate factors associated with attained height. Methods Data from 86 105 Thai Cohort Study participants was used to estimate mean heights for men and women in different birth year groups. Simple regression was used to calculate the change in height per decade of birth year among those based in rural or urban locations as children. Multiple linear regression was used to investigate effects of other childhood factors on height. Results Overall, average heights were found to have increased by approximately 1 cm per decade in those born between 1940 and 1990. However, the rate of increase was 0.4–0.5 cm per decade greater among urban-based Thais compared with those from the countryside. Parental education levels, household assets, birth size, sibling number, birth rank and region of residence were also significantly associated with adult height. Conclusions These data suggest a marked secular increase in Thai heights in the second half of the 20th century probably reflecting improved childhood health and nutrition over this time. Rural-born Thais, who benefited to a lesser extent from the changes, may face future health challenges with greater risks of, among other things, obesity and its health consequences.

Objectives: To explore individual determinants of workplace injury among Thai workers. Design: Cross-sectional analysis of a large national cohort. Setting: Thailand. Participants: Thai Cohort Study participants who responded to the 2009 follow-up survey were included if they reported doing paid work or being selfemployed (n=51 751). Outcome measures: Self-reported injury incidence over the past 12 months was calculated. Multivariate logistic regression models were used to test associations between individual determinants and self-reported workplace injury. Results: Workplace injuries were reported by 1317 study participants (2.5%); the incidence was 34 (95% CI 32 to 36)/1000 worker-years for men, and 18 (17– 20) for women. Among men working ≥41 h and earning

Objectives To provide estimates of fracture incidence among young adults in Thailand. Design Cross-sectional analysis of a large national cohort. Setting Thailand. Participants A total of 60 569 study participants residing nationwide responded to the 2009 follow-up survey; 55% were women and median age was 34 years (range 19–92). Outcome measures Self-reported lifetime fractures, along with age at fracture. Fracture incidence rates per person-year were then compared using lifetime fracture reports, and again selecting only fractures reported for the last year. Incidence rates were compared by age and sex. Results 18 010 lifetime fractures were reported; 11 645(65%) by men. Lifetime fracture prevalence was 30% for men and 15% for women. Lifetime incidence per 10 000 person-years was 83; analysing only fractures from the last year yielded a corresponding incidence rate of 187. For ages 21–30, fractures per 10 000 person-years were more common among men than women (283 (95% CI 244 to 326) and 150 (130 to 173), respectively); with increasing age, rates decreased among men and increased among women (for ages 51–60, 97 (58 to 151) and 286 (189 to 417), respectively). Conclusions Large-scale surveys provide a feasible method for establishing relative fracture incidence among informative subgroups in a population. Limiting analyses to fractures reported to have occurred recently minimises bias due to poor recall. The pattern of self-reported fracture incidence among Thais aged 20–60 was similar to that reported for Western countries: high falling rates in young men and high rising rates in older women.

Objective To investigate the relationship between short sleep and obesity among Thai adults. Design Both 4-year longitudinal and cross-sectional analyses of a large national cohort. Setting Thai adults residing nationwide from 2005 to 2009. Participants Cohort members were enrolled as distance learners at Sukhothai Thammathirat Open University (N=87 134 in 2005 and 60 569 at 2009 follow-up). At 2005 baseline, 95% were between 20 and 49 years of age. Measures Self-reported sleep duration was categorised as, Article summary Article focus The association between sleep duration and obesity for adults is controversial and has rarely been examined in middle-income countries. The evidence for a short sleep–obesity effect in adults is mostly based on cross-sectional data. This study examines both cross-sectional and longitudinal evidence linking short sleep and obesity among a large national cohort of Thai adults. Key messages Our cohort study revealed a consistent and substantial association between short sleep and obesity among Thai adults. The ORs connecting short sleep to obesity were substantial and significant: 1.36 for men and 1.49 for women in 2009; corresponding ORs were similar in 2005. Longitudinal 2004–2009 cohort data confirmed a significant short sleep–weight gain relationship with a notable dose–response. Strengths and limitations of this study The strength of this study was the large sample, longitudinal data, involvement of young adults and the opportunity to control for many covariates in the analyses. One limitation was the subjective nature of self-reporting sleep duration, a problem noted by many others conducting sleep research.

To date, over 300 million people worldwide live with low vision and blindness, imposing social and economic burdens on individual and families. Data derived from a cohort of 87,134 Thai adults. We report Odds Ratios (ORs) from logistic regression and derive Population Attributable Fractions (PAFs). Approximately 28% of the cohort members reported refractive errors and 8% had uncorrectable vision impairment. Awareness of refractive errors was associated with higher income and urban residence. Both types of vision impairment were positively associated with poor self-assessed health (adjusted ORs 1.23 to 2.03) and poor psychological health (adjusted ORs 1.13 to 1.63). PAFs show that correctable and uncorrectable vision impairments explain respectively 6.1% and 7.5% of poor self-assessed health, 3.5% and 4.7% of poor psychological health, and 2.2% and 3.1% of falls in the last year. Incorporating early detection and prevention at the primary healthcare level will help to promote the health of Thais.

Objectives To determine the baseline frequency and distribution of transport injury and prevalence of road safety behaviours in an ongoing cohort study of Thai adults. Methods The Thai Health-Risk Transition Study includes an ongoing cohort study of 87 134 adult Open University students residing across Thailand. The baseline survey data collected in 2005 includes information on self-reported transport injury within the previous 12 months and demographic, behavioural and transportation factors that could be linked to Thailand9s transport risks. Findings Overall, 7279 (8.4%) of respondents reported experiencing a transport related injury in the previous 12 months, with risk being higher for males and those aged 15–19 years. Most of the injuries occurred while using motorcycles. Approximately half of the male drivers reported driving after three or more glasses of alcohol at least once in the previous year, compared to 10% of female drivers. The prevalence of motorcycle helmet wearing and seat belt wearing were higher than previously reported for Thailand, however there is still much room for improvement. Conclusions We found much higher rates of transport injury than previously estimated and revealed valuable information about the prevalence of various road safety behaviours. Our ongoing study provides an opportunity to monitor these risks and behaviours in the context of future road safety programs. These data make a valuable contribution to the available evidence from which Thai authorities can draw on to address transport injury, one of the major causes of individual and social burden of health.