Overactive bladder (OAB) is a prevalent condition known to significantly impact individuals' quality of life and work productivity. This study investigates the prevalence and risk factors of OAB among military healthcare workers in a tertiary hospital in Thailand, with a focus on understanding prevalence, risk factor and its implications for workplace productivity.

A cross-sectional observational study was conducted among military healthcare workers undergoing annual health checks in 2023 at the tertiary hospital. The prevalence of OAB was assessed using the validated Thai version of the Overactive Bladder Symptoms Score (OABSS-T) (Bunyavejchevin S, et. al., 2015), and a questionnaire identified potential risk factors. Participants with abnormal urine analysis results (RBC ≥ 3/hpf and/or WBC ≥ 3/hpf) were excluded from the analysis. For the expected prevalence of 15.8% (Chuang YC, et. al., 2019), the required sample size was 632 for the margin of error or absolute precision of ±3% in estimating the prevalence with 95% confidence and considering the potential loss/attrition of 10%. With this sample size, the anticipated 95% CI was (12.8%, 18.8%). This sample size is calculated using the Scalex SP calculator (Naing L, et. al., 2022).

Among 923 participants, the overall prevalence of OAB was 15.8%, with no significant difference between male and female. Dry-OAB and wet-OAB were identified in 7.1% and 8.7% of cases, respectively. Individuals with OAB reported significantly higher discomfort related to bladder symptoms compared to those without OAB, as evidenced by elevated scores on the Likert scale questionnaire (2.44 ± 1.18 vs. 1.29 ± 0.61; p < 0.001). Moreover, within the OAB group, participants reported fewer work hours per week compared to those without OAB (46.85 ± 14.58 vs. 51.51 ± 22.75 hours/week; p = 0.017). Multivariate analysis revealed that risk factors for OAB included BMI ≥ 25 (OR 3.10; 95% CI 1.52-6.32; p = 0.002), education below a bachelor's degree (OR 1.67; CI 1.02-2.76; p = 0.043), prolonged sedentary work (>60% of total time) (OR 2.25; CI 1.39-3.64; p < 0.001), work affects restroom accessibility (OR 2.45; CI 1.48-4.05; p < 0.001), history of urinary tract infection (OR 2.13; CI 1.30-3.48; p = 0.003), and active smoking (OR 2.65; CI 1.11-6.32; p = 0.028). Conversely, consuming coffee was identified as a protective factor (OR 0.53; CI 0.33-0.86; p = 0.01).

The overall prevalence of OAB in the study population was 15.8%. This indicates that OAB affected around 1 in 6 participants. There was no significant difference in OAB prevalence between males and females. Both sexes were equally affected. Dry-OAB affected 7.1% while wet-OAB affected 8.7%. Wet-OAB was slightly more common. Those with OAB reported significantly higher bladder discomfort and symptoms compared to those without OAB, based on a Likert symptom scale. Within the OAB group, participants worked fewer hours per week versus those without OAB (mean differentiated 4.66 ± 1.95 hours/week; p =0.017). This suggests OAB may impact work productivity. Identified risk factors for OAB were high BMI, lower education, prolonged sitting at work, work environment limits restroom access, history of UTI, and smoking. Unexpectedly, coffee consumption was protective against OAB, contrasting some prior studies. Further research on coffee ingredients and dosing in OAB would be informative. Limitation of this study were single center, cross-sectional study, may note be generalizable to other populations and settings. And the self-report data on symptoms and risk factors could be subject to recall or reporting bias.

In conclusion, this study revealed a moderately high prevalence of OAB among healthcare workers in Thailand, with associated reductions in work hours per week, potentially due to disruption from their OAB symptoms. Modifiable risk factors like high BMI, prolonged sitting, limited restroom access, smoking, and UTI history were identified that could be targeted through workplace interventions to reduce OAB burden. Interestingly, coffee consumption was associated with lower OAB prevalence, warranting further study. Attention to modifiable OAB risk factors and ensuring prompt diagnosis and treatment may help reduce symptom burden and improve quality of life and work capacity in this population of military healthcare workers in Thailand.

Bunyavejchevin S. Reliability of Thai-version Overactive Bladder Symptom Scores (OABSS) questionnaire and the correlations of OABSS with voiding diary, International Prostate Symptom Score (IPSS), and Patient Perception of Bladder Condition (PPBC) questionnaires. J Med Assoc Thail Chotmaihet Thangphaet 2015;98:1064–74.
Chuang YC, Liu SP, Lee KS, et al. Prevalence of overactive bladder in China, Taiwan and South Korea: Results from a cross-sectional, population-based study. Low Urin Tract Symptoms. 2019;11(1):48-55. doi:10.1111/luts.12193
Naing, L., Nordin, R.B., Abdul Rahman, H. et al. Sample size calculation for prevalence studies using Scalex and ScalaR calculators. BMC Med Res Methodol 22, 209 (2022). https://doi.org/10.1186/s12874-022-01694-7