Assessment of Knowledge, Attitude and Practice on Occupational Safety and Health Among Laboratory Workers in OSHMS Certified and Non-Certified Public Universities in Malaysia

@#Introduction: The use of chemicals in teaching laboratories exposes students and laboratory staff to risk arising from hazardous chemicals. Accidents related to poor management and handling of chemicals have been reported in teaching laboratories. Good implementation of occupational safety and health (OSH) in organisation that has implemented OSH-Management System (OSH-MS) plays an important role in reducing accidents at the workplace. The aim of this study is to assess the level of knowledge, attitude and practice (KAP) related to the OSH aspect in chemical handling among workers in OSH-MS certified and non-certified public universities in Malaysia. Method: This is a cross-sectional survey involving laboratory workers in four public universities in Malaysia. A total of 120 laboratory staff were recruited and data on KAP was collected using self-administered questionnaires disseminated physically and via online platforms. Items in the questionnaire were adapted from previous studies and published guidelines. Data obtained were entered into statistical software for analysis. Results: About 76% of workers in certified universities have high knowledge, 94% have a positive attitude, and 88% have good practice in OSH. In non-certified universities, 70% have high knowledge, 97.1% have a positive attitude and 81.4% have good practice in OSH. Good practice level was significantly higher in certified universities. Knowledge, in general, was associated with younger age and higher education level while attitude was linked to gender. Conclusion: There were higher percentages of good OSH practice among laboratory workers in OSH-MS certified universities. Structured and systematic OSH governance can facilitate better OSH practice and implementation in certified public universities.

Physicians’ Attitude Towards Artificial Intelligence In Medicine, Their Expectations And Concerns: An Online Mobile Survey

@#The application of artificial intelligence (AI) is on the rise in the healthcare industry. However, the study on the physicians’ perspectives is still lacking. The study aimed to examine physicians’ attitudes, expectations, and concerns regarding the application of AI in medicine. A cross-sectional study was conducted in October 2019 among physicians in a tertiary teaching hospital in Malaysia. The survey used a validated questionnaire from the literature, which covered: (1) socio-demographic profile; (2) attitude towards the application of AI; (3) expected application in medicine; and (4) possible risks of using AI. Comparison of the mean score between the groups using a t-test or one-way analysis of variance (ANOVA). A total of 112 physicians participated in the study: 64.3% from the clinical departments; 35.7% from the non-clinical specialties. The physicians from non-clinical departments had significantly higher mean attitude score (mean = 14.94 ± 3.12) compared to the clinical (person-oriented) departments (mean = 14.13 ± 3.10) and clinical (technique-oriented) departments (mean = 13.06 ± 2.88) (p = 0.033). The tech-savvy participants had a significantly higher mean attitude score (mean = 14.72 ± 3.55) than the non–tech-savvy participants (mean = 13.21 ± 2.46) (p = 0.01). There are differences in the expectations among the respondents and some concerns exist especially on the legal aspect of AI application in medicine. Proper training and orientation should precede its implementation and must be appropriate to the physicians’ needs for its utilization and sustainability.

Effects of hydration practices on the severity of heatrelated illness among municipal workers during a heat wave phenomenon

@#Introduction: The continue rise in temperatures due to climate change increases the risk of heat-related illness (HRI) among outdoor workers. This study aims to evaluate the effects of hydration practices on the severity of HRI during a heat wave episode among municipal workers in Negeri Sembilan. Method: A cross-sectional study was performed in March and April 2016. The outdoor temperatures were measured using the wet-bulb globe temperature (WBGT) tool. The participants completed a self-administered questionnaire containing sociodemographic factors prior to work shift; while working profile, hydration practices, and HRI symptoms at the end of work shift. The hydration status of the respondents was assessed by direct observation of their urine colour. Multiple logistic regression was performed to ascertain the effects of age, working profile, hydration practice, history of previous HRI, and hydration status on the likelihood that outdoor workers having moderate to severe HRI. Results: A total of 320 respondents completed the questionnaire. The mean (standard deviation) outdoor workplace temperature was 30.5°C (SD 0.53°C). The percentage of respondents who experienced moderate to severe HRI was 44.1%. The likelihood that outdoor workers experienced moderate to severe HRI symptoms was associated with irregular fluid intake [odds ratio (OR): 16.11, 95% confidence interval (95%CI): 4.11; 63.20]; consumption of non-plain water (OR: 5.92, 95%CI: 2.79; 12.56); dehydration (OR: 3.32, 95%CI: 1.92; 5.74); and increasing outdoor workplace temperature (OR: 1.85, 95%CI: 1.09; 3.11). Conclusion: Irregular drinking pattern and non-plain fluid intake was found to have a large effect on HRI severity among outdoor workers exposed high temperatures during a heat wave phenomenon.

Comparisons Between Backs Questionnaire And Other Existing Questionnaires Against Standards Set By A Social Security Organization Based In A Developing Country

@#In a country that struggles on safety standards and relying heavily on manual labour, Malaysia over the decade had to be very objective in defining work- relatedness among musculoskeletal disorder cases especially chronic low back pain. The BACKS questionnaire was a proposed Back Apparatus; a Collaboration between National University of Malaysia Medical Centre (UKMMC) with Malaysian Social Security Organization (SOCSO) to assist in determining occupational chronic back pain. In the questionnaire, chronic back pain was defined as minimal cumulative back pain for more than 2 weeks in the past year, Pain Visual Analog Score above 2 cm and Oswestry Disability Index of above 20%. Based on the SOCSO registry from 2008 to 2010, 428 (56.3%) workers of 760 workers with back pain agreed and met the requirements of our study. According to the standards of the Medical Board, the BACKS Tool reported a sensitivity of 62.7%, specificity of 94.5%, positive- predictive value (PPV) of 92.9% and negative- predictive value (NPV) of 69.0% with moderate agreement as Kappa value was 0.56. The BACKS Tool served as a complementary assessment along with visits to the workplace that has its advantages when one would to conduct a self- administered assessment of their workplace by safety and health officers, organizations with limited funding.

Psychosocial stressors at work and well-being of male employees

@#Introduction: Psychosocial stressors appear to alter the state of mind and adoption of overeating behaviour, resulting in high body mass index. This study was conducted to determine the magnitude of psychosocial stressors on male employees' well-being. Method: This study used secondary data retrieved from a cross-sectional study involving 492 male employees' completed data. Eligible participants completed validated questionnaires of the Psychosocial Safety Climate (PSC-12) scale, short version Demand Induced Strain Compensation (DISQ 2.1), Oldenburg Burnout Inventory - Emotional Exhaustion domain and the Three Eating Factor Questionnaire (TEFQ) -Uncontrolled Eating domain; assessing psychosocial safety climate, job demands and job resources, emotional exhaustion, and uncontrolled eating behaviour, respectively. Body mass index (BMI) was calculated based on weight and height. The research statistical model was tested by two-steps of assessment replicating partial least squares structural equation modelling (PLS-SEM). Result: The results show that psychosocial stressors (psychosocial safety climate, job demands and job resources) had significant effects on emotional exhaustion (β= -0.149, p=0.004; β= 0.223, p<0.001; β= -0.127, p=0.013). Emotional exhaustion predicted by work stressors may act as a chain reaction which could result in uncontrolled eating (β=0.138, p=0.005) and high BMI (β=0.185, p<0.001). Emotional exhaustion does mediate the relationship between PSC and uncontrolled eating behaviour (β= -0.021 [95% boot CI bias corrected: -0.048, -0.002]). Conclusion: The psychosocial stressors at work are significant factors for emotional exhaustion, which further signifies the positive effect on uncontrolled eating behaviour and BMI among Malaysian male employees.

Backs Tool: A Study In Identifying Associated Factors Of Occupational Chronic Low Back Pain In A Developing Country

@#In the absence of objective definition of work- relatedness; decision- making processes, assessments, investigations, treatment and rehabilitation on chronic back pain due to work had been challenging. BACKS questionnaire was designed to assist physicians in determining occupational low back pain among employees from the aspect of reliability and validity. Each identified employee with history of chronic back pain was given chronic back pain was given the BACKS Tool prototype to be filled in. Data was analyzed via stepwise linear regression to develop a temporary model for the BACKS Tool questionnaire. A total 220 respondents were included in the study. Among the associated factors of chronic occupational back pain were physical demand, psychological demand, colleagues who complain of similar back pain, job task involved in twisting for more than 20o, age of the employees and Pain Score that was reported by the respective employees. The regression reported sensitivity of 90.9% and specificity of 95.5%. In search of determining work- relatedness among employees with occupational back pain versus those due to aging, a screening tool had to be developed to assist in providing scientific assessments that would improve employee satisfaction during educational promotion and counseling.

Thirst as the threshold symptom to prevent worsening heat-related illness

@#Introduction: The heat-related illness (HRI) is a continuum illness ranging from minor health effects to life-threatening medical emergencies when the pathological effects of heat load are not prevented. The aim of this study was to demonstrate the threshold HRI symptom for deciding to take simple preventative actions both by the individual workers and employers.

"A Systematic Review On Identifying Associated Factors In Deciding Work- Relatedness Of Chronic Back Pain Among Employee "

@#Chronic low back pain is a common and preventable complain amongworkers. Large amount of financial and benefit cost has been spent by the developed countries to prevent, treat and rehabilitate a large number of workers that are exposed to hazards attributing to low back pain. Efforts on primary prevention of low back pain has been challenging due to difficulties in affirming work-relatedness of chronic back pain among workers. As such, efforts have to be focused on the existing literatures to propose acceptable variables to define work-relatedness specific to occupational low back pain. Evidences suggest twisting, frequent manual lifting of objects, duration of daily exposure, coping mechanism towards the pain, body mass index (BMI), smoking status and physical activity are associated with occupational back pain. However, further research efforts are needed to establish stronger evidence and improve the occupational safety and health of our workers that are exposed to all these hazards throughout the day on a daily basis.

Development of Smart Fruit Basket for Pineapple Harvesting

Abstract@#Introduction: Pineapple harvesting work contributes to the reporting of musculoskeletal symptoms (MSS) and ergonomic risks. Pineapples are harvested manually in some parts of Malaysia using rattan baskets and workers are exposed to excessive bending, pain and discomfort. This intervention study developed and tested a prototype of an ergonomic harvesting basket to potentially reduce discomfort and physiological workload during a simulation of harvesting activity. Methods: The development and testing of improved harvesting basket was performed in laboratory and workshop. The improved basket had adjustable cushion straps, foam back pad and an opening for unloading of fruits. Harvesting was simulated using improved and existing basket by human subjects and questionnaires were used to assess discomfort. Physiological workload was assessed by heart rate and energy expenditure. Results: A total of 12 male respondents with average age of 22.4 (2.2) years participated in harvesting simulation. Discomfort as measured in Likert scale (mean (standard deviation) for improved basket 4.13 (6.1) vs existing basket 12.26 (11.2); p<0.05) was significantly reduced. Average heart rate (94.13 beats/min vs 89.05 beats/min) and energy expenditure (6 kJ/min vs 5 kJ/min) improved. Conclusion: The use of improved basket was linked to reduction of discomfort and overall workload. Improving design of agricultural manual tools may be able to improve health of workers and prevent MSS. Future fabrication of the improved basket using lightweight materials has potential to be expanded into plantation sectors not limited to pineapples in Malaysia and across Asia.

Psychometric properties of the Malay-translated General Practice Physical Activity Questionnaire among shipyard workers

Background: The General Practice Physical ActivityQuestionnaire (GPPAQ) is a validated and reliable screeningtool to measure the level of physical activity in adults.However, it has never been translated and validated inMalaysian population. This study aimed to translate theGPPAQ into Malay language and to evaluate thepsychometric properties of the Malay-translated GPPAQamong shipyard workers.Methods: The original English version of GPPAQ wastranslated forward and backward into Malay version byexperts. The final version of the Malay-translated GPPAQwas then tested for validity and reliability. A cross-sectionalstudy design was performed and systematic randomsampling was used to select respondents. Construct validityand internal consistency of the Malay-translated versionwere tested using exploratory factor analysis andCronbach’s alpha respectively.Results: Sixty-two male shipyard workers participated inthis study. The GPPAQ showed good factor loading valuesfor all items (0.608-0.834). The exploratory principalcomponent factor analysis delineates all seven items intotwo factors with variance of 41.65%. The Cronbach’s alphavalue was good with 0.81, 0.84 and 0.76 for total scale, factor1 and factor 2 respectively.Conclusion: The Malay-translated version of GPPAQ hashigh psychometric properties. Therefore, it is a validinstrument to assess physical activity among Malaysianworking population, particularly in male shipyard workers.

Cardiovascular risk assessment between urban and rural population in Malaysia

Introduction: Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. Methods: This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Results: Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Conclusion: Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.

A tale of two construct validation analysis: Rasch model and exploratory factor analysis approach for Three-Factor Eating Questionnaire (TFEQ-R21) among Malaysian male workers

SUMMARY Introduction: This study aims for construct validation using two approaches, i.e., exploratory factor analysis and Rasch Model. Methods: A cross sectional of 313 male workers from multiple worksites had completed self-administered Malay translated version of Three-Factor Eating QuestionnaireR21. Data quality was assessed by misfit person criteria, dimensionality, summary statistic, item measure and rating (partial credit) scale followed by exploratory factor analysis and internal consistency reliability assessment. Results: The dual approaches of construct validation analysis were complement to each other. Rasch analysis supported the theoretical constructs of three eating behaviour dimensions among respondents. In contrary to exploratory factor analysis, it did show presence of a newfound factor (α=0.04) came up from the separation of the cognitive restrain and uncontrolled eating however, the correlation between the two respective sub-factors were fair (r=0.39) and weak (r= -0.08). Both analyses had detected three problematic items but those items were psychometrically fit for used for current study setting. The data had adequate psychometric properties. Cronbach’s alpha for cognitive restraint, uncontrolled eating and emotional eating were 0.66, 0.79 and 0.87 respectively. Rating scale quality was conformed to standard criteria. Conclusion: Malay version TFEQ-R21 with promising psychometric properties and valid measures for eating behaviour dimensions among male workers aged between 20 to 60 years old is now available. Further development should focus on the items in relation to Malaysian cultural adaptation before its use for daily practice in future setting.

The Malay Version of the Perceived Stress Scale (PSS)-10 is a Reliable and Valid Measure for Stress among Nurses in Malaysia

Background: The Perceived Stress Scale-10 (PSS-10) is widely used to assess stress perception. The aim of this study was to translate the original PSS-10 into Malay and assess the reliability and validity of the Malay version among nurses. Methods: The Malay version of the PSS-10 was distributed among 229 nurses from four government hospitals in Selangor State. Test-retest reliability and concurrent validity was conducted with 25 nurses with the Malay version of the Depression Anxiety Stress Scales (DASS) 21. Cronbach’s alpha, confirmatory factor analysis (CFA), intraclass correlation coefficient and Pearson’s r correlation coefficient were used to determine the psychometric properties of the Malay PSS-10. Results: Two factor components were yielded through exploratory factor analysis with eigenvalues of 3.37 and 2.10, respectively. Both of the factors accounted for 54.6% of the variance. CFA yielded a two-factor structure with satisfactory goodness-of-fit indices [x2/df = 2.43; comparative fit index (CFI) = 0.92, goodness-of-fit Index (GFI) = 0.94; standardised root mean square residual (SRMR) = 0.07 and root mean square error of approximation (RMSEA) = 0.08 (90% CI = 0.07–0.09)]. The Cronbach’s alpha coefficient for the total items was 0.63 (0.82 for factor 1 and 0.72 for factor 2). The intraclass correlation coefficient (ICC) was 0.81 (95% CI: 0.62–0.91) for test-retest reliability testing after seven days. The total score and the negative component of the PSS-10 correlated significantly with the stress component of the DASS-21: (r = 0.61, P < 0.001) and (r = 0.56, P < 0.004), respectively. Conclusion: The Malay version of the PSS-10 demonstrated a satisfactory level of validity and reliability to assess stress perception. Therefore, this questionnaire is valid in assessing stress perception among nurses in Malaysia.

Integrated Care Pathway (Icp) On Management Of Occupational Related Chronic Low Back Pain (Oclbp) In Malaysia: A Critical Review

Occupational Related Chronic Low Back Pain (OCLBP) is a globally recognized illness that causes reduction in productivity and substantial economic burden to the countries. It requires a multidisclipinary approach involving employer, healthcare provider, compensatory and enforcement agencies. However there is no specific guideline or pathway that has integrated the roles of each responsible agency. The objective of this article is to highlight the need and to propose a coordinated approach through the concept of Integrated Care Pathway (ICP). Therefore, we reviewed international and local guidelines as well as published articles on chronic low back pain and care pathway. We believed that development of a pathway will be able to organize the role of management at every level, reducing the variations in the management, addressing issues of communicating the findings between the responsible stakeholders, fulfilling the requirements as the laws, allows effective and feasible approaches to take place in terms of cost and practicality, and increase the awareness on occupational diseases. Expected challenges such as limitation of resources, unawareness and lack of understanding on OCLBP from every level are issue that we agreed can be bridged through ICP.

Validity and Reliability of Malay Version Physical Activity (BPA) Questionnaire among Nurses

Physical activity reduces risk of non-communicable diseases. Physical activity prevalence is low due to barriers to physical activity. This study was conducted to translate the Barrier to Physical Activity (BPA) questionnaire into Malay and assess the reliability and validity of the translated version among nurses. The Malay version of BPA was developed after translating the English version of BPA through back to back translation process. The Malay BPA was distributed among 306 volunteered nurses from 5 government hospitals in Selangor state. Factor analysis, Cronbach’s alpha test and test – retest reliability was conducted to determine psychometric properties of BPA. Chronbach’s alpha coefficient was 0.79 for perceived benefits items and 0.51 for perceived barrier items (overall was 0.73). The ICC was 0.88 (95% CI: 0.78-0.93) for test-retest testing after 7 days. Two factors components were yielded through exploratory factor analysis with eigenvalues of 3.9 and 2.0 respectively. Both the factors accounts for 31.4 % of the variance. Factor 1 included 14 items and explained 19.9% of the variance. Factor 2 consisted of 5 items and explained 11.5% of variance. CFA yielded two factor structures with acceptable goodness of fit indices [x2/df = 23.99; GFI = 0.82, SRMR = 0.09; PNFI = 0.49 and RMSEA = 0.10 (90%CI = 0.09-0.11)]. The Malay version of BPA had demonstrated satisfactory level of validity and reliability to assess barriers to physical activity. Therefore, this questionnaire is valid in assessing barriers to physical activity among working population.​

Challenges In Determining Occupational Related Chronic Low Back Pain Among Employees: A Review Of The Literature

Chronic low back pain is a common preventable occupational health illness affecting most workers. Large amount of financial and benefit cost had been spent by the developed countries to prevent, treat and rehabilitate a large number of workers who are exposed to hazards that are attributed to low back pain. Efforts on primary prevention of low back pain had been challenging due to difficulties in affirming work- relatedness of chronic back pain among workers. As such, efforts have to be focused on existing literatures to propose acceptable variables to develop the definition of work- relatedness specific to chronic low back pain. Such identified variables or factors could be used to develop a set of criteria in defining work- related chronic back pain. Literature search using specific work- related and chronic low back pain key words were used. Comparable articles were judged and a summarized result was obtained. These variables could be grouped into individual characteristics, health behaviours, physical conditions at work, work organizations and ergonomic factors. With proper methodology and statistical analysis, tools could be developed to aid physicians in determining work- related chronic low back pain among employees.

Respiratory Symptoms And Pulmonary Function Among Male Steel Workers In Terengganu, Malaysia

A cross sectional study was carried out to determine the relationship between dust exposure and pulmonary function in male steel workers in Terengganu, Malaysia. The investigation included spirometric testing and detailed personal interviews using a structured questionnaire adopted from British Medical Research Council (BRMC) Questionnaire on respiratory symptoms. Respiratory symptoms commonly reported by the male workers were morning phlegm (33.1%), shortness of breath (31.9%), chest tightness (30.4%), and morning cough (17.8%). Age and duration of employment were among the factors associated with respiratory symptoms (p<0.05 and p<0.001 respectively). Forced Expiratory Volume in 1 second (FEV1) was significantly reduced when compared to the healthy population. There was a significant decrease of FEV1 between before and after work shift (t= 3.582, p<0.001). Smoking status, age, and duration of employment were also associated with reduction of pulmonary function (p<0.01).

Occupational Stress Among White Collar Employees In Esfahan Steel Company, Iran

Occupational stress is one of the major health hazards among blue and white-collar workers. However there is no data on occupational stress among white-collar workers in Iran. Aim of this study was to investigate occupational stress among white collar employees in Esfahan Steel Company organization (ESCO), Iran. A cross– sectional survey was conducted through face to face interview using validated standardized questionnaire on occupational stress among 200 white-collar workers from ESCO who agreed to participate in the study, the response rate of participation was 100%. The logistic regression test was used to determine significant associated factors of occupational stress among the study sample.. It is found that among the six items measuring source of stress, the highest source of stress related to economic problem, 117 (59.7%). The statistical analysis showed sources of stress such as task type (p=0.0001), economic problem (p=0.0001), work environment (p=0.0001) and children problem (p=0.05) were significantly associated with having stress among the workers. We found that around half of the white collar workers were under stress at ESCO. Main sources of the occupational stress of white colour workers related to their work environment, economic problem; task type, and related their children.

Occupational stress among male employees of Esfahan steel company, Iran: prevalence and associated factors

Lack of data on occupational stress among Iranian industrial employees persuaded us to design and conduct this study to evaluate the prevalence and associated parameters of occupational stress among the male employees of Esfahan Steel Company, one of the biggest industrial units in Iran. In this cross-sectional study, 400 male employees were sampled from the operational divisions of the company. Socio-demographic data and stress-related variables were entered into a logistic regression to determine the significant associated factors of occupational stress among the participants. Of all the samples, 53% were found as stressful. A monthly salary of less than $600 [odds ratio [OR] = 1.88, 95% confidence interval [CI] = 1.21-2.94], family-related problems [OR = 2.75, 95% CI = 1.22-6.21], work environment [OR = 3.09, 95% CI = 1.78-5.33], and having a second job [OR = 2.68, 95% CI = 1.78-6.78] were significantly associated with the outcome. Attention to some variables, especially economic problems and the work environment of employees, might play a protective role against the prevalence of occupational stress, not only among the employees of ESCO, but also among all industrial employees in Iran

[Analysis of occupational stress and the related issues among employees of Esfahan steel company [ESCO], Iran [2009]]

Background and aims: Occupational stress is defined as the harmful physical and emotional response that occurs when the requirements of the job do not match the capabilities, resources, or needs of the worker. Occupational stress may bring about economic and health problems. This study was conducted to determine the factors that contribute to occupational stress of the employees of ESCO [Iran]

Methods: This descriptive-analytical study was conducted on 400 ESCO employees. Data were collected using demographic and DASS questionnaire and then were analyzed using Chi statistical test and logistic regression analyzation

Results: The prevalence of stress was 53%. There was no significant relationship between stress and age, marital status, experience, literacy and shift work. However, high significant relationship was found between income and stress. It is apparent that financial problems were the most common reasons for stress among the employees and the main contributors to stress were work environment, task type, financial problems and the income below 5000000 rials [P<0.05]

Conclusion: Based on the results of this study, about half of the ESCO employees suffer from stress compared with other industrialized countries, Iranian employees appeared to have much higher prevalence of stress. This result calls for appropriate planning of the workplace and condition to improve the quality of life and reduce stress