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.

"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.

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.

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.

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.

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.

Prevalence and Risk Factors of Work Related Upper Limb Disorders (WRULD) Among Female Telephone Operators in a Telecommunication Centre in Kuala Lumpur

A study was carried out on 79 female telephone operators working in a Telecommunication Centre in Kuala Lumpur to determine the prevalence of Work Related Upper Limb Disorders (WRULD) and its risk factors. Data collection for this study was done between December 2000 and May 2001. The presence of WRULD was determined based on a guided questionnaire and physical examination. The response rate for this study was 94.9% (n= 75) and results showed that the prevalence of WRULD among the female telephone operators was 48.0%: Stage 1= 38.9%, Stage 2= 19.4%, Stage 3= 38.9%, Stage 4= 0% and Stage 5= 2.8%. In the telecommunication centre, it was found that those with WRULD had a mean of 11.59±9.09 years of employment duration whereas those without WRULD had a mean of 9.89 ± 8.48 years of employment duration. None of the factors studied such as Body Mass Index, age, ethnicity, menstrual cycle, hormone replacement therapy, overtime work, duration of employment in the present unit and in the telecommunication centre differ in distribution between subjects with and without WRULD. This could be contributed by factors such as small number of subjects or the common healthy worker effect found in occupational health research. The findings studied of this study show that almost 40.0% of the workers experienced pain and neurological symptoms. Since none of the factors was found to be associated with WRULD, an elaborate study with a case-control design is needed in order to match cases and enable researchers to control the effect of confounding factors. This will ensure risk factors pertinent to WRULD in the Malaysian setting to be identified.

Serum selenium level and other risk factors for breast cancer among patients in a Malaysian hospital

<p><b>OBJECTIVE</b>The aim of this study is to investigate the association between breast cancer and serum selenium level as well as other risk factors for breast cancer.</p><p><b>METHODS</b>A matched case-control study was conducted in a hospital in Malaysia from July 2000 to January 2001 and from May 2001 to June 2001. Sixty-two newly diagnosed breast cancer patients were selected as the cases. Each control, selected from the same hospital population was matched to each case according to age, ethnic group, and menopausal status.</p><p><b>RESULTS</b>The mean selenium concentration among the cases was significantly lower than that among the control. There was a significant association (p<0.05) between breast cancer and low selenium serum level, nulliparity (OR=5.5,95% CI=1.22 to 24.81), exposure to cigarette smoke (OR=2.2, 95% CI=1.04 to 4.65) and use of oral contraceptives (OR=3.0, 95% CI=1.09 to 8.25) as determined by the McNemar test. Multivariate analysis showed that nulliparity (OR=10.08, 95% CI=1.48 to 68.52) and use of oral contraceptives (OR=3.66, 95% CI=1.36 to 9.87) were associated with increased breast cancer risk. An increased selenium concentration contributes to a reduced risk of breast cancer (OR=0.89, 95% CI=0.84 to 0.94).</p><p><b>CONCLUSION</b>The results suggest that use of oral contraceptive pills, being nulliparous, and a low serum selenium level are associated with breast cancer.</p>

Serum Selenium Level and Other Risk Factors for Breast Cancer among Patients in a Malaysian Hospital

Objective: The aim of this study is to investigate the association between breast cancer and serum selenium level as well as other risk factors for breast cancer. Methods: A matched case-control study was conducted in a hospital in Malaysia from July 2000 to January 2001 and from May 2001 to June 2001. Sixty-two newly diagnosed breast cancer patients were selected as the cases. Each control, selected from the same hospital population was matched to each case according to age, ethnic group, and menopausal status. Results: The mean selenium concentration among the cases was significantly lower than that among the control. There was a significant association (p<0.05) between breast cancer and low selenium serum level, nulliparity (OR=5.5, 95% CI=1.22 to 24.81), exposure to cigarette smoke (OR=2.2, 95% CI=1.04 to 4.65) and use of oral contraceptives (OR=3.0, 95% CI=1.09 to 8.25) as determined by the McNemar test. Multivariate analysis showed that nulliparity (OR=10.08, 95% CI=1.48 to 68.52) and use of oral contraceptives (OR=3.66, 95% CI=1.36 to 9.87) were associated with increased breast cancer risk. An increased selenium concentration contributes to a reduced risk of breast cancer (OR=0.89, 95% CI=0.84 to 0.94). Conclusion: The results suggest that use of oral contraceptive pills, being nulliparous, and a low serum selenium level are associated with breast cancer.