Risk Factors of Unfavourable TB Treatment Outcomes in Hulu Langat, Selangor

@#Introduction: Over the last decade, tuberculosis (TB) has remained the main cause of death from communicable diseases in Malaysia. This study was aimed to determine the risk factors of unfavourable treatment outcomes (UTO) among new TB cases in Hulu Langat. Methods: A cohort study was prospectively conducted among the new TB cases registered in the government health clinics of Hulu Langat district. The event was defined as any one of the UTO (default, transferred out, treatment failure and death) whichever came first. This data was analysed using SPSS version 25.0. Survival pattern was assessed by Kaplan-Meier plots and Log rank test. Hazard ratios of unfavourable TB treatment outcomes among the new TB cases at 95% confidence interval and level of significance set at 0.05 were calculated using Cox proportional hazard model. Results: Of the 321 patients analysed, 80.4% (n=258) had favourable treatment outcomes and 19.6% (n=63) had UTO with 10.9% (n=35) transferred out, 6.9% (n=22) defaulted and 1.9% (n=6) died. There was no treatment failure. The mean survival time was 5.2 (SD=0.09) months. The risk factors of hazard probability of UTO were male, ethnicity type Others, positive human immunodeficiency virus (HIV) status and not done sputum at 2 months of treatment. Conclusion: Transferred out and default formed the bulk of the UTO in Hulu Langat. New interventions to improve the existing TB prevention and control program should be planned in the first three months of treatment.

Dermal Exposure to Pesticides among Sprayers in Different Agriculture Subsectors in Malaysia: Observational Method using DREAM

Abstract@#Introduction: An assessment of dermal exposure to pesticide mixtures among sprayers was made as a function of crop type, in four agricultural subsectors in Malaysia. Methods: The potential and actual dermal exposures for 160 pesticide sprayers performing pesticide spraying task were estimated by using Dermal Exposure Assessment Method (DREAM). Results: Results showed that there was significant difference between nationality (p<0.001), highest education (p<0.001), monthly income (p=0.002), body mass index (p<0.001) and smoking habit (p<0.001) distributions of sprayers in different agriculture subsectors. Various types of pesticides were used by respondents, where class II (moderately hazardous) and class III (slightly hazardous) pesticides were the most frequently used pesticides. There was a significant difference in both tPDE (χ2 = 118.093, p<0.001) and tADE (χ2 = 84.980, p<0.001) between different agricultural sectors, where the prominent high tPDE was observed among paddy pesticide sprayers (151.39 ± 22.64 DU) while lowest exposure was recorded among oil palm plantation sprayers (47.67 ± 18.47 DU). Conclusion: Based on DREAM exposure categories, majority of the pesticide sprayers (68.9%) working in paddy farming were exposed in low dermal exposure while 26.7% of respondents were exposed to moderate exposure. Pesticide sprayers in other agriculture sectors were exposed to very low to low exposure level. Dermal exposure distributions on body parts were varied between sectors, influenced by several factors such as crop type, height, and spraying methods.

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.

Factors of Job Satisfaction among Workers Exposed to Occupational Noise

Abstract@#Introduction: Noise was evident to reduce job satisfaction among workers which will negative impacts to workers including increase job turnover, decrease motivation and increased number of accidents. This study aims to explore job satisfaction and its risk factors among workers working in a noisy workplace. Method: The study design was cross-sectional study which involved 167 workers in a cable manufacturing factory selected by simple random sampling. MSQ was used to assess employee’s satisfaction with their job on seven facets and sound level meter was used to measure workplace noise level. Results: All respondents were exposed to noise above permissible exposure limit. Most workers (49%) were moderately satisfied with their work. Factors that were rated as lowest level of satisfaction were work itself (the ability to work alone) (40%) and the way company system policies are implemented (40%). Factors with the highest level of satisfaction were their freedom to implement their judgement (responsibility) (51%) and the supervision quality of their superiors (51%). The most dominant facet predicting total satisfaction level was recognition followed by advancement and company policy and administration. All variables in socio-demographical and job characteristics were not significantly associated with their level of job satisfaction except noise. Noise was significant in predicting one facet of job satisfaction which was physical work condition. Conclusion: Overall, the average level of job satisfaction among respondents were moderate and they were exposed to occupational noise which was the only significant study variable correlated with their job satisfaction.

Cadmium (Cd) Exposure among Waste Collector in Urban Area, Malaysia

@#Introduction: Cadmium (Cd) in urine and inhaled dust of the municipal waste operators was assessed. Methods: Urine spot samples were collected and analysed for Cd and creatinine of 60 municipal waste operators between April to June 2013. Respirable dust was collected using personal air sampling pump GilAir-3 and GilAir-5 for 8 working hours. Cd in urine and dust were analysed using the Flame Atomic Absorption Spectrometer (Perkin Elmer A Analyst 800) while urinary creatinine was measured using Reflotron® Plus creatinine. Results: The mean and standard deviation (SD) of Cd in the respirable dust (0.59 ± 50.27 μg/m3) was within the permissible exposure limit (PEL). The level of Cd in urine (0.015 ± 0.0097 μg/g Cr) was lower than the safe limit of 5 μg/g. The creatinine level (173.59 ± 50.27 mg/dl) was within the normal range (20 to 350 mg/dl). The multiple regression model shows smoking and years of smoking were the significant predictors for the Cd in the urine (R² = 0.216 F(3,56) = 5.150, p < 0.05). Conclusion: Municipal waste operators were exposed to minimal Cd exposure while handling waste and the accumulation of this metal urine was correlated with smoking habit.

Mobile Apps Application to Improve Safety and Health Knowledge, Attitude and Practice among University Students

@#Introduction: The application of M-learning or mobile application (app) as a tool to disseminate occupational safety and health (OSH) information among students and staff in the university, to replace the use of conventional noticeboard was assessed in this study. Materials and Methods: Study was conducted between February to March 2016 and involved 124 respondents from health sciences program in Universiti Putra Malaysia. OSH information was incorporated into a mobile-app using online software and respondents were requested to use the app for fourteen days. A self-administered questionnaire was used to assess the level of knowledge, attitude and practice of respondents before and after using the app. Results: The mobile app has significantly increased the knowledge score among respondents (z = -7.331, p<0.001). The mean (SD) of knowledge score has increased from 24.39 (5.84) to 30.40 (4.97). The attitude score also has significantly increased from 12.85 (2.04) to 14.02 (2.42) (z= -4.587, p<0.001). The mobile app was not significantly changed the practice (z= -0.688, p=0.491) and the perception among respondents (z= -0.337, p=0.736). Respondents stated that the app was user-friendly (49.4%, N=61), easy to access (N= 64, 51.6%), and have interesting contents (N= 63, 50.8%). They believed continuous used of the app may improve their knowledge (N= 64, 51.6%), and increase their awareness (N= 67, 54.0%) on safety and health. Conclusion: The M-learning (mobile app) has a potential to be used to promote the safety and health culture among students on the campus.

Classifying Sources of Nitrate Contamination in an Alluvial Deposit Aquifer System Using Hydrogeochemical Properties and Multivariate Statistical Techniques

@#Introduction: This study determined nitrate concentration and identify the classifying sources of nitrate pollution in the alluvial deposit aquifer system in Bachok, Kelantan. Materials and Methods: A total of 300 groundwater samples were collected in two different areas; agricultural area (150 samples) and non-agricultural area (150 samples). The samples were analyzed for nitrate and other parameters such as pH, EC, NH4+, TDS, turbidity and salinity. The multivariate analyses were used to identify factors that govern the groundwater quality and potential nitrate sources in the study area. Results: Samples in the agricultural area were slightly acidic (5.89 ± 0.67), contained high nitrate (15.10 ± 15.90 mg/L NO3-N), NH4+ (0.82 ± 1.24 mg/L) and turbidity (3.25 ± 2.78 NTU). The principal component analysis (PCA) have identified the groundwater quality in the study area was influenced by the natural processes and anthropogenic activities. Based on the hierarchal cluster analysis (HCA), Cluster II in the agricultural area was identified to be most heavily nitrate contamination, while Cluster III in the non-agricultural area was identified to be strongly affected by seawater intrusion. Conclusion: The findings of this study are useful for developing protection alternatives of private well waters to prevent further deterioration of groundwater quality by nitrate such as control of nitrogen fertilizer use, manure applications and other agricultural practices in the agricultural area. In order to reduce the health risk of nitrate, private well water users in this area should be advised to treat their water or find alternative sources for drink

The Association of Reported Respiratory Symptoms among Children in Malaysia with Particulate Matter Exposure in Municipal Solid Waste Landfills

@#Background: Prolonged exposure of heavy metals in the respirable particulate matter (PM10) from municipal solid waste (MSW) landfills may affect children health. Objective: To investigate the association of reported respiratory symptom with heavy metals in PM10, with heavy metals in fingernails among children residing close to MSW landfills. Methods: Two groups of children age 7 to 12 years old were involved in this cross-sectional study. Those residing within 3 km radius from a landfill were the exposed group and those residing more than 3 km radius as the unexposed group. Questionnaires adapted from American Thoracic Society were applied in the survey. Fingernails were used as biomarker. Ten heavy metals elements in PM and fingernail samples were analysed using inductively coupled plasma mass spectrometry (ICP-MS). Results: The cadmium, chromium, copper, manganese, nickel and lead concentrations in PM around the MSW landfills and residential areas exceeded the Canada and USEPA standard permissible limit. Heavy metals in fingernails (p<0.001) of exposed group were significantly higher than the unexposed group. Children with no pets have less reported respiratory symptoms. Elevated level of heavy metals in PM and fingernails were associated with high risk of reported respiratory symptoms. Conclusion: Heavy metals in PM10 and fingernails were associated with potential risk factor of respiratory health in children.

Disaster Debris Management during the 2014-2015 Malaysia Flood Incident

@#Introduction: Flood is a natural disaster cause by heavy rainfall and high tide phenomenon. In the event of flood, substantial amount of wastes tend to be moved away and washed with mud that cause the task of waste recovering extremely challenging. The objective of the study was to assess flood victims participation, duration and major problem arise during post flood waste clean-up activity together with respondent’s knowledge and psychological importance in the recovery process. Methods: A cross sectional survey using interview and self-administered questionnaire was conducted involving 150 flood victims in Kuala Krai, Kelantan, who were heavily affected by the recent flood. Results: Respondents participation in the clean-up process was high (N = 126, 84%). Average 1 to 3 months were taken for the clean-up activity. Majority of the respondents had low and moderate satisfaction on the cleaning service provided by the authority (N = 84, 56%). Major problem arises from the past flood waste clean up activity was the biased waste removal process (N = 124, 83%), victims have to find alternative ways for disposal (N = 108, 72%) and the temporary disposal site were located near to the housing area that creates discomfort (N = 105, 70%). The correlation test obtained significant relationship between knowledge and education level (X2 = 0.203, p=0.013). But no significant relationship was obtained between knowledge with gender, age, monthly income, duration of clean-up process, respondents participation and satisfaction. Conclusion: Disaster debris management and disposal is critically important to support the victims in their recovery process.