OBJECTIVE: The Improving Exposure Assessment Methodologies for Epidemiological Studies on Pesticides (IMPRESS) project aims to assess the reliability and external validity of the surrogate measures used to assign exposure within individuals or groups of individuals, which are frequently based on self-reported data on exposure determinants. IMPRESS will also evaluate the size of recall bias on the misclassification of exposure to pesticides; this in turn will affect epidemiological estimates of the effect of pesticides on human health.

METHODS: The IMPRESS project will recruit existing cohort participants from previous and ongoing research studies primarily of epidemiological origin from Malaysia, Uganda, and the United Kingdom. Consenting participants of each cohort will be reinterviewed using an amended version of the original questionnaire addressing pesticide use characteristics administered to that cohort. The format and relevant questions will be retained but some extraneous questions from the original (eg, relating to health) will be excluded for ethical and practical reasons. The reliability of pesticide exposure recall over different time periods (<2 years, 6-12 years, and >15 years) will then be evaluated. Where the original cohort study is still ongoing, participants will also be asked if they wish to take part in a new exposure biomonitoring survey, which involves them providing urine samples for pesticide metabolite analysis and completing questionnaire information regarding their work activities at the time of sampling. The participant's level of exposure to pesticides will be determined by analyzing the collected urine samples for selected pesticide metabolites. The biomonitoring measurement results will be used to assess the performance of algorithm-based exposure assessment methods used in epidemiological studies to estimate individual exposures during application and re-entry work.

RESULTS: The project was funded in September 2017. Enrollment and sample collection was completed for Malaysia in 2019 and is on-going for Uganda and the United Kingdom. Sample and data analysis will proceed in 2020 and the first results are expected to be submitted for publication in 2021.

CONCLUSIONS: The study will evaluate the consistency of questionnaire data and accuracy of current algorithms in assessing pesticide exposures. It will indicate where amendments can be made to better capture exposure data for future epidemiology studies and thus improve the reliability of exposure-disease associations.

METHOD: This is a cross sectional study that was conducted among students in a public university during the early phase of COVID-19 pandemic in Malaysia. An online validated self-administered questionnaire was used to collect the data. Mann-Whitney U and Kruskal Wallis test was used to determine the association between independent variables with knowledge, attitude, and practice score.

RESULTS: Overall response rate of this study was 92.9 (n=524). Median score of knowledge domain was 78.0 (IQR= ±12.0), median attitude score of 49.0 (IQR= ±5.0), and median practice score of 80.0 (IQR= ±11.0). The mean knowledge, attitude and practice score were significantly higher among diploma holder (vs degree holder, p<0.05), residing in main Kota Kinabalu campus (vs non-KK campus, p<0.001), studying in medical faculty (vs non-medical faculty, p<0.001), and attended COVID-19 education (vs non-attendance; p<0.05).