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Fulltext Application of occupational health surveillance program among responder’s during chemical incident at Pasir Gudang, Johor

Salvaraji L., Haidar R.T., Mohd Aris N., Ayob Q. A., Nordin N., Abdul Latif N., et al.

Malaysian Journal of Medicine and Health Sciences, 2019;15(106):29-29.
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Introduction: Responder’s action during mass environmental chemical incident involves collaboration of multiple agency. They clean the exposure site, control public safety and safe lives. The health of the responder is also as valuable as the public and always been neglected. Hence, this study is to highlights the method used and challenges during the incidents. Methods: A modified Occupational Health Surveillance Programme designed by Baker and Matte (Thirteen Steps in designing and implementing an Occupational Health Surveillance Programme) was imple-mented. These method full fill the criteria of impossible further reduce exposure to known hazards and uncertain health effect of the offending chemicals. Two core workplace namely the source of chemical contamination locale and victims’ evacuation centre were identified. The exposed responder is identified and categorised according to their expected exposure. Offending chemicals identified were known hazardous to health. An electronic survey form was developed and the surveillance were conducted during the event and post-exposures of one, third and sixth months. Laboratory tests were performed as a grab sample randomly and strategically to represent responder exposure. Results: During the event, 1338 responders were surveyed and twenty percent had symptoms of cough, headache, sore throat, nausea and skin irritation. After one-month post-exposure, three percent of responder noted to have continue symptoms. Laboratory tests were performed randomly due to the sheer numbers of responders in action. Only sixty-one samples were collected and sixteen percent had positive metabolites for urine cyanide. Re-sponders with abnormal laboratory result (FBC/LFT/RP/Urine) were interviewed and a repeat sample were performed. Conclusion: The health surveillance of the responder in mass environmental chemical incident is a great challenge when the exposure level is unsure and involve more than one chemicals. Likewise, reliability and validity adopting statistical test for health surveillance instruments is unattainable due to urgency. However, a proper method of occu-pational surveillance need to be devised and implemented to ensure the protection of worker’s health is guaranteed.
Fulltext Occupational Disease and Injury in Malaysia: A Thematic Review of Literature from 2016 to 2021

Awaluddin SM, Mahjom M, Lim KK, Shawaluddin NS, Tuan Lah TMA

J Environ Public Health, 2023;2023:1798434.
PMID: 36761248 DOI: 10.1155/2023/1798434

INTRODUCTION: Working people are exposed to occupational hazards and are at risk of having occupational disease or injury in a rapidly industrializing country like Malaysia. This study aims to review and summarize the occupational disease and injury in Malaysia from 2016 to 2021.
METHODS: This study used PubMed and Scopus databases to conduct a systematic literature search using a set of keywords. The selected records dated from 1 January 2016 to 8 September 2021 were extracted into the Mendeley Desktop and ATLAS.ti 8 software. Systematic screening was conducted by two independent researchers and finalized by the third researcher. Data were coded and grouped according to the themes. The results were presented as the table for descriptive analysis and cross-tabulation between the themes.
RESULTS: A total of 120 records were included in this study. Under the theme of main health problems, the findings showed that mental health, infectious disease, and work-related musculoskeletal disorders are the top three problems being discussed in the literature for the working people in Malaysia. The findings also showed an increasing trend of mental health problems during pandemic COVID-19 years. In addition, hospital was the highest workplace where the occupational health problems were reported.Discussion/Conclusion. There was substantial work on the mental health problem, infectious diseases, and work-related musculoskeletal disorders as the main health problem among workers in Malaysia in the past five years. The employers must report any occupational health and injury case to the authority and prompt intervention can be initiated.
Fulltext Factors Associated with COVID-19 among Healthcare Workers in Kedah in 2021: A Cross-Sectional Study

Omar R, Mahjom M, Haron NH, Mat Lazim R, Kamal FSQ

Int J Environ Res Public Health, 2022 Nov 24;19(23).
PMID: 36497673 DOI: 10.3390/ijerph192315601

This study aimed to examine the characteristics of HCWs infected with COVID-19 and factors associated with healthcare-associated infection. A cross-sectional study, using secondary data of COVID-19 HCW cases from a registry developed by the Occupational and Environmental Health Unit (OEHU) in Kedah State Health Department, Malaysia, was analysed using Excel and STATA version 14.0. Descriptive analysis and multiple logistic regression were conducted to identify the factors for healthcare-associated COVID-19 infection. A total of 1679 HCWs tested positive for COVID-19 between 1 January 2021 and 19 September 2021. The infection was mainly non-healthcare-associated (67.0%), with healthcare-associated cases contributing to only 33% of the cases. The significant factors associated with healthcare-associated transmission were the following: doctor (aOR = 1.433; 95% CI = 1.044, 1.968), hospital setting (aOR = 1.439; 95% CI = 1.080, 1.917), asymptomatic (aOR = 1.848; 95% CI = 1.604, 2.130), incompletely or not vaccinated (aOR = 1.400; 95% CI = 1.050, 1.866) and CT-value ≥ 30 (aOR = 2.494; 95% CI = 1.927, 3.226). Identifying factors of healthcare-associated infection would help in planning control measures preventing healthcare-associated transmission in the workplace. However, more than half of COVID-19 cases among HCWs involved non-healthcare-associated COVID-19 infection, and, thus, requires further study to identify high-risk behaviours.
Fulltext Preparing for and conducting the National Health and Morbidity Survey in Malaysia amid the COVID-19 pandemic: balancing risks and benefits to participants and society

Chong ZL, Lodz NA, Mutalip MHA, Lim YC, Mahjom M, Ahmad NA

Western Pac Surveill Response J, 2021 09 03;12(3):71-76.
PMID: 34703638 DOI: 10.5365/wpsar.2021.12.3.842

Problem: The novel coronavirus disease 2019 (COVID-19) pandemic adversely affected the preparation of Malaysia's National Health and Morbidity Survey for 2020 because conducting it would expose data collectors and participants to an increased risk of infection.
Context: The survey is nationally representative and community based and is conducted by the Institute for Public Health, part of the National Institutes of Health, to generate health-related evidence and to support the Malaysian Ministry of Health in policy-making. Its planned scope for 2020 was the seroprevalence of communicable diseases such as hepatitis B and C.
Action: Additional components were added to the survey to increase its usefulness, including COVID-19 seroprevalence and facial anthropometric studies to ensure respirator fit. The survey's scale was reduced, and data collection was changed from including only face-to-face interviews to mainly self-administered and telephone interviews. The transmission risk to participants was reduced by screening data collectors before the survey and fortnightly thereafter, using standard droplet and contact precautions, ensuring proper training and monitoring of data collectors, and implementing other administrative infection prevention measures.
Outcome: Data were collected from 7 August to 11 October 2020, with 5957 participants recruited. Only 4 out of 12 components of the survey were conducted via face-to-face interview. No COVID-19 cases were reported among data collectors and participants. All participants were given their hepatitis and COVID-19 laboratory test results; 73 participants with hepatitis B and 14 with hepatitis C who had been previously undiagnosed were referred for further case management.
Discussion: Preparing and conducting the National Health and Morbidity Survey during the COVID-19 pandemic required careful consideration of the risks and benefits, multiple infection prevention measures, strong leadership and strong stakeholder support to ensure there were no adverse events.
Fulltext Incidence, Prevalence, and Sources of COVID-19 Infection among Healthcare Workers in Hospitals in Malaysia

Harith AA, Ab Gani MH, Griffiths R, Abdul Hadi A, Abu Bakar NA, Myers J, et al.

Int J Environ Res Public Health, 2022 Sep 30;19(19).
PMID: 36231783 DOI: 10.3390/ijerph191912485

The COVID-19 pandemic introduced significant novel risks for healthcare workers and healthcare services. This study aimed to determine the prevalence, trends, characteristics, and sources of COVID-19 infection among healthcare workers during the early COVID-19 pandemic in Malaysian hospitals. A cross-sectional study used secondary data collected from a COVID-19 surveillance system for healthcare workers between January and December 2020. Two surges in COVID-19 cases among healthcare workers in Malaysia were epidemiologically correlated to a similarly intense COVID-19 pattern of transmission in the community. The period prevalence of COVID-19 infection and the mortality rate among healthcare workers in Malaysia were 1.03% and 0.0019%, respectively. The majority of infections originated from the workplace (53.3%); a total of 36.3% occurred among staff; a total of 17.0% occurred between patients and staff; and 43.2% originated from the community. Healthcare workers had a 2.9 times higher incidence risk ratio for the acquisition of COVID-19 infection than the general population. Nursing professionals were the most highly infected occupational group (40.5%), followed by medical doctors and specialists (24.1%), and healthcare assistants (9.7%). The top three departments registering COVID-19 infections were the medical department (23.3%), the emergency department (17.7%), and hospital administration and governance (9.1%). Occupational safety and health units need to be vigilant for the early detection of a disease outbreak to prevent the avoidable spread of disease in high-risk settings. The transformation of some tertiary hospitals to dedicated COVID-19 care, the monitoring of new procedures for the management of COVID-19 patients, and appropriate resource allocation are key to successful risk mitigation strategies.