The mediating role of pro-environmental attitude and intention on the translation from climate change health risk perception to pro-environmental behavior.

Climate change is a serious environmental issue appearing in China. As a public service institution operating around the clock, the negative impact of hospitals on the environment is evident, promoting their workers' pro-environmental behavior (PEB) through increasing climate change health risk perception (CHRP) is an effective method to protect the environment and achieve sustainable development. This study investigates how CHRP shapes pro-environmental attitude (PEA), pro-environmental intention (PEI), and pro-environmental behavior (PEB) among hospital workers. Using structural equation modeling (SEM) to determine the chain of causation from CHRP to PEB among hospital workers. The result shows that CHRP positively affects PEA and PEI, and PEI positively affects their PEB. In addition, although CHRP has no significant direct effect on PEB, it can play a crucial indirect effect through the mediating role of PEI. Moreover, the result of multiple regression shows that there are significant differences regarding PEA, PEI, and PEB.

Concept Development and Field Testing of Wireless Outdoor Indicator System for Use in Monitoring Exposures at Work among Malaysian Traffic Police.

Real-time exposure air monitoring is essential to protect the respiratory health of the Malaysian traffic police. However, the data from monitoring stations have been inadequate to provide accurate information about their exposure. This report describes the conceptual design of a wireless exposure indicator system, and then evaluates the field performance of the system by collocation. The study tested the accuracy of particulate matter size 2.5 (PM2.5), carbon monoxide (CO), and nitrogen dioxide (NO2) by comparing the measurements from the prototype with the measurements from reference instruments. The field testing found that the data tested were significantly correlated with each other (PM2.5-rs = 0.207, p = 0.019; NO2-rs = 0.576, p = 0.02 and CO-rs = 0.545, p = 0.04). The prototype proved to be successful as it can compute and transmit real-time monitoring data on the level of exposure to harmful air.

Effectiveness of lumbar support with built-in massager system on spinal angle profiles among high-powered traffic police motorcycle riders: A randomised controlled trial.

Traffic police riders are exposed to prolonged static postures causing significant angular deviation of the musculoskeletal, including the lumbar angle (L1-L5). This postural alteration contributes to awkward posture, musculoskeletal disorders and spinal injury, especially in the lower back area, as it is one of the most severe modern diseases nowadays. Thus, the study aimed to evaluate the effect of lumbar support with a built-in massager system on spinal angle profiles among traffic police riders. A randomised controlled trial (pre-testpost-test control design) was used to assess spinal angle pattern while riding the high-powered motorcycle for 20 minutes. Twenty-four traffic police riders were randomly selected to participate and 12 riders were assigned to the control group and 12 riders to the experimental group. The pre-test and post-test were conducted at a one-week interval. Each participant was required to wear a TruPosture Smart Shirt (to monitor spinal posture). The TruPosture Apps recorded the spinal angle pattern. The data indicated that the police riders using motorcycle seat with lumbar support and built-in massager system showed a huge improvement in maintaining posture which only involves slight spinal angle deviation changes from the spinal reference angle throughout the 20 minutes ride. The data collected then were analysed using the Mann-Whitney test and Wilcoxon signed-ranked test to verify a statistically significant difference between and within the control and experimental groups. There were significant differences in all sensors between the control group and experimental groups (p<0.05) and within the experimental group. According to the findings, it can be said that the ergonomic intervention prototype (lumbar support with built-in massager system) successfully helps to maintain and improve the natural curve of the spinal posture. This indirectly would reduce the risk of developing musculoskeletal disorders and spinal injury among traffic police riders.

Occupational hazard in Malaysian traffic police: special focus on air pollutants.

This paper provides a specific deliberation on occupational hazards confronted daily by Malaysian Traffic Police. Traffic police is a high-risk occupation that involves a wide range of tasks and, indirectly, faced with an equally wide variety of hazards at work namely, physical, biological, psychosocial, chemical, and ergonomic hazards. Thereupon, occupational injuries, diseases, and even death are common in the field. The objective of this paper is to collate and explain the major hazards of working as Malaysian traffic police especially in Point Duty Unit, their health effects, and control measures. There are many ways in which these hazards can be minimised by ensuring that sufficient safety measures are taken such as a wireless outdoor individual exposure indicator system for the traffic police. By having this system, air monitoring among traffic police may potentially be easier and accurate. Other methods of mitigating these unfortunate events are incorporated and addressed in this paper according to the duty and needs of traffic police.

Associations of Occupational, Socio-Demographic and Lifestyle Factors with Lung Functions in Malaysian Traffic Policemen.

Background: Apart from being exposed to various hazards, there are several other factors that contribute to the deterioration of traffic police health. Objectives: A cross-sectional study was carried out to explore the association of occupational, socio-demographic, and lifestyle factors with lung functions in traffic policemen in Kuala Lumpur (KL) and Johor Bahru (JB). Methods: A spirometer was used to measure lung function of subjects, whereas a self-administered questionnaire was used to obtain their information on background data, lifestyle, and occupational factors. The statistical test used was Spearman rho's test and chi-square test; then, the factors were further tested using Logistic regressions. Findings: 134 male subjects were selected as respondents in this study with 83% response rate. Among all the factors tested, age (FVC: χ = 8.42(3), p = 0.04), (FEV: χ = 8.26(3), p = 0.04), rank (FVC: χ = 8.52(3), p = 0.04), (FEV: χ = 8.05(3), p = 0.04), duration of services (FVC: χ = 11.0(1), p = 0.04), (FEV: χ = 6.53(1), p = 0.01), and average working hours (with the Measured FVC (litre), r = -3.97, p < 0.001; Measured FEV1 (litre), r = -3.70, p < 0.001; Predicted FVC, r = -0.49, p < 0.001; Predicted FEV1, r = -0.47, p < 0.001; and %Ratio FEV1/FV, r = -0.47, p < 0.001) were significantly related to lung function among traffic police. Conclusions: Occupational factors play a crucial role, and hence, the authorities should take action in generating flexible working hours and the duration of services accordingly. The data from this study can help by serving as a reference to the top management of traffic police officers to develop occupational safety and health guideline for police officers to comply with the Occupational Safety and Health Act (OSHA, Act 514 1994).

Quantification of selected steroid hormones (17ß-Estradiol and 17α-Ethynylestradiol) in wastewater treatment plants in Klang Valley (Malaysia).

Steroid estrogens, such as 17ß-estradiol (E2) and 17α-ethynylestradiol (EE2) are potent and were categorized as "Watch List" in Directive 2013/39/EU because of their potential risks to aquatic environment. Commercialized enzyme-linked immunosorbent assay (ELISA) kits have been used to quantify steroid estrogens in wastewater samples due to their simplicity, rapid, cost-effectiveness, and validated assays. Hence, this study aims to determine the occurrence and removal of steroid hormones in Malaysian wastewater treatment plants (WWTPs) by ELISA, to identify the association of removal efficiency (E2 and EE2) with respect to WWTPs operating conditions, and to assess the potential risks of steroid estrogens to aquatic environment and human. Results showed E2 concentration ranged from 88.2 ±â€¯7.0 ng/L to 93.9 ±â€¯6.9 ng/L in influent and 35.1 ±â€¯17.3 ng/L to 85.2 ±â€¯7.6 ng/L in effluent, with removal of 6.4%-63.0%. The EE2 concentration ranged from 0.2 ±â€¯0.2 ng/L to 4.9 ±â€¯6.3 ng/L in influent and 0.02 ±â€¯0.03 ng/L to 1.0 ±â€¯0.8 ng/L in effluent, with removal of 28.3-99.3%. There is a correlation between EE2 removal with total suspended solid (TSS) and oxidation reduction potential (ORP), and was statistically significant. Despite the calculated estrogenic activity for E2 and EE2 was relatively high, dilution effects could lower estrogenic response to aquatic environment. Besides, these six selected WWTPs have cumulative RQ values below the allowable limit, except WWTP 1. Relatively high precipitation (129-218 mm) could further dilute estrogens concentration in the receiving river. These outputs can be used as quantitative information for evaluating the occurrence and removal of steroid estrogens in Malaysian WWTPs.

Reducing work-related musculoskeletal symptoms through implementation of Kiken Yochi training intervention approach.

BACKGROUND: Work tasks in pineapple plantations in Malaysia are characterised by non-ergonomic work postures, repetitive tasks, awkward posture and manual handling of work tools that contribute to the reporting of musculoskeletal symptoms (MSS). There have been very limited studies performed among pineapple plantation workers focusing on ergonomic intervention programs to specifically reduce MSS. OBJECTIVE: The aim of this study was to assess the effects of work improvement module using a Kiken Yochi participatory approach intervention in reducing MSS among male migrant pineapple farm plantation workers in Pontian, Johor. METHODOLOGY: In this interventional study, a total of 68 male migrant workers from two plantation farms were invited to become a participant in this study. In total, 45 participants that consisted of 27 workers for the intervention group and 18 workers for the control group were recruited. The background of workers and MSS were assessed using questionnaires. Ergonomic and postural risks were evaluated and the work tasks with the highest risk were used as a basis for the development of the Kiken Yochi training module. MSS education and training intervention that provided information on proper lifting techniques and education on body mechanics and ergonomics to reduce MSS were implemented to both groups of workers. Kiken Yochi Training was given to the intervention group only. MSS were reassessed after 2 months of the follow-up period. Data was entered into statistical software and were analysed according to objectives. RESULTS: In terms of the postural risk assessment, almost two-third of the participants (68.5%) had working postures categorized as high risk for MSS. Ergonomic risk assessment identified cultivation, manual weeding and harvesting of pineapples as the work tasks contributing the highest health risks to workers. The most commonly reported MSS between both groups of workers were at the knees, lower back and shoulder area. Upon completion of the delivery of intervention module to both groups of workers, the MSS prevalence reported (after 2 months) were significantly lower for the ankles and feet area within the intervention group. CONCLUSION: This study suggested that development and implementation of programs using effective participatory approach training methods are able to prevent selected musculoskeletal problems for this occupation. To enhance the effects of such trainings, modifications of work tools in this occupation are desirable.

Vaping Topography and Reasons of Use among Adults in Klang Valley, Malaysia

Background: Consistency and accuracy of results in assessing health risks due to vaping or e-cigarette use are difficult to achieve without established consumption data. The present report covers baseline data on vaping topography and reasons for use among local users in Klang Valley, Malaysia. Methods: An 80-item survey regarding socio-demographic characteristics, smoking topography and reasons for e-cigarette use was employed to assess e-cigarette users recruited from several public universities and private organisations. The survey questionnaire was self-administered. Data were analysed using statistical software. Results: Eighty-six current e-cigarette users participated with more than half (51.2%) of them aged ≥ 25 years old. Significant proportions of the sample were single (51.2%), had a tertiary education level (63.5%) and a household income of less than USD1000 per month (65.2%). Median duration of e-cigarette use was less than a year; users drew approximately 50 puffs per day and refilled twice a day. The majority (74%) used e-liquids containing nicotine with a concentration of 6 µg/mL. Daily users spent USD18-23 per month. Reasons for using the e-cigarette included enjoyment of the products (85.9%), perception of lower toxicity than tobacco (87%), and the fact that it was a cheaper smoking alternative (61%). Conclusion: The data on e-cigarette smoking topography obtained in this study are novel. The reasons of usage were mainly users' enjoyment of e-cigarettes, preparation for quitting smoking, perception of low toxicity and a healthier smoking substitute and cheapness in the long run. The results establish basic knowledge for the local vaping topography and reference material for future e-cigarette-related research.

Electronic cigarettes: a systematic review of available studies on health risk assessment.

OBJECTIVE: This paper primarily aimed to review articles which specifically quantified the risk of electronic cigarette's (e-cigarette) usage via the health risk assessment (HRA) approach. METHODS: Systematic literature searches were conducted using PubMed search engine databases. Search terms such as "electronic cigarette", "e-cigarette", "electronic nicotine delivery systems", "electronic cigarette liquid", "electronic cigarette vapors", and "health risk assessment" were used to identify the relevant articles to be included in this review. To enable comparison, hazard quotient (HQ) and lifetime cancer risk (LCR) for the chemicals measured in the selected articles were calculated for three of the articles using the formula: [1] HQ=average daily dose (ADD)/reference dose (RfD) or exposure air concentration (EC)/reference concentration (RfC); [2] LCR=lifetime average daily dose (LADD) × cancer slope factor (CSF) or exposure air concentration (EC) × inhalation unit risk (IUR). RESULTS: Four articles pertaining to HRA of e-cigarettes were critically reviewed, three of the papers focused on specific chemicals namely nicotine, propylene glycol (PG), glycerol and 1,2-propanediol, while one article evaluated the health risks posed by heavy metals contained in e-cigarettes. The calculated HQs for the chemicals in this review had large variations. HQs of the six chemicals, i.e. nicotine, PG, glycerol, cadmium, ethylene glycol, nickel, aluminum and titanium, were found to have the potential to contribute to non-carcinogenic health risks. None of the LCR calculated had risks exceeding the acceptable limit. CONCLUSION: There are limited HRA studies and the ones that were available provided inconsistent scientific evidences on the health risk characterization arising from the usage of e-cigarettes. As such, there is a need to perform more studies on HRA of e-cigarettes by using uniformed and comprehensive steps and similar reference threshold levels of exposures.

Mathematical modeling for estrogenic activity prediction of 17ß-estradiol and 17α-ethynylestradiol mixtures in wastewater treatment plants effluent.

Steroid estrogens such as 17ß-Estradiol (E2) and 17α-Ethynylestradiol (EE2) are highly potent estrogens that widely detected in environmental samples. Mathematical modelling such as concentration addition (CA) and estradiol equivalent concentration (EEQ) models are usually associated with measuring techniques to assess risk, predict the mixture response and evaluate the estrogenic activity of mixture. Wastewater has played a crucial role because wastewater treatment plant (WWTP) is the major sources of estrogenic activity in aquatic environment. The aims of this is to determine E2 and EE2 concentrations in six WWTPs effluent, to predict the estrogenic activity of the WWTPs effluent using CA and EEQ models where lastly the effectiveness of two models is evaluated. Results showed that all the six WWTPs effluent had relative high E2 concentration (35.1-85.2 ng/L) compared to EE2 (0.02-1.0 ng/L). The estrogenic activity predicted by CA model was similar among the six WWTPs (105.4 ng/L), due to the similarity of individual dose potency ratio calculated by respective WWTPs. The predicted total EEQ was ranged from 35.1 EEQ-ng/L to 85.3 EEQ-ng/L, explained by high E2 concentration in WWTPs effluent and E2 EEF value that standardized to 1.0 µg/L. The CA model is more effective than EEQ model in estrogenic activity prediction because EEQ model used less data and causes disassociation from the predicted behavior. Although both models predicted relative high estrogenic activity in WWTPs effluent, dilution effects in receiving river may lower the estrogenic response to aquatic inhabitants.

Analytical techniques for steroid estrogens in water samples - A review.

In recent years, environmental concerns over ultra-trace levels of steroid estrogens concentrations in water samples have increased because of their adverse effects on human and animal life. Special attention to the analytical techniques used to quantify steroid estrogens in water samples is therefore increasingly important. The objective of this review was to present an overview of both instrumental and non-instrumental analytical techniques available for the determination of steroid estrogens in water samples, evidencing their respective potential advantages and limitations using the Need, Approach, Benefit, and Competition (NABC) approach. The analytical techniques highlighted in this review were instrumental and non-instrumental analytical techniques namely gas chromatography mass spectrometry (GC-MS), liquid chromatography mass spectrometry (LC-MS), enzyme-linked immuno sorbent assay (ELISA), radio immuno assay (RIA), yeast estrogen screen (YES) assay, and human breast cancer cell line proliferation (E-screen) assay. The complexity of water samples and their low estrogenic concentrations necessitates the use of highly sensitive instrumental analytical techniques (GC-MS and LC-MS) and non-instrumental analytical techniques (ELISA, RIA, YES assay and E-screen assay) to quantify steroid estrogens. Both instrumental and non-instrumental analytical techniques have their own advantages and limitations. However, the non-instrumental ELISA analytical techniques, thanks to its lower detection limit and simplicity, its rapidity and cost-effectiveness, currently appears to be the most reliable for determining steroid estrogens in water samples.

Implementation of smoke-free legislation in Malaysia: are adolescents protected from respiratory health effects?

BACKGROUND: This study aimed to examine the relationship between respiratory health of Malaysian adolescents with secondhand smoke (SHS) exposure and smoke-free legislation (SFL) implementation. MATERIALS AND METHODS: A total of 898 students from 21 schools across comprehensive- and partial-SFL states were recruited. SHS exposures and respiratory symptoms were assessed via questionnaire. Prenatal and postnatal SHS exposure information was obtained from parental-completed questionnaire. RESULTS: The prevalence of respiratory symptoms was: 11.9% ever wheeze, 5.6% current wheeze, 22.3% exercise-induced wheeze, 12.4% nocturnal cough, and 13.1% self-reported asthma. SHS exposure was most frequently reported in restaurants. Hierarchical logistic regression indicates living in a comprehensive-SFL state was not associated with a lower risk of reporting asthma symptoms. SHS exposure in public transport was linked to increased risk for wheeze (Adjusted Odds Ratio (AOR) 16.6; 95%confidence interval (CI), 2.69-101.7) and current wheezing (AOR 24.6; 95%CI, 3.53-171.8). CONCLUSIONS: Adolescents continue to be exposed to SHS in a range of public venues in both comprehensive- and partial-SFL states. Respiratory symptoms are common among those reporting SHS exposure on public transportation. Non-compliance with SFL appears to be frequent in many venues across Malaysia and enforcement should be given priority in order to reduce exposure.