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.

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.

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.

Cutaneous larva migrans: a neglected disease and possible association with the use of long socks.

Cutaneous larva migrans is a common parasitic skin disease that can be easily prevented by wearing 'protective' footwear. However, this has been under-emphasized in terms of what constitutes the protective footwear. Even though the disease resolves spontaneously, the significant duration of the disease along with severity of pruritus make treatment unavoidable. Here, we present a very long-standing creeping eruption, which puzzled many attending clinicians handling the case, and the possibility of long socks as a causal effect on the development of cutaneous larva migrans infection.