Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 423 434 María MORALES-SUÁREZ-VARELA Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain AND CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Agustín LLOPIS-GONZÁLEZ Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain AND CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Fernando GONZÁLEZ-CANDELA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Research Unit “Genomics and Health” CSISP-University of Valencia, Spain Jenaro ASTRAY Surveillance Branch, Community of Madrid, Spain Jordi ALONSO CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University Pompeu Fabra, Barcelona, Spain AND Institute for Research IMIM-Hospital del Mar, Spain Olatz GARIN CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University Pompeu Fabra, Barcelona, Spain AND Institute for Research IMIM-Hospital del Mar, Spain Ady CASTRO CIBER Epidemiologia y Salud Pública (CIBERESP), Spain Ramón y Cajal University Hospital, Madrid, Spain Juan Carlos GALAN CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Ramón y Cajal University Hospital, Madrid, Spain Nuria SOLDEVILA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Public Health Institute of Navarra, Spain Jesús CASTILLA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Dept. of Health, Generalitat of Catalonia, Spain Pere GO­DOY CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University of Jaen, Spain Miguel DELGADO-RODRÍGUEZ CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND University of León, Spain Vicente MARTIN CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Security Service of Andalusia, Spain Jose María MAYORAL Red Española de Investigación en Patología Infecciosa (REIPI), Spain Tomas PUMAROLA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain Basque Fundation for Health Innovation and Research, Spain José Maria QUINTANA CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Basque Fundation for Health Innovation and Research, Spain Sonia TAMAMES Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain CIBER Epidemiologia y Salud Pública (CIBERESP), Spain Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Nu­ria RUBIO-LÓPEZ Unit of Public Health, Hygiene and Environmental Health, Department of Preventive Medicine and Public Health, Food Science, Toxicology and Legal Medicine, University of Valencia, 46010 Valencia, Spain AND CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Center for Public Health Research (CSISP-FISABIO), Valencia, Spain Angela DOMINGUEZ CIBER Epidemiologia y Salud Pública (CIBERESP), Spain AND Dept. of Public Health, University of Barcelona, Spain 2016 04 27 2016 04 27 Background: The healthcare and socio-economic burden resulting from influenza A (H1N1) pdm09 in Spain was considerable. Our aim was to estimate and compare the management (resource utilization) and economic healthcare impact in an at-risk group of unvaccinated pregnant women with an unvaccinated group of non-pregnant woman of childbearing age (15-44 yr old). Methods: We addressed this question with a longitudinal, observational, multicentre study. Inputs were the requirements in managing both groups of women. Outcome measures were healthcare costs. Direct healthcare (including medical utilisation, prescriptions of antivirals, medication, diagnostic tests, and hospitalisation) costs and indirect (productivity loss) costs were considered. Unit of cost was attributed to the frequency of health service resources utilisation. The mean cost per patient was calculated in this group of women. Results: We found that the influenza clinical pattern was worse in non-pregnant women as they had a high medical risk of 20.4% versus 6.1% of pregnant women. Non-pregnant required more antipyretics and antibiotics, and needed more health service resource utilisation (338 medical visits in non-pregnant women vs. 42 in pregnant women). The total cost of non-pregnant women was higher (€4,689.4/non-pregnant and €2,945.07/pregnant). Conclusions: Cost per (H1N1) pdm09 was lower for pregnant women, probably due to more preventive measures adopted for their protection in Spain. The highest costs were incurred by hospitalisations/day and work absenteeism for non-pregnant than for pregnant women. These data will allow better future pandemic influenza planning.     https://ijph.tums.ac.ir/index.php/ijph/article/view/6572 https://ijph.tums.ac.ir/index.php/ijph/article/download/6572/5348

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 409 422 Mohammad Hossein AHMADI Dept. of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Akbar MIRSALEHIAN Dept. of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran Abbas BAHADOR Dept. of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran 2016 04 27 2016 04 27 Background: Urogenital mycoplasmas are potentially pathogenic species causing genitourinary tract infections that may be initially asymptomatic but can progress and lead to severe complications and threaten reproductive health. However, the overall prevalence rate of this bacterium and its probable impacts on fertility potential have yet to be determined. Methods: We searched both English and Persian electronic databases using key words such as "Mycoplasma," "Ureaplasma," "M. hominis," "M. genitalium," "U. urealyticum," "U. parvum," "prevalence," and "Iran". Finally, after some exclusion, 29 studies from different regions of Iran were included in our study, and a meta-analysis was performed on collected data. Results: Urogenital mycoplasmas prevalence for women and men was high and ranged from 2%–40.5% and 2%–44.3%, respectively. The pooled prevalence in the male population was 11.1% (95% CI, 7.4%–16.4%) and in female was 12.8% (95% CI, 9.8%–16.5%). The prevalence of these bacteria was significantly higher in infertile men compared with that in fertile men. A high level of heterogeneity was observed for both men (I2 = 92.4%; P<0.001) and women (I2 = 93.3%; P<0.001). Some evidence for publication bias was observed in both men [Egger’s test (two-tailed P=0.0007), and Begg’s test (two-tailed P=0.0151)] and women [Egger’s test (two-tailed P=0.0006), and Begg’s test (two-tailed P=0.0086)] analysis. Conclusion: Since urogenital mycoplasmas may play a role in male infertility, screening strategies, particularly for asymptomatic individuals, and treatment of infected ones, which can reduce consequent complications, looks to be necessary.   https://ijph.tums.ac.ir/index.php/ijph/article/view/6571 https://ijph.tums.ac.ir/index.php/ijph/article/download/6571/5347

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 531 534 Shahriar SAHRIARIAN Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Parvin AKBARI Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Elahe AMINI Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran Hosein DALILI Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran Tahereh ESMAEILNIA SHRIVANY Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Nikoo NIKNAFS Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Mamak SHARIAT Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran Vafa GHOR­BAN SABAGH Maternal-Fetal-Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran 2016 04 27 2016 04 27 Protein S (PS) is an antithrombotic plasma protein that plays essential roles in limiting thrombus formation in the anticoagulant system. Protein S deficiency is related with recurrent thrombosis. Here, the authors report a case of a term neonate with severe PS deficiency in year 2015, Imam Hospital, Tehran, Iran, that had seizures and intraventricular hemorrhage (IVH) since the age of 3 days. Nine-month follow-up did not show any developmental problems and MRI showed no hemorrhage.   https://ijph.tums.ac.ir/index.php/ijph/article/view/6584 https://ijph.tums.ac.ir/index.php/ijph/article/download/6584/5373

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 535 536 Jin Yong LEE Public Health Medical Services, Seoul National University Boramae Medical Center, Seoul, Korea Min-Woo JO Dept. of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea Hyun Joo KIM Dept. of Public Health, The Graduate School of Konyang University, Daejeon, Korea Minsu OCK Dept. of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea Hyemin JUNG Dept. of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea Sang Jun EUN Dept. of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, Korea 2016 04 27 2016 04 27  No Abstract. https://ijph.tums.ac.ir/index.php/ijph/article/view/6585 https://ijph.tums.ac.ir/index.php/ijph/article/download/6585/5374

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 515 522 Мagdalena PLATIKANOVA Dept. of Hygiene, Epidemiology and Infectious Diseases, Medical Faculty, Trakia University, Stara Zagora, Bulgaria Mariana PENKOVA-RADICHEVA Dept. of Internal Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria 2016 04 27 2016 04 27 Background: One of Europe’s most well-developed industrial regions is found in the Republic of Bulgaria. The industrialization of the region has a big impact on air pollution. Thermal power plant “Maritza East” (the largest of its kind in southeastern Europe), the army training range, machine manufacturers, household heating and high volume of automobile traffic are all major sources of pollution in the region. Methods: A five year study (2009-2013) followed yearly concentrations of principal atmospheric pollutants such as sulfur dioxide, dust, nitrogen dioxide, lead aerosols and hydrogen sulfide, and the way in which those levels had an effect on morbidity (outpatient and inpatient medical care) in the area. Statistical processing of data has been completed to represent and analyze the collected data in nonparametric and alternative format. Results: Atmospheric pollution affects human health directly through pathological changes in the human organism. The registered outpatient care provided for the period 2009-2013 is highest for diseases of the cardiovascular system (11.85%), the respiratory system (17.34%) and the genitourinary system (9.76%). The registered rate of hospitalization for the same period is for diseases of the digestive system (11.90%), the cardiovascular system (11.85%), respiratory system (10.86%) and the genitourinary system (8.88%). Conclusion: The observed period shows a decrease in average yearly concentrations of the principal atmospheric pollutants in the industrial region (Bulgaria) and reflects a decrease in morbidity based on outpatient care and an increase in morbidity by inpatient care (hospitalization). Our findings should be corroborated in future longitudinal studies.     https://ijph.tums.ac.ir/index.php/ijph/article/view/6582 https://ijph.tums.ac.ir/index.php/ijph/article/download/6582/5370

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 45 4 2016 04 27 435 440 Jingjing MA Dept. of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu City, China Dan XIA Dept. of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu City, China Jing HU Dept. of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu City, China Rui FU Dept. of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu City, China Lijun XU Dept. of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu City, China Ying ZHANG Dept. of Preventive Medicine, School of Public Health, Wannan Medical College, Wuhu City, China Mengying ZHANG Dept. of Preventive Medicine, School of Publinoise measured inside the residence was 57.5 dBA which is also considered as high. Moreover, the maximum noise level inside the residences could reach up to 85.3 dBA at night during the weekends.This study also showed that from 114 respondents who were selected randomly, 61% felt that their residential area is noisy at night. Conclusion: The noise produced by the traffic at Paka Road, Dungun at night is considerably high and affects the residents’ quality of life.   Keywords: Malaysia, Traffic, Noise  https://ijph.tums.ac.ir/index.php/ijph/article/view/4864 https://ijph.tums.ac.ir/index.php/ijph/article/download/4864/4456

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 67 71 Yu Bin HO Mohamad Pauzi ZAKARIA Puziah Abdul LATIF Nazamid SAARI 2015 10 20 2015 10 20 Background: Repeated applications of animal manure as fertilizer are normal agricultural practices in Malaysia that may release veterinary antibiotics to environment from treated animals. Methods: Environmental risk assessment (ERA) on 5 commonly used antibiotics and one hormone in Malaysian broiler farm was calculated using the ratio of measured environmental concentration (MEC) and predicted no effect concentration (PNEC) in the environment. PNEC was derived from the available acute and chronic toxicity data in the open peer-reviewed literature. Risk quotients (RQ) were then calculated for 5 antibiotics (erythromycin, norfloxacin, sulfadiazine, trimethoprim, and tylosin) and one hormone (progesterone). Results: RQ for tylosin has exceeded 1, indicating that this compound has high risk of acute toxicity in Malaysian agricultural soil while trimethoprim and tylosin possessed medium risk of chronic toxicity. The rest of the compounds showed low risk or no risk in acute or chronic ecological toxicity. Conclusion: The release of tylosin, trimethoprim, norfloxacin and progesterone from broiler manure to agricultural soil may potentially harm the environment. Keywords: Veterinary antibiotic, Environmental risk assessment, Risk quotient, Malaysia https://ijph.tums.ac.ir/index.php/ijph/article/view/4865 https://ijph.tums.ac.ir/index.php/ijph/article/download/4865/4457

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 72 80 Irwan Syah MOHD YUSOFF Shamsul Bahri MOHD TAMRIN Aini MAT SAID Yee Guan NG Mori IPPEI 2015 10 20 2015 10 20 Background: The aim of this study is to develop a new ergonomics chisel based on user centered design approach and to evaluate the effectiveness for reducing awkward posture using CATIA software for simulation analysis. Methods: Respondents were selected using purposive sampling – age 18 – 49 years old, men, experience using chisel (>1 month). A set of questionnaire were used to interview workers while postural risks were determined using Rapid Upper Limb Assessment (RULA). Selected anthropometric parameters were taken and user centered design concept were applied to determine mismatch and to facilitate design process. CATIA software was used to integrate the results of postural analysis and anthropometric measurement using 3D modeling. Results: A total of 273 male harvesters participated in this study. The result shows 5.2% of the chisels’ length of handles matches with the respondents whereas none (100%) of the chisels’ circumference of handle matches with respondents’ internal grip diameter. Tool-chisel usage, majority of harvester bend forward while harvesting (96.7%) and most of workers having blister (83.2%), redness (85.3%) and numbness (65.9%) during harvesting. RULA simulation analysis showed the score action level for new design is 3(further investigated need and changes may be required) compared to existing tool are in action score 7(investigated and changes required immediately). Conclusions: The study showed that the design of new harvesting tool has the potential to reduce awkward body posture during harvesting activities as compared to existing tools.   Keywords: Harvesting tool, Awkward posture, User centered design, CATIA simulation https://ijph.tums.ac.ir/index.php/ijph/article/view/4866 https://ijph.tums.ac.ir/index.php/ijph/article/download/4866/4458

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 81 88 Tezara CIONITA Juliana JALALUDIN Nor Mariah ADAM Januar Parlaungan SIREGAR 2015 10 21 2015 10 21 Background: Carbon dioxide (CO2) is one of the most commonly used indicators of indoor air quality (IAQ) in industrial area. The higher concentration level of CO2 and particulate matter (PM10) in day care centre could affect children’s health. The objective of this study was to assess children’s health symptom, and measure the CO2 and PM10 concentration level as IAQ parameters in different locations of day care centres near the industrial area at Kuala Lumpur, Selangor and Hulu Langat as urban, suburban and rural areas respectively. Methods: The data of children’s health symptom were collected from the distributed questionnaire. Results: The day care centres (DCC) in Kuala Lumpur has the highest number of children’s illness frequency of more than four times annually (11%), followed by the highest number of children who experienced asthma (5.3%), wheezing (3.3%) and coughing (10%). The results of data collection of day care centres in Kuala Lumpur, Selangor and Hulu Langat ranged between 629-830 ppm, 587-823 ppm and 600-830 ppm for CO2 level, and 60.80-78.60 mg/m3, 56.90-80.50 mg/m3 and 59.90-79.10 mg/m3 for PM10 level. The statistical analysis for CO2 level between areas was significantly different (P<0.05). Conclusion: Day care centers in Kuala Lumpur have the highest mean rate of CO2 and PM10 as well as frequency of children’ illness which could identify traffic congestion and less greenery of a densely populated city.   Keywords: Day care centre (DCC), IAQ, CO2, PM10, Health symptoms https://ijph.tums.ac.ir/index.php/ijph/article/view/4883 https://ijph.tums.ac.ir/index.php/ijph/article/download/4883/4459

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 89 93 Qi Jie KWONG Nor Mariah ADAM Tezara CIONITA Vijay R RAGHAVAN Mohd Fareq ABD MALEK 2015 10 21 2015 10 21 Background: Many studies have been conducted to assess the indoor air quality (IAQ) of buildings throughout the world because it is closely related to comfort, safety and work productivity of occupants. However, there is still lack of available literature about IAQ in tropical buildings that apply radiant cooling systems in conditioning the indoor air. Methods: This paper reports the results obtained from an IAQ audit that was conducted in a new radiantly cooled building in Malaysia, by focusing on the IAQ and thermal comfort parameters. Results: It was identified that the measured concentration levels for the five indoor air contaminants (CO, CO2, TVOC, formaldehyde and respirable particulates) were within the threshold limit values (TLVs) specified in the IAQ guidelines. Besides, no significant difference was found between the contaminant levels in each floor of the studied building, and a majority of the respondents did not encounter any form of physical discomfort. There is a risk of condensation problem, judging from the measured RH level. Conclusion: An increase of airflow rate and more dehumidification work in the studied building can be made to improve IAQ and prevention of condensation problem. Nevertheless, these schemes should be implemented carefully to avoid occupants’ discomfort. Relocation of workstations was suggested, especially for the lower floors, which had higher occupancy levels.   Keywords: Indoor air quality (IAQ), Radiant cooling systems, IAQ audit, Indoor air contaminants, Condensation   https://ijph.tums.ac.ir/index.php/ijph/article/view/4884 https://ijph.tums.ac.ir/index.php/ijph/article/download/4884/4460

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 94 102 Soo Hui LIAW Zailina HASHIM Munn Sann LYE Huda, ZAINUDDIN 2015 10 21 2015 10 21 Background: This study was to determine the prevalence of respiratory health complaints, allergy symptom, lung functions, and the association between airborne concentrations of chromium and aluminium with respiratory health and allergy symptoms among machining industry workers in Selangor, Malaysia. Methods: The study design was a cross-sectional comparative study. The respiratory and allergy symptoms were obtained through the American Thoracic Society (ATS) Adult Respiratory Questionnaire (ATS-DLD-78)  modified questionnaire. Results: The MWFs unexposed group had significantly higher TWA8 airborne aluminum concentration (median = 0.24 µg/m3) than the exposed group (median = 0.13 µg/m3) (P=0.027). However, no significant difference was found in the airborne chromium between both groups. Significantly higher skin itchiness was reported by the MWFs exposed group. This was further supported by the serum total IgE concentrations which was significantly higher among MWFs exposed group than the unexposed group (P=0.024). The prevalence of total serum IgE was significantly higher for the exposed group (54.3%) than the unexposed group (36.9%). The exposed group reported significantly higher prevalence of cough symptom, morning cough with sputum and health worries caused by metalworking fluids than the unexposed group. Conclusion: This study showed significantly higher allergy and respiratory symptoms among the MWFs exposed group than the unexposed group.     Keywords: Machining industry, Metalworking fluids, Allergy symptoms, IgE, Lung function https://ijph.tums.ac.ir/index.php/ijph/article/view/4885 https://ijph.tums.ac.ir/index.php/ijph/article/download/4885/4461

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 103 111 Aini Syuhaida ABDUL WAHAB Sharifah Norkhadijah SYED ISMAIL Sarva Man­gala PRAVEENA Suriyani AWANG 2015 10 21 2015 10 21 Background: Neptunia oleracea or ‘water mimosa’ has a phytoremediation ability which is rarely being assessed. This plant also can be eaten as raw or cooked and but brought such concern on its safety for human consumption. The objective of this study was to assess the phytoremediation ability of water mimosa and its safety for human consumption. Methods: Water mimosa was treated with Pb, Cu and Cd at concentrations of 0.5 to 20 mg/L and the level of heavy metals uptake was measured. Treated plants were also harvested and soaked in boiled water (100˚C) for 2 to 10 minutes to determine the level of heavy metals reduction. Heavy metals were detected by Inductively-Coupled Plasma-Optical Emission Spectrometry (ICP-OES).  Experiment was conducted in the Environmental Health laboratory, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia from June to December 2013. Results: Water mimosa accumulates up to 93% of Cd (5 mg/L) after 10 days of treatment, the highest as compared to Cu (80%) and Pb (50%). It also has the highest BCF when treated with 10 mg/L of Cd. The heavy metals concentration in plant tissue decreased as the boiling time increased. Conclusion: The overall results demonstrated that water mimosa could be used to remediate wastewater polluted with Cd, Cu and Pb. The plant is not recommended for human consumption as its ability to retain heavy metals in edible parts.   Keywords: Phytoremediation, Water mimosa, Heavy metals, Food safety, Green technology https://ijph.tums.ac.ir/index.php/ijph/article/view/4886 https://ijph.tums.ac.ir/index.php/ijph/article/download/4886/4462

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 112 116 Norhidayah MAT AZIS Amielia AB HAMID Hui Ping PUNG Putri ‘Amirah ABDUL RA­FEE Farizatul Akmawati YAHYA Syafinaz AMIN NORDIN Vasanthakumari NEELA Zarizal SUHAILI Mohd Nasir MOHD DESA 2015 10 21 2015 10 21 Background: This study was undertaken to evaluate Staphylococcus aureus carriage and persistence in health sciences students at the Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. Methods: Consent form and self-administered questionnaires on socio-demographics, hygienic practices, medical and medication history were distributed followed by nasal swab collection; sampling was done twice in one month interval in October and November 2013. Bacterial identification followed the standard phenotypic methods. Antibiotic susceptibility of isolates against oxacillin and cefoxitin was tested by disc diffusion method. Methicillin resistance determinant gene (mecA) was detected through polymerase chain reaction-assay. Results: S. aureus was isolated from 31.3% (60/192) and 33.3% (60/180) of the student population during the first and second sampling respectively. Among the S. aureus-positive participants, about 65% of them were persistent carrier (S. aureus was detected during both sampling exercises). Six methicillin-resistant S. aureus (MRSA) were detected (four and two isolates in the two sampling events respectively) as inferred by decreased susceptibility to oxacillin and cefoxitin and presence of mecA gene; two of the strains were from a single individual. Fisher’s exact test showed no significant correlation between carriage and the tested risk factors except for the habit of touching nose and chronic illnesses (P < 0.05), with a higher incidence of S. aureus among those associated with the two risk factors. Conclusions: As far as the limited sampling period is concerned, these findings indicate that a proportion of the student population may be at infection risk. Avoiding frequent nose-touching could be one of the preventive measures.   Keywords: Staphylococcus aureus, Infection risk, Nasal carriage, MRSA https://ijph.tums.ac.ir/index.php/ijph/article/view/4887 https://ijph.tums.ac.ir/index.php/ijph/article/download/4887/4463

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 117 124 Nik Nor Ronaidi NIK MAHDI Norsa’adah BACHOK Norlen MOHAMED Mohd Nazri SHAFEI 2015 10 21 2015 10 21 Background: Road traffic accident is a worldwide public health issue that has its highest impact on low and middle income countries including Malaysia. Many previous studies concerned on the causality of the actual accidents and little attention were given to near miss incidents. Hence, the current study was designed to determine the prevalence and associated factors for near miss incident among long distance bus drivers in Malaysia. Methods: A cross sectional study was conducted among 517 long distance bus drivers. Data were collected using interview-guided translated and validated Pittsburgh Sleep Quality Index and Manchester Driver Behaviour questionnaire. Multiple logistic regression analysis was performed to determine the significant factors for near miss incident among long distance bus drivers in Malaysia. Results: The prevalence of near miss incident among long distance bus drivers was 37.5% (95% CI: 33.5, 41.8). The significant associated factors for near miss incident were younger age group (ORadj : 1.99; 95% CI: 1.32, 3.01), longer distance travelled per day (ORadj : 2.34; 95% CI: 1.52, 3.60), sleep disturbances (ORadj : 1.74; 95% CI: 1.19, 2.54) and errors in driving behaviour (ORadj : 1.31; 95% CI: 1.23, 1.39). Conclusion: Self-reported near miss incidents were relatively high among long distance bus drivers in Malaysia. This issue should be taken seriously and preventive action should consider the significant human factors such as younger age group, errors in driving behaviours, sleep disturbances as well as occupational factors like distance travelled per day.   Keywords: Road traffic accident, Near miss, Bus drivers, Malaysia   https://ijph.tums.ac.ir/index.php/ijph/article/view/4888 https://ijph.tums.ac.ir/index.php/ijph/article/download/4888/4464

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 125 130 Nada ISMAIL Anita ABD RAHMAN Emilia ZAINAL ABIDIN 2015 10 21 2015 10 21 Background: A cross sectional study conducted to identify the organizational factors associated to the occupational stress among lecturers in selected Community Colleges, Peninsular Malaysia. Methods: Study was conducted by using cluster-sampling method and 189 self-administrated questionnaires were distributed. A validated Malay version of Job Content Questionnaire (JCQ) was used to obtain the information regarding respondent’s background and their respective job scope. JCQ described four organizational factors that were decision latitude, psychological job demand, social support and job insecurity. Results: Response rate was 87.1% with 25.9% of the lecturers were stressed. There were no significant association between occupational stress with any socio-demography factors but the result showed significant associations between occupational stress and all four organizational factors studied, decision latitude (P<0.001); psychological job demand (P<0.001); social support (P<0.001); and job insecurity (P<0.001). Conclusion: From the result, it clearly showed that stress among lecturers came from organizational factors in their workplace. The highest organizational factors reported were insufficient social support from the employer and limited authority in decision making. These factors might cause lack of communication and poor social interaction. The occupational stress among lecturers was associated with all the organizational factors (decision latitude, psychological job demand, social support and job insecurity) in this study. Therefore, preventive measures or intervention programs need to be implemented in Community Colleges to alleviate the negative consequences.   Keywords: Occupational stress, Lecturers, Organizational factors, Job content questionnaire (JCQ) https://ijph.tums.ac.ir/index.php/ijph/article/view/4889 https://ijph.tums.ac.ir/index.php/ijph/article/download/4889/4465

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 131 141 Najihah Zainol ABIDIN Aziemah ZULKIFLI Emilia Zainal ABIDIN Anita Abd RAHMAN Zailina HASHIM Irniza RASDI Sharifah Norkhadijah Syed ISMAIL 2015 10 21 2015 10 21 Background: Secondhand Smoke (SHS) exposure has been reported to cause a number of adverse health effects. Although studies have been conducted to identify the link between SHS exposure and cognitive functioning of children, its relationship is still unclear. This study aimed to identify the association of prenatal and postnatal SHS exposure with cognitive ability among adolescents. Methods: A total of 370 adolescents aged 13-14 years old in two states in Malaysia participated in this study. A modified Global Youth Tobacco Survey questionnaire was used to assess exposure to SHS. Parental-administered questionnaire was used to obtain information on parental smoking and prenatal SHS exposure. Cognitive ability was objectively measured using Wechsler Nonverbal Scale of Ability. Results: 75.4% and 24.6% adolescents were identified to have cognitive ability categorized as high (>90marks) and low (≤90marks), respectively. From the logistic analysis adjusting for confounders, adolescents with SHS exposure in toddlerhood (≤2years old) were three times more likely to have lower cognitive ability compared to those without exposure (Adjusted Odds Ratio (AOR), 2.89; 95% Confidence Interval (CI), 1.21-6.83). School absenteeism was associated with lower cognitive ability. Conclusion: Exposure to SHS during toddlerhood was linked to lower cognitive ability among adolescents. The findings of this study emphasize the need for preventing involuntary toddlerhood SHS exposure from parents and indirectly encourage home smoking restriction practices among Malaysian citizens.   Keywords:  Passive smoking, Adolescents, Cognitive ability, Youth, Tobacco smoke https://ijph.tums.ac.ir/index.php/ijph/article/view/4890 https://ijph.tums.ac.ir/index.php/ijph/article/download/4890/4466

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 142 147 Nehzat FADAEI Zainuddin HUDA Syed Tajuddin SYED HASSAN 2015 10 21 2015 10 21 Background: The purpose of this study was to determine the prevalence of job dissatisfaction, and to ascertain the association between job strain and job dissatisfaction and socio-demographic and occupational factors among laboratory staff of Universiti Putra Malaysia (UPM). Methods: This cross-sectional study was conducted among 450 research laboratory staff in 10 faculties and 8 institutes of Universiti Putra Malaysia. Probability appropriate to size sampling and simple random sampling method were used and data were collected via Job content Questionnaire (JCQ) from September 2012 to February 2013. SPSS (version 20.0) software was used for data analysis. Results: A total of 285 laboratory staff with at least one year job tenure participated in this study (Response rate: 91.3%). The finding revealed that 47% of laboratory staff reported job dissatisfaction. The results of this survey showed laboratory staffs with age 35, and less were two-fold more likely to report job dissatisfaction than the older staff (adjusted OR= 2.108, 95% CI: 1.241- 3.582). Laboratory staffs with higher toxic exposures 2 times more likely to report job dissatisfaction (adjusted OR= 1.887, 95% CI: 1.062-3.353). Conclusion: There is a need to have training plans to increase the knowledge on toxic exposures among younger laboratory staff, which may be helpful to reduce job dissatisfaction among them.   Keywords:  Job dissatisfaction, Laboratory staff, JCQ, UPM https://ijph.tums.ac.ir/index.php/ijph/article/view/4891 https://ijph.tums.ac.ir/index.php/ijph/article/download/4891/4467

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 148 153 Noraita TAHIR Syed Mohamed ALJUNID Jamal Hisham HASHIM Jaseema BEGUM 2015 10 21 2015 10 21 Background: Noise induced hearing loss (NIHL) is the highest reported occupational disease among industrial workers but there is scarcity of data on disease burden in Malaysia. This study estimated the risks and burden of NIHL in manufacturing industries in Malaysia. Methods: This cross-sectional industrial survey was conducted by interviewing OSH practitioners at 26 industries categorized as food, tobacco, textile, wearing apparel, wood products except furniture, paper, refined petroleum, chemicals, non-metallic mineral, basic metal, fabricated metal, motor vehicle parts. The catchment population is imputed based on stratified sampling design involving 60% of workers diagnosed with NIHL. Results: A total of 18 industries exposed to noise level of 86-90dBA and 8 industries at more than 91dBA were identified. All industries provide regular awareness training and hearing protection device to their workers but none of them implement attenuation, majority of them (81%) conduct onsite audiometric test annually. In overall, the risk of NIHL and incidence per 100,000 manufacturing workers projected is 8% (139 new cases), the highest risk and incidence is 32% (26) in motor vehicle parts industry; followed by 23% (1140 new cases) in tobacco industry and 23% (269 new cases) in fabricated metal industry. Male workers (89%) were exposed to a greater risk compared to female (11%). It was estimated that 103,000 workers were potentially affected by NIHL in Malaysia. Conclusion: NIHL is a major burden among industrial workers in Malaysia. Implementation of effective hearing conservation program and self-enforcement of noise regulations by the employer could potentially reduce the burden.   Keywords: Noise, Hearing loss, Manufacturing, Malaysia https://ijph.tums.ac.ir/index.php/ijph/article/view/4892 https://ijph.tums.ac.ir/index.php/ijph/article/download/4892/4468

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 154 166 Nurul Ainun HAMZAH Shamsul Bahri MOHD TAMRIN Noor Hassim ISMAIL 2015 10 21 2015 10 21 Background: This cross sectional study was carried out to determine the relationship between metal dust exposure and respiratory health in male steel workers in Terengganu, Malaysia. Methods: Subjects were interviewed using a structured questionnaire from British Medical Research Council (BMRC) Questionnaire regarding respiratory symptoms and were examined their lung function using spirometer. Results: The mean trace metal dusts concentration TWA8 for cobalt and chromium in most of work unit exceeded occupational exposure prescribed values. Prevalence of chest tightness, chronic phlegm, and shortness of breath was 28.0%, 26.8%, 24.1%, and 20.2% respectively. Age and smoking were among the factors associated with respiratory symptoms (OR: 0.92 – 1.78). Smoking and cumulative respirable metal dust were negatively associated with FEV1. Conclusion: The mean metal dust for cobalt and chromium were 1 to 2 times higher than permissible exposure limit (PEL). This study found that respirable cumulative metal dust exposure is one of the contributing factors to lung function values among steel workers.   Keywords: Respiratory symptoms, Lung function, Metal dust, Questionnaire https://ijph.tums.ac.ir/index.php/ijph/article/view/4893 https://ijph.tums.ac.ir/index.php/ijph/article/download/4893/4469

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 167 171 Nurul Syazani YUSWIR Nurul Syazani YUSWIR Sarva Mangala PRAVEENA Ahmad Zaharin ARIS Sharifah Norkhadijah SYED ISMAIL Zailina HASHIM 2015 10 21 2015 10 21 Background: The aim of this study was to determine bioavailability heavy metal concentrations of Cu, Cd, Cr, Co and Zn and health risk assessment in different types of Klang district, Selangor (Malaysia) urban surface soil using in Physiologically Based Extraction Test in vitro human digestion model. Methods: A total of 76 urban surface soil was sampled based on seven different types of land use, namely, industrial, residential, agriculture, town area, port, school and mangrove. For bioavailability of heavy metal concentration, the soil solution was analysed using Inductively Coupled Plasma-Optical Emission Spectrometry (ICP-OES). Results: Heavy metal concentrations for this study were in the following order: Zn, Cu, Co, Cd and Cr. Results of bioavailability heavy metal concentration from ICP-OES was used to establish Hazard Quotient in order to determine non-cancer risk. The results of Hazard Quotient are < 1 for all surface soil samples. Conclusion: All the soil samples in Klang district are safe from the non-cancer risk to human.   Keywords: Heavy metal, Bioavailability, Health risk assessment https://ijph.tums.ac.ir/index.php/ijph/article/view/4894 https://ijph.tums.ac.ir/index.php/ijph/article/download/4894/4470

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 172 179 AbulKashem Obidul HUQ HabibunNabi Muhammad Ekramul MAHMUD Kazi Mohammad Formuzul HAQUE 2015 10 21 2015 10 21 Background: With the rising of baking industries in Bangladesh, more female workers are surprisingly engaged compared to male workers. The major aim of this study was to observe the working conditions, available safety facilities and hygiene maintained by the female workers. Methods: A cross sectional survey was carried out among the randomly selected 384 female workers from different baking industries located at Dhaka and Tangail regions in Bangladesh by a well-designed semi-structured questionnaire. Results: About 33% of all respondents opined the machine room was congested, 27% narrow packaging and sealing room while 37% unhealthy storage areas. Two industries did not have proper accident prevention facilities. Although all the industries had monitoring personnel hygiene practices, about 40% of the workers were found not strictly maintaining some basic personal hygiene criteria. Socio-demographic result showed that the workers education level and monthly family income were poor. About 59.1% of all workers were suffering from various degrees of Chronic Energy Deficiencies (CED). It was also observed that nutritional status of the workers significantly related to their expenditure of the foods and working loads (χ2 Value < 0.05). Conclusion: The survey revealed that the occupational hygiene and safety practices were not at satisfactory level in some selected food industries in Bangladesh. The currently available food safety tools and system like Hazard Analysis and Critical Control Points (HACCP) should be adapted by the industries and concurrently ensure the sufficient wages for workers.   Keywords: Industrial female workers, Occupational hygiene, Safety practices, Chronic Energy Deficiencies (CED)   https://ijph.tums.ac.ir/index.php/ijph/article/view/4895 https://ijph.tums.ac.ir/index.php/ijph/article/download/4895/4471

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 180 185 Ping Yeap LOH Satoshi MURAKI 2015 10 21 2015 10 21 Background: Carpal tunnel syndrome (CTS) is one of the most common musculoskeletal disorders among computer users. Computer users exhibit various wrist angles while typing. Dynamic changes of wrist angle may cause different degrees of median nerve compression. The objective of this study was thus to investigate the effects of the combination of wrist flexion-extension with wrist deviation on median nerve cross-sectional area (MNCSA). Methods:  Eight right-handed participants were recruited in this study. Both wrists were examined by sonographic ultrasound (US) at the proximal carpal tunnel level in the transverse plane. A total of nine wrist positions were examined, including wrist neutral (WN), wrist flexion (WF)30°, and wrist extension (WE)30°, together with three wrist deviation conditions, namely, without radial deviation (RD) and ulnar deviation (UD), with maximal RD and with maximal UD. MNCSA was measured by tracing method with ImageJ. Results: Paired t-test showed a significant difference of WN MNCSA between the dominant hand (7.93 ± 0.63 mm2) and the non-dominant hand (6.98 ± 0.42 mm2) (P<0.001). Two-way repeated-measures ANOVA (handedness as an independent factor) showed that WF30° and WE30° caused significant differences of MNCSA when compared with WN (P<0.001). However, wrist RD/UD did not have a significant interaction with the changes of MNCSA in WN, WF and WE positions. Conclusion: The results indicate a significant reduction of MNCSA when WN changed to WF and WE. Wrist RD and UD did not cause significant changes of MNCSA at different wrist positions.   Keywords: Median nerve, Ultrasound, Wrist active holding, Nerve deformation https://ijph.tums.ac.ir/index.php/ijph/article/view/4896 https://ijph.tums.ac.ir/index.php/ijph/article/download/4896/4472

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 186 193 Karin REINHOLD Lea PALLON 2015 10 21 2015 10 21 Background: This paper describes the common hazards in the metal industry – chemicals and noise. The aim of the study was to get an overview of risk levels of mentioned occupational hazards and examine the implementation of adequate safety measures. Methods: Measurements of noise and chemicals were performed, self-reported exposure and usage of personal protective equipment from workers were used to assess the behavior of workers, semi-structured interviews were conducted to clarify employers’ practices to provide workers with adequate personal protective equipment. Results: The measurements of working environment in welders’ workplaces showed that the main chemicals that  reach workers’ breathing zone are carbon monoxide, ozone, nitrous oxides, carbon dioxide, and metals (manganese, iron, chromium). The results of questionnaires and interviews revealed that 57% of employees provide and only 41% of welders use respiratory protectors against hazardous welding fumes. The results of noise measurements showed that many of the machines used in the metal industry produce high levels of noise. Those values were often above occupational exposure limits, but 35% of workers do not use any personal protective equipment. Workers reported several health problems connected with chemicals and noise. Conclusion: Working conditions of the metal industry may impair workers’ health considerably. Several safety measures can be implemented to protect metal workers’ health against noise and hazardous welding fumes including noise screens, local ventilation, organizational measures (such as educational intervention, providing chemical material safety data sheets) and adequate personal protective equipment.   Keywords: Occupational hazards, Noise, Chemicals, Metal industry https://ijph.tums.ac.ir/index.php/ijph/article/view/4897 https://ijph.tums.ac.ir/index.php/ijph/article/download/4897/4473

Tehran University of Medical Sciences Iranian Journal of Public Health 2251-6085 43 Supple 3 2015 10 21 194 200 Suriani ISMAIL Muhamad Hanafiah JUNI Kulanthayan KCMANI Muhamad Suhainizam SALILUDDIN Raja Ahmad ZAKWAN Ling Rong TIONG 2015 10 21 2015 10 21 Background: Global Adult Tobacco Survey (GATS), Malaysia 2011 reported that the prevalence of smoking was highest among Malays male i.e., 24.6% (CI:22.1,27.3). The aim of this study was to evaluate the perception of a group