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Disaster preparedness is an issue that receives little attention in the community. Communities must take preventative measures to overcome obstacles and improve community preparedness. This review identifies the optimal dose of disaster preparedness intervention in the community. A systematic literature search was conducted to examine a study about the optimal dose of disaster preparedness intervention developed for implementation at a community level. A scoping review based on the PRISMA diagram was conducted from four databases. A combination of keywords was adapted for each database. Inclusion and exclusion criteria were applied. A total of eight articles were synthesized based on the intervention dose of disaster preparedness among community interventions. The summarized studies provided evidence that the optimal dose for disaster preparedness intervention in the community can be prevented with an educational intervention program with a minimal dosage of intervention. The Health Belief Model Theory was the most often cited theory by researchers. The best dose for disaster preparedness intervention in a community can be mitigated with a single dose of education. Nonetheless, we cannot disregard alternative disaster preparedness theories because each has its advantages and disadvantages.

This study aimed to estimate the potential waste management cost reduction and the recycling profit from the segregation programme implemented in Malaysia. The assessment was done among the states that implemented a waste segregation programme in Malaysia, a Southeast Asia country with a GDP of 364.7 billion USD. The solid waste (tonnes) data were collected from the Solid Waste Management and Public Cleansing Corporation, Malaysia, and analysed using mathematical models. On average, 2.69 million tonnes per year (t/yr) of waste were disposed of in the landfills, and 1,680 t/yr of waste was segregated, equivalent to 0.06%. Plastic (30.49%–39.48%) and paper (31.35%–40.88%) were the major components of segregated waste. Implementing the waste segregation program avoids the cost of waste disposal in landfills, potentially at 61,000 USD/yr and generating 130,000 USD/yr recycling profits. Therefore, the government should strengthen the programme to increase the segregation rate and provide a significant income to the community.

This study intends to deal with the environmental consequences of the COVID-19 pandemic in Malaysia, by providing a summary of the effects of COVID-19 on municipal solid waste (MSW). In this analysis, the data on domestic waste collection were collected from the Solid Waste Management and Public Cleaning Corporation (SWCorp) from 1 January 2020 to 31 December 2020 to evaluate the relative changes in MSW percentage via a waste weighing method. The data consisted of the cumulative tonnage of MSW for every local authority in Peninsular Malaysia and was classified according to MCO phases; before the MCO, during the MCO, during the conditional MCO (CMCO) and during the recovery MCO (RMCO) phases. The results indicated that the enforcement of the early MCO showed a positive effect by decreasing the volume of MSW. This decrease was noted across 41 local authorities, which accounts for 87.23% of Peninsular Malaysia. However, the amount of MSW began to increase again when the MCO reached the conditional and recovery stages. From this, it can be concluded that the implementation of the MCO, in its various incarnations, has shown us that our lifestyles can have a harmful impact on our environment. While the pandemic was still spreading and limitations were still in place in Malaysia, local governments and waste management companies had to quickly alter their waste management systems and procedures. The current circumstance allows us to rethink our social and economic structures while improving environmental and social inclusion.

Safety leadership has been advocated as the most appropriate approach towards injury prevention. Besides, supervisor safety role is also proposed to be crucial towards good safety performance in SMEs. Henceforth, this study aisled to determine the direct impact of safety leadership (safety concern, safety policy, and safety motivation) played by the owner-managers on safety performance within the SME manufacturers in Selangor, Malaysia. Furthermore, this study also evaluated the mediating effect of supervisor safety roles towards safety leadership and safety performance' relationship. The data was collected among 165 SME manufacturing workers from 37 factories and Partial Least Square – Structured Equation Model (PSL-SEM) was performed for data analyses. The results indicated that safety leadership in terms of safety concern, safety policy, and safety motivation has significant impact on safety performance. However, supervisor safety role does not mediate the relationship between safety leadership and safety performance. These results proved importance of direct safety management by the owner-managers and supervisors towards safety performance.Safety leadership approach delivered by the owner-managers could be the best way to improve safety performance despite all the limitation within SMEs.

Floods occur when a body of water overflows and submerges normally dry terrain. Tropical cyclones or tsunamis cause flooding. Health and safety are jeopardized during a flood. As a result, proactive flood mitigation measures are required. This study aimed to increase flood disaster preparedness among Selangor communities in Malaysia by implementing a Health Belief Model-Based Intervention (HEBI). Selangor’s six districts were involved in a single-blinded cluster randomized controlled trial Community-wide implementation of a Health Belief Model-Based Intervention (HEBI). A self-administered questionnaire was used. The intervention group received a HEBI module, while the control group received a health talk on non-communicable disease. The baseline variables were compared. Immediate and six-month post-intervention impacts on outcome indicators were assessed. 284 responses with a 100% response rate. At the baseline, there were no significant differences in ethnicity, monthly household income, or past disaster experience between groups (p>0.05). There were significant differences between-group for intervention on knowledge, skills, preparedness (p Clinical trial registration: The trial registry name is Thai Clinical Trials Registry, trial number TCTR20200202002.

Background Flood disaster preparedness among the community seldom received attention. Necessary intervention must be taken to prevent the problem. Health Education Based Intervention (HEBI) was developed following the Health Belief Model, particularly in improving flood disaster preparedness among the community. The main objective of this study is to assess the effect of HEBI on improving flood disaster preparedness among the community in Selangor. This study aims to develop, implement, and evaluate the impact of health education-based intervention (HEBI) based on knowledge, skills, and preparedness to improve flood disaster preparedness among the community in Selangor. Method A single-blind cluster randomized controlled trial will conduct at six districts in Selangor. Randomly selected respondents who fulfilled the inclusion criteria will be invited to participate in the study. Health education module based on Health Believed Theory will be delivered via health talks and videos coordinated by liaison officers. Data at three-time points at baseline, immediate, and 3 months post-intervention will be collected. A validated questionnaire will assess participants’ background characteristics, knowledge, skill, and preparedness on disaster preparedness and perception towards disaster. Descriptive and inferential statistics will be applied for data analysis using IBM Statistical Package for Social Sciences version 25. Longitudinal correlated data on knowledge, skills, preparedness, and perception score at baseline, immediate post-intervention, and 6 months post-intervention will be analyzed using Generalized Estimating Equations (GEE). Discussion It is expected that knowledge, skills, preparedness, and flood disaster perception score are more significant in the intervention group than the control group, indicating the Health Education Based Intervention (HEBI). Trial registration Thai Clinical Trial TCTR20200202002.

Background:Disparities of access to health services in rural areas is a global health issue, especially in middle income countries including Malaysia. Recent method called enhanced two-step floating catchment area (E2SFCA) exhibit promising results in quantifying the health care accessibility. This study aimed to describe and explore the pattern of spatial accessibility to primary care services based on secondary data.Methods:The E2SFCA method were adapted to measure the level of accessibility to primary care across rural area in Selangor state of Malaysia, with slight modification to suit our local context considering for public and private providers as well as incorporating clinic’s availability factor into the original formula. For each provider, spatial pattern of accessibility scores was mapped, spatial autocorrelation local Moran’s I and Getis-Ord-Gi* was performed and the degree of equality was computed based on Gini index.Results:Areas with high E2SFCA scores mainly concentrated encircling the periphery of the large urban areas at the centre of the state, largely contributed by the private sector whereas low E2SFCA scores areas observed predominantly at the northern region and along the coastal region. As a whole, the E2SFCA scores across rural Selangor population was fairly equal but lower degree of equality was observed at the northern region of the state.Conclusions:The level and distribution of E2SFCA scores reflects the performance of the primary health care. Findings from this study provides insight for the health authorities to identify disparities of access to primary care services and areas that need attention, hence would be basis for future health care planning and resource distribution.

This study has highlighted the trend of recently-reported dengue cases after the implementation of the Movement Control Orders (MCOs) caused due to COVID-19 pandemic in Malaysia. The researchers used the dengue surveillance data published by the Malaysian Ministry of Health during the 3 phases of MCO (which ranged between 17th March 2020 and 28th April 2020) was used for determining the cumulative number of dengue patients. Thereafter, the dengue cases were mapped using the Geographical Information System (GIS). The results indicated that during the 42 days of MCO in Peninsular Malaysia, 11,242 total cases of dengue were reported. The daily trend of the dengue cases showed a decrease from 7268 cases that occurred before the MCOs to 4662 dengue cases that occurred during the initial 14 days of the COVID-19 pandemic (i.e., MCO I), to 3075 cases occurring during the MCO II and 3505 dengue cases noted during MCO III. The central peninsular region showed a maximal decrease in new dengue cases (52.62%), followed by the northern peninsular region (1.89%); eastern coastal region (1.25%) and the southern peninsular region (1.14%) during the initial MCO implementation. However, an increase in the new dengue cases was noted during the MCO III period, wherein all states showed an increase in the new dengue cases as compared during MCO II. The decrease in the pattern was not solely based on the MCO, hence, further investigation is necessary after considering different influencing factors. These results have important implication for future large-scale risk assessment, planning and hazard mitigation on dengue management., Highlights • Dengue has been described as a “silent killer” amidst the COVID-19 pandemic. • The MCOs implemented by the Malaysian government to break the COVID-19 infection chain have positively affected the onset of new dengue cases. • The highest reduction of new dengue cases were reported in the central peninsular region (52.62%), followed by the northern peninsular region (1.89%), eastern coastal region (1.25%) and the southern peninsular region (1.14%). • New dengue cases increased during the MCO3 period, with the increase of reported dengue cases in all states in Peninsular Malaysia.

This study determines the toxic heavy metal (As, Cd, Pb) concentrations in selected leafy vegetables (pak choi, amaranth, and caisim) that were collected from an agricultural area in Jengka, Pahang, Malaysia. A potential health risk via the ingestion pathway is also evaluated. A graphite furnace atomic absorption spectrophotometer (GFAAS) analysis was applied to determine metal concentration. Heavy metal concentrations for leafy vegetables ranged between 0.03 and 0.05 mg/kg for lead (Pb), followed by 0.19–0.43 mg/kg for arsenic (As) and 0.15–0.54 mg/kg for cadmium (Cd). Cd is likely to be accumulated and absorbed more than arsenic (As) and Pb based on the bioconcentration factor (BCF). Cluster analysis (CA) and principal component analysis (PCA) suggested the metal origin is anthropogenic (the agricultural activities). Target hazard quotient (THQ) value below unity ( 1 × 10–4) possibly will pose a health risk to consumers. This study suggested leafy vegetable intake from this area poses some degree of potential health hazards to the consumer. Therefore, a comprehensive investigation such as bioavailability metal form analysis to obtain a more accurate risk assessment is needed.

Steroid estrogens, such as 17β-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 ± 7.0 ng/L to 93.9 ± 6.9 ng/L in influent and 35.1 ± 17.3 ng/L to 85.2 ± 7.6 ng/L in effluent, with removal of 6.4%–63.0%. The EE2 concentration ranged from 0.2 ± 0.2 ng/L to 4.9 ± 6.3 ng/L in influent and 0.02 ± 0.03 ng/L to 1.0 ± 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.

In this article, data on the demographic parameters of the Aedes albopictus were collected from those areas in Shah Alam, Malaysia that had experienced a dengue outbreak. The surveys were conducted from March to December 2017. The eggs of the Ae. albopictus were collected using ovitraps, and were analysed based on the demographic parameters in a controlled environment in an insectarium. The data were comprised of four types of biological information on the life demographic parameters of the Ae. albopictus that were monitored based on specific localities. The data were inferred information regarding egg productivity (n), egg development (%), immature development (days), and survivorship (days).

IntroductionCancer is now being recognised as a long term conditions due to advances in treatments that increase the survival rate of patients with cancer to as long as 10 years from the time of the disease. Anxiety is among the commonly discovered psychiatric illness in patients with cancer and is often neglected. Approximately 10% of patients with cancer are affected with anxiety worldwide. Hence, this study was aimed to determine the prevalence of anxiety disorder and its associated factors among workers with cancer in Jordanian population.MethodsA cross-sectional study was conducted at the King Husain Cancer Centre (KHCC) in Amman, Jordan. Proportional sampling technique was used to obtain the sample population of 355 workers with cancer. Data were collected through self-administered Generalized Anxiety Disorder (GAD-7) questionnaire and analyses were carried out using SPSS version 25.ResultsResponse rate of 100% were obtained from the participants. Prevalence of anxiety disorder among workers with cancer was recorded at 20.8% with male (23.1%) having the higher prevalence rate than female (17.3%) workers with cancers. A significant difference in anxiety between marital status (p=0.025), types of cancer (p=0.001), treatment types (p=0.024) were observed. A multiple regression was run to predict anxiety disorder from marital status, type of cancer and treatment types. These variables statistically significantly predicted anxiety disorder [F(3, 351) = 8.117, p < .001, R2 = 0.225].ConclusionThere is high prevalent of anxiety disorder among workers with cancer in Jordan. Predictors of anxiety among workers with cancer were also identified in this report.

This study focuses on suitable site identification for constructing a hospital in Malacca, Malaysia. Using significant environmental, topographic, and geodemographic factors, the study evaluated and compared machine learning (ML) and multicriteria decision analysis (MCDA) for hospital site suitability mapping to discover the highest influential factors that minimize the error ratio and maximize the effectiveness of the suitability investigation. Identification of the most significant conditioning parameters that impact the choice of an appropriate hospital site was accomplished using correlation-based feature selection (CFS) with a search algorithm (greedy stepwise). To model the potential hospital site map, we utilized multilayer perceptron (MLP) and analytical hierarchy process (AHP) models. The outcome of the predicted site models was validated utilizing CFS 10-fold cross-validation, as well as ROC curve (receiver operating characteristic curve). The analysis of CFS indicated a very high correlation with R2 values of 0.99 for the MLP model. However, the ROC curve indicated a prediction accuracy of 80% for the MLP model and 83% for the AHP model. The findings revealed that the MLP model is reliable and consistent with the AHP. It is a sufficiently promising approach to the location suitability of hospitals to ensure effective planning and performance of healthcare delivery.

Steroid estrogens such as 17β-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.

Background Dengue, a major international health problem, is transmitted by aedes mosquitoes. Due to the lack of a vaccine, vector control by tackling the contribution factors may reduce dengue incidence. By understanding the factors contributed to the vector densities such as sociological, environmental and climatic factors, dengue prevention and control will succeed.Objective This study is aimed at determining the major sociological, environmental and climatic factors contributing to dengue cases and to produce the risk map based on the contributing factorsMethods Questionnaire survey of 379 respondent with dengue history were utilized. The climatic data were obtained from Malaysia Meteorological Department. Geographical Information System (GIS) technology has been used to integrate the socio-environmental and climatic factors with dengue casesResult The chi-square results revealed that there is a significant association between respondent’s dengue history and houses that are shaded with vegetation (p= 0.012) and the present of playground areas near the residential (p = 0.011) whilst Pearson’s Correlation showed that dengue cases in Kuala Lumpur were significantly correlated with temperature, relative humidity and rainfall (p < 0.05)Conclusion The study identified socio-environmental factors that play an important role to develop the risk maps. The risk map can be useful baseline for decision maker to strategize and create preventive measure for controlling aedes mosquitoes.

In this research, an online monitoring system was designed to detect emergency due to uncontrolled blood glucose fluctuations in patients with diabetes mellitus. Hyperglycemia in the morning causes dawn phenomenon and Somogyi effect. This incident is very fast, and its uncontrollable time of occurrence can inflict a fatal condition causing death. Unfortunately, there are no systems able to detect such events, currently. This study proposes an online monitoring system with the input of the patient’s blood glucose measurement into the smartphone. Blood glucose values are sent and stored in the webserver, and the results are used to determine the incidence of dawn phenomenon and the Somogyi effect. The study was able to produce an online monitoring system which can be monitored by nurses, doctors, and administrators via the dashboard.

High concentrations of nitrate through drinking water have been associated with health problems. This cross sectional study sought to determine the level of nitrate concentrations in private well water and the association to the disease caused by nitrate among population of Bachok, Kelantan. The concentrations of nitrate in 256 wells were sampled from September to October 2015. About 126 respondents from the agricultural area and 130 respondents from the non-agricultural area were participated in the study. The human health risk associated with ingesting nitrate were assessed by Hazard Quotient (HQ) and Odd Ratio (OR). The physicochemical characteristics of well water in both areas (i.e., pH, ammonia, Dissolved Oxygen (DO), conductivity, turbidity, Total Dissolved Solid (TDS) and salinity) were within the acceptable limits of Malaysian Drinking Water Quality Standard. The mean ± SD levels of nitrate in the agricultural area was 13.04±14.39 mg L-1 NO3-N, exceeding the maximum acceptable limits of Malaysia NDWQS (10 mg L-1 NO3-N) and were two fold higher than the non-agriculture area (6.31±5.22 mg L-1 NO3-N). 52 wells (41.27%) in the agricultural area and 35 wells (26.9%) in the non-agricultural area had nitrate level above the maximum acceptable nitrate (10 mg L-1 NO3-N). The HQ associated with the potential non-carcinogenic risk of drinking nitrate contaminated groundwater ranged from 0.007 to 1.143×10-6 in the agricultural area, slightly higher than in the non-agricultural area (0.002 to 0.468×10-6). The OR for disease such as diabetes, goitre and gastric were not significant with high levels of nitrate in the well water. The results of the present study showed that there was no statistically significant association between nitrate in well water and the risk of related health disease such as diabetes, goitre and gastric in this study.

This study aimed to determine bioavailability of heavy metal concentrations (Al, Fe, Zn, Cu, Co, Cd, Pb and Cr) in 76 urban surface soil samples of Klang district (Malaysia). This study also aimed to determine health risks posed by bioavailability of heavy metals in urban soil on adults and children. For bioavailability of heavy metal concentrations, a physiologically bioavailability extraction test in vitro digestion model was used. Mean values of bioavailability heavy metal concentrations for this study were found to be the highest in Al (25.44 mg/kg) and lowest in Cr (0.10 mg/kg). Results of Spearman correlation coefficient (r) values showed significant correlations were observed for Al-Fe (r = 0.681), Cd-Co (r = 0.495), Cu-Zn (r = 0.232), Fe-Pb (r = 0.260), Fe-Zn (r = 0.239). For cluster analysis, output showed that these heavy metals could be classified into four clusters: Cluster 1 consisted of Cd, Cr, Co, and Pb; Cluster 2 consisted of Zn and Cu; Cluster 3 consisted of Fe; and Cluster 4 consisted o...

Heavy metals in urban soils are associated with direct and indirect human health risks. This study examined bioavailability of heavy metal (Pb, Cd, Cr and As) in urban soil of Seri Kembangan (Malaysia) and their risks to human health. Bioavailability of heavy metal concentration (arsenic, lead, cadmium and chromium) were analysed by a simplified physiologically based extraction test. Both noncarcinogenic and carcinogenic risks were assessed using health index and total lifetime cancer risk, respectively. Average concentrations of bioavailability heavy metal were found in the order of Pb (2668.8 mg/kg) > Cr (74 mg/kg) > Cd (47.5) > As (13.75 mg/kg). For non-cancer, average hazard index values of heavy metal order were Pb(1.27) > Cr(0.11) > Cd(0.05). For As, total cancer risk values of Seri Kembangan urban soil (7.2E-6) were lower than the tolerable lifetime cancer risk for regulatory purposes (1E-5). Ingestion pathway is the most contributed pathway for both cancer and non-cancer risks. Land use type is found to be the main contributor which influences heavy metal exposure corresponding to health risk assessment output. Industrial areas were found to have hazard index values were lesser than residential areas in Seri Kembangan urban soil. Location areas in Seri Kembangan as near major roads with large amount of traffics were found to be more higher with HI more than 1, indicating high heavy metal contamination in urban soil due to vehicular emissions. This study has showed that realistic estimation of human health risk of heavy metal contamination in urban soils needs combination of land use type with bioavailability heavy metal concentration.

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.

Aims: To determine the respiratory inflammation among children living near to non-sanitary municipal solid waste landfill area and the concentration of Interleukin-6 cytokine. Study Design: A cross-sectional comparative study design. Place and Duration of Study: Sample: Pajam, Negeri Sembilan, Malaysia, between September 2013 and April 2014. Methodology: A total of 72 children were randomly selected based on the inclusive and exclusive criteria. A set of pre-tested questionnaires were utilized to obtain socio-demographic information and to predict health risk faced by the respondents. Saliva samples of the respondents were collected and analyzed using Human Interleukin-6 (IL-6) Platinum ELISA (Enzyme-Linked Immunosorbent Assay) kit. Results: The PM10 concentration for the exposed group was higher than the unexposed group with the mean ± standard deviation (SD) of 152.31±31.07 μg/m3 and 87.77±30.77 μg/m3 respectively. The mean ± SD of the Interleukin-6 for the exposed group was slightly higher than the unexposed group with the mean ± SD of 6.34±1.95 pg/ml and 5.77±1.08 pg/ml respectively. The most common symptoms reported was sneezing and sore throat. There was no significant correlation between PM10 concentration and IL-6 in this study. Conclusion: The findings exhibit that there was no association between Interleukin-6 and PM10 concentration of the respondent. However, there are likely potential adverse health impacts arising from particulates exposure among exposed children in this study. Respondents are advised to have a medical check-up in order to determine respiratory health status thus elimination the risks of acquiring respiratory inflammation.

Objective:This paper is primarily aimed to review articles on electronic cigarettes (e-cigarettes) focusing on indoor air quality (IAQ) assessment that were conducted using human volunteers under natural settings that mimic actual vaping scenarios. Such studies may give a better representation of the actual potential exposure towards e-cigarettes emissions in indoor settings.Methods:A systematic literature search was conducted using PubMed search engine database. Search terms such as “electronic cigarette”, “e-cigarette”, “electronic nicotine delivery system”, and “indoor air quality” were used to identify the relevant articles to be included in this review. Articles that involved human volunteers who were asked to vape in natural settings or settings that mimic the actual vaping scenario were chosen to be reviewed. The search yielded a total of 15 published articles. Eleven articles were excluded due to 1) unavailability of its full-text (n=1), 2) did not involve human volunteers (n=5) and 3) did not involve an IAQ study (n=5). Four articles were critically reviewed in this paper.Results:From the four selected articles, two of the papers focused on the determination of nicotine level released by e-cigarettes whereas the other two covered IAQ parameters namely; particulate matters (PM), propylene glycols, formaldehyde, metals and polycyclic aromatic hydrocarbons (PAHs). Only two of the studies involved determination of biomarkers of exposure. The level of chemical contents released varied between studies. The differences in the brands of e-cigarette used, number of vapers recruited and the sensitivity of the methodologies employed in these studies may be the possible causes for such differences. However, studies using human volunteers conducted in a natural setting are more relevant to portray the actual exposure to vapors among e-cigarettes users and non-users compared to studies using a smoking machine/an exposure chamber. This is because such studies take into account the behavior of consumers and individual retention of nicotine. Such method will therefore avoid the possibility of overestimation in terms of exposures toward e-cigarettes users and non-users.Conclusion:There are limited e-cigarette studies on the impact of IAQ performed using human volunteers in natural settings. The available studies however, provided inconsistent scientific evidence on the actual exposure towards the vapor contents as unstandardized methodology were used in conducting such research. Therefore, there is a need to conduct IAQ studies in natural settings by using a standardized protocol in terms of the number of vapers recruited, the size of the indoor settings, the methods used in detecting and quantifying the contents and levels of emissions and the sensitivity of the equipment used in analyzing the contents. This will help in better utilization of the findings from such studies for the use of risk assessment of the exposures towards e-cigarette emissions. There is also a need to emphasize that it is the onus of the manufacturers in providing and proving scientifically sound safety claims for their products prior to commercializing it in the market.

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.

Rapid increases in traffic volumes in countries such as Malaysia may lead to exposure to poor air quality both outdoors and indoors. This study investigated asthma symptoms among Malaysian schoolchildren in relation to indoor and outdoor air pollution in urban and semi-rural settings in a school-based cross-sectional study of 1,952 schoolchildren living in urban and semi-rural areas. Parents completed a questionnaire including questions on asthma symptoms and environmental risk factors. Air pollutant concentrations were measured at 16 schools. Analysis used multiple logistic regression controlling for sociodemographic and indoor air pollution factors. A total of 11.4, 7.6, 9.5 and 7.0 % schoolchildren had asthma, current wheeze, dry cough at night and wheezing after exercise, respectively. Asthma and dry cough were significantly higher among urban schoolchildren. A 10-μg/m3 increase in outdoor NO2 level was associated with a twofold increase in the reporting of current wheeze (odds ratio (OR) 1.90; 95 % confidence interval (CI) 1.02–3.52); a 10-μg/m3 increase in indoor PM2.5 was similarly associated with a twofold increase in the reporting of wheeze during exercise (OR 2.08; 95 % CI 1.02–4.26). Secondhand smoke (SHS), mold and the presence of new furniture at home were also linked to asthma symptoms. NO2 concentrations in urban Malaysia frequently exceed those of the international standards. Exposure to traffic-related air pollution may be linked to asthma symptoms among children in Malaysia.

Cadmium (Cd) is ubiquitous in environment and may enter food chain through intense application of phosphate fertilizers to agricultural crops. A cross-sectional study was conducted at Kuala Terla and Blue Valley farming villages, Cameron Highlands to determine cadmium concentration in vegetables and soil and to determine the health risks among respondents. A total of 87 respondents were selected based on inclusive and exclusive criteria. A set of pre-tested questionnaires utilized to obtain socio-demographic information and to predict health risks faced by the respondents based on their vegetable ingestion rate. The Average Daily Dose (ADD) and Target Hazard Quotient (THQ) were determined in this study. Convenient sampling method was employed to obtain 15 paired soil and vegetable samples. Cadmium concentration in the samples was acid digested prior analysis using Flame Atomic Absorption Spectrophotometer (FAAS). The mean ± standard deviation concentrations of Cd in vegetable samples were 0.13±0.082 mg kg-1, within the acceptable range specified by Malaysia Food Regulation 1985 (1 mg kg-1). For sol samples, the mean ± standard deviation concentration of Cd was 2.78±2.83 mg kg-1. Eight out of 11 soil samples exceed the permissible limit of Cd outlined by The Dutch Standard (1 mg kg-1). The findings on THQ demonstrated that all respondents are within the acceptable non-carcinogenic health risk (THQ

Landfilling is the most frequent waste disposal method worldwide. It is recognised as being an important option both now and in the near future, especially in low- and middle-income countries, since it is the easiest and the cheapest technology available. Owing to financial constraints, landfills usually lack of environmental abatement measures, such as leachate collection systems and lining materials. As a result, a lot of contamination is inflicted upon the environment. Importantly, even with proper abatement measures in landfills, there is no guarantee that contamination will be prevented. Another major concern is the appropriate location for landfills to ensure the impact towards the environment are minimised. This paper highlights the challenge to find suitable place for future landfill in Malaysia. There is a tendency of landfill to be built on unsuitable area such as near to residential area or on agricultural land where most of the land are grading as high prospect value to be developed as business or industrial area that are more profitable. Key words: Municipal solid waste, disposal methods, landfilling, developing countries, Malaysia.

Nitrate in well water has become a public health co ncern especially in agriculture areas. Nitrate contamination in drinking water poses healt h risks to humans. This cross-sectional study was conducted with an aim to determine the health risk of residents in intensive agriculture area of Bacho k Kelantan from nitrate exposure in drinking well wat er. Nitrate in well water was determined with Spectrophotometer while the health risk was determi ned through calculation of Chronic Daily Intake (CDI) and Hazard Index (HI). Results indicate that nitrate level in this study was below the Maximum Concentration Limit of National Drinking Water Quality Standard of Malaysia (NDWQS) (

This pilot study aims to assess Escherichia coli (E. coli) contamination and its perceived health risks among beachgoers in ten tropical beach sands along Port Dickson coastline (Malaysia). This study also aims to determine the relationship between perceived health symptoms and tropical beach sand exposure behavior. The concentration of E. coli in tropical beach sand ranged from 60 cfu/100 g to 4113 cfu/100 g. E. coli contamination was the highest at Tanjung Gemuk (4113 ± 30 cfu/100 g) and the lowest at Tanjung Tuan (60 ± 15 cfu/100 g); the high level of contamination could be due to the location of the former at the sewage outlet of nearby hotels. Skin symptoms were the most predominant among the health symptoms indicated by beachgoers. Exposure duration was significantly correlated with the perceived health symptoms among beachgoers in the beaches studied.

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.

This study investigates the physical and chemical properties of bottled water and tap water at a university campus in Pahang, Malaysia. A total of seven bottled water brands, consisting of natural mineral (NM) and packaged drinking (PD) types, were first randomly selected. Three source locations of tap water were also examined. All water samples were analysed for their physicochemical characteristics, including pH, electrical conductivity (EC), temperature (using a YSI multi-parameter), turbidity (using a turbidity meter) and selected trace metals, along with copper (Cu) and zinc (Zn) using graphite furnace atomic absorption spectroscopy (GFAAS). Results were then examined against World Health Organization (WHO) and Malaysian Ministry of Health (MMOH) guidelines for drinking water. Health risks associated with trace metal were estimated using the risk assessment model. Turbidity values for tap water (2.85-4.94 NTU) were slightly higher than bottled water (0.77-1.03 NTU). A low turbidity value (0.77-0.93 NTU) suggests the presence of effective water treatment processes for NM bottled water. A low concentration of EC (0.003-0.010 mS/cm) indicates demineralization of PD bottled water. Overall quality of the bottled water and tap water was in compliance with guidelines recommended by WHO and MMOH, posing a minimum health risk and remaining safe for consumption.

Many cases of dermatologic complication were reported with the use of skin lightening products. This study assessed the skin lightening practice and health symptoms among female students. Self-administered questionnaire was distributed to 104 female students (56 undergraduates and 48 postgraduates) aged24±2years in Universiti Putra Malaysia. A total of 60.6% (N=63) of the female students used skin lightening products (61.9% of undergraduates and 38.1% of postgraduates). Reasonable price (N=35, 55.6%) and ingredients (N=29, 46%) were considered the most important factors in the product selection. Most respondents purchased the product from drugstores (N=39, 61.9%). Twenty-two respondents (34.9%) in this study experienced skin problem from the products they used. Skin peeling (N=13, 12.5%) and acne (N=9, 8.7%) were the most frequent symptoms experienced. Most of the respondents have the perception that lighter skin provides high self-esteem (N=56, 53.8%) and looks beautiful and healthier (N=54, 51.9%). The use of skin lightening products is common among female students in this study and some of these products can cause skin problems such as skin peeling, acne, and itching.

This study aims to determine the concentrations of total coliforms and Escherichia coli (E. coli) in beach water, Teluk Kemang beach. This study was also aimed to determine relationship between total coliforms, E. coli and physicochemical parameters. As perceived health symptoms among beach visitors are rarely incorporated in beach water studies, this element was also assessed in this study. A total of eight water sampling points were selected randomly along Teluk Kemang beach. Total coliforms concentrations were found between 20 and 1940 cfu/100ml. E. coli concentrations were between 0 and 90 cfu/100ml. Significant correlations were found between total coliforms and E. coli with pH, temperature and oxidation reduction potential. Skin and eyes symptoms were the highest reported though in small numbers. Microbiological water quality in Teluk Kemang public beach was generally safe for recreational activities except sampling location near with sewage outfall.

Urban environmental quality is vital to be investigated as the majority of people live in cities. However, given the continuous urbanization and industrialization in urban areas, heavy metals are continuously emitted into the terrestrial environment and pose a great threat to human. In this study, a total of 76 urban surface soil samples were collected in the Klang district (Malaysia), and analyzed for total and bioavailable heavy metal concentrations by inductively coupled plasma-optical emission spectrometry. Results showed that the concentrations of bioavailable heavy metals declined in the order of Al, Fe, Zn, Cu, Co, Cd, Pb, and Cr, and the concentrations of total heavy metals declined in the order of Fe, Al, Cu, Zn, Pb, Cr, Co, and Cd. Principal component analysis (PCA) showed that heavy metals could be grouped into three principal components, with PC1 containing Al and Fe, PC2 comprising Cd, Co, Cr, and Cu, and PC3 with only Zn. PCA results showed that PC1 may originate from natural sources, whereas PC2 and PC3 most likely originated from anthropogenic sources. Health risk assessment indicated that heavy metal contamination in the Klang district was below the acceptable threshold for carcinogenic and non-carcinogenic risks in adults, but above the acceptable threshold for carcinogenic and non-carcinogenic risks in children.