Displaying publications 1 - 20 of 29 in total

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  1. Abd Majid N, Rainis R, Sahani M, Mohamed AF, Abdul Ghani Aziz SA, Muhamad Nazi N
    Geospat Health, 2021 03 11;16(1).
    PMID: 33706498 DOI: 10.4081/gh.2021.915
    In recent decades, dengue outbreaks have become increasingly common around the developing countries, including Malaysia. Thus, it is essential for rural as well as urbanised livelihood to understand the distribution pattern of this infection. The objective of this study is to determine the trend of dengue cases reported from the year 2014 to 2018 and the spatial pattern for this spread. Spatial statistical analyses conducted found that the distribution pattern and spatial mean centre for dengue cases were clustered in the eastern part of the Bangi region. Directional distribution observed that the elongated polygon of dengue cluster stretched from the Northeast to the Southwest of Bangi District. The standard distance observed for dengue cases was smallest in the year 2014 (0.017 m), and largest in 2016 (0.019 m), whereas in the year 2015, 2017 and 2018, it measured 0.018 m. The average nearest neighbour analysis also displayed clustered patterns for dengue cases in the Bangi District. The three spatial statistical analyses (spatial mean centre, standard distance and directional distribution) findings illustrate that the dengue cases from the year 2014 to 2018 are clustered in the Northeast to the Southwest of the study region.
  2. Hassan NA, Sahani M, Hod R, Yahya NA
    J Environ Health, 2015 1 27;77(6):42-8.
    PMID: 25619035
    Cyanidation in gold extraction has detrimental impacts on the ecosystem and the population in surrounding areas. The research described in this article aimed to assess the health effects of environmental exposure to cyanide in a community near a gold mining area in Malaysia. A total of 255 members of the exposed community and 117 members of the control community answered questionnaires on their exposure to a gold mine and health outcomes. Urine samples were collected for biomarker assessment (i.e., urinary thiocyanate). The authors found that the mean level of urinary thiocyanate was significantly higher among the exposed community (0.30 ± 0.26 mg/dL) than the control community (0.24 ± 0.23 mg/dL) (p = .0021). The exposed community had a significantly higher prevalence of headaches (prevalence odds ratio [pOR] = 2.6, p = .001), dizziness (pOR = 3.7, p < .001), skin irritation (pOR = 2.1, p = .040), and eye irritation (pOR = 5.1, p = .004). No association occurred between dietary exposure and urinary biomarkers. Smokers living near a gold mine had a higher urinary thiocyanate level (0.56 mg/dL) than smokers in the control community (0.49 mg/dL).
  3. Ibrahim MF, Hod R, Toha HR, Mohammed Nawi A, Idris IB, Mohd Yusoff H, et al.
    PMID: 33668186 DOI: 10.3390/ijerph18052221
    Poor management of hazardous waste can lead to environmental pollution, injuries, and adverse health risks. Children's exposure to hazardous waste may cause serious acute and chronic health problems due to their higher vulnerability to the toxic effects of chemicals. This study examines an incident of illegal chemical dumping in Pasir Gudang, Malaysia and its potential health impacts on children. The study introduced a risk assessment of possible health-related effects due to chemical contamination based on a real case scenario where quantification of the contamination was not feasible. A literature review and spatial analysis were used as research methods. On 6th March 2019, tons of hazardous waste were illegally disposed into Kim Kim River, Pasir Gudang, Malaysia. They were identified as benzene, acrolein, acrylonitrile, hydrogen chloride, methane, toluene, xylene, ethylbenzene, and d-limonene. As a result, 975 students in the vicinity developed signs and symptoms of respiratory disease due to the chemical poisoning. The findings of this study indicate that more effective policies and preventive actions are urgently needed to protect human health, especially children from improper hazardous waste management.
  4. Khan MF, Maulud KNA, Latif MT, Chung JX, Amil N, Alias A, et al.
    Sci Total Environ, 2018 Feb 01;613-614:1401-1416.
    PMID: 29898507 DOI: 10.1016/j.scitotenv.2017.08.025
    Air pollution can be detected through rainwater composition. In this study, long-term measurements (2000-2014) of wet deposition were made to evaluate the physicochemical interaction and the potential sources of pollution due to changes of land use. The rainwater samples were obtained from an urban site in Kuala Lumpur and a highland-rural site in the middle of Peninsular Malaysia. The compositions of rainwater were obtained from the Malaysian Meteorological Department. The results showed that the urban site experienced more acidity in rainwater (avg=277mm, range of 13.8 to 841mm; pH=4.37) than the rural background site (avg=245mm, range of 2.90 to 598mm; pH=4.97) due to higher anthropogenic input of acid precursors. The enrichment factor (EF) analysis showed that at both sites, SO42-, Ca2+ and K+ were less sensitive to seawater but were greatly influenced by soil dust. NH4+ and Ca2+ can neutralise a larger fraction of the available acid ions in the rainwater at the urban and rural background sites. However, acidifying potential was dominant at urban site compared to rural site. Source-receptor relationship via positive matrix factorisation (PMF 5.0) revealed four similar major sources at both sites with a large variation of the contribution proportions. For urban, the major sources influence on the rainwater chemistry were in the order of secondary nitrates and sulfates>ammonium-rich/agricultural farming>soil components>marine sea salt and biomass burning, while at the background site the order was secondary nitrates and sulfates>marine sea salt and biomass burning=soil components>ammonia-rich/agricultural farming. The long-term trend showed that anthropogenic activities and land use changes have greatly altered the rainwater compositions in the urban environment while the seasonality strongly affected the contribution of sources in the background environment.
  5. Khan MF, Hamid AH, Bari MA, Tajudin ABA, Latif MT, Nadzir MSM, et al.
    Sci Total Environ, 2019 Feb 10;650(Pt 1):1195-1206.
    PMID: 30308807 DOI: 10.1016/j.scitotenv.2018.09.072
    Equatorial warming conditions in urban areas can influence the particle number concentrations (PNCs), but studies assessing such factors are limited. The aim of this study was to evaluate the level of size-resolved PNCs, their potential deposition rate in the human respiratory system, and probable local and transboundary inputs of PNCs in Kuala Lumpur. Particle size distributions of a 0.34 to 9.02 μm optical-equivalent size range were monitored at a frequency of 60 s between December 2016 and January 2017 using an optical-based compact scanning mobility particle sizer (SMPS). Diurnal and correlation analysis showed that traffic emissions and meteorological confounding factors were potential driving factors for changes in the PNCs (Dp ≤1 μm) at the modeling site. Trajectory modeling showed that a PNC <100/cm3 was influenced mainly by Indo-China region air masses. On the other hand, a PNC >100/cm3 was influenced by air masses originating from the Indian Ocean and Indochina regions. Receptor models extracted five potential sources of PNCs: industrial emissions, transportation, aged traffic emissions, miscellaneous sources, and a source of secondary origin coupled with meteorological factors. A respiratory deposition model for male and female receptors predicted that the deposition flux of PM1 (particle mass ≤1 μm) into the alveolar (AL) region was higher (0.30 and 0.25 μg/h, respectively) than the upper airway (UA) (0.29 and 0.24 μg/h, respectively) and tracheobronchial (TB) regions (0.02 μg/h for each). However, the PM2.5 deposition flux was higher in the UA (2.02 and 1.68 μg/h, respectively) than in the TB (0.18 and 0.15 μg/h, respectively) and the AL regions (1.09 and 0.91 μg/h, respectively); a similar pattern was also observed for PM10.
  6. Khan MF, Hamid AH, Rahim HA, Maulud KNA, Latif MT, Nadzir MSM, et al.
    Sci Total Environ, 2020 Aug 15;730:139091.
    PMID: 32413602 DOI: 10.1016/j.scitotenv.2020.139091
    The Southeast Asian (SEA) region is no stranger to forest fires - the region has been suffering from severe air pollution (known locally as 'haze') as a result of these fires, for decades. The fires in SEA region are caused by a combination of natural (the El Niño weather pattern) and manmade (slash-and-burn and land clearing for plantations) factors. These fires cause the emissions of toxic aerosols and pollutants that can affect millions of people in the region. Thus, this study aims to identify the impact of the SEA haze on the Southern region of the Malaysian Peninsula and Borneo region of East Malaysia using the entire air quality observation data at surface level in 2015. Overall, the concentration of PM10 was about two-fold higher during the haze period compared to non-haze period. The concentrations of CO, flux of CO and flux of BC were aligned with PM10 during the entire observation period. The wind field and cluster of trajectory indicated that the Southern Malaysian Peninsula and Borneo were influenced mainly from the wildfires and the combustion of peat soil in the Indonesian Borneo. This study finds that wildfires from Borneo impacted the Southern Malaysian Borneo more seriously than that from Sumatra region.
  7. Kwan SC, Zakaria SB, Ibrahim MF, Wan Mahiyuddin WR, Md Sofwan N, A Wahab MI, et al.
    Environ Res, 2023 Jan 01;216(Pt 2):114524.
    PMID: 36228692 DOI: 10.1016/j.envres.2022.114524
    Road transport contributes over 70% of air pollution in urban areas and is the second largest contributor to the total carbon dioxide emissions in Malaysia at 21% in 2016. Transport-related air pollutants (TRAPs) such as NOx, SO2, CO and particulate matter (PM) pose significant threats to the urban population's health. Malaysia has targeted to deploy 885,000 EV cars on the road by 2030 in the Low Carbon Mobility Blueprint (LCMB). This study aims to quantify the health co-benefits of electric vehicle adoption from their impacts on air quality in Malaysia. Two EV uptake projections, i.e. LCMB and Revised EV Adoption (REVA) projections, and five electricity generation mix scenarios were modelled up to 2040. We used comparative health risk assessment to estimate the potential changes in mortality and burden of diseases (BoD) from the emissions in each scenario. Intake fractions and exposure-risk functions were used to calculate the burden from respiratory diseases (PM2.5, NOx, SO2, CO), cardiovascular diseases and lung cancer (PM2.5). Results showed that along with a net reduction of carbon emissions across all scenarios, there could be reduced respiratory mortality from NOx by 10,200 mortality (176,200 DALYs) and SO2 by 2600 mortality (45,400 DALYs) per year in 2040. However, there could also be additional 719 mortality (9900 DALYs) per year from PM2.5 and 329 mortality (5600 DALYs) from CO per year. The scale of reduction in mortality and BoD from NOx and SO2 are significantly larger than the scale of increase from PM2.5 and CO, indicating potential net positive health impacts from the EV adoption in the scenarios. The health cost savings from the reduced BoD of respiratory mortality could reach up to RM 7.5 billion per year in 2040. In conclusion, EV is a way forward in promoting a healthy and sustainable future transport in Malaysia.
  8. Latif MT, Abd Hamid HH, Ahamad F, Khan MF, Mohd Nadzir MS, Othman M, et al.
    Chemosphere, 2019 Dec;237:124451.
    PMID: 31394440 DOI: 10.1016/j.chemosphere.2019.124451
    This study aims to determine the composition of BTEX (benzene, toluene, ethylbenzene and xylene) and assess the risk to health at different sites in Malaysia. Continuous monitoring of BTEX in Kuala Lumpur City Centre, Kuala Terengganu, Kota Kinabalu and Fraser Hill were conducted using Online Gas Chromatograph. For comparison, BTEX at selected hotspot locations were determined by active sampling method using sorbent tubes and Thermal Desorption Gas Chromatography Mass Spectrometry. The hazard quotient (HQ) for non-carcinogenic and the life-time cancer risk (LTCR) of BTEX were calculated using the United States Environmental Protection Agency (USEPA) health risk assessment (HRA) methods. The results showed that the highest total BTEX concentrations using continuous monitoring were recorded in the Kuala Lumpur City Centre (49.56 ± 23.71 μg/m3). Toluene was the most dominant among the BTEX compounds. The average concentrations of benzene ranged from 0.69 ± 0.45 μg/m3 to 6.20 ± 3.51 μg/m3. Measurements using active sampling showed that BTEX concentrations dominated at the roadside (193.11 ± 114.57 μg/m3) in comparison to petrol station (73.08 ± 30.41 μg/m3), petrochemical industry (32.10 ± 13.13 μg/m3) and airport (25.30 ± 6.17 μg/m3). Strong correlations among BTEX compounds (p<0.01, r>0.7) at Kuala Lumpur City Centre showed that BTEX compounds originated from similar sources. The values of HQ at all stations were <1 indicating the non-carcinogenic risk are negligible and do not pose threats to human health. The LTCR value based on benzene inhalation (1.59 × 10-5) at Kuala Lumpur City Centre were between 1 × 10-4 and 1 × 10-5, representing a probable carcinogenic risk.
  9. Mohd Hanif N, Limi Hawari NSS, Othman M, Abd Hamid HH, Ahamad F, Uning R, et al.
    Chemosphere, 2021 Dec;285:131355.
    PMID: 34710962 DOI: 10.1016/j.chemosphere.2021.131355
    Volatile organic compounds (VOCs) are widely recognized to affect the environment and human health. This review provides a comprehensive presentation of the types and levels of VOCs, their sources and potential effects on human health and the environment based on past and current observations made at tropical sites. Isoprene was found to be the dominant biogenic VOC in the tropics. Tropical broad leaf evergreen trees are the main emitters of isoprene, making up more than 70% of the total emissions. The VOCs found in the tropical remote marine atmosphere included isoprene (>100 ppt), dimethyl sulfide (≤100 ppt) and halocarbons, i.e. bromoform (≤8.4 ppt), dibromomethane (≤2.7 ppt) and dibromochloromethane (≤1.6 ppt). VOCs such as benzene, toluene, ethylbenzene and xylene (BTEX) are the most monitored anthropogenic VOCs and are present mainly due to motor vehicles emissions. Additionally, biomass burning contributes to anthropogenic VOCs, especially high molecular weight VOCs, e.g. methanol and acetonitrile. The relative contributions of VOC species to ozone are determined through the level of the Ozone Formation Potential (OFP) of different species. Emissions of VOCs (e.g. very short-lived halogenated gases) in the tropics are capable of contributing to stratospheric ozone depletion. BTEX has been identified as the main types of VOCs that are associated with the cancer risk in urban areas in tropical regions. Finally, future studies related to VOCs in the tropics and their associated health risks are needed to address these concerns.
  10. Mohd Ngesom AM, Ahmad Razi A, Azizan NS, Wasi Ahmad N, Md Lasim A, Liang Y, et al.
    Parasit Vectors, 2021 Aug 18;14(1):413.
    PMID: 34407881 DOI: 10.1186/s13071-021-04918-9
    BACKGROUND: Dengue is a significant public health issue that is caused by Aedes spp. mosquitoes. The current vector control methods are unable to effectively reduce Aedes populations and thus fail to decrease dengue transmission. Hence, there is an urgent need for new tools and strategies to reduce dengue transmission in a wide range of settings. In this study, the Mosquito Home System (MHS) and Mosquito Home Aqua (MHAQ) formulations were assessed as commercial autodissemination traps in laboratory and small-scale field trials.

    METHOD: Multiple series of laboratory and small-scale field trials were performed to assess the efficacy of MHS and MHAQ exposed to Ae. aegypti. In the laboratory trials, various parameters such as fecundity, fertility, wing size, oviposition preferences, residual effects, and MHAQ transference to other containers through controlled experiments were tested. For small-scale field trials, the efficacy of the MHS and MHAQ approaches was determined to ascertain whether wild mosquitoes could transfer the MHAQ formulation from MHS stations to ovitraps.

    RESULTS: The data revealed that Ae. aegypti was highly susceptible to low concentrations of MHAQ formulations and had a residual effect of up to 3 months, with MHAQ exposure affecting fecundity, fertility, and mosquito wing size. In the oviposition studies, gravid females strongly preferred the hay infusion compared to tap water and MHAQ during egg-laying in the laboratory. Nevertheless, the use of commercial MHAQ by MHS was highly attractive in field settings compared to conventional ovitraps among local Aedes spp. mosquitoes. In addition, MHAQ horizontal transfer activities in the laboratory and small-scale field trials were demonstrated through larval bioassays. These findings demonstrated the potential of MHAQ to be transferred to new containers in each study site.

    CONCLUSION: This study provided proof of principle for the autodissemination of MHAQ. Through further refinement, this technique and device could become an effective oviposition trap and offer an alternative preventive tool for vector control management.

  11. Mohd Ridzwan SF, Anual ZF, Sahani M, Ghazali AR
    Iran J Public Health, 2013 Dec;42(12):1374-86.
    PMID: 26060639
    Neurotoxicants present in water supply may affect human functions in terms of attention, response speed and perceptual motor speed. Neurobehavioural performance can be influenced by gender, age and education levels. This study aims to assess the neurobehavioral performance of palm oil estate residents with private water supply in southern Peninsular of Malaysia.
  12. Nadzir MSM, Ashfold MJ, Khan MF, Robinson AD, Bolas C, Latif MT, et al.
    Environ Sci Pollut Res Int, 2018 Jan;25(3):2194-2210.
    PMID: 29116536 DOI: 10.1007/s11356-017-0521-1
    The Antarctic continent is known to be an unpopulated region due to its extreme weather and climate conditions. However, the air quality over this continent can be affected by long-lived anthropogenic pollutants from the mainland. The Argentinian region of Ushuaia is often the main source area of accumulated hazardous gases over the Antarctic Peninsula. The main objective of this study is to report the first in situ observations yet known of surface ozone (O3) over Ushuaia, the Drake Passage, and Coastal Antarctic Peninsula (CAP) on board the RV Australis during the Malaysian Antarctic Scientific Expedition Cruise 2016 (MASEC'16). Hourly O3 data was measured continuously for 23 days using an EcoTech O3 analyzer. To understand more about the distribution of surface O3 over the Antarctic, we present the spatial and temporal of surface O3 of long-term data (2009-2015) obtained online from the World Meteorology Organization of World Data Centre for greenhouse gases (WMO WDCGG). Furthermore, surface O3 satellite data from the free online NOAA-Atmospheric Infrared Sounder (AIRS) database and online data assimilation from the European Centre for Medium-Range Weather Forecasts (ECMWF)-Monitoring Atmospheric Composition and Climate (MACC) were used. The data from both online products are compared to document the data sets and to give an indication of its quality towards in situ data. Finally, we used past carbon monoxide (CO) data as a proxy of surface O3 formation over Ushuaia and the Antarctic region. Our key findings were that the surface O3 mixing ratio during MASEC'16 increased from a minimum of 5 ppb to ~ 10-13 ppb approaching the Drake Passage and the Coastal Antarctic Peninsula (CAP) region. The anthropogenic and biogenic O3 precursors from Ushuaia and the marine region influenced the mixing ratio of surface O3 over the Drake Passage and CAP region. The past data from WDCGG showed that the annual O3 cycle has a maximum during the winter of 30 to 35 ppb between June and August and a minimum during the summer (January to February) of 10 to 20 ppb. The surface O3 mixing ratio during the summer was controlled by photochemical processes in the presence of sunlight, leading to the depletion process. During the winter, the photochemical production of surface O3 was more dominant. The NOAA-AIRS and ECMWF-MACC analysis agreed well with the MASEC'16 data but twice were higher during the expedition period. Finally, the CO past data showed the surface O3 mixing ratio was influenced by the CO mixing ratio over both the Ushuaia and Antarctic regions. Peak surface O3 and CO hourly mixing ratios reached up to ~ 38 ppb (O3) and ~ 500 ppb (CO) over Ushuaia. High CO over Ushuaia led to the depletion process of surface O3 over the region. Monthly CO mixing ratio over Antarctic (South Pole) were low, leading to the production of surface O3 over the Antarctic region.
  13. Ng CFS, Seposo XT, Moi ML, Tajudin MABA, Madaniyazi L, Sahani M
    Int J Infect Dis, 2020 Dec;101:409-411.
    PMID: 33075527 DOI: 10.1016/j.ijid.2020.10.027
    The first wave of COVID-19 epidemic began in late January in Malaysia and ended with a very small final size. The second wave of infections broke out in late February and grew rapidly in the first 3 weeks. Authorities in the country responded quickly with a series of control strategies collectively known as the Movement Control Order (MCO) with different levels of intensity matching the progression of the epidemic. We examined the characteristics of the second wave and discussed the key control strategies implemented in the country. In the second wave, the epidemic doubled in size every 3.8 days (95% confidence interval [CI]: 3.3, 4.5) in the first month and decayed slowly after that with a halving time of approximately 3 weeks. The time-varying reproduction number Rt peaked at 3.1 (95% credible interval: 2.7, 3.5) in the 3rd week, declined sharply thereafter and stayed below 1 in the last 3 weeks of April, indicating low transmissibility approximately 3 weeks after the MCO. Experience of the country suggests that adaptive triggering of distancing policies combined with a population-wide movement control measure can be effective in suppressing transmission and preventing a rebound.
  14. Othman J, Sahani M, Mahmud M, Ahmad MK
    Environ Pollut, 2014 Jun;189:194-201.
    PMID: 24682070 DOI: 10.1016/j.envpol.2014.03.010
    This study assessed the economic value of health impacts of transboundary smoke haze pollution in Kuala Lumpur and adjacent areas in the state of Selangor, Malaysia. Daily inpatient data from 2005, 2006, 2008, and 2009 for 14 haze-related illnesses were collected from four hospitals. On average, there were 19 hazy days each year during which the air pollution levels were within the Lower Moderate to Hazardous categories. No seasonal variation in inpatient cases was observed. A smoke haze occurrence was associated with an increase in inpatient cases by 2.4 per 10,000 populations each year, representing an increase of 31 percent from normal days. The average annual economic loss due to the inpatient health impact of haze was valued at MYR273,000 ($91,000 USD).
  15. Othman M, Latif MT, Jamhari AA, Abd Hamid HH, Uning R, Khan MF, et al.
    Chemosphere, 2021 Jan;262:127767.
    PMID: 32763576 DOI: 10.1016/j.chemosphere.2020.127767
    This study aimed to determine the spatial distribution of PM2.5 and PM10 collected in four regions (North, Central, South and East Coast) of Peninsular Malaysia during the southwest monsoon. Concurrent measurements of PM2.5 and PM10 were performed using a high volume sampler (HVS) for 24 h (August to September 2018) collecting a total of 104 samples. All samples were then analysed for water soluble inorganic ions (WSII) using ion chromatography, trace metals using inductively coupled plasma-mass spectroscopy (ICP-MS) and polycyclic aromatic hydrocarbon (PAHs) using gas chromatography-mass spectroscopy (GC-MS). The results showed that the highest average PM2.5 concentration during the sampling campaign was in the North region (33.2 ± 5.3 μg m-3) while for PM10 the highest was in the Central region (38.6 ± 7.70 μg m-3). WSII recorded contributions of 22% for PM2.5 and 20% for PM10 mass, with SO42- the most abundant species with average concentrations of 1.83 ± 0.42 μg m-3 (PM2.5) and 2.19 ± 0.27 μg m-3 (PM10). Using a Positive Matrix Factorization (PMF) model, soil fertilizer (23%) was identified as the major source of PM2.5 while industrial activity (25%) was identified as the major source of PM10. Overall, the studied metals had hazard quotients (HQ) value of <1 indicating a very low risk of non-carcinogenic elements while the highest excess lifetime cancer risk (ELCR) was recorded for Cr VI in the South region with values of 8.4E-06 (PM2.5) and 6.6E-05 (PM10). The incremental lifetime cancer risk (ILCR) calculated from the PAH concentrations was within the acceptable range for all regions.
  16. Phung VLH, Ueda K, Sahani M, Seposo XT, Wan Mahiyuddin WR, Honda A, et al.
    Int J Epidemiol, 2022 Feb 18;51(1):155-165.
    PMID: 34148080 DOI: 10.1093/ije/dyab100
    BACKGROUND: Studies on the association between smoke haze (hereafter 'haze') and adverse health effects have increased in recent years due to extreme weather conditions and the increased occurrence of vegetation fires. The possible adverse health effects on under-five children (U5Y) is especially worrying due to their vulnerable condition. Despite continuous repetition of serious haze occurrence in Southeast Asia, epidemiological studies in this region remained scarce. Furthermore, no study had examined the association accounting for three important aspects (time lag, duration and intensity) concurrently.

    OBJECTIVE: This study aimed to examine the association between haze and U5Y mortality in Malaysia, considering time lag, duration and intensity of exposure.

    METHODS: We performed a time-stratified case-crossover study using a generalized additive model to examine the U5Y mortality related to haze in 12 districts in Malaysia, spanning from 2014 to 2016. A 'haze day' was characterized by intensity [based on concentrations of particulate matter (PM)] and duration (continuity of haze occurrence, up to 3 days).

    RESULTS: We observed the highest but non-significant odds ratios (ORs) of U5Y mortality at lag 4 of Intensity-3. Lag patterns revealed the possibility of higher acuteness at prolonged and intensified haze. Stratifying the districts by the 95th-percentile of PM distribution, the 'low' category demonstrated marginal positive association at Intensity-2 Duration-3 [OR: 1.210 (95% confidence interval: 1.000, 1.464)].

    CONCLUSIONS: We found a null association between haze and U5Y mortality. The different lag patterns of the association observed over different duration and intensity suggest consideration of these aspects in future studies.

  17. Phung VLH, Oka K, Honda Y, Hijioka Y, Ueda K, Seposo XT, et al.
    Environ Res, 2023 Feb 01;218:114988.
    PMID: 36463996 DOI: 10.1016/j.envres.2022.114988
    BACKGROUND: Climate change and its subsequent effects on temperature have raised global public health concerns. Although numerous epidemiological studies have shown the adverse health effects of temperature, the association remains unclear for children aged below five years old and those in tropical climate regions.

    METHODS: We conducted a two-stage time-stratified case-crossover study to examine the association between temperature and under-five mortality, spanning the period from 2014 to 2018 across all six regions in Malaysia. In the first stage, we estimated region-specific temperature-mortality associations using a conditional Poisson regression and distributed lag nonlinear models. We used a multivariate meta-regression model to pool the region-specific estimates and examine the potential role of local characteristics in the association, which includes geographical information, demographics, socioeconomic status, long-term temperature metrics, and healthcare access by region.

    RESULTS: Temperature in Malaysia ranged from 22 °C to 31 °C, with a mean of 27.6 °C. No clear seasonality was observed in under-five mortality. We found no strong evidence of the association between temperature and under-five mortality, with an "M-" shaped exposure-response curve. The minimum mortality temperature (MMT) was identified at 27.1 °C. Among several local characteristics, only education level and hospital bed rates reduced the residual heterogeneity in the association. However, effect modification by these variables were not significant.

    CONCLUSION: This study suggests a null association between temperature and under-five mortality in Malaysia, which has a tropical climate. The "M-" shaped pattern suggests that under-fives may be vulnerable to temperature changes, even with a small temperature change in reference to the MMT. However, the weak risks with a large uncertainty at extreme temperatures remained inconclusive. Potential roles of education level and hospital bed rate were statistically inconclusive.

  18. Sahani M, Sulaiman NS, Tan BS, Yahya NA, Anual ZF, Mahiyuddin WR, et al.
    J Air Waste Manag Assoc, 2016 Nov;66(11):1077-1083.
    PMID: 27192328 DOI: 10.1080/10962247.2016.1188866
    Dental amalgam in fillings exposes workers to mercury. The exposure to mercury was investigated among 1871 dental health care workers. The aim of the study was to evaluate the risk of mercury exposure among dental compared to nondental health care workers and to determine other risk factors for mercury exposure. Respondents answered questionnaires to obtain demographic, personal, professional, and workplace information and were examined for their own amalgam fillings. Chronic mercury exposure was assessed through urinary mercury levels. In total, 1409 dental and 462 nondental health care workers participated in the study. Median urine mercury levels for dental and nondental health care workers were 2.75 μg/L (interquartile range [IQR] = 3.0175) and 2.66 μg/L (IQR = 3.04) respectively. For mercury exposure, there were no significant risk factor found among the workers involved within the dental care. The Mann-Whitney test showed that urine mercury levels were significantly different between respondents who eat seafood more than 5 times per week compared to those who eat it less frequently or not at all (p = 0.003). The urinary mercury levels indicated significant difference between dental workers in their practice using squeeze cloths (Mann-Whitney test, p = 0.03). Multiple logistic regression showed that only the usage of cosmetic products that might contain mercury was found to be significantly associated with the urinary mercury levels (odds ratio [OR] = 15.237; CI: 3.612-64.276). Therefore, mean urinary mercury levels of health care workers were low. Exposure to dental amalgam is not associated with high mercury exposure. However, usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury.

    IMPLICATIONS: Exposure to the high levels of mercury from dental amalgam can lead to serious health effects among the dental health care workers. Nationwide chronic mercury exposure among dental personnel was assessed through urinary mercury levels. Findings suggest low urinary mercury levels of these health care workers. Exposure to dental amalgam is not associated with high mercury exposure. However, the usage of cosmetic products containing mercury and high seafood consumption may lead to the increase of exposure to mercury.
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