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  1. Mimala Arasaratnam, Zailina Hashim, Shamsul Bahari Shamsudin
    MyJurnal
    A cross-sectional study was conducted on 83 female electronics factory workers. The respondents comprised 50 exposed workers who use lead alloy solder and 33 unexposed workers. The objective of this study was to assess the lead exposure of these workers. Breathing zone were sampled using air sampling pumps. Dust samples were collected by wipe method. Venous blood collected and blood pressure were measured. All lead analyses were carried out with Graphite Furnace Atomic Absorption Spectrophotometer. The mean air lead for exposed workers (57 0. ± 0.93 μg/m³) was significantly higher than the unexposed workers (0.0067 ± 0.0045μg/m³) (p
  2. Joshua Teo Beng Chin, Shamsul Bahari Shamsudin, Noraziah Bakri
    MyJurnal
    Introduction: Primary health care providers face a wide range of stressors and are at high risk of developing occu-pational burnout, which may cause ineffectiveness and reduce the productivity of the health care system. Methods: A cross-sectional study was conducted among the primary health care provider working in health facilities under Tuaran Area Health Office. A total of 199 of 604 providers randomly selected as respondents for this study. Self-ad-ministered questionnaire and the Maslach Burnout Inventory are used for data collection. Descriptive statistics were used to determine the prevalence and Chi-square test was used to determine the association of risk factors. Results: Prevalence of occupational burnout is 10.1% with high level of overall burnout (n = 20), 60.8% are having low to moderate level of overall burnout (n = 121) and 29.1% has no burnout (n = 58). A significant relationship was observed between burnout, high workload, out-of-scope workload and distance between home and workplace (p≤0.01). However, no significant relationship was observed between burnout and age, gender, marital status, finan-cial status, education level, experience and income. Conclusion: This study shows that distribution of workload as well as the job scope may affect burnout. Further study can be conducted to identify home-workplace distance re-lation to burnout. With the identification of these factors, a counter measures and intervention can be implemented.
  3. Shamsul Bahari Shamsudin, Zailina Hashim, Nurunniza Zainal Abidin
    This study compares the mean blood lead concentration and its association with the mean neurobehavioral scores between 2 groups of workers. The exposed group was made up of 50 male workers from 2 battery manufactur­ing factories and the comparative group was made up of 40 male adminis­trative workers from a local university. The neurobehavioral test was carried out by using a modified World Health Organization Neurobehavioral Core Test Battery (NCTS). The NCTS consists of 7 tests, which are made up of the Benton Visual Retention Test, Digit Symbol, Digit Span, Pursuit Aiming Test, Reaction Time, Santa Ana Manual Dexterity Test and Trail Making Test. Blood samples were collected by venous puncture method. Blood lead concentrations were determined by the Graphite Furnace Atomic Absorption Spectrophotometer (GFAAS). The mean blood lead concentration of the exposed group (38.5 μg/dL) is higher than the comparative group (5.6 μg/dL). Results show significant difference in the mean blood lead concentration between the 2 groups (p<0.001). There are also significant differences in the mean scores of each NCTS test such as Benton Visual Retention Test (p = 0.001), Digit Span Test (p< 0.001), Digit Symbol Test(p< 0.001), Pursuit Aiming Test (p< 0.001), Reaction Time Test (p< 0.001), Santa Ana Manual Dexterity Test (p< 0.001), Trail Making Test (p<0.001) (p< 0.001) and the overall NCTS test (p<0.001) between the 2 groups. There are significant inverse correlation between blood lead concentrations with each and overall NCTS scores when the two groups are combined. There are significant inverse correlations between blood lead concentrations with educational years and income for all respondents. Statistical tests show that blood lead, age, years of formal education, total income, years of work, and ethnicity contributes to the overall NCTS scores. The GLM model shows that 56.9% of the mean NCTS scores are influenced by the variability in the contributing factors mentioned before.
  4. Fredie Robinson, Jecelyn John, Tin Sabai Aung, Swe, Shamsul Bahari, David Matanjun
    MyJurnal
    Introduction: World Health Organization in 2019 reported that about 1.5 billion people are infected with soil-trans-mitted helminths (STH) worldwide. Infected children with STH might manifest signs of anaemia and impaired nutri-tionally or physically. This study aimed to look at the prevalence of STH in the area of North Sabah among rural pri-mary schools and examine the associated factors. Methods: A cross-sectional study was conducted in four selected primary school in the district of Kudat of Sabah from 2014 to 2015. Tools used for the study were questionnaire and stool sampling. Questionnaire focused data on sociodemographic, hygiene and use of anti-helminths drugs. Stool samples collected were sent for microscopic examination for presence of STH ova. Written consents were obtained from parents/guardians. Chi-square was used to examine the association of having STH and factors on utilities fa-cilities, hygiene and anti-helminths drug. SPSS version 23 was used for statistical analysis. Results: There was 433 school children aged 7 to 12 years old with 224 males and 209 females respondents. Three-quarters main source of water supply in the homes from treated water. Those with proper built toilet were 96%. Practices of washing hands after toilet and before eating were 96% as well. Almost 95% wear slippers when outside homes. Only 61% took their anti-helminths drug in the past 1 year while in the last 6 months the uptake was 38.7%. The prevalence of positive ova of STH in the stool sample was 57 out of 433 or 13.2%. STH infection was not statistically significant associated with the above factors. Conclusion: The prevalence of STH infection among primary school children in the district of Kudat although has lowered over the years is still considered higher than most states in Malaysia. Continuous public health intervention is necessary to further bring down the prevalence of STH infections.
  5. Mohamad Azhar Mohd Noor, Zailina Hashim, Shamsul Bahari Shamsudin, Heryati Abdul Hamid, Dasrilsyah Syahrial
    This is a study of the incidence of dental fluorosis and the urine fluoride concentration among school children. About 84 Malay students with the age range of 16 to 17 years from a National Secondary School in the district of Kuala Lipis, Pahang was selected as respondents. The selection was based on the exposure to fluoride in drinking water supply systems. Fifty two respondents were selected from the fluoridated water supply area while 32 others were selected from the non-fluoridated area (comparative group). The objectives of this study were to determine the relationship between urine fluoride concentrations with the incidence of dental fluorosis and to compare the difference in these two variables between the 2 groups of respondents. The urine fluoride concentration was determined using a fluoride-ion specific electrode. Dental fluorosis was examined through a physical examination using the Tooth Surface Index of Fluorosis (TSIF). There was no significant difference in the mean urine fluoride concentration (mg/L) (t=0.186, p=0.853), mean urine fluoride concentration (mg/g creatinine) (t=0.069, p=0.945) and dental fluorisis (TSIF mean score) (t=0.288, p=0.774) between the two groups. There was a significant direct correlation between the urine fluoride concentrations (mg/L) (r= 0.425, p<0.00l) and the urine fluoride concentra­tions (mg/g creatinine) (r=0.252, p=0.021) with dental fluorisis (TSIF mean score). Multiple regression statistics, indicated that dental fluorosis was significantly related to urine fluoride concentrations (b=0.0.61, p=0.028) and the number of glass of their favourite drink consumed daily (b=0.071, p=0.003). In conclusion, the urine fluoride concentrations, which represent the degree of exposure to fluoride, were found to be related to dental fluorosis, which is the biological indicator for excessive exposure to fluoride. There is no difference on the degree and the effects of exposure to fluoride between the two groups of respondents although they consumed water from two different water supply systems. Thus, the exposure to fluoride is not only through the drinking water supply, but also by other sources such as the intake of carbonated drinks and fruit juice.
  6. Lai YM, Zaw MT, Shamsudin SB, Lin Z
    J Microbiol Immunol Infect, 2016 Aug;49(4):591-4.
    PMID: 26212311 DOI: 10.1016/j.jmii.2015.06.002
    The putative pathogenicity island (PAI) containing the uropathogenic specific protein (usp) gene and three small open reading frames (orfU1, orfU2, and orfU3) encoding 98, 97, and 96 amino acid proteins is widely distributed among uropathogenic Escherichia coli (UPEC) strains. This PAI was designated as PAIusp. Sequencing analysis of PAIusp has revealed that the usp gene can be divided into two types - uspI and uspII - based on sequence variation at the 3' terminal region and the number and position of orfUs differ from strain to strain. Based on usp gene types and orfU sequential patterns, PAIusp can be divided into four subtypes. Subtyping of PAIusp is a useful method to characterize UPEC strains. In this study, we developed a polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method to differentiate usp gene types. This method could correctly identify the usp gene type in usp-positive UPEC strains in our laboratory.
  7. Lai YM, Zaw MT, Shamsudin SB, Lin Z
    J Infect Dev Ctries, 2016 Oct 31;10(10):1053-1058.
    PMID: 27801366 DOI: 10.3855/jidc.6944
    INTRODUCTION: Uropathogenic virulence factors have been identified by comparing the prevalence of these among urinary tract isolates and environmental strains. The uropathogenic-specific protein (USP) gene is present on the pathogenicity island (PAI) of uropathogenic Escherichia coli (UPEC) and, depending on its two diverse gene types and the sequential patterns of three open reading frame units (orfUs) following it, there is a method to characterize UPEC epidemiologically called PAIusp subtyping.
    METHODOLOGY: A total of 162 UPEC isolates from Sabah, Malaysia, were tested for the presence of the usp gene and the sequential patterns of three orfUs following it using polymerase chain reaction (PCR). In addition, by means of triplex PCR, the prevalence of the usp gene was compared with other two VFs of UPEC, namely alpha hemolysin (α-hly) and cytotoxic necrotizing factor (cnf-1) genes encoding two toxins.
    RESULTS: The results showed that the usp gene was found in 78.40% of UPEC isolates, indicating that its prevalence was comparable to that found in a previous study in Japan. The two or three orfUs were also associated with the usp gene in this study. All the PAIusp subtypes observed in Japan were present in this study, while subtype IIa was the most common in both studies. The usp gene was observed in a higher percentage of isolates when compared with α-hly and cnf-1 genes.
    CONCLUSIONS: The findings in Japan and Sabah, East Malaysia, were similar, indicating that PAIusp subtyping is applicable to the characterization of UPEC strains epidemiologically elsewhere in the world.
  8. Muktar MZ, Shamsudin SB, Lukman KA, Jeffree MS
    A cross-sectional study was conducted on 116 male pre-cast construction workers in Sipitang, Sabah to evaluate the association between Ergonomic Risk Level exposure and their working performances for 6 months (June to November 2014). Initially, a structured interview using a modified-Standardized Nordic Questionnaire was conducted on each study subject to determine the prevalence of Musculoskeletal Disorders (MSDs). The results showed that 93 out of 116 subjects (80.17%) complained of experiencing ache, pain or body discomfort during and after work with high percentage of MSDs prevalence affecting the wrist (78.5%), shoulder (73.1%), and lower leg (71.0%) regions of the body. Pictures and videos of workers performing their routine tasks were analyzed using Rapid Entire Body Assessment (REBA) tool to generate individual Ergonomic Risk Level classification. The results showed that all subjects were exposed to Medium (56.90%), High (29.31%) and Very High (13.79%) level of Ergonomic Risk. Pearson Correlation and One-way ANOVA test was conducted to determine the association between Ergonomic Risk Level and the subjects’ individual working performances. The results indicated that there was a significant negative association between Ergonomic Risk Level and the workers' performances in terms of tendency to work overtime (p
  9. Salvaraji L, Jeffree MS, Avoi R, Atil A, Mohd Akhir H, Shamsudin SBB, et al.
    J Public Health Res, 2020 Oct 14;9(4):1994.
    PMID: 33312989 DOI: 10.4081/jphr.2020.1994
    An increasing amount of waste concurrently further extends the risk of exposure to hazardous material among waste collectors. In light of the COVID-19 crisis, municipal waste collectors are one of the most at-risk groups of SARS-Cov-2 exposure. Risk assessment included hazard identification, evaluation of existing control level at the workplace, estimation of likelihood and severity of hazard, risk determination, and control measure recommendations. Five waste collection activities were identified and reviewed. High-risk exposure includes collection of garbage, mechanical manipulation of compactor lorries and unloading of garbage at the disposal site. There is poor practice of personal hygiene and unestablished continuous monitoring of personal protective equipment supplies. The preventive measures in the waste collection industry are influenced by several factors. Until the preventive measures are adopted into practice and adapted according to each company's requirements, biological agents continue to be risk factor to the health workers.
  10. Jeffree SM, Ahmed K, Safian N, Hassan R, Mihat O, Lukman KA, et al.
    Am J Trop Med Hyg, 2018 Jan;98(1):45-50.
    PMID: 29141714 DOI: 10.4269/ajtmh.17-0081
    Sabah is a Malaysian state situated in the northern part of Borneo, and it is endemic for malaria. The incidence of malaria is the lowest (0.05/1,000 population) in Penampang districts of Sabah. In June 26, 2012, two Plasmodium falciparum malaria cases were notified to public health department from a village in Penampang. Immediate investigation was initiated to identify the risk factors and to institute control measures. We performed active case finding by asking household members of all houses in the village regarding malaria symptoms and by examining blood smears. Environmental investigation was performed by collecting samples to detect mosquito breeding sites and to identify malaria transmitting vector mosquitoes. A case-control study with a ratio of 1:4 (11 cases and 44 controls) was conducted using self-administered questionnaire. The microscopic examination of blood smear for malarial parasite and entomology sampling was carried out. The malarial attack rate was 2.3%, 6/11 smears have gametocyte, and the case fatality rate was 9.1%. One case was a migrant rubber tapper from Indonesia which happened to be the first case with gametocyte positive. Overall, the incidence of malaria was higher (6/11) among rubber tappers. The odds of cases for those living nearby stagnant water were 7.3 [95% confidence interval: 1.2-43.5] times higher. In conclusion, an outbreak of P. falciparum malaria was introduced into a malaria-free village by a migrant rubber tapper, by whom the imported parasite was introduced to the community via vector Anopheles balabacensis. Living near stagnant water bodies was the risk factor in this outbreak.
  11. Shamsudin S, Selamat J, Sanny M, A R SB, Jambari NN, Khatib A
    Molecules, 2019 Oct 29;24(21).
    PMID: 31671885 DOI: 10.3390/molecules24213898
    Stingless bee honey produced by Heterotrigona itama from different botanical origins was characterised and discriminated. Three types of stingless bee honey collected from acacia, gelam, and starfruit nectars were analyzed and compared with Apis mellifera honey. The results showed that stingless bee honey samples from the three different botanical origins were significantly different in terms of their moisture content, pH, free acidity, total soluble solids, colour characteristics, sugar content, amino acid content and antioxidant properties. Stingless bee honey was significantly different from Apis mellifera honey in terms of physicochemical and antioxidant properties. The amino acid content was further used in the chemometrics analysis to evaluate the role of amino acid in discriminating honey according to botanical origin. Partial least squares-discriminant analysis (PLS-DA) revealed that the stingless bee honey was completely distinguishable from Apis mellifera honey. Notably, a clear distinction between the stingless bee honey types was also observed. The specific amino acids involved in the distinction of honey were cysteine for acacia and gelam, phenylalanine and 3-hydroxyproline for starfruit, and proline for Apis mellifera honey. The results showed that all honey samples were successfully classified based on amino acid content.
  12. Salvaraji L, Shamsudin SB, Avoi R, Saupin S, Kim Sai L, Asan SB, et al.
    Int J Environ Res Public Health, 2022 Dec 19;19(24).
    PMID: 36554980 DOI: 10.3390/ijerph192417099
    INTRODUCTION: Persistent exposure to indoor hazards in a healthcare setting poses a risk of SBS. This study determines the prevalence of and risk factors for SBS among healthcare workers in health clinics.

    METHODS: A cross-sectional study was conducted across four health clinics from February 2022 to May 2022. As part of the study, self-administered questionnaires were completed to determine symptoms related to SBS. An indoor air quality (IAQ) assessment was conducted four times daily for fifteen minutes at five areas in each clinic (laboratory, lobby, emergency room, pharmacy, and examination room).

    RESULT: Most of the areas illustrated poor air movement (<0.15 m/s), except for the laboratory. The total bacterial count (TBC) was above the standard limit in both the lobby and emergency room (>500 CFU/m3). The prevalence of SBS was 24.84% (77) among the healthcare workers at the health clinics. A significant association with SBS was noted for those working in the examination room (COR = 2.86; 95% CI = 1.31; 6.27) and those experiencing high temperature sometimes (COR = 0.25; 95% CI = 0.11; 0.55), varying temperature sometimes (COR = 0.31; 95% CI = 0.003), stuffy air sometimes (COR = 0.17; 95% CI = 0.005; 0.64), dry air sometimes (COR = 0.20; 95% CI = 0.007; 0.64), and dust sometimes (COR = 0.25; 95% CI = 0.11; 0.60) and everyday (COR = 0.34; 95% CI = 0.14; 0.81). Only healthcare workers in the examination room (AOR = 3.17; 95% CI = 1.35; 7.41) were found to have a significant risk of SBS when controlling for other variables.

    CONCLUSION: SBS is prevalent among healthcare workers at health clinics.

  13. Lim KJ, Cheng TTJ, Jeffree MS, Hayati F, Cheah PK, Nee KO, et al.
    Transplant Proc, 2020 Apr;52(3):680-686.
    PMID: 32146022 DOI: 10.1016/j.transproceed.2020.01.007
    INTRODUCTION: Worldwide, the gap between organ supply and demand has widened over the years. Malaysia has one of the lowest deceased organ donation rates. Success rate of organ or tissue procurement depends on not only the approach rate by health care providers but also the awareness among the public, whereby it can be a platform for family initiation of organ donation. The purpose of this study is to assess the knowledge of and determine the factors influencing attitude toward organ and tissue donation among patients in a primary clinic.

    METHODS: A cross-sectional analytical study was carried out. Self-administered questionnaires were given to 400 patients who registered at an outpatient clinic in April 2018. Convenience sampling was applied.

    RESULTS: Monthly income, education level, occupation, and knowledge level are significantly associated with attitude of the respondents toward organ and tissue donation. Occupation influenced attitude toward organ donation. Knowledge of organ donation and brain death both significantly affected attitude toward organ donation.

    CONCLUSION: The greater the knowledge of organ donation and brain death, the more positive impression or attitude toward organ donation. Education level and income are the main predictors that influence attitude toward organ donation. Hence, it is important for public health units to promote and deliver public education on organ donation, change public misconceptions, and work parallel with hospitals to increase organ donation rates in Sabah.

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