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Fulltext Workplace Accidents Among Nepali Male Workers in the Middle East and Malaysia: A Qualitative Study

Adhikary P, Keen S, van Teijlingen E

J Immigr Minor Health, 2019 Oct;21(5):1115-1122.
PMID: 30073437 DOI: 10.1007/s10903-018-0801-y

There are many Nepali men working in the Middle East and Malaysia and media reports and anecdotal evidence suggest a high risk of workplace-related accidents and injuries for male Nepali workers. Therefore, this study aims to explore the personal experiences of male Nepali migrants of unintentional injuries at their place of work. In-depth, face-to-face interviews (n = 20) were conducted with male Nepali migrant workers. Study participants were approached at Kathmandu International Airport, hotels and lodges around the airport. Interviews were transcribed and analysed using thematic analysis. Almost half of study participants experienced work-related accident abroad. The participants suggested that the reasons behind this are not only health and safety at work but also poor communication, taking risks by workers themselves, and perceived work pressure. Some participants experienced serious incidents causing life-long disability, extreme and harrowing accounts of injury but received no support from their employer or host countries. Nepali migrant workers would appear to be at a high risk of workplace unintentional injuries owing to a number of interrelated factors poor health and safety at work, pressure of work, risk taking practices, language barriers, and their general work environment. Both the Government of Nepal and host countries need to be better policing existing policies, introduce better legislation where necessary, ensure universal health (insurance) coverage for labour migrants, and improve preventive measures to minimize the number and severity of accidents and injuries among migrant workers.

Matched MeSH terms: Accidents, Occupational*
Fulltext Aviator's Fracture - Bilateral Fracture-Dislocation of Talus in a 29-year-old Patient: A Case Report

Noia G, Silluzio N, Sircana G, Maccauro G, Ziranu A

Malays Orthop J, 2019 Nov;13(3):80-84.
PMID: 31890117 DOI: 10.5704/MOJ.1911.015

Bilateral fracture-dislocation of the talus is a rare occurrence. It represents 0.06% of the dislocations and 2% of the traumas of the talus. We report the case of a 29-year-old patient with an exposed bilateral fracture of the talus following a plane accident. On the right ankle, the patient had a fracture-dislocation Hawkin 3 Gustilo II, on the left ankle presented a Hawkin 4 Gustilo IIIB. The patient was treated within six hours from the trauma. We reduced the dislocation and performed an osteotomy of the tibial malleolus and osteosynthesis of the fracture with screws. The definitive stabilisation has been achieved in both limbs with an external fixator. We evaluated the patient at 1, 3, 6, 8, 12 and 18 months from treatment, with a radiograph and with SF-36 and Foot and Ankle Disability Index questionnaires. No infection was reported, radiographs showed a successful consolidation of the fracture in both limbs. At the one year follow-up, the patient was able to walk without aids and there were no signs of osteonecrosis on the MRI. The treatment of these lesions requires timely treatment, an anatomical reduction of the fracture and patient's collaboration. The use of external fixator with internal osteosynthesis represents a good therapeutic option in Hawkins 3 and 4 type fractures.

Matched MeSH terms: Accidents
Fulltext Demographic and clinical characteristics of red tag patients and their one-week mortality rate from the emergency department of the Hospital Universiti Sains Malaysia

Ahmad R, Rahmat R, Hisamudin N, Rahman NA, Noh AY, Mohammad N, et al.

Southeast Asian J. Trop. Med. Public Health, 2009 Nov;40(6):1322-30.
PMID: 20578468

Early identification and rapid treatment of red tag patients may decrease morbidity and mortality. We examined the clinical characteristics, etiologies and one week mortality rate of red tag (life threatening and potentially life threatening illness) patients at the Hospital Universiti Sains Malaysai (HUSM). A cross-sectional study was conducted at the Emergency Department of the HUSM from 1 August 2006 to 31 January 2007; 440 eligible patients were analyzed. The group had a mean age of 47.2 +/- 22 years, with 67.3% of the patients being male. Twenty-three percent were trauma cases with motor vehicle accident being the major mechanism of injury. Fifty-four percent of the cases had cardiac related illnesses. The mean duration of stay in the Emergency Department (ED) was 3.9 +/- 1.5 hours. The survival rate at one week was 76.6%. The non-trauma group comprised 74.0% of death cases. Acute coronary syndrome and road traffic accidents comprised 22.0% of total death cases at one week. Red tag patients constitute a large proportion of ED cases and may remain in the ED for significant periods of time.

Study site: Hospital Universiti Sains Malaysia (HUSM)

Matched MeSH terms: Accidents, Traffic/mortality
Toxic release consequence analysis tool (TORCAT) for inherently safer design plant

Shariff AM, Zaini D

J Hazard Mater, 2010 Oct 15;182(1-3):394-402.
PMID: 20633985 DOI: 10.1016/j.jhazmat.2010.06.046

Many major accidents due to toxic release in the past have caused many fatalities such as the tragedy of MIC release in Bhopal, India (1984). One of the approaches is to use inherently safer design technique that utilizes inherent safety principle to eliminate or minimize accidents rather than to control the hazard. This technique is best implemented in preliminary design stage where the consequence of toxic release can be evaluated and necessary design improvements can be implemented to eliminate or minimize the accidents to as low as reasonably practicable (ALARP) without resorting to costly protective system. However, currently there is no commercial tool available that has such capability. This paper reports on the preliminary findings on the development of a prototype tool for consequence analysis and design improvement via inherent safety principle by utilizing an integrated process design simulator with toxic release consequence analysis model. The consequence analysis based on the worst-case scenarios during process flowsheeting stage were conducted as case studies. The preliminary finding shows that toxic release consequences analysis tool (TORCAT) has capability to eliminate or minimize the potential toxic release accidents by adopting the inherent safety principle early in preliminary design stage.

Matched MeSH terms: Accidents*
Fulltext Successful endovascular treatment of post-traumatic inferior pancreaticoduodenal artery pseudoaneurysm

Leong BD, Chuah JA, Kumar VM, Mazri MY, Zainal AA

Singapore Med J, 2008 Nov;49(11):e300-2.
PMID: 19037533

True and pseudoaneurysms of the visceral arteries are uncommon. They represent 0.1-0.2 percent of all vascular aneurysms. Visceral artery aneurysms (VAAs) should be treated due to their propensity to rupture and associated high mortality. We describe a 58-year-old man with pseudoaneurysm of the inferior pancreaticoduodenal artery and who presented with post-motor vehicle accident abdominal pain and a pulsatile epigastic mass. Computed tomography (CT) showed a pseudoaneurysm of the visceral artery, and selective mesenteric angiography showed the aneurysm to be arising from the inferior pancreaticoduodenal artery. The aneurysm was successfully treated with endovascular coil embolisation. CT angiogram at one month post-procedure revealed persistent occlusion of the aneurysm. To the best of our knowledge, this is the first reported pseudoaneurysm of inferior pancreaticoduodenal artery secondary to blunt abdominal trauma from a motor vehicle accident and also the first reported VAA from Malaysia.

Matched MeSH terms: Accidents, Traffic
Fulltext Post-traumatic Carotico-cavernous fistula: A report of two cases

Primuharsa Putra. S.H.A., Nurliza, I., Roszalina, R., Saim, L., Zahiah, M.

International Medical Journal Malaysia, 2007;6(2):1-8.
MyJurnal

We present two cases of direct traumatic carotico-cavernous fistula following motor vehicle accident. Their main symptoms include loss of vision, progressive proptosis and recurrent epistaxis. Angiogram confirmed presence of carotico-cavernous fistula in both cases. One was successfully treated by open surgery and the other by embolization with Guglielmi detachable coils (GDC). In both cases, proptosis and epistaxis resolved completely.

Matched MeSH terms: Accidents
Workplace injuries and risk reduction practices in Malaysia

Ali R, Shaharudin R, Omar A, Yusoff F

Int J Occup Environ Health, 2012 Oct-Dec;18(4):299-306.
PMID: 23433290 DOI: 10.1179/1077352512Z.00000000031

INTRODUCTION: This study on workplace injuries and risk reduction practices was part of the Malaysia National Health Morbidity Survey III (NHMS III) conducted in 2006.
METHODS: This cross-sectional population-based survey was conducted to determine the incidence of workplaces injuries and assess the magnitude of some important risk reduction practices among workers. Data were gathered through face-to-face household interviews using a pre-coded questionnaire.
RESULTS: Of the 22 880 eligible respondents, 88·2% (20 180) responded. The incidence rate for injuries at the workplace was 4·9 per 100 (95% CI: 4·6-5·2). The overall proportion of workers who had received occupational safety and health (OSH) training before or within 1 month of starting work was 33·6%. Among respondents who perceived that personal protective equipment (PPE) was required at their workplace, only 38·9% (95% CI: 37·8-39·4) were provided with it by their employers.
DISCUSSION: Further studies are urgently needed to identify reasons for and management of the low uptake of risk reduction practices. This issue needs to be addressed to ensure the safety and health of our working population.
Study name: National Health and Morbidity Survey (NHMS-2006)

Matched MeSH terms: Accidents, Occupational/prevention & control*; Accidents, Occupational/statistics & numerical data*
Composite vascularised osteocutaneous fibula and sural nerve graft for severe open tibial fracture--functional outcome at one year: a case report

Halim AS, Yusof I

J Orthop Surg (Hong Kong), 2004 Jun;12(1):110-3.
PMID: 15237132

Management of severe open tibial fracture with neurovascular injury is difficult and controversial. Primary amputation is an acceptable option as salvaging the injured, insensate, and ischaemic limb may result in chronic osteomyelitis and non-functional limb. We report a case of open tibial fracture associated with segmental bone and soft tissue loss, posterior tibial nerve and artery injuries, which was further complicated by chronic osteo-myelitis treated with composite vascularised osteocutaneous fibula and sural nerve graft. Functional outcome of the injured limb at one-year follow-up was satisfactory: the patient was capable of achieving full weightbearing and was able to appreciate crude touch, pain, proprioception, and temperature at the plantar aspect of the foot. There was no pressure sore or ulceration.

Matched MeSH terms: Accidents, Traffic
Fulltext A review of intraocular foreign bodies treated at the University Hospital Kuala Lumpur

Teoh GH, Yow CS

Med J Malaysia, 1982 Mar;37(1):7-10.
PMID: 7121351

A retrospective study of intraocular foreign bodies treated at the University Hospital over 10 years from 1970 - 1979 was carried out. Of the 48 cases reviewed, nine were anterior chamber foreign bodies while the rest were posterior segment foreign bodies. The anterior chamber foreign bodies had better visual prognosis as compared to the posterior segment foreign bodies. Most of the patients were young Chinese males and most of the injuries were due to accidents at work involving the 'hand hammer' (includes other implements used as a hammer).

Matched MeSH terms: Accidents, Occupational
Fulltext Chronic posterolateral rotatory instability of the knee

Yong CK

Med J Malaysia, 2006 Dec;61 Suppl B:27-31.
PMID: 17605179

Posterolateral corner (PLC) laxity of the knee results in rotatory instability, in association with posterior cruciate ligament (PCL) laxity led to a grossly unstable knee. This is a series of eight patients with chronic PLC and PCL laxity treated with arthroscopic quadriceps tendon PCL reconstruction and extraarticular hamstring PLC reconstruction. Seven cases had high tibial osteotomy to address associated genu varus deformity. With prospective pre- and post-operative assessments, there was a significant improvement in the 2000 International Knee Documentation Committee (IKDC) subjective assessment and knee examination, Lysholm-Gillquist and Tegner activity scores, as well as KT-1000 arthrometry measurement after one year in all knees. Surgical treatment of PLC laxity must address coexisting problems of the PCL and mechanical alignment for a successful outcome.

Matched MeSH terms: Accidents, Traffic
Fulltext Perceived work environment and the occurrence of accidents: a study based on Kuching area of Sarawak

Li, Sa Lau, Talwar, P.Y., Shahren Ahmad Zaidi Adruce, Yin, Bee Oon

Journal of Cognitive Sciences & Human Development, 2016;2(1):37-48.
MyJurnal

Perceived work environment could be described as the opinions and attitudes of workers towards their work condition. Elements of perceived work environment such as physical environment, supportive work environment, and perceived work tasks may possibly be important factors that influence the occurrence of accidents. The objective of this study is to examine the relationship between perceived work environment and the occurrence of accidents within an electronic manufacturing industry in Kuching, Sarawak. A cross-sectional survey utilizing a bilingual self-report questionnaire was conducted to garner data from 50 workers. Independent t-test and Pearson moment correlation were used to assess data. The results indicated that the occurrence of accidents was not affected by age group. Although physical environment and perceived work tasks did not demonstrate significant relationships with the occurrence of accidents, supportive work environment exhibited a significant inverse relationship, thereby indicating that accidents could be lowered in the presence of higher supportive work environment. Thus, support and help from co-workers are essential determinants of safety at the workplace.

Matched MeSH terms: Accidents
Fulltext Electrocution induced symptomatic bradycardia necessitating pacemaker implantation

Yew KL

Heart Views, 2014 Apr;15(2):49-50.
PMID: 25104983 DOI: 10.4103/1995-705X.137497

Electrical or electrocution injury is a common accidental occurrence and mostly workplace related. Fatal arrhythmias, skin injury and sudden death may ensue. However, it is rare for electrocution to result in permanent low rate sinus bradycardia, incompatible with an active lifestyle. The probable mechanisms for this pathological sinus bradycardia are sinus node dysfunction and autonomic dysfunction with vagal predominance. We describe a young patient who suffered a non fatal electrocution with resultant low rate sinus bradycardia and its successful treatment with a dual chamber rate responsive pacemaker.

Matched MeSH terms: Accidents
An ergonomics study of a semiconductors factory in an IDC for improvement in occupational health and safety

Bin WS, Richardson S, Yeow PH

Int J Occup Saf Ergon, 2010;16(3):345-56.
PMID: 20828490

The study aimed to conduct an ergonomic intervention on a conventional line (CL) in a semiconductor factory in Malaysia, an industrially developing country (IDC), to improve workers' occupational health and safety (OHS). Low-cost and simple (LCS) ergonomics methods were used (suitable for IDCs), e.g., subjective assessment, direct observation, use of archival data and assessment of noise. It was found that workers were facing noise irritation, neck and back pains and headache in the various processes in the CL. LCS ergonomic interventions to rectify the problems included installing noise insulating covers, providing earplugs, installing elevated platforms, slanting visual display terminals and installing extra exhaust fans. The interventions cost less than 3 000 USD but they significantly improved workers' OHS, which directly correlated with an improvement in working conditions and job satisfaction. The findings are useful in solving OHS problems in electronics industries in IDCs as they share similar manufacturing processes, problems and limitations.

Matched MeSH terms: Accidents, Occupational/prevention & control*
Fulltext A review on conceptualization and dimensions of safety culture

Shah Rollah Abdul Wahab, Yeong, Sook Shuen

Journal of Occupational Safety and Health, 2015;12(1):9-12.
MyJurnal

Recent development in industrialization and global economy has contributed to the increased number of workplace
injuries and accidents. Safety culture has been seen as a central medium to curb the worrying trend of workplace
accidents. The term of safety culture has emerged from the Chernobyl nuclear disaster in 1986 and the concept has
been widely used until today. However, the conceptualization of safety culture suffers from several major drawbacks
such as no definite understanding of how safety culture is being defined and measured. This paper hypothesized that
higher levels of safety culture in the workplace will display lower numbers of accidents. Due to this concern, this
paper seeks to provide a clear conceptualization of safety culture, dimensions used to measure it and common research
methodology used in the previous safety research.

Matched MeSH terms: Accidents
Fulltext Anaesthetic management in a patient requiring one lung ventilation during COVID-19 pandemic

Teah MK, Yap KY, Ismail AJ, Yeap TB

BMJ Case Rep, 2021 Feb 17;14(2).
PMID: 33597165 DOI: 10.1136/bcr-2020-241148

Placement of a double-lumen tube to achieve one lung ventilation is an aerosol-generating procedure. Performing it on a patient with COVID-19 will put healthcare workers at high risk of contracting the disease. We herein report a case of its use in a patient with traumatic diaphragmatic rupture, who was also suspected to have COVID-19. This article aims to highlight the issues, it presented and ways to address them as well as the perioperative impact of personal protective equipment.

Matched MeSH terms: Accidents, Traffic
Fulltext Design of a Smart Safety Vest Incorporated With Metal Detector Kits for Enhanced Personal Protection

Rajendran SD, Wahab SN, Yeap SP

Saf Health Work, 2020 Dec;11(4):537-542.
PMID: 33329921 DOI: 10.1016/j.shaw.2020.06.007

Background: Personal protective equipment (PPE) has been designed in such a way to reduce accident rates. Unfortunately, existing PPE is rather ineffective as it is not able to provide warning signals when hazard is around. The integration of intelligent systems is envisaged to increase the efficiency of existing PPE.
Methods: This project designed a safety vest incorporated with metal detectors which can provide immediate warning to the field workers when there is metal hazard around. This product has greater freedom of design via smart manufacturing as it involves the assembly of few commercially available parts into a single entity. Briefly, the metal detector is a do it yourself (DIY) kit, and the safety vest is purchasable from any local market. The DIY kit was connected to a copper coil and being sewed into the safety vest.
Results: The metal detector induces beeping sound when there is metal hazard around. A total of 121 engineering students were introduced to the prototype before being requested to answer a survey associated with the design. Respondents have rated >3.00/5.00 for the design simplicity, ease of usage, and light weight. Meanwhile, respondents suggested that the design should be further improved by increasing the metal detection range.
Conclusion: It is envisaged that the introduction of this smart safety vest will allow the workers to carry out their duties securely by reducing the accident rates. Particularly, such design is expected to reduce workplace accident especially during night time at construction sites where the visibility is low.

Matched MeSH terms: Accidents, Occupational
Fulltext Traumatic hemipelvectomy with free gluteus maximus fillet flap covers: a case report

Faisham W, Azman W, Muzaffar T, Muslim D, Azhar A, Yahya M

Malays Orthop J, 2012 Nov;6(3):37-9.
PMID: 25279054 MyJurnal DOI: 10.5704/MOJ.1207.002

Traumatic hemipelvectomy is an uncommon and life threatening injury. We report a case of a 16-year-old boy involved in a traffic accident who presented with an almost circumferential pelvic wound with wide diastasis of the right sacroiliac joint and symphysis pubis. The injury was associated with complete avulsion of external and internal iliac vessels as well as the femoral and sciatic nerves. He also had ipsilateral open comminuted fractures of the femur and tibia. Emergency debridement and completion of amputation with preservation of the posterior gluteal flap and primary anastomosis of the inferior gluteal vessels to the internal iliac artery stump were performed. A free fillet flap was used to close the massive exposed area.

Matched MeSH terms: Accidents, Traffic
Errors in accident data, its types, causes and methods of rectification-analysis of the literature

Ahmed A, Sadullah AFM, Yahya AS

Accid Anal Prev, 2019 Sep;130:3-21.
PMID: 28764851 DOI: 10.1016/j.aap.2017.07.018

Most of the decisions taken to improve road safety are based on accident data, which makes it the back bone of any country's road safety system. Errors in this data will lead to misidentification of black spots and hazardous road segments, projection of false estimates pertinent to accidents and fatality rates, and detection of wrong parameters responsible for accident occurrence, thereby making the entire road safety exercise ineffective. Its extent varies from country to country depending upon various factors. Knowing the type of error in the accident data and the factors causing it enables the application of the correct method for its rectification. Therefore there is a need for a systematic literature review that addresses the topic at a global level. This paper fulfils the above research gap by providing a synthesis of literature for the different types of errors found in the accident data of 46 countries across the six regions of the world. The errors are classified and discussed with respect to each type and analysed with respect to income level; assessment with regard to the magnitude for each type is provided; followed by the different causes that result in their occurrence, and the various methods used to address each type of error. Among high-income countries the extent of error in reporting slight, severe, non-fatal and fatal injury accidents varied between 39-82%, 16-52%, 12-84%, and 0-31% respectively. For middle-income countries the error for the same categories varied between 93-98%, 32.5-96%, 34-99% and 0.5-89.5% respectively. The only four studies available for low-income countries showed that the error in reporting non-fatal and fatal accidents varied between 69-80% and 0-61% respectively. The logistic relation of error in accident data reporting, dichotomised at 50%, indicated that as the income level of a country increases the probability of having less error in accident data also increases. Average error in recording information related to the variables in the categories of location, victim's information, vehicle's information, and environment was 27%, 37%, 16% and 19% respectively. Among the causes identified for errors in accident data reporting, Policing System was found to be the most important. Overall 26 causes of errors in accident data were discussed out of which 12 were related to reporting and 14 were related to recording. "Capture-Recapture" was the most widely used method among the 11 different methods: that can be used for the rectification of under-reporting. There were 12 studies pertinent to the rectification of accident location and almost all of them utilised a Geographical Information System (GIS) platform coupled with a matching algorithm to estimate the correct location. It is recommended that the policing system should be reformed and public awareness should be created to help reduce errors in accident data.

Matched MeSH terms: Accidents, Traffic/statistics & numerical data*
Evaluating the effect of lane width and roadside configurations on speed, lateral position and likelihood of comfortable overtaking in exclusive motorcycle lane

Ibrahim MKA, Hamid H, Law TH, Wong SV

Accid Anal Prev, 2018 Feb;111:63-70.
PMID: 29172046 DOI: 10.1016/j.aap.2017.10.023

Construction of exclusive motorcycle lanes is one of the measures to reduce motorcycle fatalities. Previous studies highlighted the risk of crashes with roadside objects and the tendency of motorcyclists to ride with excessive speed on exclusive motorcycle lanes. However, the risk of same-direction crashes on exclusive motorcycle lanes was not explored in much detail, especially on the impact of lane geometry and roadside configurations. This study used naturalistic riding data to determine the effects of lane width and roadside configurations on overtaking speed, lateral position and likelihood of comfortable overtaking on tangential sections of an exclusive motorcycle lane. Twenty-nine recruited motorcyclists rode the instrumented motorcycles along a 20km stretch of an exclusive motorcycle lane along a major urban road. Results revealed that both the roadside configurations and lane width significantly affect the participants' lateral position, while the roadside configurations only affects the overtaking speed. Participants' overtaking speeds and the front motorcycles' lateral position contribute significantly to the likelihood of comfortable overtaking in exclusive motorcycle lanes. The findings highlight the importance of micro-level behavior indicators in improving the design and overall safety of the exclusive motorcycle facility.

Matched MeSH terms: Accidents, Traffic*
Fulltext Traumatic herniation of the heart into the right hemithorax

Wong PS

Med J Malaysia, 1999 Dec;54(4):523-5.
PMID: 11072475

Pericardial rupture after blunt chest trauma is described in the literature. This case report summarises our experience with a 22-year old male patient who suffered blunt chest trauma during a motor vehicle accident. On admission no serious injuries could be detected, but 3 hours later, displacement of the heart to the right hemithorax combined with sudden cardiac failure appeared. Emergency thoracotomy revealed a right-sided rupture of the pericardium with complete herniation of the heart into the right pleural cavity and consequent strangulation by the margins of the pericardial defect.

Matched MeSH terms: Accidents, Traffic

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