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Fulltext Enumeration of Salmonella spp., Salmonella Typhi and Salmonella Typhimurium in fruit juices

Diana, J.E., Pui, C.F., Son, R.

International Food Research Journal, 2012;19(1):51-56.
MyJurnal

Salmonella has caused foodborne illnesses globally and it has been a rising threat on fresh produce. The objective of this study was to determine the prevalence and concentration of Salmonella spp., Salmonella Typhi and Salmonella Typhimurium in freshly prepared fruit juice sold at hawker stalls. Analysis was conducted by employing most probable number-polymerase chain reaction (MPN-PCR). A total of 50 freshly prepared fruit juices were examined and the prevalence of Salmonella spp., Salmonella Typhi and Salmonella Typhimurium in the fruit juices were 34%, 20% and 10%, respectively, with an estimated microbial load varying from 0 to 42 MPN/g. Of the five different fruits, carrot juice had the highest prevalence of Salmonella spp. (60%) and Salmonella Typhi (40%). However, Salmonella Typhimurium was detected in apple (30%), orange (10%) and starfruit juice (10%). Factors contributing to the presence of Salmonella were cross-contamination and poor sanitation practice. Besides, negligence on temperature and storage time also led to the growth of Salmonella. Proper monitoring and risk assessment are needed in order to establish control measures to ensure the quality and safety of fruit juices in Malaysia.

Matched MeSH terms: Risk Assessment
Fulltext Consumption of raw oysters: a risk factor for Vibrio parahaemolyticus infection

New, C.Y., Kantilal, H.K., Tan, M.T.H., Nakaguchi, Y., Nishibuchi, M., Son, R.

International Food Research Journal, 2014;21(6):2459-2472.
MyJurnal

Vibrio parahaemolyticus is recognized as a frequent causal agent of human gastroenteritis due to the consumption of raw, undercooked or mishandled seafood in many Asian countries. The number of V. parahaemolyticus cases reported is on the rise, and this becomes a concern to the Asian countries as seafood is favoured by Asians. This study aimed to detect and quantify V. parahaemolyticus in raw oysters and to determine the risk associated with the consumption of raw oysters. A total of 30 oyster samples were collected and analysed in this study. MPN-PCR and MPN-Plating methods were employed and carried out concurrently to determine the prevalence of V. parahaemolyticus in raw oysters. The results showed that the prevalence of total V. parahaemolyticus in oysters was 50.00% (15/30) where the MPN/g range was < 3 – > 11000 MPN/g for MPN-PCR method, and 40.00% (12/30) where the MPN/g range was < 3 – 4300 MPN/g for MPN-Plating method. MPN-PCR method was able to estimate the level of virulence (tdh+ and trh+) V. parahaemolyticus in the raw oysters where 10.00% (3/30) of samples were identified to be in a range of 3 – 30 MPN/g. A microbial risk assessment was conducted based on the enumeration data obtained from MPN-PCR method using @risk. The probability of illness annually was 1.76 X 10-6 with a prediction of 31 cases to occur with respect to the exposed Malaysian population, while the rate per 100,000 people was estimated to be at 0.104. In addition, the antibiogram of V. parahaemolyticus was determined using Kirby Bauer Disk Diffusion Test and the results indicated that the isolates were highly resistant towards Bacitracin (100.00%), Vancomycin (100.00%) and were least resistant to Chloramphenicol (8.70%). The MAR index of the isolates ranged from 0.17 to 0.50. In accordance with the results from this study, the consumption of raw oysters is a risk factor for V. parahaemolyticus infection and proactive actions should be taken to reduce the risk of the pathogen in order to improve public health.

Matched MeSH terms: Risk Assessment
Fulltext Risk of Escherichia coli O157:H7 infection linked to the consumption of beef

Premarathne J.M.K.J.K., New, C.Y., Ubong, A, Nakaguchi, Y., Nishibuchi, M., Son, R.

Food Research, 2017;1(3):67-76.
MyJurnal

Escherichia coli O157:H7 is a major food-borne pathogen that has resulted in numerous
outbreaks around the world. Widespread distribution of the organism in various ecological
niches impedes the control measures. This study aimed to detect and quantify E. coli O157:H7
in beef sold in wet markets and hypermarkets in Malaysia and to determine the risk of E. coli
O157:H7 infection linked to consumption of beef. The rfbO157 and flicH7 primers targeted on
somatic antigen (O157) and flagellar antigen (H7) respectively of E. coli O157:H7 was used for
the MPN-PCR method. A total of 99 beef samples were collected from local wet markets and
hypermarkets. The highest E. coli O157:H7 contamination rate was observed in beef samples
collected from wet markets (89.50%), whereas the contamination rate in hyper market A and B
were compratively low (35.35 and 20% respectively). However, the microbial load was highest
in the beef samples from hypermarket A (1100 MPN/g) while E. coli O157:H7 bacterial load
in beef samples from hypermarket B and wet market ranged from 3 to 93 MPN/g and 3 to 240
MPN/g, respectively. Using the Quantitative Microbial Risk Assessment (QMRA) approach
the risk was estimated incorporating the findings of the prevalence study and predictions
based on home storage, cooking and consumption patterns. Three different exposure pathways
were investigated to estimate the risk associated with contaminated beef and Monte Carlo
simulation was used to determine the level of uncertainty. The developed model predicated that
consumption of contaminated beef can be accountable for 1.83E+06 E. coli O157:H7 cases per
year in Malaysia. The reliability of the model, data gaps and further research needs, is discussed.
Through continuous improvement Quantitative Microbial Risk Assessment provides valuable
insight into controlling and prevention strategies.

Matched MeSH terms: Risk Assessment
Fulltext Risk assessment of acquiring listeriosis from consumption of chicken offal in Selangor, Malaysia

Kuan, C.H., Goh, S.G., Loo, Y.Y., Chang, W.S., Lye, Y.L., Puspanadan, S., et al.

International Food Research Journal, 2015;22(4):1711-1718.
MyJurnal

Listeria monocytogenes (L. monocytogenes) is an important foodborne pathogen which can cause foodborne listeriosis with high mortality rates especially in susceptible population groups such as pregnant women, elderly and immunocompromised individuals. The biosafety level of L. monocytogenes in chicken offal has becomes a great concern as chicken offal is a cheap source of protein and it is often served as side dishes in South East Asian countries. In Malaysia, the consumption of chicken offal has almost doubled from 5 g per capita per day in the early 1980s to 9 g per capita per day in 2009. In this study, risk assessment was conducted to estimate the risk of acquiring listeriosis from consumption of chicken offal in Malaysia. A microbial survey on the prevalence and concentration of L. monocytogenes in chicken offal were carried out in Selangor, Malaysia over a one-year period (November 2010 to October 2011). It was assumed that there were no seasonal changes in the prevalence and consumption pattern all year round. Assuming that 5.6 million people in Selangor, Malaysia consume a single serving (125 g) of chicken offal per week, it is estimated that in a year there could be 0.61 cases and 1.98 × 10-4 cases of listeriosis per 100,000 population of pregnant woman and immunocompromised individual, respectively. However, the potential for getting listeriosis among the healthy population was very low, only 1.39 × 10-8 cases per 100,000 population. This study demonstrated risk assessment model not only used as a tool to estimate the risk of acquiring illness but it can influence public health surveillance and providing data in setting appropriate level of protection.

Matched MeSH terms: Risk Assessment
Are Neonatal Trials Better Conducted and Reported over the Last 6 Decades? An Analysis on Their Risk-of-Bias Status in Cochrane Reviews

Lai NM, Ong JMJ, Chen KH, Chaiyakunapruk N, Ovelman C, Soll R

Neonatology, 2019;116(2):123-131.
PMID: 31108494 DOI: 10.1159/000497423

BACKGROUND: The introduction of Neonatology as a subspecialty in 1960 has stimulated an enormous amount of neonatal research. A large proportion of neonatal randomized-controlled trials (RCTs) have been included in the Cochrane reviews, within which methodological quality or risk-of-bias (ROB) assessment is an integral feature.
OBJECTIVES: We described the ROB profile of neonatal RCTs published since the 1950s.
METHODS: We analyzed individual studies within the Cochrane Neonatal reviews published up to December 2016. We extracted the reviewers' judgments on the ROB domains including random sequence generation, allocation concealment, blinding, incomplete outcome data, and selective reporting. We evaluated blinding of personnel in trials in which blinding was considered feasible.
RESULTS: We assessed 1980 RCTs published between 1952 and 2016 from 294 Cochrane Neonatal systematic reviews, with full ROB assessments performed in 848 trials (42.8%). Among the ROB domains, the highest proportion of trials (73%) were judged as satisfactory ("low risk") in handling incomplete outcome data, while fewest trials achieved blinding of outcome assessor (38.4%). In the last 6 decades, a progressive increase has been observed in the proportion of trials that were rated as low risk in random sequence generation, allocation concealment, and selective reporting. However, blinding was achieved in less than half of the trials with no clear improvement across decades (23-44% since the 1980s).
CONCLUSIONS: Despite steady improvement in the overall quality of neonatal RCTs over the last 6 decades, blinding remained unsatisfactory in the majority of the trials.

Matched MeSH terms: Risk Assessment
Agricultural drought risk assessment of Northern New South Wales, Australia using geospatial techniques

Hoque MA, Pradhan B, Ahmed N, Sohel MSI

Sci Total Environ, 2020 Nov 17.
PMID: 33248778 DOI: 10.1016/j.scitotenv.2020.143600

Droughts are recurring events in Australia and cause a severe effect on agricultural and water resources. However, the studies about agricultural drought risk mapping are very limited in Australia. Therefore, a comprehensive agricultural drought risk assessment approach that incorporates all the risk components with their influencing criteria is essential to generate detailed drought risk information for operational drought management. A comprehensive agricultural drought risk assessment approach was prepared in this work incorporating all components of risk (hazard, vulnerability, exposure, and mitigation capacity) with their relevant criteria using geospatial techniques. The prepared approach is then applied to identify the spatial pattern of agricultural drought risk for Northern New South Wales region of Australia. A total of 16 relevant criteria under each risk component were considered, and fuzzy logic aided geospatial techniques were used to prepare vulnerability, exposure, hazard, and mitigation capacity indices. These indices were then incorporated to quantify agricultural drought risk comprehensively in the study area. The outputs depicted that about 19.2% and 41.7% areas are under very-high and moderate to high risk to agricultural droughts, respectively. The efficiency of the results is successfully evaluated using a drought inventory map. The generated spatial drought risk information produced by this study can assist relevant authorities in formulating proactive agricultural drought mitigation strategies.

Matched MeSH terms: Risk Assessment
Safety and effectiveness of biphasic insulin aspart 30 in type 2 diabetes: results from the ASEAN cohort of the A₁chieve study

Lim-Abrahan MA, Jain AB, Bebakar WM, Seah D, Soewondo P

Diabetes Res Clin Pract, 2013 Apr;100 Suppl 1:S3-9.
PMID: 23647715 DOI: 10.1016/S0168-8227(13)70003-2

AIM:
To determine the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in the ASEAN cohort of the A₁chieve study.

METHODS:
Type 2 diabetes patients from Indonesia, Malaysia, Philippines and Singapore prescribed BIAsp 30 therapy were included. The primary outcome was evaluation of serious adverse drug reactions including major hypoglycaemia over 24 weeks. Secondary outcomes were changes in hypoglycaemic events, serious adverse events (SAEs) and effectiveness parameters.

RESULTS:
This sub-analysis included 2798 patients (insulin-naive, 1903; insulin-experienced, 895) with mean age ± SD, 55.3 ± 10.8 years, BMI, 24.9 ± 4.6 kg/m(2) and diabetes duration, 7.5 ± 5.9 years. Baseline HbA1c in the entire cohort was poor (9.9%, 85 mmol/mol). A total of 15 SAEs were reported in 7 insulin-experienced patients (1 moderate event was related to BIAsp 30). Overall hypoglycaemia at Week 24 was 0.88 events/patient-year compared to 1.71 events/patient-year reported at baseline (change in proportion of patients affected, p < 0.0001). No major hypoglycaemia was reported at Week 24. BIAsp 30 significantly improved glucose control (HbA1c, fasting plasma glucose and postprandial plasma glucose, p < 0.001) at Week 24. The proportion of patients achieving HbA1c <7.0% at Week 24 was 35.3% compared to 3.5% at baseline. The lipid profile and systolic blood pressure also improved significantly (p < 0.001). Quality of life was positively impacted (mean change in visual analogue scores from EQ-5D = 10.6 ± 13.8 points, p < 0.001).

CONCLUSION:
BIAsp 30 was well-tolerated and improved glucose control while decreasing the risk of hypoglycaemia.

Matched MeSH terms: Risk Assessment
Switching from biphasic human insulin to biphasic insulin aspart 30 in type 2 diabetes: results from the ASEAN subgroup of the A₁chieve study

Hussein Z, Lim-Abrahan MA, Jain AB, Goh SY, Soewondo P

Diabetes Res Clin Pract, 2013 Apr;100 Suppl 1:S24-9.
PMID: 23647714 DOI: 10.1016/S0168-8227(13)70006-8

Aim: To evaluate the safety and effectiveness of biphasic insulin aspart 30 (BIAsp 30) in ASEAN type 2 diabetes (T2D) patients switched from biphasic human insulin (BHI) in the non-interventional 24-week A₁chieve study.

Methods: Indonesian, Malaysian, Filipino and Singaporean patients switched from BHI to BIAsp 30 at their physicians' discretion were included. The incidence of serious adverse drug reactions (SADRs), including major hypoglycaemia was the primary endpoint. Changes in hypoglycaemia, glycated haemoglobin A1c (HbA1c), fasting plasma glucose (FPG), postprandial plasma glucose (PPPG), lipids, body weight and systolic blood pressure were also evaluated. Quality of life (QoL) was measured using the EQ-5D questionnaire.

Results: For the 465 patients included (mean ± SD age: 56 ± 10.3 years, diabetes duration: 9.7 ± 7.1 years, baseline HbA1c: 9.4 ± 1.8%), the mean pre-study BHI dose was 0.62 ± 0.28 IU/kg and 63.4% were dosing BHI twice daily (bid). The mean baseline BIAsp 30 dose was 0.65 ± 0.27 U/kg, titrated up to 0.71 ± 0.28 U/kg over 24 weeks, and most patients continued bid dosing. No SADRs or major hypoglycaemic episodes were reported. The proportion of patients reporting overall hypoglycaemia decreased significantly from 10.8% at baseline to 3.4% at Week 24 (p < 0.0001). Significant improvements in glycaemic control were noted (HbA1c: -1.4 ± 1.7%, FPG: -56.7 ± 72.5 mg/dL, post-breakfast PPPG: -84.8 ± 82.8 mg/dL, p < 0.001). Mean QoL improved by +6.6 ± 14.6 points (p < 0.001).

Conclusion: BIAsp 30 was well-tolerated and significantly increased glycaemic control in this ASEAN subgroup poorly controlled on BHI.

Matched MeSH terms: Risk Assessment
Safety and effectiveness of insulin aspart in type 2 diabetic patients: results from the ASEAN cohort of the A₁chieve study

Bebakar WM, Lim-Abrahan MA, Jain AB, Seah D, Soewondo P

Diabetes Res Clin Pract, 2013 Apr;100 Suppl 1:S17-23.
PMID: 23647713 DOI: 10.1016/S0168-8227(13)70005-6

AIM:
To examine the clinical safety and effectiveness of insulin aspart (IAsp) therapy in type 2 diabetes (T2D) patients from the ASEAN cohort of the international, 24-week, non-interventional A₁chieve study.

METHODS:
T2D patients from Indonesia, Malaysia, Philippines and Singapore, who started IAsp therapy with or without oral glucose-lowering drugs, were included. The primary endpoint was the incidence of serious adverse drug reactions (SADRs), including major hypoglycaemic events. Secondary endpoints included hypoglycaemia, glycated haemoglobin A1c [HbA1c], fasting plasma glucose [FPG], postprandial plasma glucose [PPPG], systolic blood pressure [SBP], body weight and lipids. Quality of life (QoL) was assessed using the EQ-5D questionnaire.

RESULTS:
Overall, 312 T2D patients (222 insulin-naive and 90 insulin-experienced) with a mean ± SD age of 56.6 ± 11.2 years, BMI of 24.2 ± 3.9 kg/m(2) and diabetes duration of 7.0 ± 5.7 years were included. The mean daily IAsp dose was 0.51 ± 0.31 U/kg at baseline titrated up to 0.60 ± 0.29 U/kg at Week 24. No SADRs or major hypoglycaemic events were reported in the entire subgroup. The proportion of patients who reported overall hypoglycaemia decreased from baseline to Week 24 (7.1% vs. 0.3%, p < 0.0001). The mean HbA1c improved from 9.5 ± 1.6% at baseline to 7.6 ± 1.3% after 24 weeks (p < 0.001). The mean FPG, post-breakfast PPPG and SBP also improved (p < 0.001). Health-related QoL scores increased in the entire subgroup (mean increase: 9.8 ± 14.6 points, p < 0.001).

CONCLUSIONS:
Starting IAsp therapy was well-tolerated and was associated with significantly improved overall glycaemic control in the ASEAN cohort.

Matched MeSH terms: Risk Assessment
Fulltext A new radiological classification for the risk assessment of anterior skull base injury in endoscopic sinus surgery

Abdullah B, Chew SC, Aziz ME, Shukri NM, Husain S, Joshua SW, et al.

Sci Rep, 2020 03 12;10(1):4600.
PMID: 32165705 DOI: 10.1038/s41598-020-61610-1

Keros and Gera classifications are widely used to assess the risk of skull base injury during endoscopic sinus surgery. Although, both classifications are useful preoperatively to stratify risk of patients going for surgery, it is not practical to measure the respective lengths during surgery. In this study, we aimed to propose a new radiological classification (Thailand-Malaysia-Singapore (TMS)) to assess the anatomical risk of anterior skull base injury using the orbital floor (OF) as a reference. A total of 150 computed tomography images of paranasal sinuses (300 sides) were reviewed. The TMS classification was categorized into 3 types by measuring OF to cribriform plate and OF to ethmoid roof. Most patients were classified as TMS type 1, Keros type 2 and Gera class II, followed by patients classified as TMS type 3, Keros type 1 and Gera class 1. TMS has significant correlation with Keros classification (p risk assessment of skull base injury among patients undergoing ESS. It serves as an additional assessment besides the Keros and Gera classifications.

Matched MeSH terms: Risk Assessment
Profiling cancer risk in oral potentially malignant disorders-A patient cohort study

Thomson PJ, Goodson ML, Smith DR

J Oral Pathol Med, 2017 Nov;46(10):888-895.
PMID: 28833670 DOI: 10.1111/jop.12625

BACKGROUND: Oral potentially malignant disorders harbour variable and unpredictable risk for squamous carcinoma development. Whilst current management strategies utilise histopathological diagnoses, dysplasia grading and targeted intervention for "high-risk" lesions, clinicians are unable to predict malignant potential.
METHODS: Detailed, retrospective clinico-pathological analysis of potentially malignant lesions undergoing malignant transformation, from a 590 patient cohort treated by interventional laser surgery and followed for a mean of 7.3 years, was undertaken. Clinical outcome was documented at study census date (31 December 2014).
RESULTS: A total of 99 patients (16.8%) developed cancer: 71 (12%) seen "unexpectedly" upon excision and 28 (4.8%) progressing to malignancy at a median of 87.3 months post-surgery. Thirty "unexpected" excisions were micro-invasive (42.3%) arising primarily in severely dysplastic precursors (75%) at ventro-lateral tongue and floor of mouth sites (54.5%); 1 patient (1.4%) had a cancer-related death, whilst 58 (81.7%) were disease free. A total of 19 of 28 "progressive" cancers (67.9%) arose at new sites, with erythroleukoplakia a significant predictor of malignancy (P = .0019). Nine (32.1%) developed at the same precursor site, with 6 (77.7%) on the ventro-lateral tongue and floor of mouth. Three (10.7%) were micro-invasive, 9 patients (32.1%) died from metastatic disease and 12 (42.9%) were disease free (P < .001).
CONCLUSION: Squamous carcinoma may arise at the site of a precursor lesion as transformation or new-site development via field cancerisation. Whilst interventional surgery facilitates early diagnosis and treatment of occult disease, thus reducing risk from same-site transformation, new-site cancer is a significant long-term risk for patients with potentially malignant disorder.

Matched MeSH terms: Risk Assessment
Study on the incidence of adverse events during intra-hospital transfer of critical care patients from emergency department

Mohd Ismail MR, Baharuddin KA, Zainal Abidin ZE, Abu Bakar MA, Sjahid AS

Med J Malaysia, 2020 07;75(4):325-330.
PMID: 32723989

INTRODUCTION: Emergency department (ED) plays a main role in the initial management of patients who are critically ill. These patients require intra-hospital transfer for continuation of care. Adverse events can occur during this short duration and the distance of intra -hospital transfer. The aims of this study were to determine the incidence of adverse events during intrahospital transfer from ED and to determine the factors associated.
METHODOLOGY: This was a cross-sectional observational study done from November 2017 until December 2017 at ED Hospital Sultan Abdul Halim (HSAH), a 650-bedded tertiary hospital in the state of Kedah. All patients that were triaged to red zone, age 18 years and above, and involved in intra-hospital transfer to critical coronary unit, intensive care unit and wards were included. All cases were documented in proforma by the accompanying staff.
RESULTS: Among the 170 critically ill patients, only 29 patients (17.1%) experienced adverse events during intra-hospital transfer. The adverse events seen were hypotension (12.4%), desaturation (3.5%) and dislodged peripheral line (2.4%). Cardiorespiratory related diagnosis was the commonest presentation. Intra-hospital transfer during morning shift and evening shift has 79.5% (b=-1.59, OR=0.21, 95% CI: 0.06, 0.69, p=0.011) and 75.6% ((b=-1.41, OR=0.24, 95% CI: 0.08, 0.73, p=0.012) lesser odds of experiencing adverse events compare to night shift. Patients with vasopressor/inotropes had 9 times higher odds of experiencing adverse events during transportation, compared to patients with no vasopressor/inotropes (b=2.27, OR=9.70, 95% CI: 3.39, 27.72, p<0.001).
CONCLUSIONS: Critical care patients who are involved in intrahospital transfer were at risk of adverse events such as hypotension, desaturation and dislodge peripheral line. Risk identification and maintaining level of care is important to minimize the adverse events during transfer. Patients had higher rates of adverse events if they were transferred during night shifts and on inotropic/vasopressor support.

Matched MeSH terms: Risk Assessment
Fulltext Urinary incontinence in the elderly population

Loh KY, Sivalingam N

Med J Malaysia, 2006 Oct;61(4):506-10; quiz 511.
PMID: 17243536 MyJurnal

Urinary incontinence is an important and common health care problem affecting the elderly population. Common types of incontinence affecting the elderly are: stress incontinence, urge incontinence, overflow incontinence and mixed type. The elderly patient suffering from urinary incontinence does not often seek treatment voluntary due to a misconception that it is part of a normal ageing process. Without treatment, urinary incontinence may lead to serious psychological and social complications such as depression, anxiety, embarrassment, low self-esteem and social isolation. Overall it is associated with significant poor quality of life for the elderly. Life style modification and behavioural therapy with or without pharmacotherapy help in improving the symptoms. Pelvic floor muscles' training is beneficial for stress incontinence in up to fifty percent of the patients. Elderly patients with urinary incontinence should be encouraged to seek treatment early, as the problem can be treated and they will have a better quality of life.

Matched MeSH terms: Risk Assessment
Fulltext Quantitative risk assessment on onshore gas terminal plant

Aliff, Farhan Bustani M., Siti Aslina Hussain

Journal of Occupational Safety and Health, 2018;15(2):25-33.
MyJurnal

Quantitative Risk Assessment (QRA) nowadays is an established risk assessment method used worldwide for the evaluation of risks on onshore plant and offshore facilities which associated with the major hazard installations. However, there are still many issues on QRA used. These include lack of consistency, complexity of the overall model structure, incorporation of new data, methodology and model analysis. Common problem observed for the onshore QRA methodology is conservatism of fire and explosion consequence results using DNV PhastRisk 6.7 software which is mainly contributed from the high release rate due to loss of containment. This paper presents an alternative way to predict the actual release rate for fire and explosion modelling which called limiting flowrate technique. This method has been applied for calculating risk in Onshore Gas Terminal (OGT) Plant. Adopting the limiting flowrate technique has provide more precise model towards real scenarios. Challenges facing during this research such as using the unmodified United Kingdom (UK) HSE hydrocarbon release database without integrate with the actual failure frequencies from the plant, the risk results tend to be much higher than actual experience. It should be noted that the development of improved onshore risk model has been used as an example for this research but many of the issues are equally applicable to offshore studies as well.

Matched MeSH terms: Risk Assessment
Fulltext Health risk assessment of pm10 exposure among Malaysian adult population based on physical activity pattern

Norlen Mohame, Lokman Hakim, S., Thahirahtul Asma Zakaria, Anis Salwa Kamarudin, Ahmad Riadz Mazeli, Sirajuddin Hashim

Int J Public Health Res, 2017;7(2):814-828.
MyJurnal

Introduction: Most health advisories related to outdoor physical activity during haze are general in nature. The advisories normally advise everyone to reduce or limit prolonged exertion or heavy exertion without mentioning the acceptable duration for performing outdoor physical activity causing difficulty for public to decide to stop or cancel a particular outdoor or sport event. The aim of this paper is to determine the acceptable duration for performing outdoor physical activity pattern during haze based on API level.

Methods: Health risk assessment approach that comprises of hazard identification, exposure assessment, dose-response, and risk characterization steps was used to determine the potential inhaled dose and risk associated with performing the physical activity during haze. We have considered many factors that include time spent for physical activity patterns for Malaysian adult, age and physical intensity-specific inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. A hypothetical exposure scenario of PM10 was created using the breakpoints of PM10 concentration for the calculation of respective API levels during haze.

Results: The association between physical activity pattern, API level and risk quotient were presented in the form of risk radar diagram. Based on the 50th percentile inhalation rate, all prolonged exertion and heavy exertion should be avoided when API reach >201 (very unhealthy) and >175 (unhealthy) respectively. Below the said API, the duration for performing prolonged exertion and heavy exertion should be reduced according to the API level. When API reaches 140, high intensity physical activity should be limited to < 90 minutes. A football match which requires 90 minutes, should be postponed of cancelled if API > 140. Whereas, for the same API level, prolonged exertion (moderate intensity physical activity) should be limited to 4 hours.

Conclusions: Reducing the physical activity is an effective strategy to lower the dose of inhaled pollutants and reduce the health risk during poor air quality. Based on the assessment, taking into account the uncertainty of risk assessment methodology, we proposed all prolonged exertion should be avoided when API reach very unhealthy status (>201). Below the said API level, outdoor physical activity should be reduced according to the level of API respectively. The recommendation is not applicable for the sensitive groups. The computed risk radar provide a valuable guide for the public to organize or considering postponing an outdoor event during haze.

Matched MeSH terms: Risk Assessment
Fulltext Trace metals contamination in groundwater and implications on human health: comprehensive assessment using hydrogeochemical and geostatistical methods

Brindha K, Paul R, Walter J, Tan ML, Singh MK

Environ Geochem Health, 2020 Nov;42(11):3819-3839.
PMID: 32601907 DOI: 10.1007/s10653-020-00637-9

Monitoring the groundwater chemical composition and identifying the presence of pollutants is an integral part of any comprehensive groundwater management strategy. The present study was conducted in a part of West Tripura, northeast India, to investigate the presence and sources of trace metals in groundwater and the risk to human health due to direct ingestion of groundwater. Samples were collected from 68 locations twice a year from 2016 to 2018. Mixed Ca-Mg-HCO3, Ca-Cl and Ca-Mg-Cl were the main groundwater types. Hydrogeochemical methods showed groundwater mineralization due to (1) carbonate dissolution, (2) silicate weathering, (3) cation exchange processes and (4) anthropogenic sources. Occurrence of faecal coliforms increased in groundwater after monsoons. Nitrate and microbial contamination from wastewater infiltration were apparent. Iron, manganese, lead, cadmium and arsenic were above the drinking water limits prescribed by the Bureau of Indian Standards. Water quality index indicated 1.5% had poor, 8.7% had marginal, 16.2% had fair, 66.2% had good and 7.4% had excellent water quality. Correlation and principal component analysis reiterated the sources of major ions and trace metals identified from hydrogeochemical methods. Human exposure assessment suggests health risk due to high iron in groundwater. The presence of unsafe levels of trace metals in groundwater requires proper treatment measures before domestic use.

Matched MeSH terms: Risk Assessment/methods
Preliminary Assessment of Cyanobacteria Diversity and Toxic Potential in Ten Freshwater Lakes in Selangor, Malaysia

Sinang SC, Poh KB, Shamsudin S, Sinden A

Bull Environ Contam Toxicol, 2015 Oct;95(4):542-7.
PMID: 26248788 DOI: 10.1007/s00128-015-1620-7

Toxic cyanobacteria blooms are increasing in magnitude and frequency worldwide. However, this issue has not been adequately addressed in Malaysia. Therefore, this study aims to better understand eutrophication levels, cyanobacteria diversity, and microcystin concentrations in ten Malaysian freshwater lakes. The results revealed that most lakes were eutrophic, with total phosphorus and total chlorophyll-a concentrations ranging from 15 to 4270 µg L(-1) and 1.1 to 903.1 µg L(-1), respectively. Cyanobacteria were detected in all lakes, and identified as Microcystis spp., Planktothrix spp., Phormidium spp., Oscillatoria spp., and Lyngbya spp. Microcystis spp. was the most commonly observed and most abundant cyanobacteria recorded. Semi-quantitative microcystin analysis indicated the presence of microcystin in all lakes. These findings illustrate the potential health risk of cyanobacteria in Malaysia freshwater lakes, thus magnifying the importance of cyanobacteria monitoring and management in Malaysian waterways.

Matched MeSH terms: Risk Assessment
Subclinical coronary artery disease in Asian rheumatoid arthritis patients who were in remission: a pilot study

Ma NH, Teh CL, Rapaee A, Lau KB, Fong AY, Hi S, et al.

Int J Rheum Dis, 2010 Aug;13(3):223-9.
PMID: 20704618 DOI: 10.1111/j.1756-185X.2010.01533.x

INTRODUCTION: Rheumatoid arthritis (RA) patients who have active disease with longer disease duration have been reported to have increased risk of cardiovascular events compared to the normal population.
OBJECTIVE: The primary aim of our study is to ascertain the prevalence of significant asymptomatic coronary artery disease (CAD) in Asian RA patients who are in remission using multi-detector computed tomography (MDCT). The secondary aims of our study are the usage of pulse wave velocity and the biomarkers N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-senstivity C-reactive protein (hs-CRP) to detect subclinical atherosclerosis in RA patients.
METHODS: We performed a comparative cross-sectional study of 47 RA patients who were in remission with a control group of non-RA patients with a history of atypical chest pain in Sarawak General Hospital from November 2008 to February 2009. All patients underwent 64-slice MDCT, assessment of arterial stiffness using the SphygmoCor test and blood analysis for NT-proBNP and hsCRP.
RESULTS: There were 94 patients in our study with a mean age of 50 +/- 8.8 years. The RA and control patients in each group were matched in terms of traditional CV risk factors. Our RA patients had a median disease duration of 3 years (IQR 5.5). MDCT showed evidence of CAD in nine (19.1%) RA patients and three (6.4%) control patients (P = 0.06). There was no significant association between pulse wave velocity (PWV) and presence of CAD in our RA group. There was no significant correlation between PWV with levels of proBNP or hsCRP in our RA patients.
CONCLUSIONS: In our current pilot study with the limitation of small sample size, RA was not associated with an increased risk of CAD in our RA patients who were in remission. Larger studies of CAD in Asian RA patients are needed to confirm our current finding.
Study site: Sarawak General Hospital, Kuching, Sarawak, Malaysia

Matched MeSH terms: Risk Assessment
Cumulative impact assessment of hazardous ionic liquids towards aquatic species using risk assessment methods

Khan MI, Mubashir M, Zaini D, Mahnashi MH, Alyami BA, Alqarni AO, et al.

J Hazard Mater, 2021 08 05;415:125364.
PMID: 33740721 DOI: 10.1016/j.jhazmat.2021.125364

In the present research work, a comprehensive tool for cumulative ecotoxicological impact assessment of ionic liquids (ILs) to aquatic life has been constructed. Using the probabilistic tool, impact of individual ILs to a group of aquatic species is assessed by chemical toxicity distributions (CTDs). The impact of group of ILs to individual aquatic species is assessed by species sensitivity distributions (SSDs). Acute toxicity data of imidazolium ILs with chloride (Cl-), bromide (Br-), tetrafluoroborate (BF4-), and hexafluorophosphate (PF6-) anions are used in CTD and SSD. Allowable concentrations for a group of Imidazolium ILs with the same mode of action (SMOA) to five aquatic species; Daphnia magna, Vibrio fischeri, Algae, Zebrafish, and Escherichia coli are estimated by CTDs. It has been concluded that 1-Butyl-3-methylimidazolium chloride (BMIMCl) possess the lowest risk at an acceptable risk value of 750 × 10-5 mmol/L which is 12% less than that of OMIMCl. Furthermore, the sensitivities towards the aquatic species reveal that from the studied ILs, BMIMBF4 with an acceptable risk value of 3200 × 10-5 mmol/L is the most suitable IL towards the selected aquatic species. Hence, current work provides cumulative allowable concentrations and acceptable risk values for ILs which release to aquatic compartment of ecosystem.

Matched MeSH terms: Risk Assessment
Mercury Bioaccumulation in Tropical Mangrove Wetland Fishes: Evaluating Potential Risk to Coastal Wildlife

Le DQ, Satyanarayana B, Fui SY, Shirai K

Biol Trace Elem Res, 2018 Dec;186(2):538-545.
PMID: 29577182 DOI: 10.1007/s12011-018-1313-2

The present study, aimed at observing the total concentration of mercury (Hg) in edible finfish species with an implication to human health risk, was carried out from the Setiu mangrove wetlands on the east coast of Peninsular Malaysia. Out of 20 species observed, the highest Hg concentrations were found among carnivores-fish/invertebrate-feeders, followed by omnivores and carnivores-invertebrate-feeders, while the lowest concentrations in herbivores. The Hg concentrations varied widely with fish species and body size, from 0.12 to 2.10 mg/kg dry weight. A positive relationship between body weight and Hg concentration was observed in particular for Toxotes jaculatrix and Tetraodon nigroviridis. Besides the permissible range of Hg concentration up to 0.3 mg/kg (cf. United States Environmental Protection Agency (USEPA)) in majority of species, the carnivore feeders such as Acanthopagrus pacificus, Gerres filamentosus, and Caranx ignobilis have shown excess amounts (> 0.40 mg/kg flesh weight) that raising concerns over the consumption by local people. However, the weekly intake of mercury-estimated through the fish consumption in all three trophic levels-suggests that the present Hg concentrations are still within the range of Provisional Tolerable Weekly Intake (PTWI) reported by the Joint FAO/WHO Expert Committee on Food Additives (JECFA). Perhaps, a multi-species design for Hg monitoring at Setiu wetlands would be able to provide further insights into the level of toxicity transfer among other aquatic organisms and thereby a strong health risk assessment for the local communities.

Matched MeSH terms: Risk Assessment

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