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  1. Anual ZF, Mohammad Sham N, Ambak R, Othman F, Shaharudin R
    Expo Health, 2021;13(3):391-401.
    PMID: 34722950 DOI: 10.1007/s12403-021-00390-z
    Exposure to environmental pollutants in humans can be conducted through direct measurement of biological media such as blood, urine or hair. Assessment studies of metals and metalloids in Malaysia is very scarce although cross-sectional nationwide human biomonitoring surveys have been established by the USA, Canada, Germany, Spain, France, and Korea. This study aims to assess urinary metal levels namely cadmium (Cd), nickel (Ni), lead (Pb) and arsenic (As) among Malaysian adults. This was a cross-sectional study involving 1440 adults between the age of 18 and 88 years old. After excluding those with 24 h urine samples of less than 500 ml, urine creatinine levels  3.0 g/L and those who refuse to participate in the study, a total of 817 respondents were included for analysis. A questionnaire with socio-demographic information such as age, gender, occupation, ethnic, academic qualification and medical history was administered to the respondents. Twenty-four-hour urine samples were collected in a container before being transported at 4 °C to the laboratory. Samples were then aliquoted into 15 ml tubes and kept at - 80 °C until further analysis. Urine was diluted ten-fold with ultrapure water, filtered and analysed for metals and metalloids using Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). The geometric mean of urinary As, Ni, Cd and Pb concentrations among adults in Malaysia was 48.21, 4.37, 0.32, and 0.80 µg/L, respectively. Males showed significantly higher urinary metal concentrations compared to females for As, Cd and Pb except for Ni. Those who resided in rural areas exhibited significantly higher As, Cd and Pb urinary concentrations than those who resided in urban areas. As there are no nationwide data on urinary metals, findings from this study could be used to identify high exposure groups, thus enabling policy makers to improve public health strategically.
  2. 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.
  3. Zain SMSM, Latif MT, Baharudin NH, Anual ZF, Mohd Hanif N, Khan MF
    Sci Total Environ, 2021 Aug 20;783:146929.
    PMID: 34088111 DOI: 10.1016/j.scitotenv.2021.146929
    Polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs) are toxic compounds derived from anthropogenic sources that stay in the environment for long periods. Ambient air has become the most important pathway for the transfer of PCDDs/PCDFs from emission sources to the environment. This review intends to summarise the information available on atmospheric PCDDs/PCDFs in the countries of Southeast Asia to provide a detailed description of the trends in PCDDs/PCDFs emissions, key sources, and levels in urban, rural, and industrial air as reported in peer-reviewed literature since 2000 and by the United Nations Environment Programme. As the largest country in Southeast Asia, Indonesia is the major PCDDs/PCDFs emitter, accounting for 72.81% of the total release of PCDDs/PCDFs in the air from all available inventories in this region, while Brunei Darussalam is the lowest emitter, contributing to less than 0.02%. Open burning processes have become the largest source of ambient PCDDs/PCDFs in the region (69.62%), followed by waste incineration (10.69%), and ferrous and non-ferrous metal production (8.78%). PCDDs/PCDFs levels in rural areas ranged between 10 and 38 fg TEQ m-3; however, where open burning waste has occurred, the levels rose to 12-29 times higher. In urban areas, ambient levels were 15 times greater than in rural areas, varying from 23 to 565 fg TEQ m-3. Atmospheric concentrations near industrial palm oil and waste incinerator sites were between 64 and 1530 fg TEQ m-3. The non-cancer risk of ambient exposure to PCDDs/PCDFs through inhalation is low among populations near facilities emitting PCDDs/PCDFs. The lack of local technical capacity, the high economic costs, and the lack of established human resource capacities have been the major challenges in conducting ambient PCDDs/PCDFs studies in most countries in the region.
  4. 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.
  5. Khairul Hasni NA, Anual ZF, Rashid SA, Syed Abu Thahir S, Veloo Y, Fang KS, et al.
    Environ Pollut, 2023 May 01;324:121095.
    PMID: 36682614 DOI: 10.1016/j.envpol.2023.121095
    Contamination of water systems with endocrine disrupting chemicals (EDCs) is becoming a major public health concern due to their toxicity and ubiquity. The intrusion of EDCs into water sources and drinking water has been associated with various adverse health effects on humans. However, there is no comprehensive overview of the occurrence of EDCs in Malaysia's water systems. This report aims to describe the occurrence of EDCs and their locations. Literature search was conducted electronically in two databases (PubMed and Scopus). A total of 41 peer-reviewed articles published between January 2000 and May 2021 were selected. Most of the articles dealt with pharmaceuticals (16), followed by pesticides (7), hormones (7), mixed compounds (7), and plasticisers (4). Most studies (40/41) were conducted in Peninsular Malaysia, with 60.9% in the central region and almost half (48.8%) in the Selangor State. Only one study was conducted in the northern region and East Malaysia. The Langat River, the Klang River, and the Selangor River were among the most frequently studied EDC-contaminated surface waters, while the Pahang River and the Skudai River had the highest concentrations of some of the listed compounds. Most of the risk assessments resulted in a hazard quotient (HQ) and a risk quotient (RQ)  1 in the Selangor River. An RQ > 1 for combined pharmaceuticals was found in Putrajaya tap water. Overall, this work provides a comprehensive overview of the occurrence of EDCs in Malaysia's water systems. The findings from this review can be used to mitigate risks and strengthen legislation and policies for safer drinking water.
  6. Anual ZF, Ahmad NI, Anak Robun C, Ahmad Suhaimi LR, Surawi NH, Sudin K, et al.
    PMID: 37883683 DOI: 10.1080/19440049.2023.2272726
    Food contaminated with heavy metals poses a serious threat to consumers. This study aims to assess levels of lead (Pb) and cadmium (Cd) in offals of chicken, cattle, and pig as well as tin (Sn) in canned food. A total of 378 offal samples was collected from wet markets, while 218 canned food samples were purchased locally. Samples were digested using a microwave before analysis with inductively coupled plasma mass spectrometry (ICP-MS). Pb was determined, highest in cattle lung (0.11 ± 0.20 mg/kg) followed by cattle spleen (0.09 ± 0.14 mg/kg), and cattle tripe (0.09 ± 0.12 mg/kg). For Cd, the highest concentrations were in cattle liver (0.13 ± 0.12 mg/kg), pig liver (0.08 ± 0.05 mg/kg), and chicken liver (0.03 ± 0.02 mg/kg). Significant variations of Sn levels existed in different canned food categories with 3.21% samples (n = 7) exceeded the maximum level of 250 mg/kg set by Codex Alimentarius. All offal samples were below the Malaysian regulatory limits, indicating their safety for human consumption. However, Sn levels varied significantly among canned food categories, with the highest levels found in canned pineapple chunks in syrup, mixed pineapple cubes in syrup, pineapple slices and longan. Samples exceeding the maximum level set by Codex Alimentarius may pose a risk to consumers.
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