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  1. Norlen Mohamed, Noradrenalina Isah, Fadhli Yussof
    Int J Public Health Res, 2011;1(1):48-54.
    MyJurnal
    Accepted 11 August 2011.
    Introduction Despite of its importance for preventing fatal and severe injuries in an event of a crash, limited studies were conducted to find out the status of seatbelt use among rear passengers in Malaysia. This study was conducted to the determine seatbelt use among rear passengers in Malaysia in conjunction with the introduction of the rear seatbelt law that took effect on 1st January 2009.
    Methods Two methods were used; the roadside observations and surveys. A total of 4180 rear passengers were observed during the road side observation and 793 rear passengers were interviewed in the survey.
    Results About 41.8 % (95 % CI: 38.3, 45.4) of rear passengers interviewed reported that they “Always/Often’ wore safety belts, while roadside observation recorded slightly lower rate (36.2 % [95 % CI: 34.8, 37.7]). Based on the roadside observation method, male rear passengers were more likely to use rear seatbelts as compared to female rear passengers (with Odd Ratio: 1.17 (95 % CI: 1.03, 1.33)). Both methods consistently reported that rear passengers of Multipurpose Vehicle (MPV)/Sport Utility Vehicle (SUV) (survey method “always wear”: 39.3 %, Odd Ratio: 2.02 [95 % CI: 1.13, 3.61], roadside observation method: 51.9 %, Odd Ratio: 2.23 [95 % CI: 1.89, 2.62]) were two times more likely to wear seatbelts as compared to rear passengers of a car.
    Conclusions The two research methods indicate rear passengers in Malaysia were consistently having low seatbelt usage rate. As the rear seatbelt advocacy and enforcement programme are new in Malaysia, efforts to advocate rear seatbelt use should be strengthened. The changes in rear seatbelt usage rate need to be tracked regularly and as an alternative to roadside observation method, interview survey method could be used to measure the seatbelt usage rate and to identify the reason for not using safety belt among rear passengers.
  2. Rohayu Sarani, Hizal Hanis Hashim, Wan Fairos Wan Yaakob, Norlen Mohamed, Radin Umar Radin Sohadi
    Int J Public Health Res, 2013;3(1):267-275.
    MyJurnal
    The increase in car usage due to economic prosperity has led to increase in occupant injuries. One way to reduce the injuries encountered by road accident victims is by implementing the rear seatbelt (RSB) law. Rear seatbelt wearing has been proven to save lives. In Malaysia, the implementation of the restraint system for front occupant has started in the 70's. However, the rear seatbelt enforcement law only came in 2009, after six months of an advocacy program. Prior to the introduction of the rear seatbelt law, rear seatbelt wearing rate was rather low, started to increase gradually during the advocacy period and jumped to the highest level after two month of the enforcement. This paper attempts to assess the effectiveness of the rear seatbelt intervention in reducing injuries among passenger car occupants in Malaysia using the generalized linear model (GLM). In GLM procedure, the dependent variable is the number of people from passenger vehicles that sustained severe and slight injuries, for the study period. The study period selected covers six months before implementation, six months during advocacy program, and six months after the law is implemented. The independent variables considered are enforcement and balik kampung activities (both are dummy variables) and time effect. Our results suggest that RSB intervention (p-value= 0.0001) had significantly reduced the number of people sustained serious and slight injuries by about 20%. The implementation of change in the RSB law has benefited not only in reducing the number of injuries but also result to great impact to the health outcomes.
  3. Norlen Mohamed, Lokman Hakim Sulaiman, Thahirahtul Asma Zakaria, Anis Salwa Kamarudin, Daud Abdul Rahim
    Int J Public Health Res, 2016;6(1):685-694.
    MyJurnal
    Introduction During haze, at what level should Air Pollutant Index (API) showed, public
    or private school be closed is not without controversy and is very much
    debated. Therefore, the aim of this paper is to objectively quantify the
    potential inhaled dose of PM10 associated with exposure at school and home
    microenvironments during haze. The result of the health risk assessment will
    be used to propose the API level for closing the school during haze episode.

    Methods A hypothetical haze exposure scenario was created using the breakpoints of
    PM10 concentration for calculation of API and respective inhaled dose during
    haze. To determine the potential inhaled dose, we have considered many
    factors that include time spent for specific physical intensity at school and
    home microenvironments, age-specific and physical intensity-specific
    inhalation rate (m3/min), and the indoor/outdoor ratio of PM10. To calculate
    risk quotient (RQ), the inhaled dose was compared with the health reference
    dose computed based on the concentration of PM10 in the Malaysian
    Ambient Air Quality Standard.

    Results When considering the specific exposure at each microenvironment (school
    and home), the potential inhaled dose of PM10 was substantially lower when
    school is closed for both primary and secondary school. The calculated risk
    quotient (RQ) indicates that primary school children are likely to be affected
    at slightly lower PM10 concentration (equivalent to API of 197) as compared
    to secondary school children. Short duration of high physical activity
    intensity during school breaks has contributed to a large proportion of inhaled
    dose among school children indicating the important to avoid physical
    activities during haze.

    Conclusion Based on the assessment, taking into account the uncertainty of risk
    assessment methodology, we proposed school to be closed when API reach
    190 for both primary and secondary schools. These findings and
    recommendations are only valid for naturally ventilated school and applicable
    in the context of the current API calculation system and the existing
    Recommended Air Quality Guideline values in Malaysia.
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