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Fulltext Current developments and future directions of occupational health in Malaysia

Rampal KG

Med J Malaysia, 2000 Sep;55(3):295-8.
PMID: 11200706
Fulltext Current perspectives in occupational health

Rampal KG

Med J Malaysia, 1993 Sep;48(3):256-8.
PMID: 8183135
Fulltext Prevalence of Sexual Harassment and its Associated Factors among Registered Nurses Working in Government Hospitals in Melaka State, Malaysia

Suhaila O, Rampal KG

Med J Malaysia, 2012 Oct;67(5):506-17.
PMID: 23770869 MyJurnal

INTRODUCTION: This study focuses on sexual harassment, a form of psycological hazard that female registered nurses face throughout their day to day routine. The objective of this study is to find the prevalence of sexual harassment among female registered nurses working in government hospitals in Melaka, Malaysia and factors affecting them.

METHODS: This is a cross sectional study conducted on 455 female registered nurses who have worked more than one year in the present 3 government hospitals in Melaka, Malaysia. A validated and pre tested questionnaires were given for the respondents to answer. Before respondents answer the questionaires, they are required to read the definition and the forms of sexual harassment provided. This is to help them to understand the correct definition and forms of sexual harassment that they could have experienced. The researcher is available during the distribution of the questionnaires and the respondents are free to ask the researcher anything that they do not understand about it.

RESULTS: The results of this study show that the prevalence of sexual harassment among these nurses was 51.2% with the past one year incidence recorded at 22.8%. The most common forms of sexual harassment were verbal (46.6% ), visual (24.8% ), psycological (20.9%), physical (20.7%) and non -verbal (16.7% ). The study showed that 74.7% of the victims suffered from psychological effects brought upon by their encounter with various types of sexual harrasement at work. The study also found that the victims' self-perception of their physicality was a contributing factor to the prevalance of this situation. Those who were pretty, with attractive body figure, a friendly character and easy going had a higher prevalence of sexual harassment in the workplace. Meanwhile, those who were strict, and those who had a fierce character were not prone to sexual harassment.

CONCLUSION: The prevalence of sexual harassment among registered nurses in the workplace found in this study was high and self-perception profile of the victims of sexual harassment was the main contributing factor to the problem. Sexual harassment in the workplace should not be taken lightly because the resulting effects was not only felt by the victims, but also by their family members, colleagues and patients under their care. Hence, steps should be taken by the hospital managements to manage and prevent this problem from occuring again in the future.
Serial testing of Malaysian health care workers with QuantiFERON®-TB Gold In-Tube

Rafiza S, Rampal KG

Int J Tuberc Lung Dis, 2012 Feb;16(2):163-8.
PMID: 22236915 DOI: 10.5588/ijtld.11.0364

BACKGROUND: Serial testing for tuberculosis (TB) exposure has been advocated among health care workers (HCWs) at risk of nosocomial infection.
OBJECTIVE: To determine the incidence and factors associated with TB infection among selected HCWs in Malaysia and to determine interferon-gamma response in serial testing.
DESIGN: A cohort of 769 HCWs were retested after 1 year using QuantiFERON®-TB Gold In-Tube. Incidence of TB infection was determined among HCWs who previously tested negative. Conversion and reversion rates using several definitions were explored.
RESULTS: Incidence of TB infection was 9.9 per 100 workers per year (95%CI 7.9-12.3). Working in the Emergency Department (ED; RR 2.18, 95%CI 1.07-4.43) was significantly associated with risk of TB infection. Reversion and conversion occurred frequently, with 46.7% reversion among HCWs with baseline interferon-gamma (IFN-γ) levels of 0.35-0.70 international units (IU)/ml, and 23.8% conversion among HCWs with baseline IFN-γ levels of 0.20-0.34 IU/ml.
CONCLUSIONS: TB infection control measures need to be strengthened, particularly in the ED, as the incidence of TB was high. Conversion and reversion rates in serial testing were high, and further studies are needed to facilitate its interpretation.
Multiplicative effect of smoking and age on hearing impairment

Noorhassim I, Rampal KG

Am J Otolaryngol, 1998 8 6;19(4):240-3.
PMID: 9692632

PURPOSE: To determine the combined effect of smoking and age on hearing impairment.
MATERIALS AND METHODS: Pure tone audiometry test was conducted on 263 residents of a rural village who were not exposed to noise. The pack-years of smoking were computed from the subjects' smoking history. The association between pack-years and hearing impairment was assessed. The combined effect of smoking and age on hearing impairment was determined based on prevalence rate ratio.
RESULTS: There was a statistically significant trend in the number of pack-years of smoking and age as risk factors for hearing impairment. The prevalence rates of hearing impairment for nonsmokers aged 40 years and younger, smokers aged 40 years and younger, nonsmokers older than 40 years of age, and smokers older than 40 years of age were 6.9%, 11.9%, 29.7%, and 51.3%, respectively. The prevalence rate ratio for nonsmokers aged 40 years and younger, smokers aged 40 years and younger, nonsmokers older than 40 years of age, and smokers older than 40 years of age (nonsmokers aged 40 years and younger as a reference group) was 1, 1.7, 4.3, and 7.5, respectively. The prevalence rate ratios showed a multiplicative effect of smoking and age on hearing impairment.
CONCLUSION: Age and smoking are risk factors for hearing impairment. It is clear that smoking and age have multiplicative adverse effects on hearing impairment.
Fulltext Prevalence of hearing loss and hearing impairment among rural males in Selangor, 1993. [Prevalens kurang pendengaran dan gangguan pendengaran penduduk lelaki luarbandar Selangor, 1993]

Noor Hassim I, Rampal KG

Med J Malaysia, 1994 Mar;49(1):78-85.
PMID: 8057996

A cross sectional study to determine the prevalence of hearing loss and hearing impairment was conducted on 286 male subjects from a rural area. The sample was chosen by using a simple random sampling method. Prevalence of symptoms of tinnitus, ear disease, ear drum perforation and infection of external auditory meatus was 19.0 per cent, 6.7 per cent, 3.5 per cent and 0.4 per cent respectively. Air conduction audiometry tests showed the prevalences of hearing impairment of the left, right and both ears (aged 15-30 years) were 5.9%, 8.8% and 0% respectively. The prevalence of hearing loss increased with age. The higher frequencies (> 4KHz) appeared to be more affected than the lower frequencies.
Fulltext A study of locomotor disabilities in a Malay community in Kuala Selangor

Osman A, Rampal KG

Med J Malaysia, 1989 Mar;44(1):69-74.
PMID: 2533959

A study was conducted to determine the prevalence of locomotor disability in a Malay Community in Tanjung Karang, Kuala Selangor in 1984. The causes of these disabilities, the mobility and occupational handicaps they caused and the types of treatment received were determined. Fifty percent of the households in this area were selected by stratified random sampling and all persons above seven years of age were included in the sample. The prevalence of locomotor disability was 3.9%. The prevalence among males was 5.2% and among females 2.6%. The prevalence increased with age, being as low as 0.6% in the 7-14 year age group and as high as 20.5% in the above 55 year age group. The disabilities resulted mainly from trauma (49%) and musculoskeletal and neurological problems (46.9%). Ninety percent (44 cases) had difficulty only in performance of daily activity and 20 cases (40.8%) had no mobility handicap whatsoever. Forty two (85.7%) of the 49 cases had received treatment.
Fulltext [The prevalence of visual impairment in Kuala Selangor]

Ali O, Rampal KG

Med J Malaysia, 1988 Sep;43(3):232-6.
PMID: 3266522
Fulltext Hearing loss and contributing factors among airport workers in Malaysia

Nasir MH, Rampal KG

Med J Malaysia, 2012 Feb;67(1):81-6.
PMID: 22582554 MyJurnal

Sensorineural hearing loss is a common and important source of disability among the workers and often caused by occupational noise exposure. Aims of the study were to determine the prevalence and contributing factors of hearing loss among airport workers. A cross-sectional study was carried out at an airport in Malaysia. This study used stratified sampling method that involved 358 workers who were working in 3 different units between November 2008 and March 2009. Data for this study were collected by using questionnaires eliciting sociodemographic, occupational exposure history (previous and present), life-style including smoking habits and health-related data. Otoscopic and pure-tone audiometric tests were conducted for hearing assessment. Noise exposure status was categorize by using a noise logging dosimeter to obtain 8-hour Time-Weighted Average (TWA). Data was analyzed by using SPSS version 12.0.1 and EpiInfo 6.04. The prevalence of hearing loss was 33.5%. Age >40 years old (aOR 4.3, 95%CI 2.2-8.3) is the main risk factors for hearing loss followed by duration of noise exposure >5 years (aOR 2.5, 95%CI 1.4-4.7), smoking (aOR 2.1, 95%CI 1.2-3.4), duration of service >5 years (aOR 2.1, 95%CI 1.1-3.9), exposure to explosion (aOR 6.1, 95%CI 1.3-29.8), exposure to vibration (aOR 2.2, 95%CI 1.1-4.3) and working in engineering unit (aOR 5.9, 95%CI 1.1-30.9). The prevalence rate ratio of hearing loss for nonsmokers aged 40 years old and younger, smokers aged 40 years old and younger, non-smokers older than 40 years old and smokers older than 40 years old was 1.0, 1.7, 2.8 and 4.6 respectively. This result contributes towards better understanding of risk factors for hearing loss, which is relatively common among Malaysian workers.
Relation between sick leave and selected exposure variables among women semiconductor workers in Malaysia

Chee HL, Rampal KG

Occup Environ Med, 2003 Apr;60(4):262-70.
PMID: 12660374

To determine the relation between sick leave and selected exposure variables among women semiconductor workers.
Fulltext Relationship between selected health problems and exposures among women semiconductor workers in Malaysia

Chee HL, Rampal KG

Med J Malaysia, 2003 Aug;58(3):387-98.
PMID: 14750379

A study conducted between 1998-2001 on the semiconductor industry in Penang and Selangor found that irregular menstruation, dysmenorrhea and stress were identified as the three leading health problems by women workers from a checklist of 16 health problems. After adjusting for confounding factors, including age, working duration in current factory, and marital status, in a multiple logistic regression model, wafer polishing workers were found to experience significantly higher odds of experiencing irregular menstruation. Dysmenorrhea was found to be significantly associated with chemical usage and poor ventilation, while stress was found to be related to poor ventilation, noise and low temperatures.
Fulltext The relationship between prevalence of asthma and environmental factors in rural households

Noorhassim I, Rampal KG, Hashim JH

Med J Malaysia, 1995 Sep;50(3):263-7.
PMID: 8926906

A cross sectional study was conducted among 1007 children aged 1-2 years, from padi farming area. The percentage of male children was 51.4%. The prevalence of at least one of the chronic respiratory symptoms was 12.81%, and the prevalence of chronic cough, chronic sputum, wheezing and bronchial asthma as diagnosed by doctors were 9.33%, 3.87% 5.36% and 3.38% respectively. The overall prevalence of bronchial asthma was 6.26%. The prevalence of asthma was highest among children aged 11-12 years (8.9%) and higher among males (6.95%). No significant relationship was found between the prevalence of either chronic respiratory disease symptoms of bronchial asthma, and selected environmental factors, namely exposure to cigarette smoke, use of mosquito coil and wood stove. However there was a significant relationship between prevalence of asthma in children and history of asthma among parents and grandparents.
Study site: Two villages in Tg. Karang (Kg. Sawah Sempadan and Kg Sri Tiram Jaya), Selangor, Malaysia
Fulltext Evaluation of the nutrition and health components in the future planning for food and nutrition in Kuala Selangor. [Penilaian komponen pemakanan dan kesihatan rancangan amalan makanan dan pemakanan di Kuala Selangor]

Ali O, Rampal KG, Lubis SH

Med J Malaysia, 1984 Sep;39(3):234-8.
PMID: 6544926

A study was carried out to study lite prevalence of hypertension amongst rural Malays living in two villages in Kuala Selangor district. Simple random sampling of households was carried out and all members 15 years and above were examined. Out of 359 persons examined, 92 (25.6%) had hypertension. A significant increase in prevalence was observed with increasing age and in smokers. Prevalence rates did not differ significantly in the two sexes and with income. Only 38 of the hypertensives were known cases. It was found that 78. 7% of them had been detected within less than five years and 81.6% had undergone medical treatment. It is proposed that preventive programmes in hypertension be introduced in rural health services and a national prevalence survey be conducted.
Fulltext Work-related musculoskeletal symptoms among batik workers in Kelantan

Musa R, Kyi W, Rampal KG

Malays J Med Sci, 2000 Jul;7(2):13-7.
PMID: 22977385 MyJurnal

A cross sectional study was carried out to evaluate the extent of occupational health problems focusing on some aspects of musculoskeletal symptoms among batik workers in Kelantan, Malaysia. The workers selected must have been in that industry for at least one year. Using cluster sampling, 202 workers were selected from 21 factories. More than half (60.2%) of the workers had been troubled with musculoskeletal symptoms at work. The most common symptoms were pain over the shoulders (41.0%), lower back (34.4%) and ankle (34.4%). Duration of employment, younger age group, prolonged standing and awkward working task were among contributing factors. It is therefore necessary to improve on both ergonomic and psychosocial environments of batik workers in order to prevent these musculoskeletal symptoms.
Fulltext Evaluation of psychometric properties of the malay version perceived stress scale in two occupational settings in malaysia

Al-Dubai S, Ganasegeran K, Barua A, Rizal A, Rampal K

Ann Med Health Sci Res, 2014 Jul;4(Suppl 2):S104-7.
PMID: 25184074 DOI: 10.4103/2141-9248.138023

BACKGROUND: The 10-item version of Perceived Stress Scale (PSS-10) is a widely used tool to measure stress. The Malay version of the PSS-10 has been validated among Malaysian Medical Students. However, studies have not been conducted to assess its validity in occupational settings.
AIM: The aim of this study is to assess the psychometric properties of the Malay version of the PSS-10 in two occupational setting in Malaysia.
SUBJECTS AND METHODS: This study was conducted among 191 medical residents and 513 railway workers. An exploratory factor analysis was performed using the principal component method with varimax rotation. Correlation analyses, Kaiser-Meyer-Olkin, Bartlett's test of Sphericity and Cronbach's alpha were obtained. Statistical analysis was carried out using statistical package for the social sciences version 16 (SPSS, Chicago, IL, USA) software.
RESULTS: Analysis yielded two factor structure of the Malay version of PSS-10 in both occupational groups. The two factors accounted for 59.2% and 64.8% of the variance in the medical residents and the railway workers respectively. Factor loadings were greater than 0.59 in both occupational groups. Cronbach's alpha co-efficient was 0.70 for medical residents and 0.71 for railway workers.
CONCLUSION: The Malay version of PSS-10 had adequate psychometric properties and can be used to measure stress among occupational settings in Malaysia.
KEYWORDS: Factor structure; Malaysia; Occupational; Perceived stress scale; Psychometric properties; Validity
Use of asbestos building materials in Malaysia: legislative measures, the management, and recommendations for a ban on use

Safitri Zen I, Ahamad R, Gopal Rampal K, Omar W

Int J Occup Environ Health, 2013 Jul-Sep;19(3):169-78.
PMID: 23885771 DOI: 10.1179/2049396713Y.0000000028

Malaysia has partially banned the use of asbestos. The prohibition of asbestos building materials in schools, clinics, and hospitals built by government started in 1999. Since 2005, prohibition has also been applied to all government buildings. However, asbestos construction materials such as roof and ceiling tiles are still sold in the market. There are no acts or regulations prohibiting the use of asbestos in private buildings in Malaysia. Asbestos was first used for industrial purposes in Malaysia in the 1960s and the first regulations related to asbestos have been around since the 1980s. Non-governmental organizations have been pushing the government to impose a total ban since the 1980s. Asbestos is still used in the manufacturing sector under the "control use" concept. The study found difficulties in established and validated medical record data on asbestos-related diseases. This paper reviews existing asbestos-related regulations and guidelines in Malaysia and discusses the urgency for a total ban in the use of asbestos in building materials in the country. In the meanwhile, stricter enforcement of occupational safety and health regulations related to the use and exposure of asbestos among workers in the manufacturing, construction, maintenance, and demolition sectors has been in place.
The lead content of currently available new residential paint in several Asian countries

Clark CS, Rampal KG, Thuppil V, Chen CK, Clark R, Roda S

Environ Res, 2006 Sep;102(1):9-12.
PMID: 16782088

Worldwide prohibitions on lead gasoline additives were a major international public health accomplishment, the results of which are still being documented in parts of the world. Although the need to remove lead from paints has been recognized for over a century, evidence reported in this article indicates that lead-based paints for household use, some containing more than 10% lead, are readily available for purchase in some of the largest countries in the world. Sixty-six percent of new paint samples from China, India, and Malaysia were found to contain 5000 ppm (0.5%) or more of lead, the US definition of lead-based paint in existing housing, and 78% contained 600 ppm (0.06%) or more, the limit for new paints. In contrast, the comparable levels in a nearby developed country, Singapore, were 0% and 9%. In examining lead levels in paints of the same brands purchased in different countries, it was found that some brands had lead-based paints in one of the countries and paints meeting US limits in another; another had lead-free paint available in all countries where samples were obtained. Lead-based paints have already poisoned millions of children and likely will cause similar damage in the future as paint use increases as countries in Asia and elsewhere continue their rapid development. The ready availability of lead-based paints documented in this article provides stark evidence of the urgent need for efforts to accomplish an effective worldwide ban on the use of lead in paint.
Fulltext Adjuvant chemotherapy for colorectal cancer: a Malaysian experience

Lim GCC, Rampal KG, Fuad I, Lim AK

Med J Malaysia, 1997 Jun;52(2):117-23.
PMID: 10968068

This study aims to evaluate the practice of adjuvant chemotherapy in colorectal cancer at the Institute of Radiotherapy and Oncology, Hospital Kuala Lumpur. A retrospective analysis of 320 patients' records from 1986 to 1994 was carried out. Adjuvant chemotherapy was given to 98 patients. Cancers of the rectum and sigmoid colon constituted over 60% of the patients. All the regimes used were 5-fluorouracil-based. The oral route was the most commonly used (55.1%). Toxicity was seldom the reason for stopping treatment (2%). The adjuvant treatment employed has been tolerable while the survival was comparable with other centres.
Fulltext The prevalence of musculoskeletal problems and risk factors among women assembly workers in the semiconductor industry

Chandrasakaran A, Chee HL, Rampal KG, Tan GLE

Med J Malaysia, 2003 Dec;58(5):657-66.
PMID: 15190650

A cross-sectional study to determine work-related musculoskeletal problems and ergonomic risk factors was conducted among 529 women semiconductor workers. Overall, 83.4% had musculoskeletal symptoms in the last one year. Pain in the back (57.8%), lower leg (48.4%) and shoulder (44.8%) were the three most common musculoskeletal problems. Significant associations were found between prolonged standing and upper and lower leg pain, between prolonged sitting and neck and shoulder pain and between prolonged bending and shoulder arm, back and upper leg pain. The study therefore showed a clear association between work-related musculoskeletal pain and prolonged hours spent in particular postures and movements.
Fulltext Societal risk perception of death among workers in a security company in Malaysia

Jefferelli SB, Rampal KG, Aziz AJ, Agus Salim MB

Med J Malaysia, 2003 Dec;58(5):653-6.
PMID: 15190649 MyJurnal

How people perceive risk influences their behaviour towards these risks. We do not know how workers perceive risk of dying from diseases or accidents. This study was conducted among 198 workers of a security company in Malaysia. The workers were asked to score on a Likert scale of 1 to 5 the perceived risk of death of Malaysians from selected causes of death. The highest perceived risks of death were, in order of ranking, motor vehicle accidents, cancer and diabetes mellitus whereas according to the certified causes of death in Malaysia the highest risks of death among the selected items were cardiovascular disease, cancer and stroke. The difference in perception and mortality data needs be addressed.

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