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  1. Hazrin AH, Maryam Z, Hizrri A, Mohd Shukri MA, Norhidayah A, Samsuddin N
    Malaysian Journal of Public Health Medicine, 2017;17 Special(1): 95-105.
    The effects of children’s exposure on high concentration of airborne pollutants at schools often associated with increased rate of absenteeism, low productivities and learning performances, and development of respiratory problems. Recent studies have found that the presence of occupants in the classroom seems to give major effect towards the elevation of concentration of airborne pollutants in indoors. In order to evaluate and further understand on the significance of occupancy factor on IAQ, this study has been designed to determine and compare the level of selected physical (particulate matter (PM)) and chemical (carbon dioxide (CO2) and temperature) IAQ parameters and biological contaminants via colony forming unit (CFUm-3 ) for bacteria and fungi inside the selected classrooms during occupied and non-occupied period (first objective). The second objective is to describe the possible sources of airborne pollutants inside the classrooms at the selected primary schools around Kuantan, Pahang. Assessments of physical and chemical IAQ were done by using instruments known as DustMate Environmental Dust Detector and VelociCalc® MultiFunction Ventilation Meter 9565.The data were recorded every 30 minutes for 8 hours during schooldays and weekend at the selected sampling point in the classrooms. For microbial sampling, Surface Air System Indoor Air Quality (SAS IAQ) was used to capture the bacteria and fungi. The data obtained were compared with the established standard reference known as the Industrial Code of Practice on Indoor Air Quality (2010) constructed by the Department of Occupational Safety and Health (DOSH), Malaysia. This study has found that some of the IAQ parameters in the selected classrooms were exceeding the established standards during occupied period in schooldays compared to non-occupied period during weekend. Findings of this study provide the insights for future research including the site selection of school, arrangement of the classrooms and numbers of students per class.
  2. Arushothy R, Amran F, Samsuddin N, Ahmad N, Nathan S
    PLoS Negl Trop Dis, 2020 12;14(12):e0008979.
    PMID: 33370273 DOI: 10.1371/journal.pntd.0008979
    BACKGROUND: Melioidosis is a neglected tropical disease with rising global public health and clinical importance. Melioidosis is endemic in Southeast Asia and Northern Australia and is of increasing concern in Malaysia. Despite a number of reported studies from Malaysia, these reports are limited to certain parts of the country and do not provide a cohesive link between epidemiology of melioidosis cases and the nation-wide distribution of the causative agent Burkholderia pseudomallei.

    METHODOLOGY/PRINCIPLE FINDINGS: Here we report on the distribution of B. pseudomallei sequence types (STs) in Malaysia and how the STs are related to STs globally. We obtained 84 culture-confirmed B. pseudomallei from confirmed septicaemic melioidosis patients from all over Malaysia. Prior to performing Multi Locus Sequence Typing, the isolates were subjected to antimicrobial susceptibility testing and detection of the YLF/BTFC genes and BimA allele. Up to 90.5% of the isolates were sensitive to all antimicrobials tested while resistance was observed for antimicrobials typically administered during the eradication stage of treatment. YLF gene cluster and bimABp allele variant were detected in all the isolates. The epidemiological distribution patterns of the Malaysian B. pseudomallei isolates were analysed in silico using phylogenetic tools and compared to Southeast Asian and world-wide isolates. Genotyping of the 84 Malaysian B. pseudomallei isolates revealed 29 different STs of which 6 (7.1%) were novel. ST50 was identified as the group founder followed by subgroup founders ST376, ST211 and ST84. A low-level diversity is noted for the B. pseudomallei isolates described in this study while phylogenetic analysis associated the Malaysian STs to Southeast Asian isolates especially isolates from Thailand. Further analysis also showed a strong association that implicates agriculture and domestication activities as high-risk routes of infection.

    CONCLUSIONS/SIGNIFICANCE: In conclusion, MLST analysis of B. pseudomallei clinical isolates from all states in Malaysia revealed low diversity and a close association to Southeast Asian isolates.

  3. Yusof MZ, Cherrie JW, Samsuddin N, Semple S
    Ann Work Expo Health, 2022 10 11;66(8):1044-1055.
    PMID: 35661855 DOI: 10.1093/annweh/wxac038
    BACKGROUND: Use of pesticides has been linked to neurobehavioral deficits among exposed workers. In Malaysia, organophosphate and pyrethroid pesticides are commonly used to control mosquito-borne diseases.

    OBJECTIVES: This study aims to assess workers' lifetime occupational pesticide exposure and examine the relationship with neurobehavioral health.

    METHODS: A cross-sectional study was conducted on 158 pesticide-exposed and 176 non-exposed workers. To collect historical exposure and job tasks, a questionnaire and an occupational history interview were used. Pesticide exposure was measured in a subgroup of workers via inhalation and skin contact. The total pesticide intake of each worker was assessed using inhalation and dermal exposure models. CANTAB® computerised neurobehavioral performance assessments were used.

    RESULTS: The participants' mean age was 31 (8) years. Pirimiphos-methyl (median = 0.569 mg/m3, Interquartile range [IQR] = 0.151, 0.574) and permethrin (median = 0.136 mg/m3, IQR = 0.116, 0.157) had the highest measured personal inhalation concentrations during thermal spraying. The estimated total lifetime pesticide intake for exposed workers ranged from 0.006 g to 12800 g (median = 379 g and IQR = 131, 794 g). Dermal exposure was the predominant route of pesticide intake for all workers. Compared to controls, workers with high lifetime pesticide intake had lower Match to Sample Visual (adjusted B = -1.4, 95% Confidence Interval (CI) = -2.6, 0.1), Spatial Recognition Memory (adjusted B = -3.3, 95% CI = -5.8, 0.8), Spatial Span (SSP) (adjusted B = -0.6, 95% CI = -0.9, 0.3) scores. Workers with low pesticide intake performed worse than controls (adjusted B = -0.5, 95% CI = -0.8, -0.2) in the SSP test, but scored higher in the Motor Screening test (adjusted B = 0.9, 95% CI = 0.1, 1.6). Higher Paired Associates Learning test scores were observed among higher (adjusted B = 7.4, 95% CI = 2.3, 12.4) and lower (adjusted B = 8.1, 95% CI = 3, 13.2) pesticide intake groups. There was no significant difference between the Reaction Time and Pattern Recognition Memory tests with lifetime pesticide intake after adjusting for confounders.

    CONCLUSION: Pesticide exposure has been linked to poorer neurobehavioral performance. As dermal exposure accounts for a major fraction of total intake, pesticide prevention should focus on limiting dermal exposure.

  4. Samsuddin N, Rampal KG, Ismail NH, Abdullah NZ, Nasreen HE
    Am J Hypertens, 2016 Feb;29(2):226-33.
    PMID: 26112865 DOI: 10.1093/ajh/hpv093
    Research findings have linked exposure to pesticides to an increased risk of cardiovascular (CVS) diseases. Therefore, this study aimed to assess the impact of chronic mix-pesticides exposure on CVS hemodynamic parameters.
  5. Arushothy R, Ahmad N, Amran F, Hashim R, Samsuddin N, Che Azih CR
    Genome Announc, 2018 Apr 19;6(16).
    PMID: 29674530 DOI: 10.1128/genomeA.00167-18
    After the introduction of the pneumococcal conjugate vaccine in Malaysia in recent years, the emergence of nonvaccine serotypes is of concern, particularly the antibiotic-resistant strains, with an increase specifically in serotype 15A. Here, we report the draft genome sequence of Streptococcus pneumoniae strain SS40_16, isolated from the blood sample of a 19-month-old female in 2016. SS40_16 is a multidrug-resistant strain with resistance to penicillin (MIC, ≥2 µg/ml), tetracycline, and trimethoprim-sulfamethoxazole. The strain belongs to serotype 15A and sequence type 1591 (ST1591).
  6. Arushothy R, Ramasamy H, Hashim R, Raj A S S, Amran F, Samsuddin N, et al.
    Int J Infect Dis, 2020 Jan;90:219-222.
    PMID: 31682962 DOI: 10.1016/j.ijid.2019.10.037
    The emergence of non-vaccine multidrug-resistant Streptococcus pneumoniae serotypes is on rise. This study was performed to investigate a highly resistant serotype 15A S. pneumoniae isolated from the blood specimen of a 20-month-old patient who died of her infection. The SS40_16 isolate was resistant to erythromycin, co-trimoxazole, tetracycline, and chloramphenicol, as well as to penicillin, ceftriaxone, and cefotaxime (using meningitis cut-off points, Clinical and Laboratory Standards Institute). The isolate belonged to sequence type 1591 (ST1591) and was related to CC81 clonal complex, suggesting the possibility of horizontal gene transfer. Scanning electron microscopy comparison between resistant and sensitive pneumococcal isolates also indicated similar phenotypic characteristics that confer high resistance. The emergence of highly resistant non-vaccine pneumococci is of great concern to public health and in the clinical setting. Pneumococcal surveillance programs represent a crucial tool, not only for determining the impact of pneumococcal conjugate vaccines, but also for monitoring the selective pressure of serotype replacement with regard to the treatment of invasive pneumococcal disease.
  7. Samsuddin N, Razali A, Rahman NAA, Yusof MZ, Mahmood NAKN, Hair AFA
    Malays J Med Sci, 2019 Mar;26(2):131-137.
    PMID: 31447616 MyJurnal DOI: 10.21315/mjms2019.26.2.14
    The objectives of occupational health services (OHS) are to create a healthy and safe working environment, prevent work-related diseases, optimise employees' functional capacity and promote health. According to the literature, global accessibility to OHS has not shown much improvement and even worsened in certain countries. The main challenges come from the small and medium enterprises (SMEs). To respond to these global challenges, the basic occupational health services (BOHS) guideline was published under the purview of the World Health Organization and the International Labour Organization. The guideline describes BOHS as part of the infrastructure called the occupational safety and health system, an essential element that ensures the high service coverage and sustainability of the programme. The BOHS guideline was introduced in Malaysia by the Department of Occupational Safety and Health with a focus on SMEs, but its accessibility is low. A gap analysis was conducted between the current BOHS in Malaysia and the published international guideline. The important challenges identified that contributes to the low BOHS accessibility in Malaysia is the weakness in the BOHS infrastructure and OHS system provision. The proposed BOHS infrastructure model is meant to increase accessibility and to provide fair and equitable health services for Malaysians.
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