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  1. Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Ripin ZM, Ali N
    J Occup Health, 2019 Nov;61(6):498-507.
    PMID: 31364246 DOI: 10.1002/1348-9585.12078
    BACKGROUND: Prolonged exposure to hand-arm vibration is associated with a disorder of the vascular, neurological, and musculoskeletal systems of the upper limb known as hand-arm vibration syndrome (HAVS). Currently, the evidence of HAVS in tropical environments is limited.

    OBJECTIVES: To determine the prevalence and severity of HAVS among tyre shop workers in Kelantan, Malaysia.

    METHODS: A cross-sectional study involving 200 tyre shop workers from two districts in Kelantan was performed. Part one data were collected at the field using questionnaire, and hand-arm vibration was measured. Part two involved a set of hand clinical examinations. The workers were divided into high (≥5 m s-2 ) and low/moderate (<5 m s-2 ) exposure group according to their 8-hr time weighted average [A(8)] of vibration exposure. The differences between the two exposure group were then compared.

    RESULTS: The prevalence of the vascular, neurological, and musculoskeletal symptoms was 12.5% (95% CI 10.16 to 14.84), 37.0% (95% CI 30.31 to 43.69), and 44.5% (95% CI 37.61 to 51.38) respectively. When divided according to their exposure statuses, there was a significant difference in the prevalence of HAVS for all three components of vascular, neurological, and musculoskeletal (22.68% vs 2.91%, 62.89% vs 12.62% and 50.52% and 38.83%) respectively. All the clinical examinations findings also significantly differed between the two groups with the high exposure group having a higher abnormal result.

    CONCLUSION: Exposure to high A(8) of vibration exposure was associated with a higher prevalence of all three component of HAVS. There is a need for better control of vibration exposure in Malaysia.

  2. Qamruddin AA, Husain NRN, Sidek MY, Hanafi MH, Ripin ZM, Ali N
    Int J Occup Saf Ergon, 2021 Jun;27(2):410-415.
    PMID: 30940001 DOI: 10.1080/10803548.2019.1600872
    Introduction. Cumulative lifetime exposure to vibration is believed to contribute to more severe complications of hand-arm vibration syndrome (HAVS). Objectives. To determine prevalence of the neurological component of HAVS and the correlation between lifetime vibration dose (LVD) and neurological severity of HAVS among tyre shop workers in Kelantan. Methods. The cross-sectional study involved 200 tyre shop workers from two districts in Kelantan. Part one data were collected in the field using a questionnaire and hand-arm vibration was measured. Part two involved a set of hand clinical examinations (Purdue pegboard, Semmes-Weinstein monofilament and two-point discrimination tests) carried out for neurological component severity staging. LVD for each worker was calculated from data gathered in part one. For workers who had neurological symptoms, staging according to Stockholm workshop scales was done according to part two data. The strength of correlation between LVD and neurological stages was then determined using Spearman correlation. Results. Prevalence of neurological component was 37%. Spearman correlation between LVD and the neurological stages showed a moderate positive correlation. Conclusion. Cumulative lifetime exposure to hand-transmitted vibration is likely to be related to neurological severity of HAVS and therefore must be considered when assessing workers' exposure to hand-arm vibration.
  3. Qamruddin AA, Husain NRN, Sidek MY, Hanafi MH, Ripin ZM, Ali N
    Int J Occup Saf Ergon, 2020 Dec 03.
    PMID: 33148113 DOI: 10.1080/10803548.2020.1846924
    Objectives. Exposure to hand-arm vibration (HAV) is associated with hand-arm vascular syndrome (HAVS), which is characterized by musculoskeletal complications. However, evidence on this matter has been inconclusive. Therefore, this study aimed to determine and compare the prevalence of musculoskeletal complications of HAVS between a high-exposure (≥5 m·s-2) group and a low-moderate-exposure (<5 m·s-2) group and to explore the factors associated with the musculoskeletal complications of HAVS among tyre shop workers in Kelantan, Malaysia. Methods. A cross-sectional study involving 200 tyre shop workers was carried out. HAV was measured by a vibration meter. The workers were divided into two exposure groups - according to their 8-h time-weighted average, A(8), of vibration exposure - and compared. Results. Almost half of the workers reported musculoskeletal complications of the upper limbs and neck. Only the lifetime vibration dose (LVD) was significantly associated with the development of musculoskeletal complications. Conclusion. The high-exposure group had a higher prevalence of musculoskeletal complications. Only the LVD was significantly associated with complications. However, all factors of the work system, such as ergonomics, handgrip force and posture, might contribute to the development of musculoskeletal complications of HAVS and should be included in assessments.
  4. Qamruddin AA, Nik Husain NR, Sidek MY, Hanafi MH, Mohd Ripin Z
    J Occup Health, 2021 Jan;63(1):e12220.
    PMID: 33942440 DOI: 10.1002/1348-9585.12220
    OBJECTIVE: Prolonged exposure to hand-arm vibration (HAV) at the workplace is associated with hand-arm vascular syndrome (HAVS). This study aimed to determine the prevalence and the factors associated with the vascular and neurological complications of HAVS among tire shop workers in Kelantan, Malaysia.

    METHODS: A cross-sectional study involving 200 tire shop workers from two districts in Kelantan was conducted. Data were collected at the field using Malay Translated HAVS questionnaire, and hand-arm vibration was measured. Multiple logistic regression analysis was used to determine the associated factors.

    RESULTS: The prevalence of vascular and neurological complications of HAVS among the tire shop workers was 12.5% (95% CI: 10.16, 14.84) and 37.0% (95% CI: 30.31, 43.69), respectively. From multiple logistic regression analysis, only A(8) of HAV exposure was significantly associated with the development of vascular complications and A(8) of HAV exposure, age. and body mass index were significantly associated with the development of neurological complications of HAVS.

    CONCLUSION: This study has identified that HAVS is a significant problem among workers exposed to HAV in a warm environment. A(8) of HAV exposure is significantly associated with the development of both vascular and neurological complications. Therefore, there is a need for better control of vibration exposure in Malaysia.

  5. Sidek MY, Kamarul Zaman MF, Nik Rosmawati NH, Zamzurina AB
    Med J Malaysia, 2024 Nov;79(6):661-668.
    PMID: 39614782
    INTRODUCTION: Drug-resistant tuberculosis (DR-TB) poses a serious global health threat, leading to high morbidity and mortality rates. Malaysia has witnessed an increase in DRTB cases, necessitating research into trends and characteristics. This study aims to determine the prevalence and describe the characteristics and treatment outcomes of DR-TB cases in Malaysia from 2016 to 2020.

    MATERIALS AND METHODS: A retrospective record review was carried out, utilising secondary data obtained from the TB registry of Selangor and Wilayah Persekutuan Kuala Lumpur. All registered DR-TB cases between 2016 and 2020 that met the study criteria were analysed descriptively using SPSS software version 27.

    RESULTS: Of 443 cases of registered DR-TB over 5 years, 430 cases fulfilled the study criteria. The prevalence of DR-TB increased from 0.27 to 1.79 per 100,000 population between 2016 and 2020. The average age was 40.96 years, majority were males (70.7%), Malaysian (79.3%), with Malays comprising 50.2%. Most patients had up to secondary school education (51.9%), married (57.0%), employed (53.3%) and 34.9% were smokers. For clinical characteristics, 23.5% had diabetes, and 10.9% were HIVpositive. Retreatment cases accounted for half the total, and 83.9% had positive smear results. Minimal chest X-ray lesions were observed in 54.4% of cases. The majority (66.7%) received supervised treatment from healthcare providers after being diagnosed with DR-TB, and 37.4% had more than one anti-TB resistance. Favourable treatment outcomes were observed in 56.7% of cases, while 42.1% had unfavourable outcomes, mainly due to loss to follow-up (49.7%), death (42.6%) and treatment failure (7.7%).

    CONCLUSION: The rising cases of DR-TB call for comprehensive public health interventions and stakeholder commitment to reduce its occurrence and transmission. These findings provide valuable guidance for policymakers in strengthening DR-TB control and prevention strategies.

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