Abstract: Job stressors may reduce the likelihood of quitting smoking. To assess the association between job strain, smoking behaviour and smoking cessation among Malaysian male employees involved in a smoking cessation programme. The study was conducted among employees in two major public universities in Malaysia. All staff from both universities received an invitation to participate in this study. At the start of treatment, participants completed a questionnaire on sociodemographic variables, smoking habits and the Malay version of the Job Content Questionnaire (JCQ). The JCQ consists of scales of job control, job demand, supervisor support, co-worker support, job insecurity, job decision latitude and job skill discretion. Behaviour therapy with free nicotine replacement therapy (NRT) was given as treatment for two months. Participants were contacted at 1 week, 3 months and 6 months to determine their smoking status. One hundred and eighty five staff from both universities responded and voluntarily showed interest in quitting. At three months (OR = 8.96; 95% CI: 1.14-70.76) and six months (OR = 8.9; 95% CI: 1.15-68.65), men with higher co-workers' support demonstrated a higher likelihood of quitting. Smokers in a 'passive job' also demonstrated higher likelihood of quitting compared with those working in the 'low strain' category at six months (OR = 9.92; 95% CI: 1.20-82.68). No meaningful associations were found between other psychosocial job variables and smoking cessation. A positive relationship with and support from co-workers are important factors for workplace smoking cessation.
Abstract: Perceived risks and benefits of quitting smoking may be important factors in successful treatment. This study examined the association between initial perceived risks and benefits of quitting smoking and outcomes during a two month smoking cessation attempt. Participants (n=185) were treatment-seeking smokers attending two smoking cessation clinics in Klang Valley, Malaysia. They received structured behavioral therapy and free Nicotine Replacement Therapy (NRT). Prior to treatment, a 12 item Perceived Risks and Benefits Questionnaire (PRBQ) was administered. This was used to assess the smokerâs initial perceptions during their quit attempt. Participants were re-contacted at the end of two months to determine their smoking status. The results show participants intending to quit demonstrated a greater understanding of the benefits of quitting smoking than the risks of quitting. Those with a higher education level had a greater understanding of the benefits of quitting (p=0.02). PRBQ items, such as perceived risks of quitting (ie weight gain, negative affect, social ostracism, loss of enjoyment and craving) were not associated with abstinence at two months. However, those who perceived a benefit of higher physical attraction post-cessation were less likely to have stopped smoking at two months (OR 0.18; 95%CI 0.08-0.45). Other perceived benefits at baseline, such as health, general well-being, self-esteem, finances and social approval, were not associated with smoking cessation at two months. The results suggest that in our study population, smokersâ baseline perceptions of the benefits of cessation of smoking prior to therapy are not associated with quit results at two months. Counseling patients regarding the advantages and disadvantages of quitting may have changed their perceptions during quitting process and should be further explored in future studies.
Notes: Yasin, Siti Munira Masilamani, Retneswari Ming, Moy Foong Koh, David Zaki, Rafdzah Ahmad
Abstract: This study aims to determine the prevalence and associated factors of noise-induced hearing loss (NIHL) among vector control workers in the state of Negeri Sembilan, Malaysia. This was an analytical cross-sectional study conducted on 181 vector control workers who were working in district health offices in a state in Malaysia. Data were collected using a self-administered questionnaire and audiometry. Prevalence of NIHL was 26% among this group of workers. NIHL was significantly associated with the age-group of 40 years and older, length of service of 10 or more years, current occupational noise exposure, listening to loud music, history of firearms use, and history of mumps/measles infection. Following logistic regression, age of more than 40 years and noise exposure in current occupation were associated with NIHL with an odds ratio of 3.45 (95% confidence interval = 1.68-7.07) and 6.87 (95% confidence interval = 1.54-30.69), respectively, among this group of vector control workers.
Abstract: BACKGROUND: Many smokers attempt to quit smoking, but very few succeed. OBJECTIVE: To identify the timing and risk factors involved in smoking relapse. METHODS: We conducted a prospective cohort study among staff in two public universities in Malaysia. Behavioural therapy with free nicotine replacement therapy was given as treatment. Participants were followed up for 6 months. Relapse was defined as returning to smoking after having quit for at least 24 h. RESULTS: Of 185 smokers who volunteered to participate, 120 achieved at least 24-h abstinence, and 80% of these relapsed within 2 months. Compared to participants who attended a single smoking cessation session, participants who attended three sessions had a lower likelihood of relapse within 6 months of quitting. In contrast, smokers with a much longer exposure to cigarette smoking in the workplace (>3 h per week) had a greater chance of relapse compared to those with no exposure. CONCLUSIONS: Frequent attendance at clinic sessions and less exposure to other people smoking in the workplace can potentially reduce the likelihood of relapse among smokers who have recently quit.
Abstract: The aim of this study was to determine the prevalence of job stress among secondary school teachers using Karasek Job Content Questionnaire (JCQ), the association between salivary cortisol, salivary IgA, and sociodemographic characteristics, and the association between log cortisol, IgA levels, and job strain categories. A cross-sectional study was undertaken using JCQ and salivary cortisol and IgA samples. Cluster sampling was done yielding 302 respondents. The prevalence of stress among all teachers was 20.2%. Being a Malay, teaching experience of 5 to 10 years, and those without a supervisor's support had higher prevalence of high job strain. Teachers in the 31 to 40 years age bracket, educating handicapped children with the absence of supervisor support exhibited higher stress levels with lower log salivary IgA levels. Further studies must be conducted using salivary biomarkers to study the in-depth relationship of stress, extending into other occupational groups.
Abstract: Background: There is an unclear relationship between smoker's early motivation and success rates. Here we aimed to explore the correlates of motivation and smoking abstinence and relapse in worksite smoking cessation programmes. Methods: This prospective cohort study involved employees from two major public universities in Malaysia. Participants were actively recruited into a smoking cessation programme. At the start of treatment, participants were administered a questionnaire on sociodemographic variables, smoking habits and `stage of change'. Behaviour therapy with free nicotine replacement therapy (NRT) was given as treatment for two months. A similar stage of change questionnaire was given at six months, and their smoking status was determined. Results: There were 185 smokers from both Universities, who joined the programme. At six months, 24 smokers reported sustained abstinence while the others had relapsed. Prior to the programme, the majority of smokers were seriously planning on quitting (59.5%- preparation stage), but over a third had no plans to quit (35.5%- contemplation stage). There was no significant difference noted in changes of motivation stage among the relapsers and the non quitters. In addition, logistic regression showed that sustained abstinence was not predicted by pre-session motivation stage, but this did predict higher relapse for the participants, compared to those in the preparation stage. Conclusion: It is possible to help smokers in the lower motivation groups to quit, provided extra caution is taken to prevent relapse. Healthcare providers' recruitment strategies for cessation programmes should thus encompass smokers in all motivation stages.
Abstract: OBJECTIVE: The authors examined the effects that change in perception about the advantages and disadvantages of smoking and quitting had on quitting outcome among smokers enrolled in a program for smoking cessation. METHODS: A total of 185 smokers from 2 public universities who were interested in quitting received smoking cessation counseling on understanding the risks and benefits of quitting (or smoking) in addition to a course of free nicotine replacement therapy (NRT). A decisional balance questionnaire (DBQ) was administered at baseline and at 2 months postcounseling to determine and assess changes in smoking perception. RESULTS: After counseling, 72.3% of smokers had reduced their perceptions about the advantages of smoking, and 66.4% had increased perceptions of disadvantages of smoking. At the eighth week, 51 participants (27%) had quit. Smokers who had reduced perceptions of the advantages of smoking had significantly higher quit rates compared with those with no improvement in perception (82.6% vs 17.4%; odds ratio = 2.47; 95% confidence interval = 1.00-6.10). CONCLUSION: After counseling, smokers did change their perception of the advantages and disadvantages of smoking during the quitting process. These changes are associated with a higher likelihood of smoking cessation.
Abstract: Objectives To determine the extent of hand transmitted vibration exposure problems, particularly hand-arm vibration syndrome (HAVS), among construction workers in Malaysia. Methods A cross-sectional study was conducted on a construction site in Kuala Lumpur, Malaysia. 243 workers were recruited. Questionnaire interviews and hand examinations were administered to 194 respondents. Vibration magnitudes for concrete breakers, drills and grinders were measured using a 3-axis accelerometer. Clinical outcomes were compared and analysed according to vibration exposure status. Results Vibration total values for concrete breakers, impact drills and grinders were 10.02 ms(-2), 7.72 ms(-2) and 5.29 ms(-2), respectively. The mean 8 h time-weighted hand transmitted vibration exposure, A(8), among subjects on current and previous construction sites was 7.52 (SD 2.68) ms(-2) and 9.21 (SD 2.48) ms(-2), respectively. Finger tingling, finger numbness, musculoskeletal problems of the neck, finger coldness, abnormal Phalen's test and abnormal light touch sensation were significantly more common in the high vibration exposure group (n=139) than the low-moderate vibration exposure group (n=54). Mean total lifetime vibration dose among exposed subjects was 15.2 (SD 3.2) m(2) h(3) s(-4) (In scale). HAVS prevalence was 18% and the prevalence ratio of stage 1 and higher disease in the high vibration exposure group versus the low-moderate vibration exposure group was 4.86 (95% CI 1.19 to 19.80). Conclusions Hand transmitted vibration is a recognisable problem in tropical countries including Malaysia. The current study has identified clinical symptoms and signs suggesting HAVS among construction workers exposed to hand transmitted vibration in a warm environment.
Abstract: Patients with pancreatic adenocarcinoma are known to have a high mortality rate. The 5-year survival rate still remains low even now compared to that of the 1960's despite new advances in management including surgery, chemotherapy, pathological classification and molecular diagnostic technologies. Precursors to invasive pancreatic adenocarcinoma have been identified in the last ten years that include mucinous cystic neoplasm, intraductal papillary mucinous neoplasm and pancreatic intraepithelial neoplasia. p53 protein accumulation in the nuclei is a common molecular event in most human neoplasms. Our objective is to investigate p53 expression in pancreatic adenocarcinoma and precursor lesions and their significance. The selected study material encompassed 31 invasive ductal adenocarcinoma, 15 mucinous cystic neoplasm and papillary mucinous neoplasm, and 27 cases of pancreatic intraepithelial neoplasia including grade 1, 2 and 3. Immunoscore was given for each case based on intensity of staining and percentage of cells positive and compared between precursor lesions and invasive adenocarcinoma. A score of 50 and above was considered significant. The results showed that p53 expression increased progressively and significantly with the grade of pancreatic intraepithelial neoplasia and adenocarcinoma (p-value < 0.001). These findings support the concept of multistep carcinogenesis in pancreatic adenocarcinoma and suggest that p53 inactivation occurs in the progression of precursors to pancreatic adenocarcinoma.
Abstract: Smoking cessation studies are often performed in clinic based settings. The present example aimed to find predictors of success among staff in worksite smoking cessation programmes in two major public universities in Klang Valley, Malaysia. All staff from both universities received an open invitation via staff e-mail and letters to participate. At the start of treatment, participants were administered the Rhode Island Stress and Coping Questionnaire and Family Support Redding's Questionnaire. Behaviour therapy with free nicotine replacement therapy (NRT) were given as treatment. After two months, they were contacted to determine their smoking status. 185 staff from University A (n=138) and University B (n=47), responded and voluntarily showed interest to quit. There was no significant difference in respondents with respect to socio demographic characteristics and smoking history. After two months of treatment, quit rates were 24% in University A vs. 38 % in University B (p>0.05). Univariate predictors of cessation were adherence to NRT (p<0.001), smoking fewer cigarettes per day (p<0.05) and the number of behaviour therapy sessions attended (p<0.001). Logistic regression identified 3 significant predictors of smoking cessation. Participants attending more than one session (OR= 27.00; 95% CI : 6.50; 111.6), and having higher pre-treatment general stress (OR= 2.15; 95% CI: 1.14; 4.05) were more likely to quit, while a higher number of cigarettes smoked (OR= 0.19: 95% CI: 0.06; 0.59) reduced the likelihood of quitting. Increasing age, ability to cope with stress and family support were not significant predictors. We conclude that factors such as the number of counseling sessions, the amount of cigarettes smoked at baseline, adherence to NRT and pretreatment stress are important considerations for success in a worksite smoking cessation programme.
Abstract: The Nursing Stress Scale (NSS) has been shown to be a valid and reliable instrument to assess occupational stressors among nurses. The NSS, which was previously used in the English version, was translated and back-translated into Bahasa Melayu. This study was conducted to assess the reliability of the Bahasa Melayu version of the NSS among nurses for future studies in this country. The reliability of the NSS was assessed after its readministration to 30 nurses with a 2-week interval. The Spearman coefficient was calculated to assess its stability. The internal consistency was measured through 4 measures: Cronbach's α, Spearman-Brown, Guttman split-half, and standardized item α coefficients. The total response rate was 70%. Test-retest reliability showed remarkable stability (Spearman's Ï exceeded .70). All 4 measures of internal consistency among items indicated a satisfactory level (coefficients in the range of .68 to .87). In conclusion, the Bahasa Melayu version of the NSS is a reliable and useful instrument for measuring the possible stressors at the workplace among nurses.
Abstract: Globalizations and incorporating new technologies, innovations in industrial processes have brought in greater occupational health and safety challenges. In Malaysia, the Factory and Machinery Act 1967 set the stage for addressing the preliminary issues that arose due to early industrialization in Malaysia in the 1970s. The enactment of the Occupational Safety and Health Act 1994 set requirements to be met through promotion of occupational health and safety based on self regulation, complying with industrial codes of practice in operations, implementing occupational health and safety management strategies and the ultimate inculcation of an occupational health and safety culture1.
Abstract: Aims To investigate the prevalence and factors associated with high job strain among office workers of a multinational company in Malaysia. Methods A cross-sectional study was conducted in November 2007 among 470 eligible workers. Respondents self-administered the Job Content Questionnaire downloaded from the company's intranet. A median-split procedure was applied to create four groups according to the Job Demand-Control Model: active, passive, high and low job strain. Logistic regression models were used to investigate the associations between socio-demographic, occupational and psychosocial factors and high job strain. Results A total of 356 questionnaires were received (response rate 76%). Twenty-one per cent of respondents were in the high job strain group, 35% were in the passive group, whereas 26% and 17% of workers were in the low strain and active groups, respectively. After controlling for confounders, three factors were found to be associated with high job strain: male workers (adjusted OR 1.94, 95% CI 1.04-3.64), working > 48 h per week (adjusted OR 2.51, 95% CI 1.44-4.39) and job insecurity (adjusted OR 1.14, 95% CI 1.02-1.27). One protective factor for high job strain was the scale 'created skill', which is part of skill discretion (adjusted OR 0.70, 95% CI 0.57-0.86). Conclusions About one in five workers in this study experience high job strain. Work improvement measures include reducing long working hours and job insecurity and giving workers the opportunity to learn, use creativity and develop abilities.
Abstract: Awareness of occupational safety and health (OSH) plays an important role in the prevention of occupational injuries and diseases. Following the enactment of the Occupational Safety and Health Act (OSHA) in 1994, various programmes have been implemented by different agencies to increase awareness and knowledge of OSH in the workplace, including among healthcare workers. The objective of this study was to determine the level of OSH awareness and knowledge among healthcare professionals in Malaysia.
Abstract: This small, cross-sectional study assessed the reliability of 3 scales from the Job Content Questionnaire (JCQ)-decision latitude, psychological job demand, and social support-in a group of office workers in a multinational company in Kuala Lumpur. A universal sample of 30 white-collar workers from a department of the company self-administered the English version of the JCQ comprising 21 core items selected from the full recommended version of 49 items on-site. Reliability (internal consistency) was evaluated using Cronbach's alpha coefficients for each scale. Corrected item-total correlation was presented for each and every item. Cronbach's alpha coefficients were acceptable for decision latitude (.76) and social support (.79) but slightly lower for psychological job demand (.64). Values for all item-total correlations for all 3 scales were greater than .3. In conclusion, this study suggests that the JCQ is a reliable scale for assessing job stress in this group of workers.
