Background: Metallic dust is a heterogeneous substance with respiratory sensitizing properties. Its long term exposure adversely affected lung function, thus may cause acute or chronic respiratory diseases. Methods: A cross-sectional study was conducted in a steel factory in Terengganu, Malaysia to assess the metal dust exposure and its relationship to lung function values among 184 workers. Metal dust concentrations values (Co, Cr, and Ni) for each worker were collected using air personal sampling. Lung function values (FEV 1 , FVC, and %FEV 1 /FVC) were determined using spirometer. Results: Exposure to cobalt and chromium were 1-3 times higher than permissible exposure limit (PEL) while nickel was not exceeding the PEL. Cumulative of chromium was the predictor to all lung function values (FEV 1 , FVC, and %FEV 1 /FVC). Frequency of using mask was positively associated with FVC (Adj b = 0.263, P = 0.011) while past respiratory illnesses were negatively associated with %FEV 1 /FVC (Adj b = -1.452, P = 0.026). Only few workers (36.4%) were found to wear their masks all times during the working hours. Conclusions: There was an exposure-response relationship of cumulative metal dust exposure with the deterioration of lung function values. Improvement of control measures as well as proper and efficient use or personal protection equipment while at work could help to protect the respiratory health of workers.

A cross sectional study was carried out to determine the prevalence of respiratory symptoms and associated factors with respiratory health among male steel workers. A total of 424 male workers in the steel production plant were recruited using a stratified random sampling. Subjects were interviewed regarding respiratory symptoms using a British Medical Research Council (BMRC) Questionnaire on respiratory symptoms and were examined their lung function using spirometry. Prevalence of chronic cough, chronic phlegm, chest tightness and shortness of breath were 35.8, 32.8, 23.4 and 22.4%, respectively. Age, duration employment and smoking were among the factors associated with respiratory symptoms (p<0.05). Forced Expiratory in 1 sec (FEV 1 ) and %FEV 1 /FVC of workers were significantly reduced as compared to the healthy population (p<0.05). The effect of cigarette on FEV 1 was shown among the current smokers (β = -0.099, p<0.05). Level of dustiness was significantly reduced the FVC (β = -0.047, p<0.05) while duration of work was significantly reduced the %FEV 1 /FVC (β = -0.214, p<0.01). Lung function test revealed some degree of impairment as compared to healthy population and smoking also had an additive effect on respiratory health, thus required further extensive epidemiological and pathological studies for the health and safety of the steel mill workers.

Confined space workers do a wide range of tasks, many of which have a significant risk of hazardous exposure. Hence, a reliable and valid questionnaire is important in assessing the knowledge, attitude, and practice (KAP) of workers in this field. The present study was conducted to develop and validate a questionnaire that could assess the KAP for safe working in a confined space. The questionnaire went through a development and validation process. The development stage consisted of a literature review, expert’s opinion, and evaluation by experts in the field via cognitive debriefing. The validation stage encompassed exploratory and confirmatory parts to investigate the psychometric properties of the questionnaire. A total of 350 participants were recruited among confined space workers from two oil and gas companies in Malaysia. The two-parameter logistic item response theory (2-PL IRT) analysis was used for the knowledge section. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used in the attitude and practice sections of the validation stage. The development stage resulted in 30 items for knowledge, attitude, and practice sections. Items in the knowledge section showed an acceptable difficulty and discrimination, as noted during the 2-PL IRT analysis. The EFA resulted in a one-factor model for attitude and practice sections, and contained 18 items, with factor loading > 0.4. The Cronbach’s alpha was 0.804 and 0.917 for attitude and practice sections, respectively. The CFA for attitude and practice sections indicated a good model fitness (Raykov’s rho = 0.814 and 0.912, respectively). All items indicated good reliability and valid psychometrics for determining KAP on safe working in a confined space.

One of the issues of ineffective solid waste management may be attributable by human behaviour is lack of education and ineffectiveness of reduce, reuse and recycle (3R) awareness programmes, which the solution may lie in changing that behaviour. Therefore, a 3R programme was conducted to increase the knowledge, attitude and practice (KAP) on 3R among 155 primary school students recruited by systematic random sampling from year one to six at a selected school in Tumpat, Kelantan. A set of questionnaire was given before and after the 3R programme to determine their KAP level and the effectiveness of the awareness programme in increasing their KAP on 3R. There was a significant difference in knowledge score (p = 0.030) but no significant differences in scores of attitude (p = 0.484) and practice (p=0.248) between before and after 3R programme. There was a weak correlation between knowledge and attitude (r=0.320) and between knowledge and practice (r=0.386) for before the 3R programme. There was also moderate correlation between attitude and practice (r=0.400) before the intervention programme. After the intervention programme, the correlation was increased from weak to strong correlation between knowledge and attitude (r=0.614) and weak to moderate correlation between knowledge and practice (r=0.476). There was moderate correlation between attitude and practice after the intervention programme (r=0.520). Hence, continuous awareness on 3R campaign and activities should be conducted at an early age among the students to increase their practices on 3R.

Employee performance in terms of knowledge of job scope, safe working practices, and safety-related attitude at work are used to measure an organization’s success in managing employee welfare and safety to prevent workplace injury and death. This study aims to determine the level of knowledge, attitude, and practice on safe working in confined space among water services workers. A cross-sectional study involving a randomly selected 207 water services workers working in a confined space was performed in the central region of Malaysia. The assessment was performed using a validated Malay self-administered questionnaire. Descriptive statistics, Chi-square test and Logistic regression were used for data analyses. The study’s participants were all men, with a mean (SD) age of 35.2 (8.83) years. The average working duration was 10.8 years. Overall, 67.1% of participants had good knowledge, while 65.7% had a positive attitude. The majority of the workers (60.4%) were found to follow safe working practices. Regression analysis revealed that significant predictors for knowledge were age [Adjusted odds ratio (Adj. OR) 2.793; 95% CI: 1.310, 5.955; p = 0.008] and attitude (Adj. OR 2.127; 95% CI: 1.011, 4.526; p = 0.048). Attitude was influenced by marital status (Adj. OR 4.126; 95% CI: 2.079, 8.186; p < 0.001) and knowledge level (Adj. OR 2.224; 95% CI: 1.025, 4.824; p = 0.043). A positive attitude was the sole predictor influencing the safe practice (Adj. OR; 1.878; 95% CI: 1.041, 3.388; p = 0.036). In conclusion, the workers’ levels of knowledge, attitudes, and practices were relatively satisfactory. Extensive investment in workplace safety and health programs, appropriate training, growth opportunities, and effective employee performance evaluation methodologies may assist workers in performing at their best.