Introduction: Water-based metalworking fluid (MWF) provides a suitable environment for microbes to grow. This study aimed at identifying the level and species of microbial contamination of MWF in a metal machining factory and to determine the corresponding Immunoglobulin G (IgG) levels in the workers’ blood samples. Methods: Total of 298 workers in the production section of a metal machining factory, the production section using MWF as coolant fluid, were involved in this study. The Analytical Profile Index system was used to identify the species of microbes isolated from MWF bulk and air samples. Tryptone soya agar was used to incubate unknown bacteria, and sabouraud dextrose agar was used for unknown fungi. The level of IgG antibodies in workers’ blood were measured as an indicator of the exposure to the microbes isolated from MWF, corresponded to the microbial species isolated from MWF. Results: The most dominant microbes isolated from the channels were Candida albicans, Klebsiella pneumoniae, E. coli and Pseudomonas aeruginosa. A total of 21 (34.4%) workers were positively exposed to E. coli, 30 (42.2%) to Pseudomonas aeruginosa, and 45(75%) exposed to Candida albicans. Also, the mean level of optic density of IgG to Klebsiella pneumoniae was 0.415 (0.02). Conclusion: Water-based metalworking fluid in this metal machining factory was contaminated with bacteria and fungi. The workers in the production section were exposed to MWF as well as the microbes present in MWF. The level of IgG in blood was the biomarkers for occupational exposure to microbial contaminant MWF.
Occupational exposure

Stress in medical education has been inevitable among medical students. However, the prevalence of stress among pre-clinical and clinical medical students differed by year of study. There were several stressors reported to affect medical students. Therefore, effective coping strategies were applied to manage the stress faced by medical students. The aim of this study was to determine the prevalence of stress, stressors and coping strategies comparing pre-clinical and clinical Universiti Tunku Abdul Rahman (UTAR) medical students, and the associated stressors and stress among them. This was a cross-sectional study with a study population of 223 medical students. Universal sampling was used. A self-administered questionnaire which included socio-demographic characteristics, the General Health Questionnaire (GHQ-12), the Medical Students Stressor Questionnaire (MSSQ) and the Brief COPE Inventory were used in this study. The overall prevalence of stress among medical students was 48.15%. Clinical students had a higher prevalence of stress (53.73%) compared to pre-clinical students (39.02%). Year 3 students had the highest prevalence of stress (64.58%) compared to other years of study. Nearly 1 out of 2 medical students were stressed (48.15%). Academic Related Stressor ranked the highest and Acceptance was the most practiced coping strategy. The only associated stressor with stress was Academic Related Stressor.

The cooking process may emit toxic compounds and airway irritants from both the fuel combustion and cooking fumes which is harmful to the respiratory health among the restaurant workers. A cross-sectional study of 243 restaurant workers from the selected restaurants in Sungai Long, Malaysia was conducted. The standardized British Medical Research Council questionnaire on Respiratory Symptoms (1986) was used during the interview to access the symptoms and the spirometry test was performed to evaluate the pulmonary functions of the participants. The data of socio-demography and occupational characteristics were also collected. The most complaint respiratory symptoms by the restaurant workers were breathlessness, which accounted for 33.7%, followed by wheezing (14%). The mean values of all pulmonary function tests (PFT) of the restaurant workers were within the normal range (>80%), except for the Peak Expiratory Flow (PEF) (79.09%). The results of the bivariate statistical analysis, Chi-square, ANOVA and t-test, showed the determining factors of the respiratory health among the workers were workers’ age and gender in addition to the working duration and the ethnicity. The restaurant workers in Sungai Long were at risk of developing respiratory symptoms and lower pulmonary function values due to prolonged exposure to cooking fumes. Emphasis should be given to the safety and health of restaurant workers and health education should be provided to the restaurant workers and owners. Strategies to increase notification of such occurrences among these workers should be looked into by related agencies in the country.

Introduction: The provision of a satisfactory service by community healthcare centres in China plays an important role in the prevention and control of communicable diseases, especially during the COVID-19 pandemic. However, there is a lack of study in this field. This study aimed to determine the level of patient satisfaction with primary healthcare services in China and its associated factors during the COVID-19 pandemic. Methods: This cross-sectional study was conducted at 10 primary healthcare clinics in Xi’an, China. The 18-Item Patient Satisfaction Questionnaire was used for data evaluation and SPSS version 23.0 for data analysis. Results: A total of 315 patients were recruited. The overall patient satisfaction score was 26.1±3.1. In the multiple linear regression analysis, the highly educated patients had a higher patient satisfaction score than the low-educated patients (β=1.138, 95% confidence interval=0.135–2.141, P=0.026). Conclusion The overall patient satisfaction level of the patients who attended community healthcare centres in Xi’an was high. The patients with a higher educational level showed a higher patient satisfaction level than did those with a lower educational level.
Community Health Services ; Patient Satisfaction ; China ; COVID-19