A study was carried out on 79 female telephone operators working in a Telecommunication Centre in Kuala Lumpur to determine the prevalence of Work Related Upper Limb Disorders (WRULD) and its risk factors. Data collection for this study was done between December 2000 and May 2001. The presence of WRULD was determined based on a guided questionnaire and physical examination. The response rate for this study was 94.9% (n= 75) and results showed that the prevalence of WRULD among the female telephone operators was 48.0%: Stage 1= 38.9%, Stage 2= 19.4%, Stage 3= 38.9%, Stage 4= 0% and Stage 5= 2.8%. In the telecommunication centre, it was found that those with WRULD had a mean of 11.59±9.09 years of employment duration whereas those without WRULD had a mean of 9.89 ± 8.48 years of employment duration. None of the factors studied such as Body Mass Index, age, ethnicity, menstrual cycle, hormone replacement therapy, overtime work, duration of employment in the present unit and in the telecommunication centre differ in distribution between subjects with and without WRULD. This could be contributed by factors such as small number of subjects or the common healthy worker effect found in occupational health research. The findings studied of this study show that almost 40.0% of the workers experienced pain and neurological symptoms. Since none of the factors was found to be associated with WRULD, an elaborate study with a case-control design is needed in order to match cases and enable researchers to control the effect of confounding factors. This will ensure risk factors pertinent to WRULD in the Malaysian setting to be identified.

Occupational stress is one of the major health hazards among blue and white-collar workers. However there is no data on occupational stress among white-collar workers in Iran. Aim of this study was to investigate occupational stress among white collar employees in Esfahan Steel Company organization (ESCO), Iran. A cross– sectional survey was conducted through face to face interview using validated standardized questionnaire on occupational stress among 200 white-collar workers from ESCO who agreed to participate in the study, the response rate of participation was 100%. The logistic regression test was used to determine significant associated factors of occupational stress among the study sample.. It is found that among the six items measuring source of stress, the highest source of stress related to economic problem, 117 (59.7%). The statistical analysis showed sources of stress such as task type (p=0.0001), economic problem (p=0.0001), work environment (p=0.0001) and children problem (p=0.05) were significantly associated with having stress among the workers. We found that around half of the white collar workers were under stress at ESCO. Main sources of the occupational stress of white colour workers related to their work environment, economic problem; task type, and related their children.
Stress, Psychological ; Occupational Health

Occupational Related Chronic Low Back Pain (OCLBP) is a globally recognized illness that causes reduction in productivity and substantial economic burden to the countries. It requires a multidisclipinary approach involving employer, healthcare provider, compensatory and enforcement agencies. However there is no specific guideline or pathway that has integrated the roles of each responsible agency. The objective of this article is to highlight the need and to propose a coordinated approach through the concept of Integrated Care Pathway (ICP). Therefore, we reviewed international and local guidelines as well as published articles on chronic low back pain and care pathway. We believed that development of a pathway will be able to organize the role of management at every level, reducing the variations in the management, addressing issues of communicating the findings between the responsible stakeholders, fulfilling the requirements as the laws, allows effective and feasible approaches to take place in terms of cost and practicality, and increase the awareness on occupational diseases. Expected challenges such as limitation of resources, unawareness and lack of understanding on OCLBP from every level are issue that we agreed can be bridged through ICP.

Background: The Perceived Stress Scale-10 (PSS-10) is widely used to assess stress perception. The aim of this study was to translate the original PSS-10 into Malay and assess the reliability and validity of the Malay version among nurses. Methods: The Malay version of the PSS-10 was distributed among 229 nurses from four government hospitals in Selangor State. Test-retest reliability and concurrent validity was conducted with 25 nurses with the Malay version of the Depression Anxiety Stress Scales (DASS) 21. Cronbach’s alpha, confirmatory factor analysis (CFA), intraclass correlation coefficient and Pearson’s r correlation coefficient were used to determine the psychometric properties of the Malay PSS-10. Results: Two factor components were yielded through exploratory factor analysis with eigenvalues of 3.37 and 2.10, respectively. Both of the factors accounted for 54.6% of the variance. CFA yielded a two-factor structure with satisfactory goodness-of-fit indices [x2/df = 2.43; comparative fit index (CFI) = 0.92, goodness-of-fit Index (GFI) = 0.94; standardised root mean square residual (SRMR) = 0.07 and root mean square error of approximation (RMSEA) = 0.08 (90% CI = 0.07–0.09)]. The Cronbach’s alpha coefficient for the total items was 0.63 (0.82 for factor 1 and 0.72 for factor 2). The intraclass correlation coefficient (ICC) was 0.81 (95% CI: 0.62–0.91) for test-retest reliability testing after seven days. The total score and the negative component of the PSS-10 correlated significantly with the stress component of the DASS-21: (r = 0.61, P < 0.001) and (r = 0.56, P < 0.004), respectively. Conclusion: The Malay version of the PSS-10 demonstrated a satisfactory level of validity and reliability to assess stress perception. Therefore, this questionnaire is valid in assessing stress perception among nurses in Malaysia.

Physical activity reduces risk of non-communicable diseases. Physical activity prevalence is low due to barriers to physical activity. This study was conducted to translate the Barrier to Physical Activity (BPA) questionnaire into Malay and assess the reliability and validity of the translated version among nurses. The Malay version of BPA was developed after translating the English version of BPA through back to back translation process. The Malay BPA was distributed among 306 volunteered nurses from 5 government hospitals in Selangor state. Factor analysis, Cronbach’s alpha test and test – retest reliability was conducted to determine psychometric properties of BPA. Chronbach’s alpha coefficient was 0.79 for perceived benefits items and 0.51 for perceived barrier items (overall was 0.73). The ICC was 0.88 (95% CI: 0.78-0.93) for test-retest testing after 7 days. Two factors components were yielded through exploratory factor analysis with eigenvalues of 3.9 and 2.0 respectively. Both the factors accounts for 31.4 % of the variance. Factor 1 included 14 items and explained 19.9% of the variance. Factor 2 consisted of 5 items and explained 11.5% of variance. CFA yielded two factor structures with acceptable goodness of fit indices [x2/df = 23.99; GFI = 0.82, SRMR = 0.09; PNFI = 0.49 and RMSEA = 0.10 (90%CI = 0.09-0.11)]. The Malay version of BPA had demonstrated satisfactory level of validity and reliability to assess barriers to physical activity. Therefore, this questionnaire is valid in assessing barriers to physical activity among working population.​

Chronic low back pain is a common preventable occupational health illness affecting most workers. Large amount of financial and benefit cost had been spent by the developed countries to prevent, treat and rehabilitate a large number of workers who are exposed to hazards that are attributed to low back pain. Efforts on primary prevention of low back pain had been challenging due to difficulties in affirming work- relatedness of chronic back pain among workers. As such, efforts have to be focused on existing literatures to propose acceptable variables to develop the definition of work- relatedness specific to chronic low back pain. Such identified variables or factors could be used to develop a set of criteria in defining work- related chronic back pain. Literature search using specific work- related and chronic low back pain key words were used. Comparable articles were judged and a summarized result was obtained. These variables could be grouped into individual characteristics, health behaviours, physical conditions at work, work organizations and ergonomic factors. With proper methodology and statistical analysis, tools could be developed to aid physicians in determining work- related chronic low back pain among employees.

SUMMARY Introduction: This study aims for construct validation using two approaches, i.e., exploratory factor analysis and Rasch Model. Methods: A cross sectional of 313 male workers from multiple worksites had completed self-administered Malay translated version of Three-Factor Eating QuestionnaireR21. Data quality was assessed by misfit person criteria, dimensionality, summary statistic, item measure and rating (partial credit) scale followed by exploratory factor analysis and internal consistency reliability assessment. Results: The dual approaches of construct validation analysis were complement to each other. Rasch analysis supported the theoretical constructs of three eating behaviour dimensions among respondents. In contrary to exploratory factor analysis, it did show presence of a newfound factor (α=0.04) came up from the separation of the cognitive restrain and uncontrolled eating however, the correlation between the two respective sub-factors were fair (r=0.39) and weak (r= -0.08). Both analyses had detected three problematic items but those items were psychometrically fit for used for current study setting. The data had adequate psychometric properties. Cronbach’s alpha for cognitive restraint, uncontrolled eating and emotional eating were 0.66, 0.79 and 0.87 respectively. Rating scale quality was conformed to standard criteria. Conclusion: Malay version TFEQ-R21 with promising psychometric properties and valid measures for eating behaviour dimensions among male workers aged between 20 to 60 years old is now available. Further development should focus on the items in relation to Malaysian cultural adaptation before its use for daily practice in future setting.
Psychometrics

Introduction: Cardiovascular disease (CVD) caused significant burden to Malaysia as it accounted for 36% of total deaths. This study aims to evaluate the burden of cardiovascular risk factors among Malaysian adult and assess the difference between urban and rural population in the selected communities. Methods: This study is part of the ongoing Prospective Urban Rural Epidemiology (PURE) database, whereby the baseline data were collected since June 2008. CVD risk was measured using INTERHEART risk score which comprised of eleven risk factors i.e. age and gender, family history of heart attack, smoking status, exposure to second hand smoke, diabetes mellitus, hypertension status, waist-hip ratio, self-reported stress, depression, dietary habits and physical activity status. Results: Majority of the studied participants had low cardiovascular risk (57%). Participants from rural area were generally older, had lower educational status, higher prevalence of smokers, obesity, hypertension, diabetes, and more likely to be depressed. In comparison, urbanites had lower physical activities and more likely to be stressful. Mean INTERHEART score among rural participants were higher, especially for male, in comparison to urbanite (11.5±5.83 vs. 10.01±5.74, p<0.001). Conclusion: Contradict to common beliefs, participants in rural areas generally have higher cardiovascular risk factors compared to their urban counterparts. The rural population should be targeted for focused preventive interventions, taking account the socioeconomic and cultural context.

Background: The General Practice Physical ActivityQuestionnaire (GPPAQ) is a validated and reliable screeningtool to measure the level of physical activity in adults.However, it has never been translated and validated inMalaysian population. This study aimed to translate theGPPAQ into Malay language and to evaluate thepsychometric properties of the Malay-translated GPPAQamong shipyard workers.Methods: The original English version of GPPAQ wastranslated forward and backward into Malay version byexperts. The final version of the Malay-translated GPPAQwas then tested for validity and reliability. A cross-sectionalstudy design was performed and systematic randomsampling was used to select respondents. Construct validityand internal consistency of the Malay-translated versionwere tested using exploratory factor analysis andCronbach’s alpha respectively.Results: Sixty-two male shipyard workers participated inthis study. The GPPAQ showed good factor loading valuesfor all items (0.608-0.834). The exploratory principalcomponent factor analysis delineates all seven items intotwo factors with variance of 41.65%. The Cronbach’s alphavalue was good with 0.81, 0.84 and 0.76 for total scale, factor1 and factor 2 respectively.Conclusion: The Malay-translated version of GPPAQ hashigh psychometric properties. Therefore, it is a validinstrument to assess physical activity among Malaysianworking population, particularly in male shipyard workers.

In the absence of objective definition of work- relatedness; decision- making processes, assessments, investigations, treatment and rehabilitation on chronic back pain due to work had been challenging. BACKS questionnaire was designed to assist physicians in determining occupational low back pain among employees from the aspect of reliability and validity. Each identified employee with history of chronic back pain was given chronic back pain was given the BACKS Tool prototype to be filled in. Data was analyzed via stepwise linear regression to develop a temporary model for the BACKS Tool questionnaire. A total 220 respondents were included in the study. Among the associated factors of chronic occupational back pain were physical demand, psychological demand, colleagues who complain of similar back pain, job task involved in twisting for more than 20o, age of the employees and Pain Score that was reported by the respective employees. The regression reported sensitivity of 90.9% and specificity of 95.5%. In search of determining work- relatedness among employees with occupational back pain versus those due to aging, a screening tool had to be developed to assist in providing scientific assessments that would improve employee satisfaction during educational promotion and counseling.