Kimia Obesogen dan Obesiti Kanak-kanak sebagai Ancaman Kesihatan Awam: Satu Ulasan Naratif PengenalanObesiti dalam kalangan kanak-kanak ialah isu kesihatan global yang semakin meningkat dengan prevalens yang tinggi, termasuk di Malaysia. Faktor persekitaran seperti pendedahan kepada bahan kimia obesogen dipercayai menyumbang kepada peningkatan risiko obesiti. Ulasan naratif ini bertujuan untuk menyiasat hubungan antara bahan kimia obesogenik dan obesiti kanak-kanak secara mendalam bagi menyokong pembangunan strategi pencegahan yang lebih berkesan.MetodologiUlasan naratif ini dijalankan menggunakan pangkalan data PubMed, Google Scholar, Web of Science, dan Scopus untuk menyiasat hubungan antara bahan kimia obesogenik dan obesiti kanak-kanak. Kata kunci yang relevan digunakan untuk mengenal pasti artikel yang memenuhi skop kajian. Artikel tambahan diperoleh melalui rujukan silang daripada artikel yang dipilih dalam carian awal.Hasil KajianObesogen ialah bahan kimia eksogen yang mengganggu fungsi metabolik, mempromosikan pengumpulan lemak, dan meningkatkan risiko obesiti dalam kalangan kanak-kanak, terutamanya melalui mekanisme seperti gangguan adipogenesis, penurunan kadar metabolik basal, dan perubahan kawalan selera makan. Kajian menunjukkan hubungan yang signifikan antara pendedahan pranatal kepada bahan kimia seperti phthalate dan PFAS dengan peningkatan indeks jisim badan (BMI) dan risiko obesiti kanak-kanak. Kajian eksperimen turut mengesahkan bahawa obesogen seperti BPA dan phthalate mempromosikan adipogenesis dan gangguan metabolik dalam model haiwan dan sel manusia, memberikan bukti kukuh tentang peranan obesogen terhadap obesiti kanak-kanak.KesimpulanPendedahan kepada obesogen kimia memberi kesan negatif terhadap obesiti kanak-kanak. Oleh itu, tindakan segera melalui kawalan bahan kimia dan pendidikan awam amat diperlukan. Penyelidikan lanjutan dan perubahan polisi global juga perlu dilaksanakan bagi memastikan masa depan yang lebih sihat untuk generasi akan datang.

Risks, Incidents, Guidelines, and Strategies Pertaining to Chemical Storage and Handling in Primary Healthcare – A Narrative Review Introduction Effective chemical storage and handling are critical in primary healthcare (PHC) to safeguard healthcare workers, patients, and the environment. Despite their importance, PHC facilities face unique challenges due to limited resources, inadequate monitoring, and the absence of tailored guidelines and protocols. This narrative review explores the state of chemical storage and handling practices in PHC. Methods A systematic methodology guided this narrative review, including a comprehensive literature search using PubMed, Scopus and Web of Science with defined inclusion and exclusion criteria. Given the scarcity of PHC-specific studies, a purposive selection approach was employed to incorporate evidence from broader healthcare contexts. Data extraction and thematic analysis identified key risks, documented incidents, and evidence-based strategies for improving chemical storage and handling. Results Findings reveal that improper chemical practices lead to acute health effects such as respiratory distress and chemical burns, chronic conditions like asthma and operational disruptions. Non-compliance with regulations exacerbates financial and reputational risks. Case studies, including an ammonia gas leak in Malaysia and chlorine gas exposure in the United Kingdom, highlight the severe consequences of inadequate practices. Six strategies to improve chemical storage and handling in PHC settings were identified: i) regular monitoring and risk assessments, ii) safe physical storage practices, iii) training and education, iv) use of personal protective equipment (PPE), v) incident management and response plans, and vi) inventory organization and storage efficiency. Conclusions These evidence-based strategies can mitigate risks and enhance safety. The review underscores the urgent need for PHC-specific guidelines and future research to address existing gaps and foster safer PHC environments.

Physiological Changes and Recovery After Short-Term High-Altitude Hypoxia: A Narrative Review Introduction Exposure to high altitude induces substantial physiological changes across various systems, enabling humans to withstand hypoxic environments. These physiological changes have been frequently explored and described in the existing literature. In contrast, the process of readjusting to lower altitudes, known as high-altitude de-acclimatization, remains understudied, especially for individuals who spend brief periods at high altitudes. This narrative review aims to consolidate existing research on the physiological alterations and recovery patterns experienced by individuals returning from short-term stays at high altitudes, highlighting the acclimatization and de-acclimatization processes. Methods A total of 29 articles were reviewed to extract insights from current evidence. Results The findings reveal that de-acclimatization is a complex process influenced by various factors. Cardiovascular adaptations, such as increased heart rate, cardiac output, and pulmonary artery pressure, begin to reverse upon descent but demonstrate varying recovery timelines. While heart rate typically normalises within days, stroke volume and pulmonary pressures may take weeks to months to recover fully. Similarly, respiratory adaptations, including ventilatory drive and oxygen saturation, show gradual improvement, although symptoms such as nocturnal hypoxemia and periodic breathing may persist for several days’ post-descent. Haematological parameters, such as haemoglobin and haematocrit levels, decline rapidly, yet full recovery of molecular and systemic markers may extend beyond three months. Metabolic and immune system changes, including increased oxidative stress and immune suppression persist, highlighting the long-term impact of high-altitude exposure. Hormonal fluctuations affecting reproductive health in both sexes further underscore the systemic effects of high-altitude environments. This review also highlights the need for comprehensive public health strategies, including medical consultations prior to travel to high altitude, plans for structured acclimatization and de-acclimatization protocols, and extended monitoring for vulnerable populations such as frequent high-altitude workers or hikers with pre-existing medical conditions. Conclusions Although progress has been made in understanding the physiological challenges of de-acclimatization, substantial gaps remain, particularly in the long-term implications and recovery trajectories. Addressing these gaps through targeted research will enhance guidelines for managing high-altitude transitions and safeguarding the health of diverse populations.

The Impact of Urban Residential Noise and Air Pollution on Youth Mental Health: A Scoping Review Introduction Urban noise and air pollution contribute indirectly to mental health disorders, particularly among adolescents and young adults, due to their ongoing neurodevelopment and increased exposure to environmental pollutants. Hence, it is crucial to understand the impact of urban environmental pollution on youth's mental health. Methods This scoping review was conducted to evaluate the impact of urban air and noise pollution on youth mental health. Articles published between January 2014 and October 2024 were identified through four databases (PubMed, Scopus, Web of Science, and ProQuest), using terms such as noise pollution, air pollution, mental health, and youth. Studies involving urban youth and mental health as an outcome were included. Data from eligible studies were synthesized to identify patterns and gaps in the literature. Results Fourteen studies (n = 14) were included out of 1555 records retrieved. Long term exposure to air pollutants, such as PM 2.5, PM 10, and NO2, were consistently associated with negative mental health outcomes, including poor mental health (PM2.5: OR 1.19, 95% CI 1.03-1.38; NO2: OR 1.23, 95% CI 1.04-1.38; PM10: OR 1.07, 95% CI 0.98-1.17); depression and anxiety (PM2.5: OR 1.24, 95% CI 1.12-1.38; PM10: OR = 1.87, 95 % CI 1.69–2.07); and internalizing symptoms. Short-term exposure also contributed to indirect mental health burden through increased emergency visits and increased psychotropic medications. Findings were heterogeneous for noise pollution, with short-term exposure linked to generally poor mental health, whereas long-term exposure was associated with depression, anxiety, and suicidal risk in some studies. Conclusions The review highlights the significant effect of urban air and noise pollution on youth mental health. Targeted and effective interventions, including urban planning, environmental regulations, and youth-focused public health strategies, are necessary to mitigate these negative effects.

Pengurusan Sisa Penjagaan Kesihatan Pesakit di Rumah oleh Penjaga bagi Pesakit yang Menghidap Penyakit Tidak Berjangkit: Ulasan Naratif Pengenalan Pengurusan sisa penjagaan kesihatan adalah penting dalam menjaga alam sekitar dan kesihatan awam. Dalam konteks penjagaan pesakit penyakit tidak berjangkit (NCD) di rumah, penghasilan sisa berbahaya seperti benda tajam dan bahan berjangkit menuntut pengurusan yang berkesan bagi mengurangkan risiko pencemaran dan jangkitan. Ulasan naratif ini bertujuan untuk mengenalpasti jenis sisa yang dijana, amalan pelupusan dan kekangan yang dihadapi semasa pengurusan sisa penjagaan di rumah. Metodologi Kajian ini menggunakan pendekatan ulasan naratif dengan meneliti artikel jurnal, laporan kes, dan panduan berkaitan pengurusan sisa penjagaan kesihatan di rumah bagi pesakit NCD dalam tempoh 10 tahun. Carian artikel dilakukan dalam pangkalan data seperti PubMed, Scopus dan WOS. Hasil Tujuh artikel telah memenuhi kriteria inklusi melalui carian literatur yang dijalankan. Penemuan menunjukkan sisa yang dihasilkan terdiri daripada benda tajam, bahan berjangkit, dan sisa farmaseutikal. Walau bagaimanapun, terdapat kekurangan dalam amalan pengasingan dan pelupusan sisa yang sesuai oleh penjaga. Sebahagian besar penjaga membuang sisa klinikal bercampur dengan sisa domestik biasa, yang meningkatkan risiko kesihatan.KesimpulanPerbezaan amalan pengurusan sisa penjagaan pesakit di rumah adalah berdasarkan tahap ekonomi sesebuah negara. Kekurangan pengetahuan, garis panduan khusus serta pemantauan bagi pengurusan sisa penjagaan di rumah menyebabkan penjaga menghadapi cabaran dalampelupusan yang selamat. Di samping itu, ketiadaan infrastruktur yang mencukupi turut memburukkan keadaan bagi negara berpendapatan rendah atau sederhana. Latihan dan kesedaran kepada penjaga serta dasar yang komprehensif diperlukan untuk memastikan pengurusan sisa penjagaan kesihatan yang lebih selamat dan efektif. Hal ini penting bagi mengurangkan risiko jangkitan dan perlindungan alam sekitar.

Breastfeeding Under Siege: A Scoping Review of Flood Impacts on Lactating Mothers Introduction Floods, as one of the most frequent and devastating natural disasters, create unique challenges for breastfeeding mothers. However, there is limited understanding of the multifaceted impacts of floods on breastfeeding practices. This review aims to examine the impact of floods on breastfeeding mothers and aims to guide disaster response strategies to support maternal and infant health. Methods A scoping review was conducted using the Arksey and O'Malley framework and the PRISMA-ScR methodology. A systematic search of PubMed, Web of Science, and Scopus databases identified eight studies that met predefined inclusion criteria. Eligibility criteria encompassed peer-reviewed articles with quantitative, qualitative, or mixed methods designs. Studies were included if they focused on breastfeeding mothers affected by floods. Results Eight studies from diverse geographic regions reported significant impacts on breastfeeding practices, including environmental hazard, sociocultural, malnutrition and psychosocial impacts dimensions. Displacement and lack of privacy (e.g., overcrowded shelters, absence of breastfeeding-friendly spaces) disrupted feeding routines. Additionally, maternal malnutrition, stress, and unregulated distribution of formula milk further undermined breastfeeding efforts. Conclusions Flood disasters pose significant challenges in terms of environmental hazard, sociocultural, malnutrition and psychosocial impacts on breastfeeding mothers, jeopardizing maternal and infant well-being. Addressing these issues requires integrated disaster response strategies, including breastfeeding-friendly facilities, nutritional aid, and mental health support. These findings underscore the importance of prioritizing breastfeeding in disaster preparedness and response plans to enhance resilience and reduceinfant mortality during crises.

Introduction: The term "urban heat island" refers to a phenomenon that occurs when temperatures in urban areas are higher than those in the areas that surround them (suburban area). Methods: The urban heat island phenomenon can result in increase of energy consumption, increase of air pollution, decrease of water quality, and increase of greenhouse gas emissions, all of which have the potential to negatively impact people in a variety of ways. Results: In this review we identified certain groups such as elderly, children, woman, pregnant woman, single person, and minority communities, who are living in dense area or in high rise building, low education level, low income, work in outdoor environment and had pre-existing illnesses may face health issues or insufficient resources to cope with the heat in urban area. There were more susceptible to heat-related illnesses and mortality, particularly during extreme heat events. Conclusions Recognising these vulnerable populations is crucial to develop effective strategies to mitigate the effects of urban heat islands and protect them. This can aid policy makers and urban planners to implement targeted interventions to address these issues. Keywords Urban heat island – UHI – Vulnerable population – Heat exposure

Dioxins are a most toxic compound ever studied by human until today. Their significant health effects involved all ranges of age, including infants due to exposure to contaminated breast milk. The objective of the study was to appraise the status of dioxin contamination in breast milk among postnatal mothers live in urban and suburban areas in Klang Valley. It was conducted as a cross sectional study involving 101 postnatal mothers who came for their infant second hepatitis B vaccination. The samples were analysed using High Resolution Gas Chromatography (HRGC) following the USEPA Method 8290. About 70.3% of the samples were found detected with dioxin congeners. More suburban mothers have positive breast milk dioxins compared to urban mothers, 100.0% and 67.0% respectively. Significant associated factors include high fat daily intake (p=0.013), high milk daily intake (p= 0.044), high meat daily intake (p=0.001), body mass index more than 30 kg/m2 (p=0.005), and body fat % of more than 26% (p=0.046). In conclusion, amount daily intake of fat diet, meat, milk, body mass index and body fat are significant associated factors for the present of dioxins in breast milk among postnatal mothers in Klang Valley. More suburban mothers contain dioxins in their breast milk, which poses higher risk of health problems among their infants. A comprehensive study need to be conducted and regular followup need to be established in monitoring the future severity of maternal breast milk contamination to ensure the health of the next generations.
Dioxins ; Milk, Human ; Suburban Population ; Breast Feeding

An Analysis of a Survey Questionnaire on health care workers’ knowledge and practices regarding of infection control and complains them to apply universal precautions. Health care workers are at substantial risk of acquiring blood borne pathogen infections through exposure to blood or other products of patients. To assess of infection control among health care workers in Sana'a healthcare centers, Yemen. A cross-sectional study was conducted in the health center to assess knowledge and practices regarding of infection control among 237 health workers in Sana,a city. A structured self-administered questionnaires were used and data was analyzed using SPSS version 20 and the associations were tested with chi-square, with p-value of < 0.05. The health care workers in public centers ware (51.1%) and (48.9%) of them works in private centers. One hundred and seventeen (49.4%) respondents had poor infection control knowledge, 113 (43.5%) had fair knowledge, and 17 (7.2%) had good knowledge. The knowledge was significantly associated with type of center (P < 0.018), such that the public center had the highest proportion with poor knowledge. And nurses and midwife having the highest proportion with fair knowledge of infection control. Eight (3.4%) respondents had a poor practice of universal precautions, 93 (39.2%) had fair practice, and 136 (57.4%) good practice. The practice was significantly associated with the profession, level of education and work experience (P < 0.001), (P < 0.006), (P < 0.001) respectively, and nurses and midwives as the profession with the highest proportion with good practice. We conclude that the practices and knowledge of universal precautions were low and that's need for intensive programmes to educate health care workers on various aspects of standard precautions and infection control programmes and policies.

The extensive and intensive use of pesticides in agricultural practices has exposed farmers to various hazards resulting in varying degrees of health outcomes. We conducted a cross-sectional study among paddy farmers in Sabak Bernam district, Malaysia. The objective of this study was to gather baseline information on chlorpyrifos blood level and its relationship with pesticides exposure symptoms. We detected chlorpyrifos in farmers’ blood in 7 percent of the respondents, with mean 7.29 nanogram per millilitre blood (sd 5.84 nanogram per millilitre). The percentage of farmers who experienced at least one pesticide exposure symptoms was 75 percent. However, we found no significant association between chlorpyrifos blood level and its exposure symptoms. The farmers had low scores on safe practice of pesticide use even though they have high marks on knowledge and attitude. We found no significant association between the scores on knowledge, attitude and practice on pesticide use and the chlorpyrifos blood level. The presence of pesticide exposure symptoms proved that most of the farmers were exposed to hazardous effects of pesticides. Specific trainings on safe use and handling of pesticides should be given on regular basis to these farmers to ensure they are protected from hazardous effects of pesticides exposure.
Chlorpyrifos ; Pesticides ; Hazardous Substances