Musculoskeletal Disorders (MSDs) and Their Related Factors Among Nurses in a Private Hospital in Muar District, Johor Introduction MSDs are a major occupational health concern among nurses due to the physically demanding nature of their work. Despite global recognition, local data in private hospitals in Malaysia remains scarce. This study aims to address this gap by assessing the prevalence of MSDs among nurses in a private hospital setting. Additionally, it intends to examine the associations between MSDs and various sociodemographic, lifestyle, occupational, and psychosocial factors, while also exploring the potential mitigating role of ergonomic awareness in reducing MSD-related risks. Methods A cross-sectional study was conducted from June to July 2024 among nurses at a private hospital in Muar, Johor. A total of 103 nurses (n=103) who met the inclusion criteria were recruited using universal sampling (73% response rate). Data were collected using a set of validated, self-administered questionnaires, including the Modified Nordic Questionnaire (MNQ), the Occupational Factor Questionnaire (OFQ), the Workplace Stress Scale (WSS), and the Ergonomic Knowledge Questionnaire (EKQ). All data were analysed using IBM SPSS Statistics version 27.0 with simple and multiple logistic regression to identify significant associations (p<0.25). Results The 12-month prevalence of MSDs was 90.3%, with the lower back (86.7%), neck (86.0%), and shoulder (85.0%) being the most affected regions. In simple logistic regression, repetitive tasks were significantly associated with MSDs, and this association remained significant in the multiple logistic regression model (adjusted OR=4.50, 95% CI: 1.11–18.30, p=0.036). Conclusions Stress at work is the strongest determinant of musculoskeletal pain among the ultrasound machine operators, this is followed by uncomfortable use of ultrasound transducers, and lastly the higher number of patients examined in one day.

Kesan Pendedahan Mikroplastik terhadap Jantung: Ulasan Naratif Introduction World Health Organization (WHO) reported that heart disease is among the global main cause of death. The significant environmental factor for heart disease is microplastic exposure. In cardiology, microplastic has been widely used due to stability and biocompatibility. Therefore, this narrative aimed to study the effect of microplastic exposure towards heart. The findings will contribute to evidence-based medicine in heart disease prevention strategies Methods A literature search was conducted on ninth November 2024, across three scientific databases of Scopus, PubMed, and Web of Science using specified keywords like microplastic and heart. The target was original articles published between 2019 and 2024. Results A total of six articles published within 2023 and 2024 have been analysed. All articles reported that microplastic exposure triggers the oxidative process and inflammatory response of cardiomyocyte cells. These processes led to myocardial ischemia and infarction that resulted in heart failure. Conclusions Microplastic exposure is a new risk factor for heart disease. The findings should be integrated in public health promotion programme and the clinical practice guideline of cardiovascular disease for multilevel prevention.

Effective Strategies for Managing Lithium Water Pollution: A Scoping Review Introduction At the moment, calls for sustainable management approaches throughout the Lithium (Li) lifecycle have increased due to growing concerns about the environmental and societal impacts of Li extraction and use. Moreover, long-term exposure to elevated Li levels has been linked to thyroid, neurological, and renal problems in humans. Currently, no comprehensive evaluation exists that thoroughly evaluates the technological, policy, and environmental surveillance strategies for addressing Li water contamination across its entire life cycle. Therefore, this review aims to synthesize evidence on integrated management strategies, including technological innovations, policy measures, and environmental surveillance approaches, to prevent and mitigate Li contamination in surface water throughout its life cycle. Methods This scoping review was developed using the Arksey and O'Malley (2005) Approach, which complied with the Meta-Analyses Extension for Scoping Reviews and the Preferred Reporting Items for Systematic Reviews. The Arksey and O'Malley (2005) framework's recommended actions were carried out. For the literature search, three databases were selected. PubMed, Web of Science, and Scopus were the three primary databases chosen for this review. This review includes only articles published over the past 20 years (2004-2024). Results A total of 403 studies were identified, of which 24 met the inclusion criteria. Among the 24 included studies, 42% were observational, 33% experimental, and 15% reviews. Seven thematic domains were identified: Surveillance (25%), Resource Recovery (33%), Water Filtration System (13%), Extraction (17%), Policy, Remediation, and Recycling (each 4%). Several interventions demonstrated high Li removal or recovery efficiencies, including adsorption and reverse osmosis, achieving up to 99% Li removal; precipitation, recovering 84–90% of Li; and bioleaching, yielding 100% Li recovery from waste batteries. Conclusions A systematic, evidence-based approach is necessary for effective management of Li pollution. Moreover, to ensure that the global transition toward renewable and electrified energy remains sustainable and safeguards public health, Li management must evolve beyond mitigation to prevention and circularity. Therefore, a multifaceted strategy combining technological innovation, regulatory enforcement, and international cooperation is necessary to effectively manage Li pollution and ensure that green energy transitions remain environmentally responsible.

Climate-Driven Dengue Prediction Models In Southeast Asia: A Scoping Review For Public Health Application Introduction Dengue remains a major public health threat in Southeast Asia, with climate factors playing a significant role in its transmission. Climate-driven dengue modelling offers a valuable tool for outbreak forecasting and risk assessment. However, methodological rigour, predictive accuracy, and applicability vary across studies. This review aimed to map climate-driven dengue modelling approaches in Southeast Asia and evaluate their public health applicability. Methods A scoping review was conducted in accordance with the JBI framework and PRISMA-ScR guidelines. Studies focusing on climate-driven dengue prediction models were identified from PubMed, Scopus, and Web of Science. A total of 20 studies (N = 20) met the eligibility criteria. Eligible studies included those conducted in Southeast Asia that incorporated at least one climatic predictor into a dengue model and were published in English. Data extraction included model types, predictors, and model performance. Results The studies were included and categorized into four themes, Short-Term Forecasting, Long-Term Forecasting, Risk Mapping, and Climate–Transmission Simulation Models. Temperature, rainfall, and humidity were the most used climatic variables. Short-term models demonstrated high predictive accuracy (80%–95%). Long-term and simulation models offered insights into seasonal dynamics and intervention scenarios. Risk mapping enhanced spatial targeting, particularly when integrating land-use or mobility data. Across all themes, reliance on internal validation and inconsistent performance reporting limited generalisability. Conclusions These models showed significant potential to improve surveillance and outbreak preparedness in Southeast Asia. Strengthening external validation, integrating socio-environmental predictors, and fostering regional collaboration through platforms such as the ASEAN Centre for Public Health Emergencies and Emerging Diseases (ACPHEED) are essential to scaling model use for public health decision-making.

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.