Comparing the sensitivity and specificity of otoacoustic emission screeners in diagnosing noise-induced hearing loss from air conduction pure tone audiogram in a hearing conservation programme

One of the key components of hearing conservation programme is the yearly pure tone audiogram (PTA) obtained from workers who are at risk of developing noise-induced hearing loss from occupational noise exposure. Although it is the current gold-standard for assessing one’s hearing threshold, a number of limitations are associated with the PTA. It is not an objective test, it is time consuming, it needs trained technician and a sound-proof room (or at least a very quiet ambience) and it is deemed not sensitive enough to detect subtle changes in the cochlea due to early exposure to noise as it assesses the whole auditory pathway and not just the cochlea, where damage from noise mainly occur. A likely alternative would be otoacoustic emission (OAE), an objective test that measures the emission of outer hair cells which ideally would reflect early damages from sound, and takes only fraction of the time to do PTA to complete. Our objective is to see whether screening OAE can be used instead of PTA for early detection of NIHL. A total of 72 workers from a quarry in Kuantan recently underwent PTA, TEOAE, DPOAE and DDPOAE. The association between PTA and OAE (right and left ear) was tested using McNemar’s test and the proportion between the pass and refer cases of OAE and PTA findings was noted to be significant. We will then report on the sensitivity and specificity of different types of OAE as stated above when compared to PTA as gold-standard

Can FMA (Noise) 1989 prevent occupational noise-induced hearing loss? an evaluation using fault tree analysis

Occupational health practitioners in our country were heartened following the gazettement of the new regulation with regard to occupational noise exposure in alignment with the Occupational Safety and Health Act (OSHA 1994) by the Attorney General’s Chamber in early June this year. It took almost two decades for the Factory Machinery Act (Noise Exposure) to be finally revoked.1,2The new regulation is expected to play a crucial role in further curbing occupational noise-induced hearing loss (NIHL), a disease that has consistently been the most notified to Department of Occupational Safety and Health (DOSH) and one of the most compensated of occupational diseases Social Security Organization (SOCSO). This piece is a brief summary of the regulation and its’ impact on the relevant players and stakeholders in the occupational safety and health fraternity

A speech enhancement improvement in communication through hearing protection device

This book is written with the main purpose to distribute the knowledge ofone of the many studies made about enhancing speech enhancement in communication among those workers who wear hearing protection devices (HPD) as part of the Hearing Conservation Programme (HCP). A HCP may be as important as if no other engineering approach or from the management side is impractical, therefore the HPD must be worn whenever and wherever required. Nowadays, there are so many HPD like the earmuff that provide the user to protect their hearing if said properly worn. Some of the HPDs have the feature that allowing the speech of a worker to be understood by the other whom wear HPD that block out unnecessary noise. In the engineering approach, many researchers have study about many methods to achieve the communication while HPD worn. In addition, the importance of the communication at noisy workplace is that it may give warning indicator and clear instruction. In the public health perspective, wearing a HPD is a method to reduce the occurrence of occupational Noise Induced Hearing Loss (NIHL). However, HPD usage is not liked at all time or for all workers, thus they tend to not use the device accordingly. One of the reason is the user cannot make good communication while wearing HPD. It is hopefully, through the written content of this book, people would have a better option of HPD with appropriate communication feature by continuing previous researches made

Efficacy of a targeted intervention method to improve the use of hearing protection devices among agro-industrial workers in Malaysia

Hearing-protection devices (HPD) are crucial in protecting workers from hazardous noise exposures. Despite the mandatory implementation of hearing-conservation programmes at the workplace, compliance with proper HPD usage among workers has been shown to be poor. This study aims to develop and determine the efficacy of a targeted intervention to improve the use of HPD among noise-exposed agro-industrial workers. One group of workers was given a targeted training module, while another group received a standard training module. Their self-reported HPD use and the intention to use HPD in the future were compared to evaluate the effect of the interventions. The targeted intervention significantly increased HPD use after four months com�pared to the control intervention. The findings showed that improving the workers’ compliance with HPD usage is possible by implementing a well-designed training method

Ethical issues on using invertebrates in environmental and biomedical practices – a case study on living fossil horseshoe crab

Increasing utilization of living animals in ecological and biomedical research has drawn serious concerns in terms of animal welfare and ethical practices in animal handling. Significant attention has been given to animals of higher taxonomical hierarchy especially vertebrates such as fishes, rodents, reptiles and mammals, while ethical framework on invertebrate handling and welfare is less addressed (except for cephalopods). The definition of ‘Animal’ itself by any international consortia or Animal Research Act (ARA) does not include invertebrates as an animal entity. This is due to the lack of standard ethical framework to understand the pain and other physiological stress experienced by the invertebrate test animal. One such example would be the living fossil ‘horseshoe crab’ which is extensively bled to obtain its blue blood that is used for endotoxin quantification in biological samples. The biomedical bleeding itself leads to 15-30% post bleeding mortality of crabs, while pain and stress caused by the bleeding practice is not studied. Hence, this paper discusses the technicality of establishing standard framework for invertebrate handling. The paper also highlights the shari’ah (Islamic law) principles on scientific experimentations on animal subjects, particularly the norms related to the adoption of invertebrates in environmental and biomedical practice. Comprehensive review of ethical regulations in animal experiments, especially invertebrates, would be beneficial for revising and improving existing animal ethical practice

Human resource development for future basic occupational health services in Malaysia

A guideline on Basic Occupational Health Services (BOHS) has been established jointly by ILO/WHO/ICOH in response to poor achievements of the Occupational Health Services (OHS), especially among workers in small and medium enterprises at the global level. Malaysia. The international guideline describes competent and skilled human resources as an essential strategy for BOHS implementation. This commentary will discuss the challenges faced by current occupational health personnel providing OHS in Malaysia and proposes improvements of human resource development for future BOHS in Malaysia to ensure fair and better OHS coverage for Malaysian workers

The proposed future infrastructure model for basic occupational health services in Malaysia

The objectives of occupational health services (OHS) are to create a healthy and safe working environment, prevent work-related diseases, optimise employees’ functional capacity and promote health. According to the literature, global accessibility to OHS has not shown much improvement and even worsened in certain countries. The main challenges come from the small and medium enterprises (SMEs). To respond to these global challenges, the basic occupational health services (BOHS) guideline was published under the purview of the World Health Organization and the International Labour Organization. The guideline describes BOHS as part of the infrastructure called the occupational safety and health system, an essential element that ensures the high service coverage and sustainability of the programme. The BOHS guideline was introduced in Malaysia by the Department of Occupational Safety and Health with a focus on SMEs, but its accessibility is low. A gap analysis was conducted between the current BOHS in Malaysia and the published international guideline. The important challenges identified that contributes to the low BOHS accessibility in Malaysia is the weakness in the BOHS infrastructure and OHS system provision. The proposed BOHS infrastructure model is meant to increase accessibility and to provide fair and equitable health services for Malaysians

Prevalence of Occupational Diseases among Small and Medium Industry Workers in Malaysia: A Systematic Review

Occupational diseases are one of the major health problems related to workplace hazards. However, the epidemiological data for this problem is scarce especially among Small and Medium Industry (SMI) workers. These workers are vulnerable to occupational health problem due to lack of knowledge and implementation of health and safety in the workplace. In Malaysia, most of the SMI workers have limited coverage for basic occupational health services which may worsen their health. Thus, this article aims to provide a review on the burden of occupational health problems among them. The electronic and library searches were used to extract the information from both published and unpublished articles that were not limited to any year of publication until 2017. One hundred and ninety-six published articles and 198 unpublished articles were retrieved from the database. Only 19 published articles and 25 unpublished articles met the eligibility criteria. Prevalence data of occupational diseases/poisoning, including overall and body specific (musculoskeletal disorders) was extracted in raw data from the eligible studies. Prevalent statistics on occupational musculoskeletal diseases (1.3% - 97.6%), noise-induced hearing loss (29.4% - 73.3%), occupational skin diseases (10.5% - 84.3%), respiratory (1.9% - 92.2%) and occupational poisoning (14.9% - 17.7%) among the working population is different within published papers compared to unpublished ones. In Malaysia, there are no specific statistic that give a true picture of the burden of occupational diseases in the SMI. However, this review concludes that musculoskeletal diseases are significant occupational problems among SMI workers