Karmegam Karuppiah

Electronic cigarettes and indoor air quality: a review of studies using human volunteers

Abstract Objective: This paper is primarily aimed to review articles on electronic cigarettes (e-cigarettes) focusing on indoor air quality (IAQ) assessment that were conducted using human volunteers under natural settings that mimic actual vaping scenarios. Such studies may give a better representation of the actual potential exposure towards e-cigarettes emissions in indoor settings. Methods: A systematic literature search was conducted using PubMed search engine database. Search terms such as “electronic cigarette”, “e-cigarette”, “electronic nicotine delivery system”, and “indoor air quality” were used to identify the relevant articles to be included in this review. Articles that involved human volunteers who were asked to vape in natural settings or settings that mimic the actual vaping scenario were chosen to be reviewed. The search yielded a total of 15 published articles. Eleven articles were excluded due to 1) unavailability of its full-text (n=1), 2) did not involve human volunteers (n=5) and 3) did not involve an IAQ study (n=5). Four articles were critically reviewed in this paper. Results: From the four selected articles, two of the papers focused on the determination of nicotine level released by e-cigarettes whereas the other two covered IAQ parameters namely; particulate matters (PM), propylene glycols, formaldehyde, metals and polycyclic aromatic hydrocarbons (PAHs). Only two of the studies involved determination of biomarkers of exposure. The level of chemical contents released varied between studies. The differences in the brands of e-cigarette used, number of vapers recruited and the sensitivity of the methodologies employed in these studies may be the possible causes for such differences. However, studies using human volunteers conducted in a natural setting are more relevant to portray the actual exposure to vapors among e-cigarettes users and non-users compared to studies using a smoking machine/an exposure chamber. This is because such studies take into account the behavior of consumers and individual retention of nicotine. Such method will therefore avoid the possibility of overestimation in terms of exposures toward e-cigarettes users and non-users. Conclusion: There are limited e-cigarette studies on the impact of IAQ performed using human volunteers in natural settings. The available studies however, provided inconsistent scientific evidence on the actual exposure towards the vapor contents as unstandardized methodology were used in conducting such research. Therefore, there is a need to conduct IAQ studies in natural settings by using a standardized protocol in terms of the number of vapers recruited, the size of the indoor settings, the methods used in detecting and quantifying the contents and levels of emissions and the sensitivity of the equipment used in analyzing the contents. This will help in better utilization of the findings from such studies for the use of risk assessment of the exposures towards e-cigarette emissions. There is also a need to emphasize that it is the onus of the manufacturers in providing and proving scientifically sound safety claims for their products prior to commercializing it in the market.

Vibration exposure and work‐musculoskeletal disorders among traffic police riders in Malaysia: A review

Background: The traffic police force is one of the occupations that utilize motorcycles as the main mode of transport. The main ergonomic hazard with the constant use of motorcycles is exposure of riders to vibration while riding their motorcycles, which can potentially lead to work.related musculoskeletal disorders (WMSDs). Objective: This review is meant to provide an overview of the available vibration exposure with WMSDs for traffic police riders and to review the related guidelines. Method: This study involved comprehensive search of database from 1945 to 2015. Published research paper that reported on the vibration exposure, prevalence, and/or risk factors of WMSDs and occupational riders were assessed and reviewed. Result: The review suggests that the main factors involving vibration in motorcycles come from the motorcycles itself, the posture of the hands and arms during the gripping of the handlebars, the surrounding environment, and the period of riding motorcycles. Majority of the studies agreed that police riders had higher percentage of WMSDs especially in lower back, neck, and shoulder. Conclusion: Overall, police riders have a high incidence of WMSDs, which in combination with exposure to vibrations with prolonged sitting and static posture may increase their susceptibility to WMSDs. Further research is required to explore the level of exposure to vibrations and WMSDs among traffic police riders, its potentially consequences, and ways to reduce exposure and risk associated with vibrations and WMSDs.

Potential safety risks in schools: Ensuring the safety of our precious ones

The school has become an inextricable part of the modern society throughout the world and especially in Malaysia. During the weekdays, schools are typically a hive of activities where the adults (teachers and other workers) and children (students) interact with each other daily. Schools often maintain a low-risk level of safety and health. Schools have potential variety of risk and hazards (physical and social) that can negatively affect the wellbeing and health of the people. The Malaysian Department of Safety and Health (DOSH) have issued the Hazard Identification, Risk Assessment and Risk Control (HIRARC) for identifying the risk elements during usual and special operations and to predict the likelihood and severity in workplaces. This study was carried out to identify all the factors and hazards that may cause harm to occupant of a selected school in the state of Selangor, Malaysia. An assessment was carried out to consider the chances of that harm befalling anyone in the circumstances of a particular case and the possible severity of the outcome to enable school administrators to plan, introduce, and monitor preventive measures to ensure that the risks are adequately controlled at all times. The HIRARC assessment on the selected school identified that physical hazard has the highest frequency, followed by ergonomic, biological, chemical, and psychosocial hazards. The kitchen, science laboratory, and toilet are the areas that have higher potential for accident to happen. Although in terms of risk, most of the hazards are categorized under medium followed by low risk, but none of hazards are categorized under the high-risk group. There is a critical need to ensure that the school environment is constantly kept safe and healthy to ensure that the process of lifelong building of knowledge and practices can be sustained for the future of the nation.