Validation of a Malay version of knowledge, attitude, and practice towards safe working in a confined space questionnaire and respiratory health problems among confined space workers of water services industry in the Central Region of Malaysia
Background: Water services industry workers who work in confined spaces (CS) execute a variety of duties, each with its own special hazardous exposures. Working in this type of environment necessitates extreme caution in terms of safety. They could die or suffer from respiratory difficulties as a...
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| Format: | Thesis |
| Language: | English |
| Published: |
2022
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| Subjects: | |
| Online Access: | http://eprints.usm.my/53449/1/Hamiza%20Ngah-24%20pages.pdf http://eprints.usm.my/53449/ |
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| Summary: | Background: Water services industry workers who work in confined spaces (CS)
execute a variety of duties, each with its own special hazardous exposures. Working
in this type of environment necessitates extreme caution in terms of safety. They could
die or suffer from respiratory difficulties as a result of their exposure to potentially
dangerous situations in the CS.
Objectives: This study aims to develop and validate a Malay version of the knowledge,
attitude, and practice toward safe working in a confined space (CS-KAP) questionnaire
and to determine the associated factors of respiratory health problems among confined
space workers of water services industry in the central region of Malaysia.
Methods: This study consists of two phases conducted from April 2020 until
December 2021. Phase 1 involved the development and validation of a Malay version
of the knowledge, attitude, and practice questionnaire for safe working in a confined
space (CS-KAP) among 350 participants from two oil and gas industries in Malaysia.
The knowledge component of the validation stage employed two-parameter logistic
item response theory (2-PL IRT) analysis, whereas the attitude and practice sections
used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A
cross-sectional study was conducted for Phase 2 among 207 confined space workers
working in the water service industry in the central region of Malaysia. A self
administered validated CS-KAP questionnaire, an interview guide of the British
Medical Research Council (BMRC) and American Thoracic Society (ATS) respiratory
symptoms questionnaire, and a pulmonary function test were performed. Hazardous
atmosphere gas concentrations (H2S, CO, O2, CH4, and Cl) were collected using a
portable multi-gas detector. A descriptive analysis, chi-square, multiple logistic
regression, and a general linear regression were performed for the data analysis.
Result: The Malay validated CS-KAP questionnaires had good internal consistency
reliability. The items in the knowledge section had an adequate level of difficulty and
discrimination. Cronbach's alpha values for the attitude and practice sections were
0.804 and 0.917, respectively. Model fitness is high in both sections (Raykov's rho =
0.814 and 0.912, respectively). There was relatively good knowledge (67.1%), a
positive attitude (65.7%), and safe practice (60.4%) among CS workers in the water
services industry. The presence of chlorine and carbon monoxide gases was detected
in a few confined space areas in water treatment facilities. Approximately 45 workers
(21.7%) were identified as having at least one respiratory symptom. The proportion of
reported phlegm was 27.5%, followed by cough (23.7%), and shortness of breath
(13.5%). Respiratory illnesses were associated with the increased frequency of
working in CS per year (Adj. OR 0.97; 95% CI: 0.94, 0.99; P = 0.041), lack of training
(Adj. OR 0.50; 95% CI: 0.27, 0.92; P = 0.026), and absence of toolbox meetings (Adj.
OR 2.53; 95% CI: 1.18, 5.43; P = 0.017). Multiple linear regression revealed that the
significant associated factors of pulmonary function were height, age, Malay ethnicity,
diastolic blood pressure, obesity, comorbidity, working experience in CS, and
knowledge of safe working in CS. Malay ethnicity was associated with an increased
in forced vital capacity (FVC) (Adj. b 0.66; 95% CI: 0.34, 0.99; P 0.001) and a
decreased in %FEV1/FVC (Adj. b -10.17; 95% CI: -16.00, -4.34; P< 0.001). Height was associated with an increase in forced expiratory volume in one second (FEV1) and
FVC (Adj. b 1.55; 95% CI: 0.26, 2.84; P = 0.019; Adj. b 3.57; 95% CI: 2.43, 4.72; P
0.001, respectively). Obesity was positively associated with %FEV1/FVC (Adj. b 3.99;
95% CI: 1.20, 6.79; P= 0.005).
Conclusion: The findings suggest that the CS-KAP is a reliable and valid
questionnaire for assessing knowledge, attitude, and practice in safe confined space
work. Pulmonary function declines and the occurrence of respiratory illnesses indicate
that confined space workers in the water service industry are also at risk for chronic
exposure to hazardous materials in confined spaces. Safety management and safety
hierarchy control should be adopted effectively to provide a safe environmental
workplace and lower the impact of respiratory health problems among workers. |
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