The Facilitators and Barriers Associated With Notification of Occupational Diseases Among Medical Officers in Primary Care Clinics
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Abstract
Introduction: Reporting occupational diseases is crucial for improving employee health, but underreporting remains a global issue. This study aims to identify facilitators and barriers to the notification of occupational diseases and to explore the role of intention as a mediating factor. Materials and methods: A cross-sectional study using self-administered questionnaires was conducted among medical officers aged 18-59 years from 22 public clinics in Kuala Lumpur and Putrajaya, Malaysia. Variables assessed included sociodemographic, knowledge, attitudes, interest, practices, and barriers related to occupational disease notification, based on the Theory of Planned Behaviour. Data analysis was performed using SPSS v19. Results: Of 542 medical officers recruited, 416 responded. Among these, 180 (43%) had diagnosed occupational diseases, but only 56 (31%) reported them, resulting in a notification proportion of 13.5%. Positive intention was significantly associated with notification (AOR: 2.64, p = 0.016). Factors contributing to positive intention included interest in occupational health (AOR: 2.4, p = 0.016), taking occupational history (AOR: 2.0, p = 0.004), high attitude scores (AOR: 3.64, p = 0.004), and high knowledge scores (AOR: 1.74, p = 0.023). More barriers to diagnosing occupational diseases were inversely associated with notification (AOR: 0.52, p = 0.012), with intention acting as a complete mediator (IE = 0.1181, 95% CI: 0.0132–0.2943). Conclusion: Targeted interventions to enhance knowledge, skills, and attitudes in occupational health, beginning at the undergraduate level, can strengthen the intention to notify occupational diseases. By bolstering intention as a mediator, these interventions can help overcome diagnostic barriers, thereby improving notification rates.
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Niu S. ILO list of occupational diseases and health care workers. Asian-Pacific Newsletter on occupational health and safety [Internet]. 2010; 17(2):[34-8 pp.]. Available from: https://www.cabidigitallibrary.org/doi/full/10.5555/20103332304.
Kurppa K. Severe under-reporting of work injuries in many countries of the Baltic sea region: an exploratory semi-quantitative study. Helsinki: Finnish Institute of Occupational Health; 2015.
Azaroff LS, Levenstein C, Wegman DH. Occupational injury and illness surveillance: conceptual filters explain underreporting. American Journal of Public Health. 2002;92(9):1421-9 DOI: 10.2105/ajph.92.9.1421.
Fagan KM, Hodgson MJ. Under-recording of work-related injuries and illnesses: An OSHA priority. Journal of Safety Research. 2017;60:79-83 DOI: https://doi.org/10.1016/j.jsr.2016.12.002.
Concha-Barrientos M, Nelson DI, Fingerhut M, Driscoll T, Leigh J. The global burden due to occupational injury. Am J Ind Med. 2005;48(6):470-81 DOI: 10.1002/ajim.20226.
Schulte PA. Characterizing the burden of occupational injury and disease. Journal of Occupational and Environmental Medicine. 2005;47(6):607-22 DOI: 10.1097/01.jom.0000165086.25595.9d.
Yusof MZ, Mahmod NAKN, Rahman NAA, Razali A, Samsuddin N, Mohamed NMNN, et al. Prevalence of Occupational Diseases among Small and Medium Industry Workers in Malaysia: A Systematic Review. Journal of Clinical and Health Sciences. 2019;4(2):4-30 DOI: https://doi.org/10.24191/jchs.v4i2.7508.
Elsler D, Takala J, Remes J. An international comparison of the cost of work-related accidents and illnesses. European Agency for Safety and Health at Work. 2017;8 DOI: https://doi.org/10.5271/sjweh.4132.
DOSH. Annual Report 2021. Ministry of Human Resources; 2021. Available from: https://www.dosh.gov.my/index.php/publication-sp-249/annual-report.
SOCSO. Annual Report 2021. Ministry of Human Resources, Organisation SS; 2021. Available from: https://www.perkeso.gov.my/mengenai-kami/rujukan/laporan-tahunan.html.
Bagozzi RP, Baumgartner J, Yi Y. An investigation into the role of intentions as mediators of the attitude-behavior relationship. Journal of Economic Psychology. 1989;10(1):35-62 DOI: https://doi.org/10.1016/0167-4870(89)90056-1.
D. Albarracín BTJ, M. P. Zanna. The handbook of attitudes. United States: Mahwah, NJ: Lawrence Erlbaum Associates; 2005. p. 173-221.
Ali M, Saeed MMS, Ali MM, Haidar N. Determinants of helmet use behaviour among employed motorcycle riders in Yazd, Iran based on theory of planned behaviour. Injury. 2011;42(9):864-9 DOI: 10.1016/j.injury.2010.08.030.
Ajzen I. The theory of planned behavior. Organizational behavior and human decision processes. 1991;50(2):179-211 DOI: https://doi.org/10.1016/0749-5978(91)90020-T.
Arie Rotem GR. Profile of Allied Health Professions in Ministry of Health Malaysia A Consultation Report by World Health Organization (WHO). Ministry of Health Putrajaya 2020. Contract No.: ISBN 978-967-0668-62-8. Available from: https://hq.moh.gov.my/alliedhealth/index.php/ms/penerbitan/buku-laporan.
Hazrin H, Fadhli Y, Tahir A, Safurah J, Kamaliah M, Noraini M. Spatial patterns of health clinic in Malaysia. Health. 2013;2013 DOI: 10.4236/health.2013.512287.
DOSM. Current Population Estimates, Malaysia, 2023 dosm2023 [updated 31 July 2023. Available from: https://open.dosm.gov.my/dashboard/population.
Israel GD. Determining sample size1992. Available from: https://www.psycholosphere.com/Determining%20sample%20size%20by%20Glen%20Israel.pdf.
Mason MJ. A Review of Procedural and Statistical Methods for Handling Attrition and Missing Data in Clinical Research. Measurement and Evaluation in Counseling and Development. 1999;32(2):111-8 DOI: 10.1080/07481756.1999.12068976.
Soe HHK, Than NN, Lwin H, Phyu KL, Htay MNN, Moe S, et al. Knowledge and attitude of mandatory infectious disease notification among final year medical students. Journal of family medicine and primary care. 2018;7(4):756 DOI: 10.4103/jfmpc.jfmpc_300_17.
Isahak M, Hoe VCW, Darus A, Othman I. The Malaysian Notification of Occupational Diseases study(MyNODS). Report. Center for Occupational and Enviromental Health UM (COEHUM), University Of Malaya.; 2014. Available from: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://spm.um.edu.my/wp-content/uploads/2018/02/spm-annual-report-2014.pdf.
McHugh ML. Interrater reliability: the kappa statistic. Biochemia medica. 2012;22(3):276-82.
Bursac Z, Gauss CH, Williams DK, Hosmer DW. Purposeful selection of variables in logistic regression. Source code for biology and medicine. 2008;3:17 DOI: 10.1186/1751-0473-3-17.
Parhar A, Lemiere C, Beach JR. Barriers to the recognition and reporting of occupational asthma by Canadian pulmonologists. Canadian respiratory journal. 2011;18(2):90-6 DOI: 10.1155/2011/754726.
Boschman JS, Brand T, Frings-Dresen MHW, van der Molen HF. Improving the assessment of occupational diseases by occupational physicians. Occupational Medicine-Oxford. 2017;67(1):13-9 DOI: 10.1093/occmed/kqw149.
Taiwo OA, Mobo Jr BHP, Cantley L. Recognizing occupational illnesses and injuries. American Family Physician. 2010;82(2):169-74.
Poonai N, van Diepen S, Bharatha A, Manduch M, Deklaj T, Tarlo SM. Barriers to diagnosis of occupational asthma in Ontario. Canadian Journal of Public Health. 2005;96(3):230-3 DOI: 10.1007/bf03403697.
Verger P, Viau A, Arnaud S, Cabut S, Saliba ML, Iarmarcovai G, et al. Barriers to physician reporting of workers' compensation cases in France. International Journal of Occupational and Environmental Health. 2008;14(3):198-205 DOI: 10.1179/oeh.2008.14.3.198.
Uzmezoglus B, Ocaktan ME, Sari G, Caliskan D. Awareness of Occupational Diseases in Training Internal Medicine: The Importance of Continuing Education. Cyprus Journal of Medical Sciences. 2019;4(1):5-13 DOI: 10.5152/cjms.2019.497.
Ofili AN, Ugwu EN, Ziregbe A, Richards R, Salami S. Knowledge of disease notification among doctors in Government hospitals in Benin City, Edo State, Nigeria. Public Health. 2003;117(3):214-7 DOI: https://doi.org/10.1016/S0033-3506(02)00021-5.
Arnaud S, Cabut S, Viau A, Souville M, Verger P. Different reporting patterns for occupational diseases among physicians: a study of French general practitioners, pulmonologists and rheumatologists. Int Arch Occup Environ Health. 2010;83(3):251-8 DOI: 10.1007/s00420-009-0457-y.
Govender M, Ehrlich R, Mohammed A. Notification of occupational diseases by general practitioners in the Western Cape. South African Medical Journal. 2000;90(10):1012-4.
Prochaska JO, DiClemente CC. The transtheoretical approach2005. 147-71 p.
Shofer S, Haus BM, Kuschner WG. Quality of Occupational History Assessments in Working Age Adults With Newly Diagnosed Asthma. Chest. 2006;130(2):455-62 DOI: https://doi.org/10.1378/chest.130.2.455.
Simmons JM, Liebman AK, Sokas RK. Occupational health in community health centers: Practitioner challenges and recommendations. New solutions: A Journal of Environmental and Occupational Health Policy. 2018;28(1):110-30 DOI: 10.1177/1048291117749937.
Holness DL, Tabassum S, Tarlo SM, Liss GM, Silverman F, Manno M. Practice Patterns of Pulmonologists and Family Physicians for Occupational Asthma. Chest. 2007;132(5):1526-31 DOI: https://doi.org/10.1378/chest.06-2224.
Ripabelli G, Tamburro M, Di Tella D, Carrozza F, Sammarco ML. Asbestos Exposures, Mesothelioma Incidence and Mortality, and Awareness by General Practitioners in the Molise Region, Central Italy. Journal of Occupational and Environmental Medicine. 2018;60(2):E90-E7 DOI: 10.1097/jom.0000000000001211.
Miedema HS, van der Molen HF, Kuijer P, Koes BW, Burdorf A. Incidence of low back pain related occupational diseases in the Netherlands. European Journal of Pain. 2014;18(6):873-82 DOI: 10.1002/j.1532-2149.2013.00430.x.
Armitage CJ, Conner M. Efficacy of the theory of planned behaviour: A meta-analytic review. British Journal of Social Psychology. 2001;40(4):471-99 DOI: 10.1348/014466601164939.
Curti S, Sauni R, Spreeuwers D, De Schryver A, Valenty M, Rivière S, et al. Interventions to increase the reporting of occupational diseases by physicians. Cochrane Database of Systematic Reviews. 2015(3) DOI: 10.1136/oemed-2015-103209.
Webb G, Redman S, Wilkinson C, Sanson-Fisher R. Filtering effects in reporting work injuries*. Accident Analysis & Prevention. 1989;21(2):115-23 DOI: 10.1016/0001-4575(89)90081-x.
Alaguney ME, Yildiz AN, Demir AU, Ergor OA. Physicians’ opinions about the causes of underreporting of occupational diseases. Archives of Environmental & Occupational Health. 2020;75(3):165-76 DOI: 10.1080/19338244.2019.1594663.
Pedroso HC, Gonçalves CGO. Primary care health professionals' perception and knowledge on notification of noise-induced hearing loss in Curitiba - Paraná. CODAS. 2016;28(5):575-82 DOI: 10.1590/2317-1782/20162015264.