1. Principle investigator: Dato’ Dr. Hajah Marlia Mohammed Salleh Co-investigators: Dr. Thillainathan Dr. Ng Kok Huan Presenter: YANTIE SHAHIDA BT ABDUL MANAN Pegawai Pendidikan Kesihatan Jabatan Kesihatan Negeri Pahang HEALTH SCREENING STUDY AMONG HOSPITAL STAFF

2. H EALTH S CREENING I We often assume that when a person is not sick - he or she must be in good health, but this is not always the case. The root of many common diseases such as HPT, DM, MI and cancer often set in years before the illness actually surfaces. Therefore, early detection of risk factors is essential (Patel et al. 2011).

3. H EALTH S CREENING II o As it not only improves chances of successfully treating early stages of medical conditions but also of preventing or delaying disease, thus maintaining a high quality of life and prolonged life expectancy. o CVD is one of the most prevalent and devastating health problems in the world and is responsible for approximately 30% of deaths worldwide (WHO, 2005) which equate to about 16.6 million deaths. (Erhardt, Moller & Puig, 2007). o Our study emphasized on coronary risk.

4. O BJECTIVES o General To investigate the health status of the staff o Specific Screening on => Obesity => BMI => MI risk => Procam => Lifestyle factors

5. S TUDY D ESIGN & S AMPLE S ELECTION Cross-sectional study All hospital staff with age ≥ 40 years old Duration: 3 months Study centre: HTAA Participants were asked to fast for at least 8 hours before the study begun

6. I NSTRUMENT Health status screening questionnaire Medical history Personal Particulars Personal Family Life style Basic health screening Biometry measurements PROCAM Screening Habits

7. o SPSS 17.0 for Windows was utilized. o Patients’ socio-demographic data was descriptively presented as frequencies and percentages. o Procam calculator was used to determine the risk of MI. S TATISTICAL A NALYSIS

8. P ROCEDURE Briefing. Agreement of participation. On the day of participation eligible participants were asked to  complete the instruments- BSSK/W/I/2008  biometry assessment  Blood pressure (Bp)  Waist circumference (WC)  Weight and height  Blood test => glucose, lipid profile

9. Male (n = 97) n (%) Female (n = 256) n (%) NationalityMalaysian Non- citizen 94 (96.9) 3 (3.1) 254 (99.2) 2 (0.8) Race RaceMalay Chinese/Indian/Othe rs 84 (86.6) 13 (13.4) 232 (90.6) 24 (9.4) ReligionIslam Buddha/Hindu/Christ ian/Others 82 (84.5) 15 (15.5) 233 (91.0) 23 (9.0) Level of education > Higher (> SPM) < Lower (≤ SPM) 33 (34.0) 64 (66.0) 45 (17.6) 211 (82.4) Marital Status Married Single/Divorce 94 (96.9) 3 (3.1) 3 (3.1) 235 (91.8) 22 (9.2) Results: Demography A total of 398 participants were recruited A total of 398 participants were recruited only 353 included in the analysis only 353 included in the analysis 97 male and 256 female 97 male and 256 female The average mean age for male participants was 48.59 The average mean age for male participants was 48.59 and female was 47.82 years

10. Female n (%)Male n (%) YesNoYesNo Breakfast208 (81.2)48 (18.8)90 (92.8)7 (7.2) Lunch207 (80.9)49 (19.1)78 (80.4)19 (19.6) Dinner200 (78.1)56 (21.9)81 (83.5)16 (16.5) Cereal249 (97.3)7 (2.7)91 (93.8)6 (6.2) Fruits219 (85.5)37 (14.5)62 (63.9)35 (36.1) Vegetables245 (95.7)11 (4.3)87 (89.7)10 (10.3) Dairy180 (70.3)76 (29.7)49 (50.5)48 (49.5) Meats242 (94.5)14 (5.5)89 (91.8)8 (8.2) L IFE S TYLE I HealthyHealthy

11. L IFE S TYLE II Female n (%) Male n (%) YesNoYesNo Smoking 4 (1.6) 252 (98.4) 26 (26.8) 71 (73.2) Alcohol 3 (1.2) 253 (98.8) 7 (7.2) 90 (92.8) Drugs 3 (1.2) 253 (98.8) 1 (1.0) 96 (99.0) Other substances 0 (0.0) 256 (100.0) 0 (0.0) 97 (100.0) Female n (%)Male n (%) < 3 times a week ≥ 3 times a week < 3 times a week ≥ 3 times a week Exercise > 30minutes > 3 times a week 202 (78.9)54 (31.1)61 (62.9)36 (37.1) HealthyHealthy

12. L IFE S TYLE III Female n (%) Male n (%) DepressionYesNoYesNo Symptom 1 59 (23.0) 197 (77.0) 5 (5.2) 92 (94.8) Symptom 2 24 (9.4) 232 (90.6) 8 (8.2) 89 (91.8) HealthyHealthy Calculation of marks for life style health score: Yes = 5 mark No = 0 mark E.g- Scores for depression (yes, no) Sum of depression symptoms 1 + 2 / Total scores x 100 = 5 + 0 / 10 x 100 = 50% of risk of unhealthy life style

13. Female n (%) Male n (%) HealthyUnhealthyHealthyUnhealthy Eating Habits 203 (79.3) 53 (20.7) 51 (52.6) 46 (47.7) Substances 254 (98.8) 2 (7.8) 89 (91.8) 8 (8.2) Physical activities 202 (78.9) 54 (31.1) 61 (62.9) 36 (37.1) Depression 215 (83.9) 41 (16.1) 91 (93.3) 6 (6.1) L IFE S TYLE III Score interpretation - 0- <50 – Healthy - >50 -100 – Unhealthy lifestyle - >50 -100 – Unhealthy lifestyleFemaleMaleHealthyUnhealthyHealthyUnhealthy Total lifestyle scores (mean) 85.218.975.224.8

14. P ROCAM I o The PROCAM Risk Scores? o It was developed based on 450 coronary events occurring in a cohort of about 5,000 men aged 35-65 years at recruitment and with at least 10 years of unbroken follow-up. o Generally two type => PROCAM Quick Check and the PROCAM Health Check. The PROCAM Quick Check: o o allows rapid initial assessment of coronary risk. o suitable for men and women aged 20-75 years.. o provides an estimation of risk sufficiently accurate to determine if further examination by a physician is advisable. Empana et al. 2003

15. Assessment Age Gender Glucose Smoking Anamnenies (Family medical history) Blood pressure Weight Hypertension history P ROCAM II Website: http://www.chd-taskforce.com/procam_interactive.html

16. R ISK F ACTORS : MI Female n (%) Male n (%) NormalAbnormalNormalAbnormal BMI 93 (36.3) 163 (63.7) 27 (27.9) 70 (71.1) Waist Circumference 59 (23.0) 197 (77.0) 31 (32.0) 66 (78.0) Blood Pressure 137 (50.3) 119 (46.5) 58 (59.8) 39 (40.2) Normal reading: BMI <25; WC<90 (M) <80 (F); BP<100 FemaleMeanMaleMean PROCAM Risk 1.432.47 n = 32 (12.5%) Ranging from 1 - 6.22 fold increased risk compared to risk of average person with same age n = 20 (20.6%) Ranging from 1 – 3.08 fold increased risk compared to risk of average person with same age n =18 (18.5%) The risk is lower than risk of average person with same age

17. D ISCUSSION & C ONCLUSION I o Female tend to possess better life style scores than male in terms of all lifestyle scores o Eating habits o Usage of substances o Physical activities o Majority of the staff were with healthy lifestyle => lifestyle score (mean scores> 75.5). o Procam results showed that the staff were at risk of CORONARY diseases particularly MI.

18. D ISCUSSION & C ONCLUSION II Limitation: - The instruments used was not tested on its psychometric. - Since the results was based on a sample of hospital staff therefore, we can’t generalize the results to other cohorts.Suggestion: - Future studies should also involved psychometric evaluation and quality of life assessments. - For intervention study with longitudinal designed should be implemented.

19. THE SCREENING WAS STRONGLY SUPPORTED BY HOSPITAL DIRECTOR

20. T HE STAFFS CONCENTRATED FILLING IN BSSK / W / I /2008 FORM

21. T OO SCARED ! B UT IT ’ S A MUST FOR AGE > 40 YEARS

22. S CREENING ! S CREENING ! H EALTH SCREENING !

23. R EFERENCES Patel, J. V., Gill, P. S., Chackathayil, J., Ojukwu, H., Stemman, P., et al. 2011. Short-Term Effects of Screening for Cardiovascular Risk in the Deaf Community: A Pilot Study. Cardiology Research and Practice. 10.4061/2011/493546 WHO. World Health Organization. 2005. Cardiovascular disease: Prevention and control. Geneva. Empanaa, J.P., Ducimetie`reb, P., Arveilerc, D., Ferrie`resd, J., Evanse, A., et al. 2003. Are the Framingham and PROCAM coronary heart disease risk functions applicable to different European populations? European Heart Journal 24, 1903–1911. International task force for prevention of coronary disease. 2010. http://www.chd-taskforce.com/procam_interactive.html http://www.chd-taskforce.com/procam_interactive.html Erhardt, L., Moller, R. & Puig, J.G. 2007. Comprehensive cardiovascular risk management – what does it mean in practice? 3(5): 587–603.

24. T HANK YOU