jL. . . Universiti Malaysia

V PAHANG Engineering . Technology Creativity FACULTY OF TECHNOLOGY

FINAL EXAMINATION

COURSE : OCCUPATIONAL EPIDEMIOLOGY AND

DISEASE

COURSE CODE : BPS4423

LECTURER : DR. NORAZURA BINTI ISMAIL

DATE : 15 JANUARY 2013

DURATION : 3 HOURS

SESSION/SEMESTER : SESSION 2012/2013 SEMESTER I

PROGRAMME CODE : BPS

INSTRUCTIONS TO CANDIDATE:

1. This question paper consists of TWO (2) sections. 2. Answer ALL questions. 3. All answers to a new question should start on new page. 4. All the calculations and assumptions must be clearly stated. 5. Candidates are not allowed to bring any material other than those allowed

by the invigilator into the examination room.

DO NOT TURN THIS PAGE UNTIL YOU ARE TOLD TO DO SO

This examination paper consists of FOUR (4) printed pages including front page.

CONFIDENTIAL

BPS/12 13! /BPS4423

SECTION A

QUESTION 1 A case control study was conducted among men in Malaysia in order to find out whether a mother's use of hormones during pregnancy influenced her son's risk of developing testicular cancer later in life. Investigators selected 450 cases who were hospitalized for testicular cancer and 850 controls. The study found that 95 cases's mothers and 55 controls's mothers had used hormones during pregnancy.

a) Set up two-by-two table for these data(4 Marks)

b) Calculate the odds ratio(2 Marks)

c) State in words your interpretation of this odds ratio(2 Marks)

QUESTION 2

You are the Occupational Safety and Health Officer in a paint manufacturing industry. Year end report for burden of diseases among the workers in the factory shows remarkable increase in the number of neurobehavioral problem such as numbness among the workers exposed to chemical used mainly organic solvents. You were given a task to produce a report and make the conclusion on the factors contributing to respiratory health effects among the workers. In preparing the proposal for the study;

a) Identify the appropriate study design for this case.(1 Mark)

b) Describe the reason for the type of study selected in (a)?(2 Marks)

c) Explain the measurements obtained from the type of study selected in (a). (3 Marks)

d) Discuss the limitations of the study.(3 Marks)

e) Identify a potential confounder and discuss how you control the confounder. (3 Marks)

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CONFIDENTIAL BPS/12131 /BPS4423

SECTION B Instruction: answer ALL questions

QUESTION 1 a) Discuss the following types of research design in terms of strengths and limitations

in determining cause-effect relationships: i. Case-control study ii. Prospective cohort study iii. Experimental study

(12 Marks)

b) Identify and explain the appropriate study design to determine the prevalence of restrictive lung impairment among workers exposed to carbon black in a tyre manufacturing industry. Your explanation must include sample selection, advantages and disadvantages of the study design.

(8 Marks)

QUESTION 2

a) Discuss the epidemiologic triad of disease. Explain a factor relating to host and agent that influence disease transmission.

(8 Marks)

b) Describe FOUR (4) levels of prevention for communicable disease. Give an example of action at each level which would be appropriate as part of a comprehensive programme to prevent tuberculosis.

(12 Marks)

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QUESTION 3

a) Based on Table 1, smoking and exposure to asbestos interact, creating exceedingly high lung cancer rates for workers who both smoke and are exposed to asbestos dust. Discuss the contribution of asbestos exposure and smoking to the risk of lung cancer.

Table 1: Age-standardized lung cancer death rates (per 100 000 population) in

relation to cigarette smoking and occupational exposure to asbestos dust Exposure to asbestos History of cigarette

smokingLung cancer death rate per

100 000 No No 11 Yes No 58 No Yes 123 Yes Yes 602

(6 Marks)

b) Based on Table 2, explain which age group is more susceptible to the effects of lead. Discuss which effect is the more sensitive indicator of lead exposure.

Table 2: Lowest blood lead levels (ig/l) at which effects on health have been reported

in children and adultsEffect Children Adult

Decreased haemoglobin 40 50 levels Changes in 25 40 neurobehavioural function

(6 Marks) c) Define systematic error in epidemiological studies. Explain TWO (2) types of

systematic error and how to reduce their effects.(8 Marks)

END OF QUESTION PAPER 4

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