Knowledge and attitude regarding mercury hygiene and their predictors among primary healthcare workers in Seremban, Negeri Sembilan

Background: Mercury poses a serious threat to human and environmental health. In Malaysia, health industry contributes to approximately 10% of mercury emission, mainly from incineration of medical waste, mercury-containing equipment and dental amalgams. Healthcare workers are potentially at risk for occupational mercury exposure, thus, should be equipped with proper training in mercury hygiene to ensure safety and health at work as well as to reduce the impact of mercury on the environment. Nevertheless, currently, data on knowledge and attitude regarding mercury hygiene among healthcare workers in Malaysia is scarce. Objectives: To assess the level of and predictors for good knowledge and favourable attitude regarding mercury hygiene among primary healthcare workers in Seremban, Negeri Sembilan. Methodology: An analytical cross-sectional study was conducted in health facilities in Seremban, Negeri Sembilan from April 2017 to June 2017 among 578 primary healthcare workers. Respondents were selected based on their job using proportionate stratified random sampling method and handed a validated self-administered questionnaire that focused on knowledge and attitude regarding mercury hygiene. Data was analysed using SPSS version 22.0. The Chi-square Test of Independence was used to determine the association between categorical variables. Multiple logistic regression using Enter method was used to identify significant predictors. Results: The response rate was 91%.The median age of respondents was 33 years (IQR = 29, 38) and ranged from 22 to 59 years. The majority of respondents were staff nurses (20.0%), worked in health clinics (71.4%) and had less than 10 years of working experience (57.2%). Only 23.7% of the respondents had attended training in mercury hygiene, 15.4% had previous exposure to mercury spillage and 8.1% had prior experience in cleaning mercury spillage. The results showed that 81.2% of respondents had good knowledge while only 45.2% had favourable attitude towards mercury hygiene. Six factors, namely; level of education, monthly income, job, workplace, working experience in the Ministry of Health (MOH) and training in mercury hygiene, were found to be associated with knowledge and attitude regarding mercury hygiene. Significant predictor for good knowledge was job; being a health professional and a health associate professional increased the odds of attaining good knowledge by six (AOR = 5.94, 95% CI [2.25, 15.66], p < 0.001) and three times (AOR = 2.83, 95% CI [1.47, 5.46], p = 0.002), respectively, compared to a personal care workers in health service. Significant predictor for favourable attitude was good knowledge; respondents with good knowledge had three times higher odds of favourable attitude than those with poor knowledge (AOR = 2.75, 95% CI [1.66, 4.56], p < 0.001).Conclusion: Attitude towards mercury hygiene among primary healthcare workers in Seremban was poor despite good knowledge. Future mercury hygiene awareness programme, education and training should focus on personal care workers in health service with emphasis on the importance of mercury hygiene and behaviourally-relevant knowledge.

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