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Universiti
Malaysia
V
P A H A N G
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)
2
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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CONFIDENTIAL

BPS/12131 1BPS4423
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
smoking
Lung cancer death rate per
100 000
No No 11
Yes No 5 8
No Yes
12 3
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 adults

Effect
Children
Adult
Decreased haemoglobin
40
5 0
levels
Changes in
2 5
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
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