Introduction: Risk factors for Parkinson’s disease (PD) fall into three broad categories, namely environmental, genetic, and lifestyle factors. Identifying environmental factors that increase the risk of PD would allow these exposure to be reduced and the disease prevented while facilitating experimental investigation of mechanisms and intervention options. Thus, the aim of this review is to summarise the current evidence on the role of environmental factors in the development of PD. Methods: All original articles published between 2018 and 2022 and written in English were searched from three databases, i.e., PubMed, Scopus Web of Science (WoS), using combination of primary keyword (PD and its MeSH and synonyms), and two secondary keywords; (“environment*”) and risk (factor*). Result: After a thorough screening process, nineteen articles were included in this scoping review. The environmental risk factors examined in the included studies fell into five categories: a) pesticide exposure, b) heavy metals and organic solvent exposure, c) drug abuse and d) air pollution and e) source of water. Conclusions: In summary, PD is a complex neurological disorder for which there are several environmental risk factors involved. Identifying and reducing exposure to these environmental factors could have a significant impact on the future occurrence of the disease.
Introduction: Over the past two years, coronavirus disease 2019 (COVID-19) and tuberculosis (TB) have killed over 5.7 million people globally. TB and COVID-19 continue to be significant public health problems worldwide. A growing body of research supports a link between socio-environmental factors and the transmission of COVID-19 and TB disease. Methods: This review article discussed the socio-environmental factors influencing the transmission, prevention, and control of COVID-19 and Tuberculosis disease. Result: In this review, we highlight similarities and differences between these two infectious diseases and explore the roles of socio-environmental factors (air pollution exposure and climate change) and socioeconomic factors in disease transmission. A comprehensive, integrated TB-COVID-19 management for prevention and disease control, which includes administrative, engineering, environmental control, effective personal protective equipment, and community-based public health activities were discussed. Conclusion: Understanding the similarities and differences between these two infectious diseases and the role of socio-environmental factors in disease transmission helps in planning and strengthening an integrated system for disease prevention and control strategies.
Introduction: COVID-19 is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus-2. Methods: A cross-sectional study aimed to investigate the knowledge, attitude, and practice of COVID-19 among diploma students. A total of 120 students were recruited from students of the diploma program at the Sirindhorn College of Public Health, Ubon Ratchathani, Northeastern Thailand. An online survey was obtained in June 2021. Data were analyzed using descriptive statistics and the independent t-test to understand the relationship between variables. Results: The results found that most participants were female (87.5%), and the mean age was 22 years. The participants (59.17%) studied the Diploma of Sciences program in Emergency Medical Operation. The majority of them (49.71%) were in the first year. 93.33% of them were not underlying diseases (49.71%). The majority of respondents (57.5%) had a strong knowledge of COVID-19 (mean=17, S.D.=1.83). The majority of individuals (66.7%) had a positive attitude (mean=3.24, SD=1.35), and 80 % had good COVID-19 preventive behavior (mean=3.54, S.D.=1.35). When comparison of variables between knowledge, attitude, and practice for the prevention of COVID-19. The relationship between COVID-19 preventative behavior and variables such as gender, study program, and attitude toward the virus was statistically significant at p<.05. Conclusion Even though our results indicate that the students had a positive attitude and practice regarding COVID-19. The knowledge, attitude, and practice about COVID-19 in participants' education remain to be continually improved.
Introduction: Malaysia’s economic development leads to increased demand for immigrant workers. This article addresses the challenges of immigrant health equity. Methods: A comprehensive literature review was conducted to analyze the existing literature and identify key findings. Results: Immigrants face health inequalities due to complex immigration policies, and cultural and social differences that result in poor health outcomes among immigrants. Discussion: Comprehensive strategies need to be addressed relating to immigration policy and social and cultural differences in order to ensure access for all immigrants Conclusion: Efforts should be made to provide equitable healthcare access to ensure that all immigrants receive optimum health equality in Malaysia.
Introduction: Haze imposes a substantial health burden especially in Southeast Asia where occurrences are frequent. Reduction in air quality levels has resulted in an increase in healthcare utilization, especially to the front door of healthcare, the emergency department (ED). Data on ED utilization during haze period is lacking. Methods: This is a retrospective study aimed to determine the association between haze and ED utilization of haze-related acute respiratory illnesses between April 2013 to September 2013. The study period was divided into haze/ non-haze period. Clinical data was collected from the registration book and patients’ case notes. Environmental data was obtained from Institute of Environment and Development Universiti Kebangsaan Malaysia. Results: Total number of patients presented to ED during the study was 32,661. Fifteen percent (n= 5177) presented with acute respiratory symptoms. Total Emergency Department visits during haze period reduced due to emergency declaration, hence reducing non-emergency visits. However, there was a significant increase in hospital admission (p=0.0015) and infective respiratory illnesses (p=0.001) during haze which correlates with increase air pollutant. Patients with chronic respiratory illnesses were more affected by haze (p = 0.001). PM10 and ozone were the main pollutant during the haze period. Conclusion: Increasing pollutant levels from the haze significantly increases ED hospital admission. Evidence from this study can influence policymakers to prepare and allocate resources to hospitals in response to haze-related illnesses.
Introduction: Air pollution and air quality are growing concerns among urban citizens of Southeast Asia, especially the University students who devote most of their days to the vicinity of campus. However, there is limited data available on the extent of the problem, as well as an understanding of the knowledge of and perceptions of people who may be exposed to poor air quality. Methods: This focused study evaluated University students’ opinions, perceptions, and behavioral responses to local air quality in the Iskandar Puteri, Johor region of Malaysia using an online questionnaire, and measurements of NO2, SO2, formaldehyde, and particulate matter levels in the area using diffusion tubes. All air quality parameters were within the standards recommended by the local environmental authority, however, NO2 levels exceeded the recommended World Health Organization (WHO) standards at all sites. Results: Questionnaire findings indicate that students most commonly suffered from respiratory diseases, and were very concerned about air pollution and its impacts. Respondents perceived the situation to be worse in the afternoons and weekends, corroborated by the PM2.5 readings in the area. Preferred preventive measures included wearing masks and limiting active time outdoors. Conclusions: The evidence from this study highlighted the need to improve air quality in Iskandar Puteri as the NO2 level exceeded international standards for human health at all study sites. This could be supported by educational programs for industry, limitations on traffic emissions, and general awareness of air quality issues present locally.
Introduction: A healthy home is a physical building that meets health criteria. The surrounding environment benefits physical and mental health and provides an appropriate social environment for family and individual health. Acute Respiratory Infection (ARI) is one of the effects of diseases caused by houses that do not meet healthy housing standards. ARI incidence was ranked 5th in Banten Province, with a prevalence of 17.7%. This study aims to determine whether healthy home indicators affect the incidence of ARI in assisted families in Tangerang Regency, Banten Province. Material and Methods: This analytic study with a cross-sectional approach was conducted on 115 Kresek Village and Kemiri Village residents, who were taken using a purposive sampling technique. Methods of data analysis using univariate, bivariate, and multivariate analysis using software IBM-SPSS version 29.0 and Microsoft Excel. Results: ARI was found in 50.4% of people in the past three months. There was a significant effect (P<0.05) between the incidence of ARI and indicators of a healthy home, specifically the area of ventilation in the house (P=0.002, OR:3.5, 95% CI 2.1 - 28.4) and opening the windows in the family room (P=0.030, OR:3.5, 95% CI 1.3 - 10.78). Conclusion: The indicator that most dominantly influenced the incidence of ARI in this study was the ventilation indicator. Thus, a strategy is needed to increase the use of ventilation by the people of Tangerang Regency. Keywords: Healthy Homes; Acute Respiratory Infections (ARI); Ventilation; Indicators
Introduction: The present study determined the adversity quotient (AQ) and the school connectedness (SC) of education students in one of the state universities in Region VII, Philippines and establish if there is an influence between AQ and SC. Methods: Randomized sampling through fishbowl technique was employed in this study which were participated by one hundred (100) third year Education students from Bachelor of Elementary Education (BEED) and Bachelor of Secondary Education (BSED). There were two (2) major research tools used: AQ using student norm and self-made school connections checklist. Results: The result revealed a significant relationship between overall AQ and SC of the respondents by computing Pearson Product Moment Correlation (Pearson r). However, the reach dimension of AQ showed no significant relationship between factors of SC. Lastly, AQ does not affect the respondents’ connectedness in school in factors like commitment to education and school environment. Conclusions: Hence, this study concluded that AQ is a predictor of SC.
Introduction: The global impact of the coronavirus disease 2019 (COVID-19) pandemic has continually jeopardized vulnerable populations encompassing children, youth, elders, and individuals with immunodeficiency and comorbidities. Methods: In recognizing the crucial role of predictive analytics in shaping public health decisions, this study utilizes a predictive design, drawing on official data from the Department of Health (DOH) in the Davao Region, Philippines, spanning 57 days from March 15 to May 10, 2020. By comparing the Susceptible, Infected, Recovered (SIR) model and the Autoregressive Integrated Moving Average (ARIMA) model, the research aims to provide a scientific foundation for informed decision-making by public health authorities. Result: Analysis revealed that the SIR model emerged as the most effective in identifying trends and forecasting future cases. Despite both models indicating a substantial reduction in infection rates, caution is advised against discontinuing control and preventive measures due to the latent potential for another surge. The findings underscore the necessity for scientifically forecasted data to guide decision-makers in enhancing the responsiveness of public health services during similar and potentially worsening conditions. Conclusions: Hence, this study contributes to the ongoing pandemic preparedness and responsiveness discourse. Its emphasis on predictive analytics, particularly the SIR model, offers valuable insights for authorities tasked with safeguarding public health. The significance lies in addressing the current situation in the Davao region and providing a template for future scenarios. As the world grapples with the unpredictable nature of infectious diseases, informed decision-making based on scientific forecasts becomes imperative for effective public health management.
Introduction: Tuberculosis (TB) patients default their treatment during the treatment course. Therefore, this study aims to analyze the demographic characteristics of the patient who missed follow-ups and identify the reasons for missed appointments or defaulted their treatment. Methods: The records of patients diagnosed with TB follow-up at the chest clinic from January to June 2023 were reviewed based on our inclusion and exclusion criteria. Results: The retrospective descriptive analysis was conducted based on the data collected. Based on the study sample (n=33), the result shows that the majority of the defaulted patients were male in gender (n=22). Most of the missed appointments patients and defaulters are of Malay (39.4%) ethnicity and Malaysian nationality (66.7%). Most patients gave the transport issues as the reason for missed appointments followed by financial issues and feeling healthy. The majority of them missed follow-up in the first month after starting anti-TB. Conclusions: In conclusion, missed appointments, treatment compliance and defaulted cases in TB treatment remain as one of the main challenges in the effort to end TB epidemics. Further in-depth research is required to propose effective measures to solve this issue and improve the national TB control program.
Pengenalan Soal selidik sebagai alat untuk mengukur faktor sosiobudaya berkaitan COVID-19 masih belum digunakan secara meluas oleh kebanyakan penyelidik. Di Malaysia, tiada soal selidik yang dibina dan disahkan untuk tujuan tersebut. Oleh itu, tujuan kajian ini adalah untuk membina dan mengesahkan soal selidik sebagai alat ujian yang baru bagi mengukur faktor sosiobudaya berkaitan COVID-19 dalam kalangan Orang Asli di Malaysia. Metodologi Kajian rintis ini melibatkan 30 orang penduduk Orang Asli di Pos Lenjang, Kuala Lipis, Pahang. Indeks Kesahan Kandungan (CVI) digunakan untuk menguji kesahan kandungan soal selidik, manakala kesahan konstruk dan kebolehpercayaan konsistensi dalaman soal selidik ditentukan menggunakan Exploratory factor analysis (EFA) dan Cronbach’s Alpha. Hasil Kajian Satu set soal selidik terdiri daripada empat konstruk telah dibina iaitu kepercayaan, amalan perubatan tradisional, adat dan budaya tradisional, dan sokongan sosial. Sebanyak 16 item telah dikekalkan di dalam EFA dengan nilai Cronbach’s Alpha setiap konstruk adalah 0.617, 0.778, 0.773 dan 0.779. Rumusan Soal selidik yang telah dibina ini berjaya divalidasi dan boleh digunakan untuk mengukur faktor sosiobudaya berkaitan COVID-19 dalam kalangan Orang Asli. Walau bagaimanapun, penambahbaikan masih perlu dilakukan dari masa ke semasa untuk memastikan soal selidik ini relevan terutamanya jika ia digunakan ke atas populasi atau dari negara yang berbeza dari Malaysia, dengan mengambil kira juga penyakit yang berbeza. Kata Kunci Sosiobudaya - COVID-19 - Orang Asli - kepercayaan - perubatan tradisional – adat budaya tradisional – sokongan sosial.
Introduction: Concerns about the quality of life (QoL) of parents of children with autism spectrum disorder have been raised by previous study. Policy decision-makers and healthcare professionals can be better informed about the environmental factors associated with parental QoL, which will enhance outcomes for both parents and children. The objective of this review is to perform a comprehensive review that assessed the environmental relevant factors associated with quality of life (QoL) of parents of ASD children (under 18 years old). Methodology: To identify the environmental factors associated with parental QoL, a scoping review was conducted using the Arksey and O'Malley original and enhanced framework. Three electronic data bases (PubMed, Scopus & WOS) and reference list checks were used in the search. Results: Social support, family support, residential condition and access to services were all factors linked to parental quality of life in this group. Conclusion: The review clarified environmental factors as one of variables that have association with parental QoL. The results of this analysis also highlighted potential areas of support that have implications on future policy and practices. Keywords : environmental factors, autism spectrum disorder, quality of life, parents, children References CDC. Prevalence of autism spectrum disorders--Autism and Developmental Disabilities Monitoring Network, 14 sites, United States, 2008. MMWR Surveill Summ. 2012;61(3):1-19. CDC. Prevalence of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2010. MMWR Surveill Summ. 2014;63(2):1-21. Elsabbagh M, Divan G, Koh Y-J, Kim YS, Kauchali S, Marcín C, et al. Global Prevalence of Autism and Other Pervasive Developmental Disorders. Autism Research. 2012;5(3):160-79. McTiernan A, Leader G, Healy O, Mannion A. Analysis of risk factors and early predictors of challenging behavior for children with autism spectrum disorder. Research in Autism Spectrum Disorders. 2011;5(3):1215-22. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921-9. Bolton PF. Medical conditions in autism spectrum disorders. Journal of Neurodevelopmental Disorders. 2009;1(2):102-13. Khanna R, Madhavan SS, Smith MJ, Patrick JH, Tworek C, Becker-Cottrill B. Assessment of Health-Related Quality of Life Among Primary Caregivers of Children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. 2011;41(9):1214-27.
There has been growing recognition linking spread of COVID-19 with environmental factors. One of the environmental factors with robust epidemiological literature supporting its role in diseases is the housing or built environment. COVID-19 spread has been found to occur mostly at homes through secondary household transmission. As most people spend more times inside homes during the pandemic, household remains an important site of COVID-19 spread. The aim of this study is to examine how housing and indoor factors affect the transmission and spread of COVID-19. This article summarizes the housing indoor factors involved in COVID-19 transmission, including the role of transmission from contaminated household surfaces. Indoor transmission of COVID-19 is found to be more likely due to contact transmission and close-contact aerosol transmission in a crowded, confined, and poorly ventilated indoor environment, related to poor housing condition. Whilst role of spread through contaminated household surfaces is of low probability. Based on this review, it can be suggested that besides the existing measures including avoiding crowding, close contacts and proper ventilation, specific standards for indoor environmental quality control and housing condition might be required. Housing is a public health issue and healthy housing is of universal concern.
Introduction: Elderly is a vulnerable population that is prone to sarcopenia which is associated with the loss of muscle mass, strength and function which are some of the diseases that affect the elderly. The association between environmental factors with sarcopenia should be explored as it has the potential to influence the health and disability of a person. At present, limited research is conducted to investigate the association that could be attributed to the complex interaction between human and environmental interactions. Hence this review is conducted to identify the environmental factors associated with sarcopenia. Methods: A systematic review was conducted using PubMed, SCOPUS, Web of Science and manual search following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. We used articles that had been written in English and relevant articles were then screened, duplicates were removed, eligibility criteria were applied, and studies that met the criteria were reviewed. The keywords environmental factors, pollutants food environment, neighbourhood environment, locality and sarcopenia were included. Results: Initial search generated 934 publications and 12 articles were included after the inclusion and exclusion criteria for this review. In this review, environmental factors associated with sarcopenia are divided into 3 themes that comprises of food environment (availability and physical access, economic access and food quality and safety), neighbourhood environment and pollutants. Conclusion: This systematic review revealed an association between the food environment, neighbourhood environment and pollutants with sarcopenia. The findings are salient as they could aid policymakers in formulating the necessary strategy to reduce the morbidity and mortality associated with sarcopenia, especially with the increase in the ageing population globally. Keywords: Environmental factors - elderly - sarcopenia
Introduction: Commuting accidents (CAs) caused significant detrimental impacts on the Malaysian fire department. Therefore, this study aims to identify factors of CA by mainly focusing on environmental factors. Methodology: The qualitative data was obtained from accident investigation reports from five states (Kedah, Selangor, Kuala Lumpur, Negeri Sembilan and Johor) between 2017-2021. The data were analysed using content analysis. Results: The identified environmental factors categories were 1) environmental conditions, 2) time, 3) road conditions and 4) road environment. Conclusion: These findings provide valuable information on environmental factors that contributed to accidents among firefighters, which could be useful for future research and intervention plans. Keywords: Commuting accident – environmental factor - firefighter
Introduction The construction workers are performing manual tasks in harsh conditions. Various environmental risk factors could have significant influence on work fatigue. Methods This review article discussed the environmental causal factors which involved in work fatigue development in the occupational health perspective, with the aim in enhancing the body of knowledge specifically in the construction industry so that mitigation measures and interventions can be formulated and implemented for fatigue prevention and productivity enhancement. Results Data derived from a total of 11 relevant articles identified climatic heat, vibration and elevation change as the major risk factors that associated with work fatigue. The mechanism of the environmental factors’ influences on muscle, mental and visual fatigue were understood, pointedly the underlying physiological alteration. Additionally, appropriate preventive measures in accordance to the OSHA guides including work-break cycles, work management, cool-down arrangements with drinking water were discussed. The limitation of existing OSH requirements on work limits at heat exposure was recognized, including the lack of consideration on personal characteristics therefore might inaccurately estimate the personal heat tolerance time. Conclusions The proper understanding of the environmental stressors and its impact on workers production and safety performance may help construction organisations and regulatory body to develop strategies for workers protection and fatigue-related accidents prevention. Keywords Environmental influence - Risk factors - Fatigue - Construction
Air pollutants including PM2.5 are an increasing threat to public health. Studies have reported the adverse effect of PM2.5 exposure during pregnancy on neurodevelopment in children. We performed a narrative review using the PubMed, Web of Science and Scopus databases using keywords such as prenatal, particulate matter, neurodevelopment, and children. This review aims to identify symptoms of impaired neurodevelopment in children associated with prenatal PM2.5 exposure, the association between the timing of prenatal exposure PM2.5 and symptoms of impaired neurodevelopment in children as well as other factors that may influence the association of prenatal PM2.5 exposure and symptoms of impaired neurodevelopment in children. 25 papers were included in this review. There are ranges of symptoms of neurodevelopmental impairment associated with prenatal exposure of PM2.5, including language, speech, and communication symptoms; motor skills; behaviour and social skills; memory as well as learning/cognitive symptoms. Neurodevelopmental impairments were associated with exposure to PM2.5 across all three trimesters with impairment in communication and behavioural domains predominate in those exposed during the first trimester. Generally, male was more susceptible to having neurodevelopmental impairment symptoms compared to females. More information regarding the effect of prenatal PM2.5 exposure towards neurodevelopmental domains of the children will support public health policies that reduce air pollution and improve children’s health.
Background: Taxing sugar-sweetened beverages (SSB) is one of many other best strategies to reduce consumption of SSB among populations. It is known that SSB consumption is the main contributor which cause obesity and further lead to non-communicable diseases. This study aimed to gather the evidence on the effectiveness of sugar-sweetened beverages tax implementation, in terms of health outcome and healthcare cost benefit. Methodology: A systematic review was done related to literature that reported about effectiveness of sugar-sweetened beverages tax implementation, in terms of health outcome and healthcare cost benefit. Four databases were used to identify the literature, namely PubMed, Cochrane, Scopus and Ovid and Medline. PRISMA flow checklist was used as a guide to search for the eligible articles. Results: In total, there were sixteen eligible articles included in this systematic review. All studies are simulation studies. Results shows that both excise and ad valorem tax are effective to reduce healthcare costs and could avert diseases related to high sugar intake. Other than that, it is proven that implementing tax will gain favorable health outcome rather than do nothing. Better results seen when the tax is increased. Conclusion: As a conclusion, SSB tax is proven as an effective public health intervention in terms of giving benefit to the health outcome and healthcare cost. Keywords: sugar-sweetened beverages tax, effectiveness, health, healthcare costs
Introduction: Influenza is an upper respiratory infection is caused by the influenza virus. It occurs throughout the whole year in Malaysia with occasional outbreaks. Influenza-like illnesses (ILI) are generally treated as outpatient care while the more severe ‘SARI’ is managed in patient care. The Casemix system, used in healthcare professionals' practices, may help in estimating the cost of influenza management.Methods: This cross-sectional study extracts the cost of influenza management from different public hospitals in years 2016, 2017 and 2018. Data used selected ICD-10 codes, and the cost was abstracted from Malaysian Diagnostic Related Groups (MyDRG) software. The secondary data are from 2 sources, an urban teaching hospital Hospital Cancellor Tuanku Muhriz (HCTM) and Ministry of Health (MoH) inpatient hospitals database. The sample size of the study was 586, while a structured datasheet collating patients’ sociodemographic data and cost of admission, per case, was obtained from the MyDRG software. Microsoft Excel and SPSS software were used in the analysis.Results: Most influenza cases (61.8%) are between the ages of 0 and 10, Malays, and have similar gender proportions. Overall, the influenza treatment cost for inpatient care, totalled to RM 294,017,112. In 2018, the GDP for health consumed 3.76% of Malaysia's GDP income of RM 1.4 trillion, with an estimated RM 60,339 million used for health. Thus, the three-year public cost consumed 0.5% of 2018 GDP.Conclusion: Influenza screening at the primary healthcare setting, health education and treatment compliance should be scale-up to minimize the cost of influenza management of the public providers.
Pengenalan Pencemaran sungai di Malaysia pada masa ini berada di tahap yang kritikal dan amat membimbangkan dengan pelbagai masalah pencemaran sungai berlaku hampir setiap hari. Tahap pengetahuan, sikap dan tingkah laku individu memberikan impak yang besar terhadap isu pencemaran sungai. Oleh itu, kajian ini bertujuan untuk menilai tahap pengetahuan, sikap dan tingkah laku komuniti yang tinggal berhampiran Sungai Klang. Metodologi Kajian keratan rentas yang menggunakan persampelan rawak mudah telah dilakukan untuk mengkaji tahap pengetahuan, sikap dan tingkah laku komuniti Sungai Klang terhadap pencemaran sungai. Responden kajian terdiri daripada penduduk kawasan setinggan dan penduduk kawasan perumahan biasa yang menetap berhampiran Sungai Klang. Kajian ini telah menggunakan borang soal selidik. Analisis deskriptif dan ujian t telah digunakan untuk menganalisis data. Hasil Kajian Hasil deskriptif mendapati bahawa tahap pengetahuan (min=3.13, s.p.=0.40), sikap (min=3.28, s.p.=0.65) dan tingkah laku (min=2.96, s.p.=0.72) pencemaran sungai bagi penduduk setinggan adalah lebih rendah daripada penduduk perumahan biasa. Ujian t juga menunjukkan perbezaan yang signifikan (p<0.05) untuk tahap pengetahuan, sikap dan tingkah laku antara penduduk setinggan dan penduduk perumahan biasa. Rumusan Kesimpulannya, tahap pengetahuan, sikap dan tingkah laku pencemaran sungai komuniti Sungai Klang berada di tahap yang tidak memuaskan. Oleh yang demikian, tindakan perlulah diambil oleh pihak yang berkaitan untuk memantapkan lagi tahap pengetahuan, sikap dan tingkah laku penduduk berkaitan pencemaran sungai agar isu pencemaran sungai ini dapat diatasi. Kata Kunci Pengetahuan – Sikap – Tingkah Laku – Pencemaran Sungai – Sungai Klang
