Background: Indoor microbial exposure is associated with asthma, but the health effects of indoor metabolites and chemicals have not been comprehensively assessed.Methods: We collected classroom dust from 24 junior high schools in three geographically distanced areas in Malaysia (Johor Bahru, Terengganu and Penang), and conducted culture-independent high-throughput microbiome and untargeted metabolomics/chemical profiling.Results: 1290 students were surveyed for asthma symptoms (wheeze). In each centre, we found significant variation in the prevalence of wheeze among schools, which could be explained by personal characteristics and air pollutants. Large-scale microbial variations were observed between the three centres; the potential protective bacteria were mainly from phyla Actinobacteria in Johor Bahru, Cyanobacteria in Terengganu and Proteobacteria in Penang. In total, 2633 metabolites and chemicals were characterised. Many metabolites were enriched in low-wheeze schools, including plant secondary metabolites flavonoids/isoflavonoids (isoliquiritigenin, formononetin, astragalin), indole and derivatives (indole, serotonin, 1H-indole-3-carboxaldehyde), and others (biotin, chavicol). A neural network analysis showed that the indole derivatives were co-occurring with the potential protective microbial taxa, includingActinomycetospora,FischerellaandTruepera, suggesting these microorganisms may pose health effects by releasing indole metabolites. A few synthetic chemicals were enriched in high-wheeze schools, including pesticides (2(3H)-benzothiazolethione), fragrances (2-aminobenzoic acid, isovaleric acid), detergents and plastics (phthalic acid), and industrial materials (4,4-sulfonyldiphenol).Conclusions: This is the first association study between high-throughput indoor chemical profiling and asthma symptoms. The consistent results from the three centres indicate that indoor metabolites/chemicals could be a better indicator than the indoor microbiome for environmental and health assessments, providing new insights for asthma prediction, prevention and control.

With the increasing challenge of addressing environmental health issues, various approaches have been proposed to reduce environmental problems. For Muslims all over the world, the Qur’an, Hadith, and Sunnah are recognised as the authoritative messages for spiritual and behavioural guidance on how humans can react to protect the environment and health. This review aims to integrate the environment with health from the perspective of Islam. An exploration of Qur’anic, Hadith, and Sunnah Muslim scholar views and articles was carried out to identify environmental health issues. Integrating Islamic aspects into environmental health includes: (i) environmental dimensions of natural and social environments; (ii) dimensions of health including disease, wellness, intellectual health, transcendence, and Qalbe Salim; and (iii) principles that can be used to describe people’s attitudes towards the environment through unity, balance, and responsibility. Differences between Islamic and Western views on the environment include that taqwa-centric is the highest level of environmental responsibility, with religious duty serving as the key driver of environmental activity. About 89 verses were identified in 42 Qur’anic chapters, with a strong emphasis on the health aspect in relation to the water, biodiversity, corruption of the earth, waste minimisation, and climate change. The Hadith and Sunnah highlight cleanliness as another important value in Islamic ethics, focusing on environmental conservation. Current and future research trends may be able to identify research gaps concerning the Islamic aspect of handling environmental health issues, which can then be implemented into the educational system. These findings imply that Islam could be a powerful source and educational medium for environmental health interventions in large communities, as well as for improving and preserving a healthy environment.

A prevalence study was conducted among office workers in Malaysia (N= 695). The aim of this study was to examine associations between asthma, airway symptoms, rhinitis and house dust mites (HDM) and cat allergy and HDM levels in office dust. Medical data was collected by a questionnaire. Skin prick tests were performed for HDM allergens (Dermatophagoides pteronyssinus, Dermatophagoides farinae) and cat allergen Felis domesticus. Indoor temperature and relative air humidity (RH) were measured in the offices and vacuumed dust samples were analyzed for HDM allergens. The prevalence of D. pteronyssinus, D. farinae and cat allergy were 50.3%, 49.0% and 25.5% respectively. Totally 9.6% had doctor-diagnosed asthma, 15.5% had current wheeze and 53.0% had current rhinitis. The Der p 1 (from D. pteronyssinus) and Der f 1 (from D. farinae) allergens levels in dust were 556 ng/g and 658 ng/g respectively. Statistical analysis was conducted by multilevel logistic regression, adjusting for age, gender, current smoking, HDM or cat allergy, home dampness and recent indoor painting at home. Office workers with HDM allergy had more wheeze (p= 0.035), any airway symptoms (p= 0.032), doctor-diagnosed asthma (p= 0.005), current asthma (p= 0.007), current rhinitis (p= 0.021) and rhinoconjuctivitis (p< 0.001). Cat allergy was associated with wheeze (p= 0.021), wheeze when not having a cold (p= 0.033), any airway symptoms (p= 0.034), doctor-diagnosed asthma (p= 0.010), current asthma (p= 0.020) and nasal allergy medication (p= 0.042). Der f 1 level in dust was associated with daytime breathlessness (p= 0.033) especially among those with HDM allergy. Der f 1 levels were correlated with indoor temperature (p< 0.001) and inversely correlated with RH (p< 0.001). In conclusion, HDM and cat allergies were common and independently associated with asthma, airway symptoms and rhinitis. Der f 1 allergen can be a risk factor for daytime breathlessness.

Background. Heat stress disorders may cause negative health outcome and subsequent productivity reduction especially in those who work under direct sunlight for an extended number of hours. Objective. This study assessed the impact of heat on the health and productivity among maize farmers in a hot tropical country. Methods. A cross-sectional study was conducted among 396 maize farmers, randomly selected across Gombe province, Nigeria. The wet bulb globe temperature monitor (WBGT) Model QuesTemp⁰36 was used in determining the heat index. Health was determined using a validated questionnaire, while productivity was determined by recording work output based on the number of ridges cultivated during the working hours. Results. The farms recorded mean heat index with standard deviation (SD) of 31.56 (2.19) and 34.08 (1.54) in the hours of 9 am to 12 pm and 12–3 pm respectively, which exceeded the threshold level set by the ACGIH. Heavy sweating (93.2%), tiredness (48.5%), dizziness (34.1%), and headache (40.4%) were experienced by the respondents almost on daily basis. The finding further showed a significant difference in the farmers’ productivity during the three time duration of the work day (p<0.001). The productivity was significantly higher between the hours of 6–9 am (p<0.001) and 12–3 pm (p<0.001), compared to the hours of 9 am to 12 pm (p<0.001). The factors that significantly predict the productivity outcome include temperature (p<0.001), gender (p<0.001), age (p=0.033), and BMI (p=0.008). Conclusion. The farmers were frequently experiencing heat exhaustion which decreased their productivity.