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At least 451 records · Page 25Linked to original sources

Noise exposure and hearing conservation in U.S. coal mines--a surveillance report.

This study examines the patterns and trends in noise exposure documented in data collected by Mine Safety and Health Administration inspectors at U.S. coal mines from 1987 through 2004. During this period, MSHA issued a new regulation on occupational noise exposure that changed the regulatory requirements and enforcement policies. The data were examined to identify potential impacts from these changes. The overall annual median noise dose declined 67% for surface coal mining and 24% for underground coal mining, and the reduction in each group accelerated after promulgation of the new noise rule. However, not all mining occupations experienced a decrease. The exposure reduction was accompanied by an increase of shift length as represented by dosimeter sample duration. For coal miners exposed above the permissible exposure level, use of hearing protection devices increased from 61% to 89% during this period. Participation of miners exposed at or above the action level in hearing conservation programs rapidly reached 86% following the effective date of the noise rule. Based on inspection data, the occupational noise regulation appears to be having a strong positive impact on hearing conservation by reducing exposures and increasing the use of hearing protection devices and medical surveillance. However, the increase in shift duration and resulting reduction in recovery time may mitigate the gains somewhat.

Coal Mining↗

Reversed blood flow during internal carotid artery stenting using Parodi Anti-Emboli System--progress in protection against cerebral stroke.

Carotid artery stenosis is one of the main causes of stroke. Nowadays two techniques for treating carotid stenosis are available - surgical endarterectomy and percutaneous angioplasty combined with stent implantation at the site of stenosis. Cerebral protection devices during internal carotid stenting significantly decrease the incidence of periprocedural complications, however, during the introduction of protective devices the cerebral blood flow remains unprotected. Therefore, the quest for a system specifically protecting cerebral flow during the whole procedure is still underway. Temporary reversal of carotid flow during the procedure using the Parodi Anti-Emboli System seems a viable solution. The present study describes the first two patients who underwent internal carotid artery stenting using this technique in our institution.

Journal Article↗

A comprehensive noise survey of the S-70A-9 Black Hawk helicopter.

PURPOSE: This paper reports the results of a comprehensive noise survey of the Sikorsky S-70A-9 Black Hawk helicopter environment and provides an assessment of the hearing protection devices worn by Australian Army personnel exposed to that environment. METHODS AND RESULTS: At-ear noise levels were measured at 4 positions in the cabin of the Black Hawk under various flight conditions and at 13 positions outside the Black Hawk under various ground running conditions using the Head Acoustic Measurement System (Head, GmbH). The attenuation properties of the hearing protection devices (HPDs) normally worn by aircrew and maintenance crews (the ALPHA helmet and the Roanwell MX-2507 Communications headset) were also assessed. At-ear sound pressure levels that would be experienced by personnel wearing their normal HPDs were determined at the positions they would normally occupy in and around the aircraft. CONCLUSION: Results indicate that HPDs do not provide adequate hearing protection to meet current hearing conservation regulations which allow a permissible noise exposure of 85 dB(A) for an 8-h day.

Acoustics↗

Are US hospitals making progress in implementing guidelines for prevention of Mycobacterium tuberculosis transmission?

BACKGROUND: Outbreaks of tuberculosis (TB) in hospitals have occurred when the Centers for Disease Control and Prevention (CDC) guideline recommendations for preventing the transmission of Mycobacterium tuberculosis were not fully implemented. OBJECTIVE: To determine whether US hospitals are making progress in implementing the CDC guidelines for preventing TB. METHODS: In 1992, we surveyed all public (city, county, Veterans Affairs, and primary medical school-affiliated) US hospitals (n = 632) and 444 (20%) random samples of all private hospitals with 100 beds or more. In 1996, we resurveyed 136 random samples (50%) of all 1992 respondent hospitals with 6 or more TB admissions in 1991. RESULTS: Of the 1076 hospitals surveyed in 1992, 763 (71%) respondents returned a completed questionnaire. Among these, 536 (71%) of 755 reported having rooms that met CDC criteria for acid-fast bacilli isolation, ie, negative air pressure, 6 or more air exchanges per hour, and air directly vented to the outside. The predominant respiratory protective device for health care workers was nonfitted surgical mask and attending physicians were infrequently (50%) included in tuberculin skin-testing programs. In the 1996 resurvey, 103 (76%) of 136 respondents returned a completed questionnaire. Of these, 99 (96%) reported having rooms that met CDC criteria for acid-fast bacilli isolation. The N95 respiratory protective devices were predominantly used by health care workers, and attending physicians were increasingly (69%) included in the hospitals' tuberculin skin-testing programs. CONCLUSIONS: Most US hospitals are making progress in the implementation of CDC guidelines for preventing the transmission of M tuberculosis.

Centers for Disease Control and Prevention, U.S.↗

Injury outcomes in children following automobile, motorcycle, and all-terrain vehicle accidents: an institutional review.

OBJECT: The authors performed an analysis of retrospectively obtained data to compare the outcomes of pediatric patients admitted to their institution for traumatic injuries resulting from car, motorcycle, and all-terrain vehicle (ATV) accidents. METHODS: The authors conducted a retrospective review of Columbus Children's Hospital's Trauma Registry data collected between January 1993 and December 2003. Data obtained in patients admitted with motor vehicle-related injuries were compiled for a total of 1608 patient records. Data regarding sex, age, hospital length of stay (LOS), Glasgow Coma Scale (GCS) score, revised trauma score, injury severity score (ISS), and use of a protective device were analyzed. CONCLUSIONS: Of 1608 patients, 1257 (78%) were injured in automobile accidents, 123 (7.6%) in motorcycle accidents, and 228 (14.2%) in ATV accidents. Injuries sustained in all vehicle types peaked during the summer months. Patients involved in automobile crashes presented with significantly lower GCS scores than those injured in motorcycle and ATV accidents; however, there was no statistically significant difference in LOS among all three injury modalities. Protective devices were underutilized in all three motor vehicle categories but, when used, were associated with significantly higher GCS scores, ISSs, and shorter LOSs among patients admitted after automobile accidents. The correlation of seat belt use with better outcomes underscores the necessity to improve motor vehicle safety education for children, who are less likely to be restrained as they age.

Accidents, Traffic↗

[Can hand radiation absorbed dose from radiosynomicronvectomy be high?].

Preparing and injecting radiopharmaceuticals containing beta emitting radionuclides, for radiosynovectomy (RS), implies the risk of exceeding the upper limit of skin and hand radiation absorbed dose, of 500 mSv/year to both technologists, who prepare and to doctors, who inject these radiopharmacuticals. A high number of RS treatments per day lack of effective radiation protection devices and skin contamination, increase the skin radiation absorbed dose. Pronounced dosimetric and radiation protection data for radionuclides used for RS, like yttrium-90, erbium-169, rhenium-186, dysprosium-165 and holmium-166, indicate the risk and the rationale for minimizing skin radiation doses to the hands of technologists and to doctors. Hands and skin radiation exposure is mainly due to direct beta radiation from yttrium-90 containing syringes. However skin contamination, may increase this dose independently of the radionuclide used for RS. Using a syringe shield with 5 mm perspex and holding the syringe by forceps, especially for the fixation of the needle to the syringe, beta radiation exposure to the finger tips may be reduced effectively. The use of radiation-resistant gloves reduces beta radiation dose to the skin only slightly, but offers a much better protection than Latex gloves for radioactive contamination. In this article we report measurements performed by us, underlining aspects of the most effective syringe shielding applied for RS. For reducing hands beta radiation exposure during RS the following are proposed: a) To use radiation protection devices, like manipulators and perspex syringe shields and b) Special training of the personnel for the proper handling of doses and for the removal of possible contamination from beta-emitting radionuclides and c) To use beta radiation personal ring dosimeters.

Body Burden↗

Airways inflammation after exposure in a swine confinement building during cleaning procedure.

BACKGROUND: Healthy volunteers exposed for 3 hr during weighing of pigs develop an airway inflammation characterized by a massive influx of neutrophilic granulocytes in the upper and lower airways and increased bronchial responsiveness to methacholine. The purpose of the present study was to investigate health effects from exposure during cleaning of the swine confinement building and to evaluate the effect of a respiratory protection device. METHODS: Sixteen subjects were exposed for 3 hr during cleaning of a swine confinement room with a high-pressure cleaner. Seven out of sixteen subjects were equipped with a mask during exposure. RESULTS: The bronchial responsiveness increased in all subjects following exposure, significantly more in the group exposed without a mask (P < 0.05). The cell concentration (mainly neutrophilic granulocytes) in nasal lavage fluid as well as the concentration of interleukin-8, increased significantly only in those subjects exposed without a respiratory protection device. In peripheral blood, an increase of neutrophilic granulocytes was observed in both groups, although it was significantly higher in the group without mask (P < 0.05). The inhalable dust level was 0.94 (0.74 - 1.55) mg/m(3) and respirable dust 0.56 (0.51-0.63) mg/m(3). CONCLUSION: Exposure to dust aerosols during the cleaning of the interior of a swine confinement building induces increased bronchial responsiveness and an acute inflammatory reaction in the upper airways. The use of a mask attenuated but did not abolish the inflammatory response. This suggests that gases and/or ultrafine particles in this environment could be important factors in the development of increased bronchial responsiveness.

Animal Husbandry↗

Stent deployment with distal vascular protection for the culprit vein graft stenosis in a patient with an acute infarct and cardiogenic shock.

A case of emergency stent deployment to a critical vein graft lesion in a patient with an acute myocardial infarction and cardiogenic shock is described. An Angioguard vascular protection device was used, retrieving a large amount of atheromatous debris. Use of filter-type protection devices to prevent distal atheroembolism may be lifesaving in such patients.

Aged↗

A case-control study of eye injuries in the workplace in Hong Kong.

OBJECTIVE: Eye injury in the workplace is common worldwide. This study proposed to explore both risk and preventive factors re eye injuries in Hong Kong. DESIGN: Case-control study. PARTICIPANTS: A total of 239 work-related eye injury patients, and 253 subjects without a history of any eye injury as controls. METHODS: Patients with all incident cases of work-related eye injuries attending the ophthalmology clinics of 3 major public hospitals in Hong Kong during the first 3 months of 2000 were invited to participate. Controls were selected from the general population and were frequency matched to patients based on gender. Patients were interviewed face-to-face by trained interviewers in the ophthalmology clinics, using a structured questionnaire. Telephone interviews were used for controls. MAIN OUTCOME MEASURES: Risk and protective factors associated with eye injuries. RESULTS: Among eye injury cases, 158 patients (66.1%) reported having incurred 1 episode of eye injury during employment, 49 (20.5%) having suffered 2 episodes, and 32 (13.4%) having experienced >/==" BORDER="0">3 eye injuries at work. Most of the patients (85.4%) did not wear any protective devices at the time of injury. Subjects who wore safety glasses regularly were less likely to have eye injuries (odds ratio [OR] = 0.29, 95% confidence interval [CI] = 0.14-0.62). Having a safety requirement for wearing safety glasses was negatively associated with eye injuries (OR = 0.31, 95% CI = 0.15-0.62). Multivariate analysis indicated that exposures to certain work hazards and working in the construction industry were positively associated with eye injuries. Subjects who worked longer in their current job, who reported having received job safety training before employment, or whose machines or equipment were maintained or repaired regularly by employers were at lower risk of experiencing eye injuries. CONCLUSIONS: Construction workers and those exposed to multiple hazards may get eye injuries at work. They should be provided with protective devices that are effective in preventing such exposures. Health education and safety training are important in preventing eye injuries. Maintenance and repair of machines and equipment may effectively reduce or eliminate the sources of exposures.

Accidents, Occupational↗

Influence of inspiratory resistance on performance during graded exercise tests on a cycle ergometer.

Due to more stringent requirements to protect personnel against hazardous gasses, the inspiratory resistance of the present generation of respiratory protective devices tends to increase. Therefore an important question is to what extent inspiratory resistance may increase without giving problems during physical work. In this study the effects of three levels (0.24; 1.4 and 8.3 kPa s l(-1)) of inspiratory resistance were tested on maximal voluntary performance. Nine male subjects performed a graded exercise test on a cycle ergometer with and without these three levels of inspiratory resistance. Oxygen consumption, heart rate, time to exhaustion and external work were measured. The results of these experiments showed that increasing inspiratory resistance led to a reduction of time to exhaustion (TTE) on a graded exercise test(GXT). Without inspiratory resistance the mean TTE was 11.9 min, the three levels of resistance gave the following mean TTE's: 10.7, 7.8 and 2.7 min. This study showed that TTE on a GXT can be predicted when physical fitness (VO2-max) of the subject and inspiratory resistance are known. The metabolic rate of the subjects was higher with inspiratory resistance, but no differences were found between the three selected inspiratory loads. Other breathing parameters as minute ventilation, tidal volume, expiration time and breathing frequency showed no or minor differences between the inspiratory resistances. The most important conclusion of these experiments is that the overall workload increases due to an increase in inspiratory resistance by wearing respiratory protective devices.

Adolescent↗

Use of a large angioplasty balloon for predilation is a risk factor for embolic complications in protected carotid stenting.

Periprocedural neurological complications (PNCs) after carotid stenting were retrospectively analyzed to determine the risk factors with the use of various protective devices. Forty-three lesions in 40 patients were treated by carotid stenting with distal balloon protection for nearly all postdilation procedures and some predilation procedures. The following variables were statistically analyzed for association with PNCs: diameter of the angioplasty balloon used for predilation, use of a distal protection balloon during predilation, use of a protection balloon during postdilation, lesion-bifurcation distance, length of the lesion, age, clinical presentation of the lesion (symptomatic or asymptomatic), and hypercholesterolemia. PNCs occurred in five patients, four with minor deficits and one with major deficits. Univariate analysis showed large diameter of the predilation angioplasty balloon (p = 0.0026), use of a protection balloon during predilation (p = 0.0075), lesion length (p = 0.0003), and lesion-bifurcation distance (p = 0.0006) were significantly associated with PNCs. Multivariate analysis of these four variables showed that use of a large angioplasty balloon for predilation was the only independent predictor (p = 0.004, odds ratio 34.00) for the occurrence of PNCs. Use of a large angioplasty balloon for predilation carries the risk of periprocedural embolic complications. Therefore, even when a protection device is used, predilation should be performed with a small balloon.

Aged↗

Reversal of flow during carotid artery stenting: use of the Parodi antiembolism system.

INTRODUCTION: To evaluate the flow reversal efficacy of the Parodi antiembolism system (PAES) in the prevention of distal emboli during carotid stenting. METHODS: A total of 90 patients were treated for internal carotid artery (ICA) stenosis with a stent device. A PAES device was used in 31 symptomatic and 5 asymptomatic patients (total 36 patients) with ICA stenosis, and 54 patients were stented without any protection device. Diffusion-weighted (DW) imaging was performed before and after stenting. RESULTS: In the group without PAES protection, 23 out of 54 patients showed new lesions on DW images after stenting. Of the lesions seen, 147 (2.72 lesions/patient) were in the vessel-dependent area. In the group with protection, 19 out of 36 patients had new lesions, and only 34 (0.94 lesions/patient) were noted in the vessel-dependent area. The number of new lesions in the nondependent vessel area did not differ if a protection system was used (P = 0.671). The use of PAES led to a significant reduction (P = 0.024) in the incidence of the most frequently seen lesions (size <2 mm). The stroke death rate was 3.3% overall, 3.7% in the group without protection device, and 2.7% in the PAES group. There were no permanent neurological deficits after 3 months. CONCLUSION: The PAES is a safe and effective tool to reduce the incidence of embolic complications during carotid stenting. Older patients and patients with higher grade stenosis seem to profit more.

Aged↗

An exploratory study of moderate physical activity and selected design attribute effects on earmuff attenuation.

Hearing protective devices are tested for their attenuation characteristics under controlled laboratory conditions. Unfortunately, these tests overestimate the typical attenuation performance of the devices in the field, posing the possibility of inadequate protection for the user. Many factors may affect achieved in-field attenuation. This research investigated the influence of the user's work-related movement and variations in headband compression force and earcup cushion material (liquid- or foam-filled) on the frequency-specific noise attenuation achieved with earmuffs. Real-ear attenuation at threshold (REAT) testing procedures were used to collect attenuation data on 24 subjects both prior to and following completion of a simulated work task. Statistical analyses indicated that moderate work-related movement significantly decreased low-frequency attenuation but by only a small amount (1.5 dB at 125 Hz). A high headband compression force was found to increase attenuation by approximately 1.5 to 4 dB at 125, 250, 500, and 8000 Hz. There was no significant difference at any frequency between cushion types. The results indicate a small effect of moderate physical work activity on hearing protector effectiveness and illustrate the importance of certain earmuff design parameters to achieved attenuation.

Ear Protective Devices↗

[Methods of detecting defects in x-ray protective equipment].

A comparison of five different methods of quality control for X-ray protective devices has shown that electroradiogrpahic control is the most efficient. It allows reliable disclosure of defects and is economically profitable. Roentgenoscopic approach proved to be more reasonable for rapid checking of protective devices.

Methods↗

The use of polyethylene intramammary device in protection of the lactating bovine udder against experimental infection with Staphylococcus aureus or Streptococcus agalactiae.

The susceptibility of lactating bovine udder quarters fitted with a polyethylene intramammary device to infection was investigated. Following experimental challenge with Streptococcus agalactiae or Staphylococcus aureus, the incidence of infection was significantly (p less than 0.05) lower in intramammary device-fitted quarters compared to control quarters. In general, total foremilk and strippings milk somatic cell counts for intramammary device-fitted and control quarters were not significantly (p less than 0.05) different. Differential foremilk and strippings milk somatic cell counts were significantly (p less than 0.05) higher in samples from intramammary device-fitted quarters compared to control quarters.

Animals↗

Role of distal protection during carotid stenting.

The most common complication of carotid angioplasty is distal embolization of debris and/or thrombus. The only way to avoid this complication is with the use of embolic protection devices. Several filters, distal balloon occlusion devices, and proximal balloon occlusion devices are available. These devices make it possible to capture arteriosclerotic debris during angioplasty and stenting. During the majority of procedures at least some particles can be retrieved. Therefore there is no doubt that these devices are important for carotid angioplasty. However, due to the low complication rate of carotid angioplasty even without embolic protection devices, large randomized trials are necessary to statistically prove the clinical efficacy of these devices.

Angioplasty↗

[Injury pattern caused by aggressive inline skating].

In order to evaluate the special injury pattern of aggressive inline skating, a field study was conducted in a local, non-commercial skate park equipped with all the typical features like ramps, halfpipes, gully areas. 66 unselected aggressive inline skaters were randomly enrolled and interviewed concerning their skating habits and their skating injury history. Average age was 15 (10 to 41) years, skating was performed since 2.1 (0.1 to 6) years, as aggressive skating since 1.3 (0.1 to 4) years. Medical treatment in a doctor's practice or in a hospital had been necessary in 66 cases, averaging 1.4 times per skater and year, averaging one injury per 586 hours of aggressive skating. The injury pattern reflected the regions typically injured in fitness skating, too, with a higher percentage of injuries concerning knee, tibia and ankle region. The use of protective devices varied from 41 % (wrist guards) to 94 % (knee pads), with an average of 69 %. Only 32 % of skaters wore all protective devices. As the personal thrill is an important motivation for aggressive skating, safer skating campaigns are quite unlikely to decrease the risk of injury in aggressive skaters.

Adolescent↗