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PubMed2000

[Pattern of injuries and prophylaxis in paragliding].

This study will present trends and recommendations to increase active and passive safety in paragliding on the basis of current state-of-the-art equipment and typical patterns of injury. This German-Swiss teamwork presents data of 55 male and 9 female patients treated after paragliding accidents between 1994 to 1998 respectively 1996 to 1998. 43.7% of the pilots presented with multiple injuries, 62.5% suffered spinal fractures and 18.8% pelvic fractures. 28.4% of the injured pilots were admitted with injuries of the lower extremities mainly affecting the tarsus or the ankle joint. Only three patients with single injuries could be treated in an ambulatory setting. 54.0% of the injuries left the patients with lasting functional residues and complaints. Main causes of accidents were either pilot error in handling the paraglider or general lack of awareness about potential risk factors. 46.0% of injuries occurred during landing, 42.9% of injuries during the flight and another 11.1% of injuries during starting procedures. With noticeable enhanced performance sails of the beginners and intermediate level are increasingly popular. Protective helmets and sturdy footwear reaching above the ankle joint are indispensable pieces of equipment. The use of protective gloves is highly recommended. Back protection devices of the new generation provide the best passive prophylaxis for the pilot against pelvic and spinal cord injuries. This area hold the most promise for increasing safety and reducing risk of injury in future, apart from using beginners and intermediate wings. After acquisition of the pilot license performance and security training provide the best preparing to master unforeseeable situations.

Accident Prevention↗
PubMedDate not supplied

Pests, peasants, and pesticides on the Northern Nicaraguan Pacific Plain.

With the aim of exploring possible reasons for dangerous work practices among small-scale farmers in the Pacific plain of Nicaragua, a qualitative study was performed. Four focus groups were involved. The information gathered was analyzed with an emphasis on the farmers' relationships to and perspectives on their crops, the economy, pests, and pesticide hazards. Factors that had been anticipated, such as poverty, inadequacy of protective devices, and environmental factors, were found to lead to dangerous work practices. Cultural factors also affected the farmers' attitudes in ways that favored hazardous work procedures. This finding, which had not been anticipated, has important practical implications. It suggests that, to be effective, education and training courses on occupational health should assure that their design, language, materials, and execution are culturally relevant and appropriate.

Adolescent↗
PubMed1997

Gender differences in blue collar workers' use of hearing protection.

In this study, the Health Promotion Model (HPM) was used as the basis for a structural equation model of male and female blue collar workers' self-reported use of hearing protection devices (HPDs). Overall use did not differ by gender; in addition, self-efficacy and barriers to use of HPDs were the two best predictors of this behavior for both men and women. Despite the similarities in HPD use and the most important predictors of that use between men and women, the predictive models differed by gender in several ways. Significant predictors of use among men also included age and value of use of HPDs. For women, ethnic status and plant site were additional significant predictors of use. Because the influences of plant site and gender on self-reported use of HPDs could not be separated in this study, further research should address worksite culture and assess differences by gender. Knowledge of these differences will aid development of more effective interventions and may increase the use of hearing protection.

Adult↗
PubMed1990

[Anamnestic incidence of hepatitis B in the population of Prague stomatologists].

The author assessed by means of questionnaires the incidence of hepatitis B and the use of protective devices in a group of 612 Prague stomatologists. Fifty-four (3.8%) reported hepatitis B. 17.5% of the doctors were vaccinated against the condition. Doctors who treat 20 or more patients per day report hepatitis B four times more frequently than those who treat only to 20 patients per day. 53.5% of the doctors never use rubber gloves during treatment. For the prevention of transmission of infection in addition to hygienic provisions also the organization of work must be changed.

Adult↗
PubMed2000

Evaluation of interventions to prevent needlestick injuries in health care occupations.

OBJECTIVE: The objective of this study was to evaluate interventions that reduce or prevent needlestick injuries in health care occupations. METHODS: Cochrane Collaboration search strategies to locate studies that evaluated interventions to reduce needlestick injuries in health care occupations were used. Studies were selected if they met the following criteria: (1) interventions were evaluated in the defined population; (2) interventions were randomized, with a comparison group(s); (3) outcomes were objectively measured and had interpretable data. Eleven studies met inclusion criteria. The main outcomes of interest were changes in the number of glove or skin perforations and changes in amount of skin contamination. RESULTS: Three studies found a decrease in glove or skin perforations when double gloves or combinations of gloves were used by surgeons and their assistants. One study found an increase in glove perforations but a decrease in hand contamination. Three studies evaluated the effectiveness of specialized needles in reducing needlestick injuries during surgical wound closure with decreases in glove or skin perforations reported. Protective devices were evaluated in three studies and significant reductions in glove perforations were found with the use of a needleless intravenous system and surgical assist device. One study evaluated a "no-touch" technique used by surgeons during wound closure and found a significant decrease in the number of glove perforations compared to the traditional "hand-in" method of closure. CONCLUSIONS: Few randomized controlled trials have been employed to evaluate the effectiveness of interventions to reduce needlestick injuries in health care occupations. The majority of the studies evaluated interventions during surgical procedures, rather than during patient care on nursing units, probably because the latter is more difficult to observe.

Evaluation Studies as Topic↗
PubMed2001

Cerebral protection systems for distal emboli during carotid artery interventions.

Carotid angioplasty and stenting is associated with liberation of cerebral emboli that can cause periprocedural stroke. There are currently three classes of emboli protection devices (EPDs) that are undergoing feasibility studies and one randomized clinical trial. Preliminary data from a small series appear to be promising, and there appears to be attenuation of embolic signals on a cerebral Doppler exam with EPD use. However, rare strokes and patient intolerance due to imposed ischemia have been observed. The advantages and disadvantages of each EPD class and the issues involving clinical trials and surrogate end points in this area of study are discussed.

Angioplasty↗
PubMed1996

Evaluation of muff-type hearing protectors as used in a working environment.

Studies evaluated muff-type hearing protection devices (HPDs) in a mining environment. Noise reduction measurements were made using miniature microphones inside and outside the HPD cup. Laboratory tests conducted prior to field evaluations indicated that the results of this physical method were similar to the results of the American National Standards Institute (ANSI) real-ear-attenuation-at-threshold method. A total of 23 models of HPDs and 545 machines (20 different machine types) were evaluated in the field phase, resulting in 1265 HPD evaluations. The effectiveness of each HPD model in terms of dBA noise reduction is presented as a function of the metric (C-A), which characterizes the spectrum of the machine noise. The dBA reductions for various combinations of HPD models and machine types are also presented. The results show that the field performance of muff-type HPDs is significantly less than that specified by the Environmental Protection Agency Noise Reduction Rating (NRR), especially for low-frequency noise sources such as internal combustion engines. Thirty-two percent of the operators of such machines observed noise reductions of 10 dBA or less. Across all machine types, 20% of the workers realized an observed noise reduction of 10 dBA or less. It is concluded that the NRR grossly overestimates HPD performance. In addition, the NRR is not a good indicator for comparing HPD models since in many instances HPDs with lower NRRs out-performed those with higher NRRs. The laboratory-derived NRRs' failure to predict the HPD field performance was related primarily to the inaccuracy of the basic laboratory attenuation data from which the NRRs were computed, and to a lesser extent to shortcomings in the NRR computational procedure.

Ear Protective Devices↗
PubMed1991

A controlled investigation of in-field attenuation performance of selected insert, earmuff, and canal cap hearing protectors.

A field study assessed the actual spectral noise attenuation achieved by 40 industrial workers wearing four different hearing protection devices (HPDs) while on the job. The effect of two different HPD fitting procedures (subject fit vs. trained fit) on attenuation performance over two three-week periods of protector use was determined. Subjects were retrieved from their workplaces without prior knowledge of when they were to be tested and were not permitted to readjust the fit of their HPDs. Attenuation data were then collected using psychophysical procedures testing real ear attenuation at threshold. Statistical analyses indicated that the earplugs' attenuation significantly improved when training for proper fitting was used, whereas the earmuff and the ear canal cap were relatively insensitive to the training effect. The training was most effective for a slow-recovery foam plug over the three-week period. Results confirmed that laboratory protocols designed to simulate workplace influences on attenuation may not be relied on to yield reasonable estimates of field protection performance of HPDs, particularly for earplugs; however, the laboratory results were much better predictors of field protection for the earmuff. This study also demonstrated that the labeled manufacturers' noise reduction ratings (NRRs) substantially overestimated the actual field attenuation performance.

Adult↗
PubMed1998

Biological monitoring of controlled toluene exposure.

OBJECTIVES: Widespread exposure to toluene occurs in the printing, painting, automotive, shoemaking, and speaker-manufacturing industries. The relationship between air concentrations and the absorbed dose is confounded by dermal exposure, personal protective devices, movement throughout the workplace, and interindividual differences in toluene uptake and elimination. METHODS: To determine the best biological indicator of exposure we examined the blood and alveolar breath concentrations of toluene as well as the urinary excretion rates of hippuric acid and of o-, m-, and p-cresols from 33 controlled human inhalation exposures to 50 ppm for 2 h. RESULTS: Among the metabolites, o-cresol was least influenced by background contributions, whereas the p-cresol and hippuric acid rates were obscured by endogenous and dietary sources. Toluene levels in alveolar breath proved to be the most accurate and noninvasive indicator of the absorbed dose. A physiologic model described blood and breath data using four measured anthropometric parameters and the fit values of extrahepatic metabolism and adipose-tissue blood flow. CONCLUSIONS: After breathing rate and extrahepatic metabolism had been set to conservative (protective) values (the 97.5th and 2.5th percentiles, respectively) the model predicted that pre-final-shift breath levels of < or =10 micromol/m3 and post-final-shift levels of < or =150 micromol/m3 corresponded to average workplace exposure levels of < or =50 ppm toluene. Alternately, we used the distributions and covariances of the measured and fit model parameters to yield conservative pre-final-shift levels of < or =7.3 micromol/m3 and post-final-shift breath levels of < or =120 micromol/m3 that were reflective of workplace exposure levels of < or =50 ppm toluene.

Adult↗
PubMedDate not supplied

Migrant farm workers' access to pesticide protection and information: Cultivando Buenos Habitos campaign development.

Formative evaluation of south Georgian migrant farm workers' access to information and products to promote pesticide protection and understanding of cancer risk associated with pesticide exposure was conducted using field observation, in-depth interviews of Georgia's Migrant Health Program's outreach workers, and structured face-to-face surveys of migrant farm workers. The data indicated that fewer than one-third of the pesticide products reviewed contained messages about pesticide use and exposure risk for humans. Risk information on products appeared in English only. Few protective devices were available for purchase. Migrant farm workers were aware in a very general sense of health risks posed by pesticides, but they were specifically unaware of the reach of pesticides sprayed, as illustrated by their field behaviors. Findings also demonstrated the need to educate outreach workers about migrant farm workers' cancer risk, so that they may act as migrant farm workers' health advocates to reduce the adverse effects associated with pesticide exposure.

Adolescent↗
PubMedDate not supplied

Construction noise: exposure, effects, and the potential for remediation; a review and analysis.

More than one-half million construction workers are exposed to potentially hazardous levels of noise, yet federal and state Occupational Safety and Health Administration (OSHA) programs provide little incentive to protect them against noise-induced hearing loss. Construction noise regulations lack the specificity of general industry noise regulations. In addition, problems that characterize the construction industry, such as worker mobility and the large proportion of small businesses, make implementing hearing conservation measures more difficult. The apparent severity of exposure depends greatly on the measurement method, with the 3-dB exchange rate almost always showing higher average exposure levels than the 5-dB (OSHA) rule. Construction workers demonstrate hearing threshold levels that generally conform to those expected in manufacturing. The prevalence of hearing protection device (HPD) use among U.S. construction workers is very poor, partly because of perceived difficulties in hearing and understanding speech communication and warning signals. In addition, masking by noise of necessary communication and warning signals is of particular concern in construction, where recent research demonstrated the association between fatalities and the failure to hear reverse alarms. Judicial use of HPDs is of the utmost importance, along with avoiding overattenuation, selecting HPDs with uniform attenuation, and using noise-attenuating communication systems when possible. A successful hearing conservation program in British Columbia can serve as a model for the United States, with a long-standing positive safety culture, a high percentage of HPD use, improvement in average hearing threshold levels over the last decade, and a centralized record-keeping procedure, which helps solve the problem of worker mobility. However, controlling construction noise at the source is the most reliable way to protect worker hearing. U.S. manufacturers and contractors should benefit from the activities of the European Community, where noise control and product labeling in construction has been carried out for more than 20 years.

Ear Protective Devices↗
PubMedDate not supplied

Applying the health promotion model to development of a worksite intervention.

INTRODUCTION: Consistent use of hearing protection devices (HPDs) decreases noise-induced hearing loss, however, many workers do not use them consistently. Past research has supported the need to use a conceptual framework to understand behaviors and guide intervention programs; however, few reports have specified a process to translate a conceptual model into an intervention. PURPOSE: The strongest predictors from the Health Promotion Model were used to design a training program to increase HPD use among construction workers. SUBJECTS/SETTING: Carpenters (n = 118), operating engineers (n = 109), and plumber/pipefitters (n = 129) in the Midwest were recruited to participate in the study. DESIGN: Written questionnaires including scales measuring the components of the Health Promotion Model were completed in classroom settings at worker trade group meetings. MEASURES: All items from scales predicting HPD use were reviewed to determine the basis for the content of a program to promote the use of HPDs. Three selection criteria were developed: (1) correlation with use of hearing protection (at least .20), (2) amenability to change, and (3) room for improvement (mean score not at ceiling). RESULTS: Linear regression and Pearson's correlation were used to assess the components of the model as predictors of HPD use. Five predictors had statistically significant regression coefficients: perceived noise exposure, self-efficacy, value of use, barriers to use, and modeling of use of hearing protection. Using items meeting the selection criteria, a 20-minute videotape with written handouts was developed as the core of an intervention. A clearly defined practice session was also incorporated in the training intervention. CONCLUSION: Determining salient factors for worker populations and specific protective equipment prior to designing an intervention is essential. These predictors provided the basis for a training program that addressed the specific needs of construction workers. Results of tests of the effectiveness of the program will be available in the near future.

Adult↗
PubMed2001

[Occupationally induced nitric acid and sulfuric acid burns: an analysis of 2 patients from the aspect of occupational health].

We report two patients who suffered from acid burns while working in chemical factories. Case 1: a 44-year-old man who received burn induced by nitric acid on the face and extremities. Despite his protecting facial mask, he was exposed to nitric acid on his face through a gap between the mask and skin surface. Nitric acid was also sprinkled on his scalp which was not covered by a helmet or a protecting device. In addition, he suffered from acid burn on the right scapular region, the right upper arm, and the lower extremities through the work clothes. Case 2: a 26-year-old man who suffered from sulfuric acid burn on the forearms. Both patients were accidentally exposed to acids while they filled tanks with the acids through a hose. Following the manual of the factories, they washed the exposed skin with water for more than 15 minutes after the exposure. Although they recovered without any serious sequel, there remained partial deep tissue destruction of the skin. We reviewed these two cases from the aspect of industrial medicine, and proposed the following three points for improvement in the workplace to prevent accidental acid burns. 1) re-education or enlightenment activities for the well-experienced workers to avoid negligence to the danger of strong acid. 2) recommendation to take a complete shower to avoid overlooking of unaware acid injury. 3) improvement in the protecting facial mask. In addition, clinicians who examine acid-burn patients should not pass over the presence of deep ulcers lying behind the thick crust on the injured area.

Adult↗
PubMed2006

Dose response effect of cement dust on respiratory muscles competence in cement mill workers.

Electromyography (EMG) of respiratory muscles is a reliable method of assessing the ventilatory muscle function, but still its use has not been fully utilized to determine the occupational and environmental hazards on respiratory muscles. Therefore, EMG of intercostal muscles was performed to determine the dose response effect of cement dust on respiratory muscles competence. Matched cross-sectional study of EMG in 50 non-smoking cement mill workers with an age range of 20 - 60 years, who worked without the benefit of cement dust control ventilation or respiratory protective devices. EMG was performed by using surface electrodes and chart recorder. Significant reduction was observed in number of peaks (p < 0.0005), maximum peak amplitude (p < 0.0005), peak-to-peak amplitude (p < 0.0005) and duration of response (p < 0.0005) in cement mill workers compared to their matched control. Cement dust impairs the intercostal muscle competence and stratification of results shows a dose-effect of years of exposure in cement mill.

Adult↗
PubMedDate not supplied

Creating a tailored, multimedia, computer-based intervention.

Tailoring of health-related messages is effective in motivating behavior change. However, planning, designing, and implementing a tailored health promotion program can be a challenge. This article describes the process of creating a tailored multimedia program for presentation via computer to promote factory workers' use of hearing-protection devices to prevent noise-induced hearing loss. The creation process was segmented into 5 phases: 1) determination of program content; 2) creation of overall program design, including live action and still video and addition of sound and graphics; 3) development and integration of tailoring pathways into the final intervention; 4) development of a database and participant handouts; and 5) pilot testing of the intervention program. The approach used in this research program can serve as a prototype for future development of computerized multimedia health promotion interventions and can assist others in the effective use of this medium.

Algorithms↗
PubMedDate not supplied

The use of hearing protectors among forest, shipyard and paper mill workers in Finland--a longitudinal study.

From 1953 to 1995 the usage rate of hearing protective devices (HPD) was tracked at a paper mill, a shipyard, and in selected areas of forestry work. For each work period, observations were made of HPD use among workers. In the paper mill, the usage rate increased steadily from 1965. In 1990, 39% of workers used HPDs full-time. At the shipyard, the usage rate remained low up to the mid-1980s, but thereafter the proportion of full-time users rose to 70%. A similar trend was noted in forest workers, with the full-time use at 97% by the 1990s. Due to the increased usage rate in all measured industries, the mean effective noise level at the ear has decreased to below 85 dB.

Cross-Sectional Studies↗
PubMed2002

The Kabuto, or the Japanese helmet: evolution from war implement to status symbol.

WARRIORS THROUGHOUT THE AGES have considered the unprotected head to be particularly vulnerable. The traditional Japanese helmet, the Kabuto, was the part of a protective suit of armor that reflected the wearer's character and personality. Over time, it changed from a primarily protective device to a vehicle for the expression of a distinctly Japanese sense of magnificent artistry. Each Kabuto was custom-made, and these helmets remain without peer in the world. They were designed and crafted to answer the demands of their era, and thus they provide historical evidence not only of the state of Japanese warfare, but also of social organization, metallurgical knowledge, artisanship, and aesthetic sensibility. Even now, during the national Golden Week Festival in early May, Kabuto are displayed in the alcoves of Japanese homes as a petition that the boys in the house be granted courage and good health. Thus, even in modern Japan, the Kabuto represents a talisman. We present an overview of the evolution of the Kabuto, with special reference to the Japanese sword and the warrior tradition.

Head Protective Devices↗
PubMed1995

Prevention of noise-induced hearing loss in the Canadian military.

A prospective study was undertaken to investigate the development of noise-induced hearing loss in Canadian military recruits, and to assess the effectiveness of the hearing conservation program currently in place. The participants were 134 men and women, 20 to 30 years of age, employed in four trades, three of these (infantry, artillery, and armour) associated with high noise levels. The data comprised audiometric measurements made at the time of entry and after 3 years of employment, and responses to a questionnaire mainly relating to noise exposure in the workplace and during leisure activities, and the utilization of personal hearing protective devices. The findings showed that group audiograms at entry and at the 3-year recall were characterized by a 6-kHz notch that was indicative of noise-induced hearing loss, although mean threshold values were within normal limits. By the 3-year recall, 11% of the infantry had sustained a mild-to-moderate hearing loss in the left ear, greater than 25-dB HL, that was consistent with the use of small-calibre weapons. Responses to the questionnaire indicated that, while subjects appreciated the potential benefit of wearing hearing protectors, instructions in their proper use and education on the hazards of noise exposure were poor. The results suggested methods to strengthen the existing scheme for hearing conservation to further minimize risk.

Adult↗