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PubMed1997

Study of respirator effect on nasal-oral flow partition.

Factors affecting worker tolerance of respiratory personal protective devices are inadequately understood. This study evaluates whether respirator-type loads affected the switch from nasal to oral breathing. Eleven healthy subjects were studied under progressive exercise conditions, using a respirator full-face mask with inspiratory resistance (I), pressure breathing (P) (10 cm H2O end-expiratory pressure), or no load (N). A rapid-response thermistor was used to determine whether flow was predominantly oral or nasal. Both P and I increased the percentage of time that breathing was predominantly oral. The effect was most pronounced at higher exercise levels. The percentage of mouth breathing appeared to be closely related to the expiratory time. This study suggests that nasal-oral flow partitioning should be considered as a possible determinant of respirator tolerance.

Adult↗
PubMed1995

Most comfortable loudness shift as a measure of speech attenuation by hearing protectors.

The feasibility of using most comfortable loudness (MCL) as a real-world measure of speech attenuation introduced by hearing protection devices (HPDs) was studied. The authors compared three insert HPDs and an earmuff under three test conditions: (a) monaural earphone listening, (b) binaural earphone listening, and (c) sound field listening. The earmuff was used only in the sound-field condition. In addition, three sets of fitting instructions were utilized. Twelve normal hearing subjects participated. Results indicate that MCL shift can be used as a simple measure of speech attenuation provided by HPDs. The observed MCL shifts were affected by the fitting instruction but not by the listening condition. Findings support the notion that MCL-based tests of speech attenuation by HPDs can be conducted reliably both in sound field and under earphones and may be a simple and valid tool for assessing changes in speech audibility due to the wearing of HPDs.

Adult↗
PubMed1989

Ethylene oxide sterilizer use and short-term symptoms amongst workers.

We surveyed training, the use of protective devices, personal and environmental exposure levels and self-reported short-term health complaints amongst 165 health care workers (response = 76 per cent) using ethylene oxide (EtO) sterilizers in 27 hospitals in the province of Alberta, Canada. Data were collected via self-administered questionnaires. Personal and environmental sampling was carried out during site visits to 18 hospitals. Although no detectable levels of EtO were found in environmental samples, over half of the respondents stated they could smell EtO at work. While sampling results never revealed concentrations above the provincial 15 min time weighted average short-term exposure limit (STEL; = 50 p.p.m.), personal exposure concentrations and the use of portable sterilizers were positively associated with short-term symptoms such as irritations of the mucous membranes and skins (P less than 0.05).

Environmental Exposure↗
PubMed2004

Partial protection by respirators on airways responses following exposure in a swine house.

BACKGROUND: Exposure to swine dust leads to an intense airway inflammation and increased bronchial responsiveness. The purpose of the present study was to evaluate the effect of a respiratory protection device during exposure in a swine house. METHODS: Twenty-two subjects, 11 with a respirator, were exposed. Symptoms, body temperature, nasal lavage, and a bronchial metacholine challenge were performed before and 7 hr after exposure. For exposure assessment a nasal sampler was evaluated. RESULTS: The subjects with a respirator showed an attenuated inflammatory nasal response. An increase in bronchial responsiveness was observed in both groups, significantly greater in the unprotected group. The use of respirators reduced endotoxin exposure by more than 90% (assessed by nasal samplers). CONCLUSION: The use of a respirator attenuated the inflammatory response compared with an unprotected group. The minor effect on bronchial responsiveness suggests that gases and/or ultrafine particles may also be important factors.

Adult↗
PubMed2002

Pesticide sprayers' knowledge, attitude and practice of pesticide use on agricultural farms of Ethiopia.

Pesticide sprayers from five state-owned agricultural farms took part in a study that evaluated their knowledge, attitude and practice of pesticide use on farms. Demographic features of the sprayers showed that the majority of them had primary-level education. The duration of work as sprayers on the farms ranged from 1 month to approximately 10 years, with 59% of them having worked as sprayers for <5 years. Their knowledge about hazards from pesticides was indicated by the responses they gave to the standard questionnaire. Careful working was considered to be very important by 93% of them, while only 7% suggested the use of personal protective devices (PPD). On some of the farms, sprayers were provided with inappropriate/unfit and worn-out PPD; 18% of the sprayers had unfit goggles and 29% used worn-out gloves. To minimize risk from pesticide application, 63% suggested avoiding applications during windy and sunny weather, 32% suggested the provision and proper use of PPD, while only 3% of them felt medical check-ups and training were important, and 2% suggested risks from spraying were best controlled by leaving their job. The hygiene and sanitation practices of the sprayers require much improvement. An attitudinal change is needed, together with the provision of better facilities and infrastructure. We recommend that pesticide safety education be given to the sprayers. In addition, appropriate PPD should be used, with regular maintenance and timely replacement of worn-out parts.

Adolescent↗
PubMed1995

Respiratory protection and the risk of Mycobacterium tuberculosis infection.

Tuberculosis (TB) can be transmitted to susceptible healthcare workers via inhalation of droplet nuclei carrying viable Mycobacterium tuberculosis bacilli. Several types of respiratory protective devices are compared with respect to efficacy against droplet nuclei penetration: surgical masks, disposable dust/mist particulate respirators (PRs), elastomeric halfmask respirators with high-efficiency (HEPA) filters, and powered air-purifying respirators (PAPRs) with elastomeric halfmask facepieces and HEPA filters. It is estimated that these devices permit, respectively, 42%, 5.7%, 2%, and 0.39% penetration of droplet nuclei into the facepiece. More limited data for the disposable HEPA filtering-facepiece respirator suggest that it would allow droplet nuclei penetration of 3% or less, similar to the value estimated for the elastomeric halfmask HEPA filter respirator. Because a respirator wearer's cumulative infection risk depends on the extent of droplet nuclei penetration, the cumulative risk will differ, given use of these different respirators. Hypothetical but realistic "low-exposure" and "high-exposure" scenarios are posed that involve, respectively, a 1.6% and a 6.4% annual risk of infection for healthcare workers. For the low-exposure scenario, the 10-year cumulative risks given no respirators versus surgical masks versus disposable dust/mist PRs versus elastomeric halfmask HEPA filter respirators versus HEPA filter PAPRs are, respectively, 15%, 6.7%, 0.94%, 0.33%, and .064%. For the high-exposure scenario, the 10-year cumulative risks for no respirator use versus use of the same four types of respirators are, respectively, 48%, 24%, 3.7%, 1.3%, and 0.26%. The use of disposable HEPA filtering-facepiece respirator should permit cumulative risks close to those estimated for the elastomeric halfmask HEPA filter respirator. It is concluded that when an infectious TB patient undergoes a procedure that generates respiratory aerosols, and when droplet nuclei source control is inadequate, healthcare workers attending the patient may need to wear highly protective respirators, such as HEPA filter PAPRs.

Aerosols↗
PubMed2005

Individual perception of noise exposure and hearing protection in industry.

Existing approaches that explain the behavior of workers in noisy environments rarely include quantitative variables related to central factors such as noise exposure levels and workers' hearing status. The aim of this study is to analyze the relationship among individual, contextual, and perceptual-cognitive factors and the use of hearing protection devices (HPDs). We studied 516 industrial workers exposed to noise levels greater than the Portuguese action level and developed a conceptual model for HPD use. The multivariate data analysis of the several variables considered revealed that individual risk perception and the outcome value for hearing preservation were the main direct predictors of the use of HPDs. Workers' opinions about the company's safety climate and their perception of noise exposure effects also play important roles as predictors. However, much of the effects of these factors are indirect (i.e., mediated by other variables). Furthermore, these results suggest that risk perception should be considered an essential issue in the design and implementation of any hearing conservation program, particularly in the development of training programs. Actual or potential applications of this research include the definition of more accurate strategies for promoting and motivating the use of HPDs.

Adult↗
PubMed1995

Audibility of reverse alarms under hearing protectors for normal and hearing-impaired listeners.

The question of whether or not an individual suffering from a hearing loss is capable of hearing an auditory alarm or warning is an extremely important industrial safety issue. The ISO Standard that addresses auditory warnings for workplaces requires that any auditory alarm or warning be audible to all individuals in the workplace including those suffering from a hearing loss and/or wearing hearing protection devices (HPDs). Research was undertaken to determine how the ability to detect an alarm or warning signal changed for individuals with normal hearing and two levels of hearing loss as the levels of masking noise and alarm were manipulated. Pink noise was used as the masker and a heavy-equipment reverse alarm was used as the signal. The rating method paradigm of signal detection theory was used as the experimental procedure to separate the subjects' absolute sensitivities to the alarm from their individual criteria for deciding to respond in an affirmative manner. Results indicated that even at a fairly low signal-to-noise ratio (0 dB), subjects with a substantial hearing loss [a pure-tone average (PTA) hearing level of 45-50 dBHL in both ears] were capable of hearing the reverse alarm while wearing a high-attenuation earmuff in the pink noise used in the study.

Adult↗
PubMed2003

[The occurrence of coercive measures towards non-hospitalized elderly].

INTRODUCTION: The study is a nation-wide investigation of the occurrence of coercive measures towards non-hospitalised elderly (+65 years) with dementia in Denmark. These measures include the use of alarm and tracking systems, use of physical force and protective devices, detention of the elderly in their own homes, and forced movement to another domicile e.g. nursing home. These types of coercive measures are regulated in the Danish jurisdiction, but not systematically recorded. MATERIAL AND METHODS: A questionnaire was sent to all counties in Denmark concerning occurrence of the coercive measurements mentioned above. RESULTS: All 14 counties reported a very low use of all types of coercion with only a total of 123 incidents reported in all in 2001. DISCUSSION: This modest number gives rise to concern about lack of sufficient care towards elderly with dementia. The autonomy of the demented is important, but must not overrule basic care with the aim of ensuring dignified living conditions and safety from harm. The jurisdiction in this area is complicated and sometimes unclear.

Aged↗
PubMed1996

Methyl iodide poisoning: report of two cases.

Two workers were poisoned following exposure to methyl iodide with inadequate protective devices. Their cases are presented together with a review of literature. Both patients developed symptoms and signs of cerebellar lesions and damage of the third, fourth, or sixth cranial nerve pathways. Spinal cord lesions producing motor and sensory disturbances were present in one. Late psychiatric disorders were observed in both patients. Although these symptoms were very similar to those reported in the nine published cases of methyl iodide poisoning, the toxicological diagnosis was delayed in one case: as repeated overexposure produced recurrent attacks of multifocal neurological dysfunction, multiple sclerosis was initially diagnosed, although several of the features observed are unusual in this disease. The manifestations of methyl iodide poisoning are similar to those of intoxication with other monohalomethanes. All these compounds probably share the same mechanisms of action. This mechanism and its therapeutic consequences are discussed.

Abducens Nerve↗
PubMed1998

Use of hearing protection and perceptions of noise exposure and hearing loss among construction workers.

The purpose of this study was to describe construction workers' use of hearing protection devices (HPDs) and determine their perceptions of noise exposure and hearing loss. Operating engineers, carpenters, and plumbers/pipe fitters in the Midwest (n = 400) completed a written questionnaire regarding their use of HPDs and their perceptions of noise exposure and hearing loss. Subjects were recruited through their trade union groups. Mean reported use of HPDs and mean perceived noise exposure were compared across trade groups. Bivariate and multivariate analysis techniques were used to assess relationships between use of HPDs and trade category, education, age, years of employment, noise exposure, and hearing loss. Bivariate analyses identified significant differences in mean use of HPDs by age, years of employment, and trade group. Multivariate logistic regression assessing the independent effects of these variables found significant differences only by trade group. Results indicate a need for significant improvement in all three trade groups' use of HPDs, and suggest a need to consider use and exposure levels, demographics, and trade group membership in designing hearing conservation programs.

Adult↗
PubMed2004

Effect of electronic ANR and conventional hearing protectors on vehicle backup alarm detection in noise.

An experiment was conducted wherein masked thresholds (using ascending method of limits) for a backup alarm were obtained in pink and red noise at 85 and 100 dBA for 12 participants immersed in a probability monitoring task and wearing a conventional passive hearing protection device (HPD, an earmuff or a foam earplug), an active noise reduction (ANR) headset, or no HPD at all (only in 85 dBA noise). Results revealed statistically significant between-HPD differences in red noise (from 2.3 to 3.1 dB) and in the 100-dBA noise level (from 2.6 to 4.3 dB). An additional finding, which corroborates other studies using different protocols, was that masked thresholds in 85-dBA noise were significantly lower (from 3.2 to 4.4 dB) for the occluded conditions (wearing an HPD) than for the open-ear (unoccluded) condition. This result refutes the belief among many normal-hearing workers that the use of HPDs in relatively low levels of noise compromises their ability to hear necessary workplace sounds. Actual or potential applications of this research include (a) the selection of appropriate HPDs for low-frequency-biased noise exposures wherein signal detection is important and (b) gaining insight into the appropriateness of ANR-based HPDs for certain industrial noise environments.

Adolescent↗
PubMed1999

Effectiveness of an intervention to increase construction workers' use of hearing protection.

In this project we tested the effectiveness of a theory-based intervention (video, pamphlets, and guided practice session) to increase the use of hearing protection devices (HPDs) among Midwestern construction workers and a national group of plumber/pipefitter trainers. Posttest measures were collected 10-12 months following this intervention. Pender's Health Promotion Model (1987) provided the conceptual basis for development of the training program. A total of 837 high-noise-exposed workers were included in the analysis: 652 regional Midwestern construction workers and 185 national plumber/pipefitter trainers. Effectiveness of the intervention was determined through the sequence of analyses recommended by Braver and Braver (1988) for the Solomon Four-Group Design. Analysis of variance and covariance of postintervention use and intention to use HPDs and a meta-analytic test were done. These analyses indicated that the intervention significantly increased use of HPDs but had no effect on intention to use HPDs in the future. Pretesting had no effect on use. Actual or potential applications of this research include guidance in the development of successful theory-based interventions to increase use of HPDs.

Adult↗
PubMed2006

Variability of real-world hearing protector attenuation measurements.

The attenuation provided by a hearing protection device (HPD) in the field is usually estimated by applying a derating factor to the laboratory-determined noise reduction rating (NRR) of the HPD. However, attenuation is highly dependent on individual-specific HPD fit. Prediction of an individual's attenuation depends on the accuracy of the measurement system and the variability of attenuation over time (e.g. after HPD refitting). Variability in attenuation and attenuation test systems has not been adequately characterized to allow for such an assessment. This study compared attenuation measurements made with two systems, Real-Ear-at-Threshold (REAT) and Microphone-in-Real-Ear (MIRE), on 20 workers using two earplugs (foam and custom-molded). Workers' perceptions of the earplugs were also evaluated. Individuals' attenuation results were summarized as personal attenuation ratings (PARs, similar to NRRs). Variability in PARs from between-subject, within-subject and within-day (i.e. repeated tests on a subject without earplug refitting) differences was assessed and used to present the lower confidence limit, or uncertainty factor (UF), of an average individual's attenuation. The custom-molded earplug PARs achieved a higher mean percentage of labeled attenuation than did the foam earplug with both test systems. The custom-molded earplugs also had higher overall acceptance among workers. MIRE PAR levels were lower than REAT levels for both earplugs, but the relationship between the two test systems was highly variable. The MIRE system had lower within-day variability than the REAT system. One individual's MIRE results were highly influential; removal of these results greatly reduced the UF for the custom-molded earplug/MIRE combination. UFs ranged from 8.8 to 13.5 dB. These findings highlight the importance of evaluating variability in individual-specific protection results for personal protective equipment like HPDs, rather than relying on single measurements.

Ear Protective Devices↗
PubMed1995

High-risk behavior and the public burden for funding the costs of acute injury.

OBJECTIVE: To determine if high-risk behavior is associated with increased injury severity and cost and if public agencies bear a disproportionate burden of that cost. DESIGN: Case comparison study utilizing patient data collected over a 10-year period. SETTING: Five level 1 and 2 trauma centers in an urban-suburban community with a population of 2.4 million. PARTICIPANTS: Trauma registry data from 37,304 consecutive hospitalized adult patients with trauma. Financial data were reported and analyzed on 28,842 of these. MAIN OUTCOME MEASURES: Incidence of alcohol intoxication, other drug use, use of vehicular protective devices, and firearm violence injuries in patients with private vs public health care sponsorship. Length of hospital stay, injury severity, and hospital unit charges were assessed for high-risk behavior. RESULTS: High-risk behavior was more prevalent among trauma patients relying on public funding to cover the costs of their injuries (P < .001). Total hospital unit charges were 28% and 35% higher for motorists not wearing seat belts and motorcyclists not wearing helmets, respectively. Injury severity and length of stay were also higher (P < .001). CONCLUSIONS: High-risk behavior is associated with increased injury severity and cost. Trauma victims exhibiting high-risk behavior more often depend on public agencies to cover the cost of acute injury. Failure to establish and enforce laws and policies designed to reduce or prevent injury may generate enormous trauma care costs, borne to a large extent by public agencies. Further restriction of certain types of high-risk behavior and the institution of "users' fees," taxes, or penalties may be necessary to reduce the disproportionate public agency cost generated by this activity.

Acute Disease↗
PubMed1998

Noise induced hearing loss among male airport workers in Korea.

The purposes of this study of airport workers were to a) determine the prevalence and symptoms of hearing loss, and b) identify compliance in using hearing protective devices (HPDs) and its relationship with hearing loss. This cross sectional epidemiological study was conducted with 255 noise exposed and 195 non-noise exposed, full time, male workers at a large metropolitan airport in Seoul, Korea. The three measures used were the self administered Occupational Hearing Questionnaire (OHQ), an audiological assessment, and a record review of baseline hearing and noise levels of locations in which the employee worked. The results showed a significant difference in prevalence of hearing loss (more than 25dB) between the noise and the non-noise exposed groups (p < .05). About 60.8% of noise exposed workers reported continuous use of the HPDs. The continuous HPD users had significantly lower rates of hearing loss than the occasional users or non-users. The major symptom for workers with low frequency hearing loss was trouble in communication, whereas tinnitus and fullness in the ear were the most common symptoms for the workers with high frequency hearing loss. The airport workers exposed to excessive noise had a great deal of high frequency hearing loss. The degree of hearing loss present reinforces the need for aggressive hearing conservation programs among airport workers exposed to noise.

Adult↗
PubMed2004

Knowledge, behaviors, and attitudes about hearing loss and hearing protection among racial/ethnically diverse young adults.

Over 11 million individuals exhibit some degree of permanent noise induced hearing loss (NIHL). Despite such data, there remains a paucity of empirical evidence on the knowledge of noise exposure and hearing protection devices (HPDs) for young adults, particularly those of diverse racial/ethnic backgrounds. This lack of research is unfortunate, as prior research suggests that the incidence of NIHL can be reduced through educational programs, such as hearing conservation programs (HCPs). Moreover, research also indicates that such educational programs are more beneficial when developed for specific age and/or ethnic/racial groups. The primary aim of this investigation was to determine the knowledge base of 200 college-aged young adults aged 18-29, concerning the auditory mechanism, NIHL, and the use of HPDs. The second aim of this study was to identify race and ethnicity differences or similarities in knowledge of these areas among African-American and caucasian young adults. Overall, in many instances, a majority of the young adults in our study demonstrated a high degree of knowledge concerning factors associated with exposure to excessive noise and the risk of hearing loss. Yet, the results also revealed significant racial/ethnic differences in knowledge, behaviors, and attitudes about the use of HPDs. Recent estimates suggest that more than 11 million individuals in the United States exhibit some degree of NIHL. Moreover, 40 million individuals work in environments that contain potentially harmful noise levels, and over 50 million Americans routinely use firearms--a common cause of noise-induced hearing impairment. A specific hallmark manifestation of NIHL is a permanent decrease in hearing sensitivity from 3,000-6,000 Hz, with a characteristic notch at 4,000 Hz. Additional effects of exposure to high noise levels include physiological changes in heart rate and blood pressure, decrease in work productivity, and an interference with communication that results from the masking of speech. With these considerations in mind, the purpose of this study was to investigate the knowledge, behaviors, and attitudes of a young-adult population in the United States concerning the factors that contribute to NIHL and the use of hearing protection. Additionally, this study was interested in whether there were racial/ethnic differences or similarities in knowledge of hearing loss and the use of HPDs among African-American and caucasian young adults.

Adolescent↗
PubMedDate not supplied

Effectiveness of a tailored intervention to increase factory workers' use of hearing protection.

BACKGROUND: In the United States it is estimated that more than 30 million workers are exposed to harmful levels of noise on the job. When engineering or administrative controls cannot be used to reduce noise, workers should always use hearing protection devices (HPDs) when exposed to loud noise to prevent noise-induced hearing loss (NIHL). Previous research has shown that workers do not always use HPDs when required; therefore, it is essential that workers assume personal responsibility for preventing NIHL by increasing their use of HPDs. OBJECTIVES: This study tested the effectiveness of an individually tailored multimedia intervention to increase use of HPDs by factory workers. METHODS: A randomized controlled design was used to compare the effects of a tailored intervention (n= 446) with two other interventions (a nontailored predictor-based intervention (n= 447) and a control intervention (n= 432)) on workers' self-reported use of HPDs 6 to 18 months following the intervention. RESULTS: Only those workers receiving the tailored intervention significantly increased their use of HPDs from pretest to posttest. However, this increase significantly differed from the nontailored group but not from the control group. CONCLUSIONS: Individually-tailored interventions offer promise for changing behavior. In light of the similarity between the results for the tailored intervention and the control intervention groups, further research is needed to understand barriers to HPD use and how to maximize the benefits of individually tailored interventions in this setting.

Adult↗