Occupational Noise-Induced Hearing Loss Kirchner, D. Bruce; Evenson, Eric; Dobie, Robert A. ...
Journal of occupational and environmental medicine,
01/2012, Letnik:
54, Številka:
1
Journal Article
Recenzirano
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Noise-induced hearing loss (NIHL) continues to be one of the most prevalent occupational conditions and occurs across a wide spectrum of industries. Occupational hearing loss is preventable through a ...hierarchy of controls, which prioritize the use of engineering controls over administrative controls and personal protective equipment. The occupational and environmental medicine (OEM) physician works with management, safety, industrial hygiene, engineering, and human resources to insure that all components of hearing loss prevention programs are in place. super(1) The OEM physician should emphasize to employers the critical importance of preventing hearing loss through controls and periodic performance audits rather than just conducting audiometric testing. Nevertheless, audiometric testing, besides documenting the permanent loss of hearing, can be of value in the identification of hearing loss at a time when early preventive intervention is possible. The American College of Occupational and Environmental Medicine (ACOEM) believes that OEM physicians should understand a worker's noise exposure history and become proficient in the early detection and prevention of NIHL.
The creation of a “ntional water availability and use assessment program” within the USGS is part of the SECURE Water Act, Omnibus Public Land Management Act of 2009. Among the goals of this program ...are to provide a more accurate assessment of the status of water resources in the U.S., and develop the basis for an improved ability to forecast the availability of water for future economic, energy production, and environmental uses.
This study investigated the validity of the Booklet Category Test as a neuropsychological measure with inmates incarcerated in a psychiatric prison. Two samples of male inmates were selected from a ...medium-security psychiatric prison. The first sample consisted of inmates who reported a history of a closed head injury that resulted in at least 30 minutes of unconsciousness. The second sample consisted of inmates who denied ever experiencing a closed head injury. The two samples were compared in terms of the total number of errors on the Booklet Category Test and the number of errors on each of the individual subtests. A statistically significant difference did not exist between the two samples for any of the comparisons (p > .05). To investigate the validity of the normative data that is currently available for the Category Test the non-head-injured sample was compared to a normative sample matched for age and education. This analysis produced significant results (p < .00), with the non-head-injured sample committing significantly more errors (92) than the non-forensic normative sample (54). Using the cutoff score of 50/51 errors suggested by Reitan (1993) 95% of the inmates who reported a traumatic brain injury were correctly classified as “brain-injured.” However, based on this cut-off score 90% of the non-head injured sample in this study were misclassified as “brain-injured.” The results of this study suggest that the Booklet Category Test has limited validity with incarcerated psychiatric patients. Although it demonstrates adequate sensitivity, it appears to lack discriminate validity and specificity. The results suggest that use of the current normative data (based on non-forensic samples) with this population is likely to lead to a high rate of false positives (falsely categorizing “normals” as brain-injured). The implications of these results in relation to the neuropsychological assessment and treatment of male psychiatric inmates are discussed.
For a variety of reasons, occupational health services at Army Material Command installations became severely strained during the 1980s. The Occupational Health Partnership Program, developed to ...improve this support, describes control, responsibility, and cost sharing between Army Materiel Command and Army Medical Command. This innovative approach is finding new solutions to challenging problems. The authors describe the history, principles, status, and possible future of the partnership program.
Despite the increasing popularity of activity trackers, little evidence exists that they can improve health outcomes. We aimed to investigate whether use of activity trackers, alone or in combination ...with cash incentives or charitable donations, lead to increases in physical activity and improvements in health outcomes.
In this randomised controlled trial, employees from 13 organisations in Singapore were randomly assigned (1:1:1:1) with a computer generated assignment schedule to control (no tracker or incentives), Fitbit Zip activity tracker, tracker plus charity incentives, or tracker plus cash incentives. Participants had to be English speaking, full-time employees, aged 21-65 years, able to walk at least ten steps continuously, and non-pregnant. Incentives were tied to weekly steps, and the primary outcome, moderate-to-vigorous physical activity (MVPA) bout min per week, was measured via a sealed accelerometer and assessed on an intention-to-treat basis at 6 months (end of intervention) and 12 months (after a 6 month post-intervention follow-up period). Other outcome measures included steps, participants meeting 70 000 steps per week target, and health-related outcomes including weight, blood pressure, and quality-of-life measures. This trial is registered at ClinicalTrials.gov, number NCT01855776.
Between June 13, 2013, and Aug 15, 2014, 800 participants were recruited and randomly assigned to the control (n=201), Fitbit (n=203), charity (n=199), and cash (n=197) groups. At 6 months, compared with control, the cash group logged an additional 29 MVPA bout min per week (95% CI 10-47; p=0·0024) and the charity group an additional 21 MVPA bout min per week (2-39; p=0·0310); the difference between Fitbit only and control was not significant (16 MVPA bout min per week -2 to 35; p=0·0854). Increases in MVPA bout min per week in the cash and charity groups were not significantly greater than that of the Fitbit group. At 12 months, the Fitbit group logged an additional 37 MVPA bout min per week (19-56; p=0·0001) and the charity group an additional 32 MVPA bout min per week (12-51; p=0·0013) compared with control; the difference between cash and control was not significant (15 MVPA bout min per week -5 to 34; p=0·1363). A decrease in physical activity of -23 MVPA bout min per week (95% CI -42 to -4; p=0·0184) was seen when comparing the cash group with the Fitbit group. There were no improvements in any health outcomes (weight, blood pressure, etc) at either assessment.
The cash incentive was most effective at increasing MVPA bout min per week at 6 months, but this effect was not sustained 6 months after the incentives were discontinued. At 12 months, the activity tracker with or without charity incentives were effective at stemming the reduction in MVPA bout min per week seen in the control group, but we identified no evidence of improvements in health outcomes, either with or without incentives, calling into question the value of these devices for health promotion. Although other incentive strategies might generate greater increases in step activity and improvements in health outcomes, incentives would probably need to be in place long term to avoid any potential decrease in physical activity resulting from discontinuation.
Ministry of Health, Singapore.
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