COVID-19 risk mitigation in reopening mass cultural events: population-based observational study for the UK Events Research Programme in Liverpool City Region.

OBJECTIVES: To understand severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission risks, perceived risks and the feasibility of risk mitigations from experimental mass cultural events before coronavirus disease 2019 (COVID-19) restrictions were lifted. DESIGN: Prospective, population-wide observational study. SETTING: Four events (two nightclubs, an outdoor music festival and a business conference) open to Liverpool City Region UK residents, requiring a negative lateral flow test (LFT) within the 36 h before the event, but not requiring social distancing or face-coverings. PARTICIPANTS: A total of 12,256 individuals attending one or more events between 28 April and 2 May 2021. MAIN OUTCOME MEASURES: SARS-CoV-2 infections detected using audience self-swabbed (5-7 days post-event) polymerase chain reaction (PCR) tests, with viral genomic analysis of cases, plus linked National Health Service COVID-19 testing data. Audience experiences were gathered via questionnaires, focus groups and social media. Indoor CO2 concentrations were monitored. RESULTS: A total of 12 PCR-positive cases (likely 4 index, 8 primary or secondary), 10 from the nightclubs. Two further cases had positive LFTs but no PCR. A total of 11,896 (97.1%) participants with scanned tickets were matched to a negative pre-event LFT: 4972 (40.6%) returned a PCR within a week. CO2 concentrations showed areas for improving ventilation at the nightclubs. Population infection rates were low, yet with a concurrent outbreak of >50 linked cases around a local swimming pool without equivalent risk mitigations. Audience anxiety was low and enjoyment high. CONCLUSIONS: We observed minor SARS-CoV-2 transmission and low perceived risks around events when prevalence was low and risk mitigations prominent. Partnership between audiences, event organisers and public health services, supported by information systems with real-time linked data, can improve health security for mass cultural events.

The association of forced expiratory volume in one second with occupational exposures in a longitudinal study of adults in a rural community in Iowa.

PURPOSE: The Keokuk County Rural Health Study (KCRHS) is a longitudinal population-based study conducted in rural Iowa. A prior analysis of enrollment data identified an association of airflow obstruction with occupational exposures only among cigarette smokers. The current study used spirometry data from all three rounds to investigate whether level of forced expiratory volume in one second (FEV1) and longitudinal change in FEV1 were associated with occupational vapor-gas, dust, and fumes (VGDF) exposures, and whether these associations were modified by smoking. METHODS: This study sample comprised 1071 adult KCRHS participants with longitudinal data. A job-exposure matrix (JEM) was applied to participants' lifetime work histories to assign exposures to occupational VGDF. Mixed regression models of pre-bronchodilator FEV1 (millimeters, ml) were fit to test for associations with occupational exposures while adjusting for potential confounders. RESULTS: Mineral dust had the most consistent association with change in FEV1, including ever/never ( - 6.3 ml/year) and nearly every level of duration, intensity, and cumulative exposure. Because 92% of participants with mineral dust also had organic dust exposure, the results for mineral dust may be due to a combination of the two. An association of FEV1 level with fumes was observed for high intensity ( - 91.4 ml) among all participants, and limited to cigarette smokers with results of - 104.6 ml ever/never exposed, - 170.3 ml high duration, and - 172.4 ml high cumulative. CONCLUSION: The current findings suggest that mineral dust, possibly in combination with organic dust, and fumes exposure, especially among cigarette smokers, were risk factors for adverse FEV1 results.

Estimating the economic burden attributable to online only child sexual abuse offenders: implications for police strategy.

Evidence is beginning to emerge of the serious negative effects online only child sexual abuse (OOCSA) can have on victims. Establishing the scale and nature of the problem could assist police in prioritizing suspects. In study 1, scoping review identified eleven studies that examined OOCSA's impact on victims. Five themes emerged from narrative review; definitional issues, a new normal, OOCSA grooming processes, comparisons with offline CSA, mechanisms between OOCSA and harm. In study 2, OOCSA national prevalence was estimated by applying 2.9% rate of OOCSA observed from original police data to a lower bound ("sexual communication with a child" crimes recorded by the police), middle (scaling up to estimate undetected offenses) and upper bound estimate of the national offender pool (self-reported sexual solicitation offenders). Recent UK Home Office figures were adapted to establish economic costs. Lifetime costs estimates attributable to OOCSA are £7.4 million (police reports), £59.6 million (including undetected offenders) and £1.4 billion (national prevalence estimates). Over 75% of this is non-financial costs borne by victims in terms of emotional harm and lost output. Government bears around 20% of the cost burden, mostly non-financial costs for police forces. Findings are discussed in relation to evidence-led recommendations for prioritization and wider police actions that can be taken to avoid the considerable economic and social burden associated with OOCSA offenses.

The association of chronic bronchitis and airflow obstruction with lifetime and current farm activities in a sample of rural adults in Iowa.

OBJECTIVE: Farmers have an increased risk for chronic bronchitis and airflow obstruction. The objective of this study was to investigate the association of these health outcomes with farm activities. METHODS: We evaluated the Keokuk County Rural Health Study (KCRHS) enrollment data for farm activities and the two health outcomes chronic bronchitis based on self-reported symptoms and airflow obstruction based on spirometry. We used logistic regression to model the health outcomes, yielding an odds ratio (OR) and 95% confidence interval (95% CI) for farm activities while adjusting for potential confounders and other risk factors. RESULTS: Of the 1234 farmers, 104 (8.4%) had chronic bronchitis, 75 (6.1%) fulfilled the criteria for airflow obstruction, and the two outcomes overlapped by 18 participants. Chronic bronchitis without airflow obstruction (n = 86) had a statistically significant association with crop storage insecticides (OR 3.1, 95% CI 1.6, 6.1) and a low number of years (≤ 3) worked with turkeys (OR 3.3, 95% CI 1.2, 9.4). The latter result should be interpreted with caution because it is based on a small number of cases (n = 5). Airflow obstruction with or without chronic bronchitis (n = 75) was significantly associated with ever working in a hog or chicken confinement setting (OR 2.2, 95% CI 1.0, 4.5). CONCLUSIONS: These results suggest that work with crop storage insecticides or turkeys may increase the risk for chronic bronchitis and work in hog or chicken confinement may increase the risk for airflow obstruction.

An Economic Evaluation of the Impact of Using Rapport-Based Interviewing Approaches With Child Sexual Abuse Suspects.

Two studies examined whether rapport-based interviewing with child sexual abuse (CSA) suspects provides greater interview yield that could result in overall cost-savings to the investigation. First, multi-level modelling was applied to 35 naturalistic CSA suspect interviews to establish whether rapport-based interviewing techniques increase "yield" - defined as information of investigative value. The Observing Rapport Based Interviewing Technique (ORBIT coding manual was used to code interviews; it includes an assessment of both interpersonal adaptive and maladaptive rapport-based interviewer engagement as well as motivational interviewing (MI) strategies. The impact of these two strands (interpersonal and MI) on extracting information of investigative value (including strengthening a case for court and safeguarding) were examined. Adaptive interpersonal strategies increased case strengthening and safeguarding yield, with motivational interviewing having the largest impact on safeguarding yield. Both strategies increase the likelihood of gaining additional types of economic yield. Maladaptive interviewer strategies reduced case strengthening and different types of economic yield. In study two, literature-based economic estimates were applied to establish the potential cost benefits from following national ORBIT rapport training. Further training in adaptive and motivational interviewing could contribute cost savings between £19 and £78 million (annual unit costs) increasing to £238-£972 million (lifetime costs) for online CSA across England and Wales; and £157-£639 million (annual unit costs) increasing to £2-£8 billion (lifetime costs) for all CSA. Failure to commit training resource to this, or an alternative strategy, could mean the cost burden attributable to maladaptive interviewing (between £1 and £6 million for online CSA and £12 and £48 million for all CSA) is not successfully averted.

Workplace indoor environmental quality and asthma-related outcomes in healthcare workers.

BACKGROUND: Asthma-related health outcomes are known to be associated with indoor moisture and renovations. The objective of this study was to estimate the frequency of these indoor environmental quality (IEQ) factors in healthcare facilities and their association with asthma-related outcomes among workers. METHODS: New York City healthcare workers (n = 2030) were surveyed regarding asthma-related symptoms, and moisture and renovation factors at work and at home during the last 12 months. Questions for workplace moisture addressed water damage (WD), mold growth (MG), and mold odor (MO), while for renovations they addressed painting (P), floor renovations (FR), and wall renovations (WR). Regression models were fit to examine associations between work and home IEQ factors and multiple asthma-related outcomes. RESULTS: Reports of any moisture (n = 728, 36%) and renovations (n = 1412, 70%) at work were common. Workplace risk factors for asthma-related outcomes included the moisture categories of WD by itself, WD with MO (without MG), and WD with MG and MO, and the renovation category with the three factors P, FR, and WR. Reports of home IEQ factors were less frequent and less likely to be associated with health outcomes. Data analyses suggested that MG and/or MO at work and at home had a synergistic effect on the additive scale with a symptom-based algorithm for bronchial hyperresponsiveness. CONCLUSIONS: The current study determined that moisture and renovation factors are common in healthcare facilities, potentially putting workers at risk for asthma-related outcomes. More research is needed to confirm these results, especially prospective studies.

Clustering asthma symptoms and cleaning and disinfecting activities and evaluating their associations among healthcare workers.

Asthma is a heterogeneous disease with varying severity and subtypes. Recent reviews of epidemiologic studies have identified cleaning and disinfecting activities (CDAs) as important risk factors for asthma-related outcomes among healthcare workers. However, the complexity of CDAs in healthcare settings has rarely been examined. This study utilized a complex survey dataset and data reduction approaches to identify and group healthcare workers with similar patterns of asthma symptoms, and then explored their associations with groups of participants with similar patterns of CDAs. Self-reported information on asthma symptoms/care, CDAs, demographics, smoking status, allergic status, and other characteristics were collected from 2030 healthcare workers within nine selected occupations in New York City. Hierarchical clustering was conducted to systematically group participants based on similarity of patterns of the 27 asthma symptom/care variables, and 14 product applications during CDAs, separately. Word clouds were used to visualize the complex information on the resulting clusters. The associations of asthma health clusters (HCs) with exposure clusters (ECs) were evaluated using multinomial logistic regression. Five HCs were identified (HC-1 to HC-5), labelled based on predominant features as: "no symptoms", "winter cough/phlegm", "mild asthma symptoms", "undiagnosed/untreated asthma", and "asthma attacks/exacerbations". For CDAs, five ECs were identified (EC-1 to EC-5), labelled as: "no products", "housekeeping/chlorine", "patient care", "general cleaning/laboratory", and "disinfection products". Using HC-1 and EC-1 as the reference groups, EC-2 was associated with HC-4 (odds ratio (OR) = 3.11, 95% confidence interval (95% CI) = 1.46-6.63) and HC-5 (OR = 2.71, 95% CI = 1.25-5.86). EC-3 was associated with HC-5 (OR = 2.34, 95% CI = 1.16-4.72). EC-4 was associated with HC-5 (OR = 2.35, 95% CI = 1.07-5.13). EC-5 was associated with HC-3 (OR = 1.81, 95% CI = 1.09-2.99) and HC-4 (OR = 3.42, 95% CI = 1.24-9.39). Various combinations of product applications like using alcohols, bleach, high-level disinfectants, and enzymes to disinfect instruments and clean surfaces captured by the ECs were identified as risk factors for the different asthma symptoms clusters, indicating that prevention efforts may require targeting multiple products. The associations of HCs with EC can be used to better inform prevention strategies and treatment options to avoid disease progression. This study demonstrated hierarchical clustering and word clouds were useful techniques for analyzing and visualizing a complex dataset with a large number of potentially correlated variables to generate practical information that can inform prevention activities.

Facilitators and barriers to effective information sharing during international disaster response.

Effective information sharing is essential for the successful management of disasters. But as 30 years' worth of UK public inquiries repeatedly highlight, differences in terminology and goals across agencies can make this difficult to achieve. The growing scale and intensity of disasters raises additional challenges, with emergency responders being required to work across regions and even countries. The following study focuses on identifying facilitators and barriers to information sharing in dynamic contexts, where interdisciplinary teams from across geographic regions form ad hoc to rapidly address challenges. This case study draws on 257 naturalistic observations made by subject-matter experts during the largest disaster management exercise to take place in Europe to date. The 4-day exercise, funded by the European Commission, involved over 5,000 emergency responders from the UK, Cyprus, Hungary, and Italy, providing a unique opportunity to examine information sharing practices across international boundaries. Results of a mixed-method analysis highlight that barriers within and between countries are particularly prevalent during periods of greater uncertainty. These barriers include language and technological difficulties, differences in roles and responsibilities, and failure to co-locate and coordinate activities. Developing shared frames of reference, including adopting common structures for presenting information and understanding roles and responsibilities, facilitates information sharing, potentially reducing cognitive load. Implications for developing evidence-based approaches to disaster response are discussed.

Occupation and task as risk factors for asthma-related outcomes among healthcare workers in New York City.

BACKGROUND: Previous studies have suggested an association of asthma onset and exacerbation with cleaning and disinfecting activities in a number of industries, including healthcare. The objective of the current study was to investigate the association of asthma and related outcomes with occupations and tasks in urban healthcare workers in the United States. METHODS: A questionnaire was implemented in a sample of workers from nine healthcare occupations in New York City. We used regression models to examine the association of post-hire asthma, current asthma, exacerbation of asthma, a symptom algorithm for bronchial hyper-responsiveness (BHR-related symptoms), a symptom-based asthma score, and the symptom wheeze with occupation and four healthcare tasks, while adjusting for other risk factors and potential confounders. RESULTS: A total of 2030 participants completed the questionnaire. The task of cleaning fixed surfaces was significantly associated with most outcome variables, including current asthma (odds ratio (OR) = 1.84, 95% confidence interval (CI) 1.26-2.68), moderate exacerbation (OR = 3.10, 95% CI 1.25-7.67), and BHR-related symptoms (OR = 1.38, 95% CI 1.08-1.77). In comparison to nursing assistants, the occupations environmental service workers and registered nurses were at higher risk for current asthma, and licensed practical nurses were at higher risk for moderate exacerbation. Other tasks associated with outcomes were administering aerosolized medications with current asthma and moderate exacerbation, and sterilizing medical equipment with BHR-related symptoms. CONCLUSIONS: These findings add to the growing body of evidence for the association of asthma with cleaning and other activities in healthcare. Further research is especially needed to investigate the association of asthma-related outcomes with exposure metrics based on tasks, products, and chemical exposures in healthcare.

Information sharing in interteam responses to disaster.

Research demonstrates that information sharing is facilitated by familiarity, and having a common understanding of problems, use of lexicon, and semantic meaning. These factors can be difficult to develop within extreme environments such as disasters as members of the multi-agency system that responds often have limited experience of working together. Public inquiries repeatedly highlight the impact of information sharing difficulties on public safety, but limited academic research has focused on identifying concrete behaviours that facilitate interteam information sharing within such environments. This paper presents a case study of a national disaster response exercise involving 1,000 emergency responders. Data consist of structured observations, recordings of interteam meetings, and interviews with emergency responders. Results of mixed-method analysis indicate that interteam information sharing is delayed by limited situation awareness and poor articulation. Conversely, adopting behaviours that promote common frames for understanding interteam capabilities and information requirements improves information sharing and potentially reduces cognitive effort required to process information. Findings contribute to interteam communication theory by highlighting that in complex, time-constrained environments, having a shared understanding of responsibilities and information requirement is important for minimizing redundant deliberation and improving relevance and speed. PRACTITIONER POINTS: Facilitating the exchange and interpretation of relevant information is important for improving situation assessment, decision-making, and the implementation of appropriate actions for addressing risks.Interteam information sharing can be particularly challenging when teams are comprised of members from across different organizations with different language and cultures that must form ad hoc to rapidly respond to problems in extreme environments.Adopting communication strategies that develop common frames-of-reference can facilitate information sharing and interteam responses to disasters.

Exposures to Volatile Organic Compounds among Healthcare Workers: Modeling the Effects of Cleaning Tasks and Product Use.

Objectives: Use of cleaning and disinfecting products is associated with work-related asthma among healthcare workers, but the specific levels and factors that affect exposures remain unclear. The objective of this study was to evaluate the determinants of selected volatile organic compound (VOC) exposures in healthcare settings. Methods: Personal and mobile-area air measurements (n = 143) from 100 healthcare workers at four hospitals were used to model the determinants of ethanol, acetone, 2-propanol, d-limonene, α-pinene, and chloroform exposures. Hierarchical cluster analysis was conducted to partition workers into groups with similar cleaning task/product-use profiles. Linear mixed-effect regression models using log-transformed VOC measurements were applied to evaluate the association of individual VOCs with clusters of task/product use, industrial hygienists' grouping (IH) of tasks, grouping of product application, chemical ingredients of the cleaning products used, amount of product use, and ventilation. Results: Cluster analysis identified eight task/product-use clusters that were distributed across multiple occupations and hospital units, with the exception of clusters consisting of housekeepers and floor strippers/waxers. Results of the mixed-effect models showed significant associations between selected VOC exposures and several clusters, combinations of IH-generated task groups and chemical ingredients, and product application groups. The patient/personal cleaning task using products containing chlorine was associated with elevated levels of personal chloroform and α-pinene exposures. Tasks associated with instrument sterilizing and disinfecting were significantly associated with personal d-limonene and 2-propanol exposures. Surface and floor cleaning and stripping tasks were predominated by housekeepers and floor strippers/waxers, and use of chlorine-, alcohol-, ethanolamine-, and quaternary ammonium compounds-based products was associated with exposures to chloroform, α-pinene, acetone, 2-propanol, or d-limonene. Conclusions: Healthcare workers are exposed to a variety of chemicals that vary with tasks and ingredients of products used during cleaning and disinfecting. The combination of product ingredients with cleaning and disinfecting tasks were associated with specific VOCs. Exposure modules for questionnaires used in epidemiologic studies might benefit from seeking information on products used within a task context.

Occupational Exposure to Vapor-Gas, Dust, and Fumes in a Cohort of Rural Adults in Iowa Compared with a Cohort of Urban Adults.

PROBLEM/CONDITION: Many rural residents work in the field of agriculture; however, employment in nonagricultural jobs also is common. Because previous studies in rural communities often have focused on agricultural workers, much less is known about the occupational exposures in other types of jobs in rural settings. Characterizing airborne occupational exposures that can contribute to respiratory diseases is important so that differences between rural and urban working populations can be assessed. REPORTING PERIOD: 1994-2011. DESCRIPTION OF SYSTEM: This investigation used data from the baseline questionnaire completed by adult rural residents participating in the Keokuk County Rural Health Study (KCRHS). The distribution of jobs and occupational exposures to vapor-gas, dust, and fumes (VGDF) among all participants was analyzed and stratified by farming status (current, former, and never) then compared with a cohort of urban workers from the Multi-Ethnic Study of Atherosclerosis (MESA). Occupational exposure in the last job was assessed with a job-exposure matrix (JEM) developed for chronic obstructive pulmonary disease (COPD). The COPD JEM assesses VGDF exposure at levels of none or low, medium, and high. RESULTS: The 1,699 KCRHS (rural) participants were more likely to have medium or high occupational VGDF exposure (43.2%) at their last job than their urban MESA counterparts (15.0% of 3,667 participants). One fifth (20.8%) of the rural participants currently farmed, 43.1% were former farmers, and approximately one third (36.1%) had never farmed. These three farming groups differed in VGDF exposure at the last job, with the prevalence of medium or high exposure at 80.2% for current farmers, 38.7% for former farmers, and 27.4% for never farmers, and all three percentages were higher than the 15.0% medium or high level of VGDF exposure for urban workers. INTERPRETATION: Rural workers, including those who had never farmed, were more likely to experience occupational VGDF exposure than urban workers. PUBLIC HEALTH ACTION: The occupational exposures of rural adults assessed using the COPD JEM will be used to investigate their potential association with obstructive respiratory health problems (e.g., airflow limitation and chronic bronchitis). This assessment might highlight occupations in need of preventive interventions.

Characterization of cleaning and disinfecting tasks and product use among hospital occupations.

BACKGROUND: Healthcare workers have an elevated prevalence of asthma and related symptoms associated with the use of cleaning/disinfecting products. The objective of this study was to identify and characterize cleaning/disinfecting tasks and products used among hospital occupations. METHODS: Workers from 14 occupations at five hospitals were monitored for 216 shifts, and work tasks and products used were recorded at five-minute intervals. The major chemical constituents of each product were identified from safety data sheets. RESULTS: Cleaning and disinfecting tasks were performed with a high frequency at least once per shift in many occupations. Medical equipment preparers, housekeepers, floor strippers/waxers, and endoscopy technicians spent on average 108-177 min/shift performing cleaning/disinfecting tasks. Many occupations used products containing amines and quaternary ammonium compounds for >100 min/shift. CONCLUSIONS: This analysis demonstrates that many occupations besides housekeeping incur exposures to cleaning/disinfecting products, albeit for different durations and using products containing different chemicals.

Indoor and outdoor particulate matter and endotoxin concentrations in an intensely agricultural county.

The objectives of this study were to characterize rural populations' indoor and outdoor exposure to particulate matter (PM)(10), PM(2.5), and endotoxin and identify factors that influence these concentrations. Samples were collected at 197 rural households over five continuous days between 2007 and 2011. Geometric mean (GM) indoor PM(10) (21.2 µg/m(3)) and PM(2.5) (12.2 µg/m(3)) concentrations tended to be larger than outdoor PM(10) (19.6 µg/m(3)) and PM(2.5) (8.2 µg/m(3)) concentrations (PM(10) P=0.086; PM(2.5) P<0.001). Conversely, GM outdoor endotoxin concentrations (1.93 EU/m(-3)) were significantly larger than indoor (0.32 EU/m(3); P<0.001). Compared with measurements from previous urban studies, indoor and outdoor concentrations of PM(10) and PM(2.5) in the study area tended to be smaller, whereas ambient endotoxin concentrations measured outside rural households were 3-10 times larger. Contrary to our initial hypothesis, seasonality did not have a significant effect on mean ambient PM(10) concentrations; however, endotoxin concentrations in the autumn were almost seven times larger than winter. Excluding home cleanliness, the majority of agricultural and housing characteristics evaluated were found to be poorly associated with indoor and outdoor particulate and endotoxin concentrations.

Effects of common agricultural tasks on measures of hearing loss.

BACKGROUND: Among agricultural populations, hearing loss caused by excessive noise exposure is common. However, examinations of associations between exposure to agricultural tasks and hearing loss are limited. METHODS: Audiometry and lifetime exposure to 11 agricultural tasks were analyzed among 1,568 participants. Gender stratified multivariable linear regression was used to estimate associations between exposure duration and three hearing loss metrics. RESULTS: Among men, significant associations were observed between hearing loss and hunting or target shooting, all-terrain vehicle (ATV) or motorcycle riding, chain saw use, electric or pneumatic tool use, living on a farm, and all agricultural tasks combined. When all significant exposure metrics were included in a single model, associations remained for hunting or target shooting, electric or pneumatic tool use and living on a farm. Significant associations were sparse among women, and in all cases paradoxical. CONCLUSIONS: Despite imprecise estimation of noise exposure, specific agricultural tasks were associated with hearing loss.

Noise exposures of rural adolescents.

PURPOSE: This project was conducted to characterize the noise exposure of adolescents living in rural and agricultural environments. METHODS: From May to October, 25 adolescents ages 13 through 17, living either on a farm or a rural nonfarm, were enrolled in the study. Subjects received training on the correct operation and use of personal noise dosimeters and the proper way to record their daily tasks on activity cards. Subjects completed 4 days of self-monitoring noise dosimetry, 2 days in the first round (May-July) and 2 days in the second round (August-October). In addition to dosimetry, subjects completed activity logs of their daily tasks. RESULTS: The mean daily noise exposures of adolescents living on farms and in nonfarm rural homes were between 55.4 dBA (A-weighted decibels) and 103.5 dBA, with 44% of the daily measurements greater than the National Institute of Occupational Safety and Health Recommended Exposure Level of 85 dBA. Task-based analysis of noise exposures found that activities involving mechanized equipment resulted in the highest exposures, while activities in the home resulted in the lowest exposure. No particular demographic group had a statistically higher noise exposure; therefore, specific factors apart from activities and noise sources could not be identified as risk factors for exposure to hazardous noise levels. CONCLUSIONS: The results of this project indicate that rural adolescents complete a variety of activities and are exposed to noise sources with a broad range of decibel levels. While the exposures may change from day to day, there are occasions when exposure to noise exceeds the recommended levels.

Occupational noise exposure assessment in intensive swine farrowing systems: dosimetry, octave band, and specific task analysis.

The scientific literature is lacking in published agricultural noise assessments for employees of swine confinement facilities that have included dosimeter data, octave band analysis, or specific task exposure assessments. This study reports on the former three types of noise assessments in the farrowing stage of swine. Dosimeter data on workers revealed all assessments to be greater than 90 decibels measured on the A-scale (dBA), which exceeds the 85 dBA National Institute for Occupational Safety and Health (NIOSH) Recommended Exposure Limit (REL). RELs were exceeded for all of the employees monitored in the swine facility, as well as the part-time employees who power-washed the farrowing rooms. The recorded time-weighted values were actually underestimated slightly because the dosimeters were set to record only noise at 85 dBA and higher.