Partial cooling of the upper body with a water-cooled vest in an environment exceeding body temperature.

OBJECTIVES: To evaluate the efficacy of water-cooled clothing that continuously cools restricted body areas to suppress body temperature increase as an anti-heatstroke measure for workers in hot environments that exceed body temperature. METHODS: Ten healthy men were placed in Room A (air temperature: 25°C, relative humidity: 50%) for 15 min. They were then transferred to Room B (air temperature: 40°C, relative humidity: 50%), where they rested for 10 min, then put on cooling clothing, and again rested for 15 min (the control group rested for 25 min). They then performed intense ergometer exercise for 40 min at 40% maximal oxygen consumption after which they rested for 10 min. The three trial conditions were CON (long-sleeved summer work clothes), VEST (cooling vest), and P-VEST (partial cooling vest). In VEST and P-VEST, water-cooled clothing continuously recirculated with 10°C water was used to cool the upper body. In P-VEST, only the neck, axillae, and heart areas were in contact with the cooled clothing. The measured indices were the rectal, esophageal, and external auditory canal temperatures; heart rate; estimated sweat volume; and subjective evaluations. RESULTS: Compared with the CON condition, the rectal, esophageal, and external auditory canal temperatures and the heart rate were significantly lower and the subjective indices were decreased in the VEST and P-VEST conditions. CONCLUSIONS: Partial cooling showed a body cooling effect similar to that of whole upper body cooling. Partial body cooling promoted the heat dissipation, suggesting that partial cooling is efficient for maintaining body cooling in hot environments.

A fan-attached jacket worn in an environment exceeding body temperature suppresses an increase in core temperature.

We examined whether blowing hot air above body temperature under work clothing may suppress core temperature. Nine Japanese men engaged in two 30-min bicycle ergometer sessions at a workload of 40% VO2max at 40 °C and 50% relative humidity. The experiment was conducted without wearing any cooling apparatus (CON), wearing a cooling vest that circulated 10.0 °C water (VEST), and wearing a fan-attached jacket that transferred ambient air underneath the jacket at a rate of 30 L/s (FAN). The VEST and FAN conditions suppressed the increases of rectal temperature (CON, VEST, FAN; 38.01 ± 0.19 °C, 37.72 ± 0.12 °C (p = 0.0076), 37.54 ± 0.19 °C (p = 0.0023), respectively), esophageal temperature (38.22 ± 0.30 °C, 37.55 ± 0.18 °C (p = 0.0039), 37.54 ± 0.21 °C (p = 0.0039), respectively), and heart rate (157.3 ± 9.8 bpm, 136.9 ± 8.9 bpm, (p = 0.0042), 137.5 ± 6.5 bpm (p = 0.0023), respectively). Two conditions also reduced the estimated amount of sweating and improved various subjective evaluations. Even in the 40 °C and 50% relative humidity environment, we may recommend wearing a fan-attached jacket because the heat dissipation through evaporation exceeded the heat convection from the hot ambient air.

Efficacy of ice slurry and carbohydrate-electrolyte solutions for firefighters.

OBJECTIVES: To examine the thermoregulatory and fluid-electrolyte responses of firefighters ingesting ice slurry and carbohydrate-electrolyte solutions before and after firefighting operations. METHODS: Twelve volunteer firefighters put on fireproof clothing and ingested 5 g/kg of beverage in an anteroom at 25°C and 50% relative humidity (RH; pre-ingestion), and then performed 30 minutes of exercise on a cycle ergometer (at 125 W for 10 minutes and then 75 W for 20 minutes) in a room at 35℃ and 50% RH. The participants then returned to the anteroom, removed their fireproof clothing, ingested 20 g/kg of beverage (post-ingestion), and rested for 90 minutes. Three combinations of pre-ingestion and post-ingestion beverages were provided: a 25℃ carbohydrate-electrolyte solution for both (CH condition); 25℃ water for both (W condition); and a -1.7℃ ice slurry pre-exercise and 25℃ carbohydrate-electrolyte solution post-exercise (ICE condition). RESULTS: The elevation of body temperature during exercise was lower in the ICE condition than in the other conditions. The sweat volume during exercise was lower in the ICE condition than in the other conditions. The serum sodium concentration and serum osmolality were lower in the W condition than in the CH condition. CONCLUSIONS: The ingestion of ice slurry while firefighters were wearing fireproof clothing before exercise suppressed the elevation of body temperature during exercise. Moreover, the ingestion of carbohydrate-electrolyte solution by firefighters after exercise was useful for recovery from dehydration.

Development of a method for estimating oesophageal temperature by multi-locational temperature measurement inside the external auditory canal.

We aimed to develop a practical method to estimate oesophageal temperature by measuring multi-locational auditory canal temperatures. This method can be applied to prevent heatstroke by simultaneously and continuously monitoring the core temperatures of people working under hot environments. We asked 11 healthy male volunteers to exercise, generating 80 W for 45 min in a climatic chamber set at 24, 32 and 40 °C, at 50% relative humidity. We also exposed the participants to radiation at 32 °C. We continuously measured temperatures at the oesophagus, rectum and three different locations along the external auditory canal. We developed equations for estimating oesophageal temperatures from auditory canal temperatures and compared their fitness and errors. The rectal temperature increased or decreased faster than oesophageal temperature at the start or end of exercise in all conditions. Estimated temperature showed good similarity with oesophageal temperature, and the square of the correlation coefficient of the best fitting model reached 0.904. We observed intermediate values between rectal and oesophageal temperatures during the rest phase. Even under the condition with radiation, estimated oesophageal temperature demonstrated concordant movement with oesophageal temperature at around 0.1 °C overestimation. Our method measured temperatures at three different locations along the external auditory canal. We confirmed that the approach can credibly estimate the oesophageal temperature from 24 to 40 °C for people performing exercise in the same place in a windless environment.

Assessment of exposure to voices and noise via earphones in manufacturing industry workers in Japan.

OBJECTIVES: There is concern that sound via earphones and headphones attached to headsets used in workplaces may be a risk factor for noise-induced hearing loss (NIHL). Although there are some previous studies investigating exposure to noise from headphones, almost none have assessed the risks to workers who use earphones. We assessed exposure to noise among workers who regularly wear earphones in noisy workplaces. METHODS: The subjects of this study were 21 workers who regularly wear earphones in three manufacturing companies in Japan. The sound pressure output from earphones and personal exposure to occupational noise was measured for each worker. A noise-dosimeter was used to measure individual exposure to occupational noise. The sound pressure output from the earphones was measured by recording the electric signal with a data recorder attached to the earphones, and the recording was analyzed by playing it back in the laboratory through a sound analyzer via an ear simulator. RESULTS: The mean scores for personal exposure and earphone output LAeq were 87.9 dB and 87.6 dB, respectively. Earphone output LAeq exceeded 85 dB for two-thirds of the subjects. Nearly all the subjects lacked hearing protection devices (HPDs) on their earphones. CONCLUSIONS: The results suggest that workers who use earphones in noisy workplaces are exposed to the following NIHL risk factors: (1) they are deprived of the opportunity to fit appropriate HPDs, and (2) the sound pressure output from the earphones themselves exceeds the occupational exposure limit.

Urinary 1-hydroxypyrene levels among office workers living in industrial areas.

We examined exposure to polycyclic aromatic hydrocarbons (PAHs) among non-smoking office workers in 2 countries living in the vicinity of a coke-oven factory by measuring their levels of urinary 1-OHP, a known metabolite of PAHs. Subjects included 10 non-smoking office workers in Kitakyushu city (Japan) and 20 workers in Thai Nguyen city (Vietnam). Measurement was optimized by using the high-performance liquid chromatography (HPLC) method developed by Jongeneelen et al. This method required only a small amount of urine and had a short incubation time, and its detection limit was very low (0.00448 ng/ml), which was practical and highly sensitive.The median urinary 1-OHP concentration in the Vietnamese subjects (0.417 ng/mg creatinine) was six times as high as that in the Japanese subjects (0.069 ng/mg creatinine) (P < 0.001). However, both concentrations were significantly below the guideline level, below which there is no genotoxic effect, implying a low probability of any adverse health effects.Our measurements from both countries showed higher urinary 1-OHP concentrations than in previous studies from locations without factories, indicating that ambient air pollution from industrial emissions is an important source of PAH exposure. Finally, the urinary 1-OHP concentrations did not correlate with gender or lifestyle factors.

Urinary 1-hydroxypyrene and 8-hydroxydeoxyguanosine levels among coke-oven workers for 2 consecutive days.

OBJECTIVES: This study evaluated the levels of exposure to polycyclic aromatic hydrocarbons (PAHs) and their relationship with oxidative DNA damage among Vietnamese coke-oven workers. METHODS: We collected urine from 36 coke-oven workers (exposed group) at the beginning and end of the shift on 2 consecutive days. We also collected urine from 78 medical staff (control group). Information was collected by questionnaire about smoking status, drinking habit, and working position. Urinary 1-hydroxypyrene (1-OHP) and 8-hydroxydeoxyguanosine (8-OH-dG) were measured using HPLC. All statistical analyses were performed with SPSS version 19. RESULTS: Urinary 1-OHP was significantly higher in the coke-oven workers than in the control group (p<0.05). Top-oven workers had the highest levels of internal exposure to PAHs, followed by side-oven and then bottom-oven workers (5.41, 4.41 and 1.35 ng/mg creatinine, respectively, at the end of the shift on day 2). Urinary 8-OH-dG was significantly higher in top- and side-oven workers at the end of the shift on day 2 (4.63 and 5.88 ng/mg creatinine, respectively) than in the control group (3.85 ng/mg creatinine). Based on a multi-regression analysis, smoking status had a significant effect on urinary 8-OH-dG (p=0.049). Urinary 1-OHP tended to have a positive correlation with urinary 8-OH-dG (p=0.070). CONCLUSIONS: Vietnamese coke-oven workers were exposed to PAHs during their work shift. Urinary 1-OHP exceeded the recommended limit, and elevated oxidative DNA damage occurred in top- and side-oven workers on the second day of work. A tendency for positive correlation was found between urinary 1-OHP and urinary 8-OH-dG.

Urine temperature as an index for the core temperature of industrial workers in hot or cold environments.

Workers working in hot or cold environments are at risk for heat stroke and hypothermia. In Japan, 1718 people including 47 workers died of heat stroke in 2010 (Ministry of Health Labour and Welfare, Japan 2011). While the American Conference of Governmental Industrial Hygienists (ACGIH) recommendation lists the abnormal core temperature of workers as a criterion for halting work, no method has been established for reliably measuring core temperatures at workplaces. ISO 9886 (Ergonomics-evaluation of thermal strain by physiological measurements. ISO copyright office, Geneva, pp 3-14; 2004) recognizes urine temperature as an index of core temperature only at normal temperature. In this study we ascertained whether or not urine temperature could serve as an index for core temperature at temperatures above and below the ISO range. We measured urine temperature of 31 subjects (29.8 ± 11.9 years) using a thermocouple sensor placed in the toilet bowl at ambient temperature settings of 40, 20, and 5˚C, and compared them with rectal temperature. At all ambient temperature settings, urine temperature correlated closely with rectal temperature exhibiting small mean bias. Urine temperature changed in a synchronized manner with rectal temperature at 40˚C. A Bland and Altman analysis showed that the limits of agreement (mean bias ± 2SD) between rectal and urine temperatures were -0.39 to +0.15˚C at 40˚C (95%CI -0.44 to +0.20˚C) and -0.79 to +0.29˚C at 5˚C (-0.89 to +0.39˚C). Hence, urine temperature as measured by the present method is a practical surrogate index for rectal temperature and represents a highly reliable biological monitoring index for assessing hot and cold stresses of workers at actual workplaces.

[Assessment of telephone operators' exposure to sound through headphones].

We estimated the level of noise that telephone operators were exposed to through headphones by a two-step method using an artificial ear technique and a manikin technique. In the artificial ear technique, the sound pressure level (Leq) of the total work hours was 81.5 dB, whereas the Leq of the total duration of phone calls was 89.3 dB. Therefore, we conducted a more accurate measurement by the manikin technique (ISO11904-2). By this method, we could simulate the headphone-wearing condition of the workers and convert the measurements to a diffuse-field related L(Aeq). By this manikin technique, the corrected L(Aeq) of the total work hours was 68.3 dB, whereas the corrected L(Aeq) of the total duration of call was 76.6 dB, which was below the standard of the Occupational Exposure Limits of the Japan Society of Occupational Health. We confirmed that in a workplace where the background noise is low (51.3 dBA), a good signal-noise ratio is maintained so that operators don't have to listen to loud sounds through headphones. Neither the gender nor the type of the telephone equipment of the callers affected the sound pressure levels.

Improvements in sound attenuation performance with earplugs following checklist-based self-practice.

The hearing protectors most often used in noisy workplaces are earplugs. The sound attenuation performance of earplugs depends in part on the user's skill and knowledge. This study sought to clarify whether individual training and self-practice based on a checklist can improve sound attenuation. Measurements were performed as follows: Ten subjects, including both men and women, were provided with semi-insert earplugs (E-A-R flex 350-1001) and wore them based only on the printed instructions of the product. Sound attenuation was measured from 125 Hz to 8000 Hz, in accordance with JIS T8161-1983. Intervention was provided through 5 minute individual training with oral and written instructions, followed by 10 minute self-practice each day for 7 days. Sound attenuation was then measured once again. The results indicated significantly improved attenuation, ranging from 7.7 dB to 11.7 dB, in all frequencies following training, confirming the effectiveness of the intervention. This is an easy and effective method for training workers in how to wear earplugs most effectively.

Temporary threshold shifts at 1500 and 2000 Hz induced by loud voice signals communicated through earphones in the pinball industry.

To assess the risk of hearing loss among workers using earphones as communication devices at noisy worksites, we compared temporary threshold shifts (TTS) between ears on which workers wore earphones and ears on which no earphones were worn. We measured ambient noise and personal noise exposure as well as noise generated by and passed through earphones by applying frequency analysis at three pinball facilities during their hours of actual operation. We assessed hearing levels before and after a work shift (prework and postwork) of 54 workers by pure tone audiometry at six frequencies. The time-weighted averages for ambient noise and personal noise exposure exceeded 85 dB(A) and 90 dB(A), respectively. Overall sound pressure levels generated by and passing through earphones reached 109 dB(A). The one-third octave band spectrum of the earphone noise during the shift exceeded 90 dB(SPL) in the range of 315-2000 Hz. The number of ears demonstrating a TTS, defined as a shift of 10 dB or more in postwork over prework hearing thresholds, was significantly greater at 1500 and 2000 Hz among ears with earphones (P < 0.05 and P < 0.01, respectively) compared to those without. The reverse was observed at 4000 Hz for ears without earphones (P < 0.01). Workers wearing earphones or headsets as communication devices in noisy environments are exposed to high risk of hearing loss, particularly at the frequencies of 1500 and 2000 Hz. Ideally, hearing conservation programs for such workers should account for potential hearing losses at frequencies of 2000 Hz or lower frequencies induced by amplified voice signals.

[Development of a computerized sound attenuation measurement system of hearing protectors based on Japanese Industrial Standard(JIS)].

Sound attenuation measurement of hearing protectors is done in accordance with JIS T 8161 in Japan. In the JIS T 8161 it is stated that more than three non-coherent sets which include a noise generator, one-third octave band-pass filter, amplifier, calibrated attenuator and signal interrupter are required. To realize this measurement system, various expenses and a large space are required. In our study, four channel test signals were generated by our programs, and fed to a digital/analog converter. Consequently, the hardware of a noise generator and one-third octave band-pass filter could be reduced. Moreover, a program, which automatically controlled sound pressure level by digitally controlled attenuators, was developed with the result that the sound attenuation measurement could be performed by operating the mouse. Furthermore, sound attenuation of the earplug was measured in accordance with JIS T 8161 to evaluate our system. The result showed that practical sound attenuation values were obtained by easy operation. It was considered that this system was effective in hardware reduction, and useful for sound attenuation measurement of hearing protectors.

[Development of a hospital information system simulator for education].

When teaching students the hospital information system, it is impossible to use an actual hospital information system because of security reasons. To overcome this problem, a simulator of the hospital information system for student education has been developed. The purpose of this system is to help students understanding a hospital information system from actual experience. The characteristics of this system are as follows: 1) Students can easily learn a hospital information system on the Web pages in the computer training room. 2) The present system is not as complete as a hospital information system, however, helpful explanations regarding the data processing have been inserted. 3) The fictional patient data have been prepared for the pages relating to the electronic medical chart. Consequently, students can understand what kind of data has been saved in this system. Through a questionnaire, students evaluated this system in terms of understandability. The result from four years between 1999 and 2002 showed that 70% of them evaluated it as good system. We therefore consider this system to be effective over a short period of time, and useful for medical education.

Noise attenuation characteristics of a foam type earplug measured using a dummy head.

The attenuation characteristics of the earplug using a dummy head (KEMAR; Knowles Electronics Manikin for Acoustic Research) were measured, when it was exposed to pure tones or broadband noises at three different sound pressure levels (SPLs) of 70, 80 and 90 dB SPL in the 'wide frequency range from 250 to 20 k Hz. We ascertained the satisfactory capacity of noise attenuation except for from 10 k to 14 k Hz. The noise attenuation level increased with frequency until 2 k Hz, became almost constant until 8 k Hz, then decreased at around 10 k to 14 k Hz, and recovered in the range from 16 k to 20 k Hz. The frequency characteristics were identical among three different sound pressure levels and almost identical between pure tones and broadband noises. The change of frequency characteristics affected by the depth of the earplug that was inserted into the artificial ear canal of the KEMAR was also investigated. Measured sound pressure level by the builetin microphone in the KEMAR revealed a region in which the measured sound pressure levels were relatively higher around 10 k Hz. The frequency of the region moved higher when the earplug was inserted more deeply. Therefore it was considered that this phenomenon was related to the resonance frequency of the cylinder-like cavity made between the end section of the earplug and the diaphragm of the built-in microphone.