Noise Exposure and Quality of Life Among Nurses.

BACKGROUND: The purpose of this study was to describe the relationship between noise exposure, selected health conditions, and well-being among nurses. METHODS: A secondary analysis was performed on data obtained from 3,818 U.S. nurses who responded to a survey regarding noise exposure, health conditions, stress, professional quality of life, and workplace support. FINDINGS: Those who reported high noise exposure reported more health conditions, higher stress and burnout scores, and lower supportive environments. High noise exposure was significantly associated with lower professional quality of life. CONCLUSION/APPLICATION TO PRACTICE: Noise may impact the health and quality of professional life of nurses. Occupational health nurses should advocate for the regular monitoring of nurses' exposure to hazardous noise at work, compare it to OSHA permissible levels, and collaborate with the occupational health team to ensure safe noise levels are maintained. Occupational health nurses should advocate for expanded research on effects of noise on health.

Predictors of use of hearing protection among a representative sample of farmers.

Farmers experience higher rates of noise-induced hearing loss (NIHL) than workers in most other industries. We developed a model of farmers' use of hearing protection, and tested it with a random sample (n = 532) of farmers from the upper Midwest. Barriers to using hearing protection (e.g., difficulty communicating; OR = .44, p < .003) were negatively related to use. Greater access/availability of hearing protectors (OR = 1.75, p < .010) and male gender (OR = .43, p < .019) were positively related to use. The model correctly predicted use of hearing protection for 74% of the cases. Overall, farmers demonstrated low hearing protector use, and results were similar to those from previous studies of non-farm workers. Findings from this study will be useful in designing interventions to increase farmers' hearing protector use and decrease their rates of NIHL.

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.

Implementation of a Victorian Cardiac Surgery Database.

The Victorian Cardiac Surgery Database project will be jointly developed and delivered by Melbourne Information Management and the Baker Medical Research Institute. After a pilot phase involving one hospital, all Victorian public hospitals with cardiac surgery units will provide data for developing and testing the Cardiac Surgery Database. In the initial proposal, the period of data collection is from 1 April 2001 to 31 March 2002. Issues being addressed in preparation for the implementation phase are those of ownership, management and administration of the Database as well as taxation, liability and governance. Completeness and accuracy of the data collection process and the maintenance of confidentiality are prime considerations in the implementation phase of the project.

Benefits of a nurse directed over the counter medication dispensing system in an automotive plant. A preliminary study.

Information is limited about the effects of the availability of over the counter medicines (OTCs) at a worksite on workers' ability to remain at work and the effect on health care utilization. The purpose of this preliminary study was to assess workers' perceptions related to the benefits of having a nurse directed over the counter medication dispensing system (OTCMS) at an automotive manufacturing plant. Fifty-six percent of 257 randomly selected workers who participated in semistructured interviews indicated they used OTCs as the first intervention when at home, and 88% had obtained OTCs from the plant's medical department. The workers were overwhelmingly positive about having an OTCMS available at their worksite. Eighty-nine percent indicated that having OTCs available from the occupational health nurse made it possible for them to stay at work and complete their shift. Not only did the workers find the OTCMS to be an asset in their worksite, but they also highly recommended having an OTCMS available in work settings that do not presently have one in place.

West Nile virus investigations in South Moravia, Czechland.

Seven virus isolates were obtained from 11,334 mosquitoes after the 1997 Morava River flooding in South Moravia (Czech Republic): 6 strains of Tahyna bunyavirus, California antigenic group (5 from Aedes vexans, 1 from Ae. cinereus), and 1 strain of West Nile flavivirus (WNV) from Culex pipiens. In 1999, one isolate of Tahyna virus from Ae. vexans and one isolate of WNV from Cx. pipiens were recovered from a total of 14,354 mosquitoes examined in the same area, whereas no virus was detected there in 1,179 overwintering mosquitoes (mostly Cx. pipiens) in March 2000. The infection rate of mosquitoes with arboviruses was significantly higher in 1997, the year of the flood and an enormously high population density of mosquitoes. Antibodies neutralizing WNV were detected in 13 of 619 (2.1%) hospitalized patients or persons seeking outpatient clinics of the area in 1997. Five of the seroreactors revealed clinical symptoms compatible with West Nile fever: in 2 of them (children), recent infection with WNV was confirmed by a significant increase of antibody titer between acute and convalescent serum samples.

Factor replication of the Reduced Laffrey Health Conception Scale.

This study replicated the factor model for the Reduced Laffrey Health Conception Scale (RLHCS), which was originally developed by Laffrey (1986) and reduced by Lusk, Kerr, and Baer (1995). Two independent samples of construction workers (n = 697 and n = 510) were used. The samples were predominately Caucasian males (over 97%), with mean ages of 35 and 38 years, respectively. Principal components factor analysis with direct oblimin rotation and structural equation modeling were used to replicate factors and to test the equality of the three observed covariance matrices (factory workers and two groups of construction workers), respectively. Results replicated the two-factor structure (clinical health and overall wellness) found in the earlier study with factory workers (Lusk et al., 1995) and demonstrated factor invariance across different samples.

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.

Perceived psychological stress and upper extremity cumulative trauma disorders.

This report presents data exploring the relationship between perceived psychological stress and several variables implicated in the etiology of upper extremity cumulative trauma disorders (UECTDs). The sample was 354 workers from three different manufacturing companies. The primary job exposure for the subjects was that they were engaged in jobs that involved repetitious movements of the upper extremities, primarily of the hands and arms. Data collection included a detailed health history, a comprehensive physical examination of the upper extremities, limited electrodiagnostic testing, Cohen's Perceived Stress Scale, Karasek's Job Content Questionnaire, demographic information, and a measurement of repetition. Descriptive analyses, analysis of variance, correlational analyses, and multiple linear regression were used to examine the data. Perceived stress, as measured in this study, was only weakly associated with repetition, job dissatisfaction, and subjective complaints related to UECTDs. In addition, factors generally accepted as related to UECTDs (e.g., repetition, female gender, hormonal influences, and existing medical conditions) were not robust predictors of perceived stress. The major limitation is related to the measurement of perceived psychological stress. Like most psychosocial phenomena, perceived stress is a complex construct, one that is difficult to measure and correlate with health outcomes. Further research is necessary to examine what role, if any, perceived stress may have in the etiology of UECTDs.

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.

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.

Event-related potential correlates of primed and unprimed words in children co-morbid for disruptive behaviour disorders and academic delay.

Children with disruptive behaviour disorders and academic delay (DD-AD) were compared to children with disruptive behaviour disorders only (DD) and normal control children with no psychiatric disturbance or academic delay (NO) with respect to scalp-recorded event-related electrical potentials (ERPs) elicited by semantically primed and unprimed words. Primed words were preceded by spoken words having a related meaning, while unprimed words were preceded by nonassociated spoken words. For normal controls, the unprimed words elicited greater N400 amplitudes at frontal-central recording sites than primed words. Primed vs. unprimed N400 differences were not evident at frontal sites in DD and the DD-AD group failed to exhibit differences in primed vs. unprimed N400 amplitudes at either frontal, central or parietal sites. These findings suggest that DD-AD children may represent a unique neuroelectric subgroup of learning disabilities.