Influence of Environmental Factors on the Evolution of Industrial Noise-Induced Hearing Loss

The aim of the study is to investigate how environmental factors, associated with exposure to industrial noise, affect the development of chronic noise-induced hearing loss.The studywas conducted on 186 male subjectsworking in two bottling plants, situated respectively in a small farming community, and in a medium-sized city with significant levels of noise pollution. Levels of occupational exposure were the same for the two groups.The subjects were selected by means of a preliminary medical examination, and exposed to tonal hearing tests and acoustic impedance tests. Statistical analysis was performed on hearing threshold values obtained at the frequencies of 500, 1000, 2000 and 4000 Hz.The comparison between the thresholds obtained in the two groups showed a statistically significant difference, especially at the frequency of 4000 Hz and for occupational exposure exceeding 17 yr. The results led us to conclude that environmental factors, and urban noise in particular, influence the onset and development of occupational acoustic trauma, and that those working in the country are significantly less affected than those in the city. Since occupational exposure was the same for both groups, their different responses must therefore be interpreted as due to differences in nonoccupational exposure, in turn dependent on different opportunities for rest from noise and different levels of exposure to noise pollution.     

Abdominopelvic injuries due to road traffic accidents: Characteristics in a registry of 162,695 victims

Objective: Road traffic accidents (RTAs) are the first cause of abdominopelvic injuries (APIs). The objective of this study was to describe the characteristics and severity of APIs due to traffic accidents in a large French trauma registry and to identify risk factors for API.

Methods: All victims from the French Rhône registry of victims of RTAs were analyzed from 1996 to 2013. This registry contained data that were issued over a 20-year period from 245 medical departments, from prehospital care until re-adaptation, and forensic medicine departments. All APIs, defined as an injury between the diaphragm and the pelvic bone, were extracted and studied.

Results: Among 162,695 victims, 10,165 had an API (6.7%). Accidents frequently involved young men and 2 cars. Mean Injury Severity Score (ISS) was 8.7. Mortality rate was 5.6%. Soft tissue injuries largely predominated (n = 6,388; 54.4% of patients). Overall, 2,322 victims had a pelvic bone injury. Internal abdominal organs were involved in 2,425 patients; the most frequent were the spleen, liver, and kidney. Wearing of the seat belt appeared to be a significant protective factor in API, including serious injuries. A partial analysis over the past 2 years among the most severe patients hospitalized in the intensive care unit indicated that nonoperative management was carried out in two thirds of the wounded. In uni- or multivariate analysis, sex, age, type of user, antagonist, time of occurrence, associated severe lesions, or wearing of the seat belt were statistically associated with the occurrence of API, highlighting a more dangerous user profile.

Conclusions: Abdominopelvic injuries concern a minority of road traffic injuries, but they are responsible for significant mortality. Large solid organs are the most frequently affected. Women drivers wearing a seat belt and driving in town during the day appear to be more protected against API.     

Deprived neighborhoods and risk of road trauma (incidence and severity) among under 25year-olds in the Rhône Département (France)

Introduction

Previous research has shown that there are inequalities with regard to traffic accident risk between different social categories. This study describes the influence of the type of residential municipality (with or without deprived urban areas, “ZUS, zones urbaines sensibles”), used as an indicator of contextual deprivation, on the incidence and severity of road trauma involving people of under 25 years of age in the Rhône.

Method

Injury data were taken from The Rhône Road Trauma Registry. The study covers the 2004–2007 period, with 13,589 young casualties. The incidence of traffic injury of all severities were computed according to the type of municipality and the age, gender, and type of road user. The ratios of the incidences of deprived municipalities, compared with others were calculated. Subsequently the severity factors and incidences according to the severity level (ISS 1–8, ISS 9+) were studied.

Results

For the main types of road users except motorized two-wheeler users, the incidences were higher in the deprived municipalities: the greatest difference was for pedestrians, where the incidences were almost twice those of other municipalities. This excess risk, constituting a health inequality topic rarely considered, was even greater in municipalities with two or three ZUSs. It was essentially observed for minor injuries among motorists, cyclists, and pedestrians.

Conclusions

While the incidence increased among people less than 25 years of age, the severity of road injuries was lower in deprived neighborhoods, contrary to what is suggested by other studies. This lower severity disappeared when taking into account the crash characteristics.

Impact on industry

The incidence of injuries as a pedestrian, cyclist or motorist is higher among young people living in deprived municipalities. These areas should therefore be the targets of dedicated education programs, as well as further investigations about urban planning.     

Road trauma among young Australians: Implementing policy to reduce road deaths and serious injury

Objective: The objective of this study was to estimate the likely reduction in road trauma associated with the implementation of effective interventions to reduce road trauma among young Australians.

Methods: A desktop evaluation was conducted to model the likely reduction in road trauma (deaths and serious injuries resulting in hospitalization) among young people aged 17–24 years residing in Queensland, New South Wales, and Victoria. Potential interventions were identified using a rapid literature review and assigned a score based on evidence of effectiveness and implementation feasibility with the 3 highest scoring interventions included in the modeling. Likely reduction in road trauma was estimated by applying the average risk reduction effect sizes for each intervention to baseline risk (passenger or driver death or serious injury per 100,000 population) of road trauma for young Australians. Point estimates were calculated for the potential number of deaths and serious injuries averted in each state and per 100,000 population, with a one-way sensitivity analysis conducted using uncertainty ranges identified.

Results: Peer passenger and night driving restrictions as well as improved vehicle safety measures had the greatest potential to reduce road trauma. Peer passenger restrictions could avert 14 (range: 5–24) and 24 (range: 8–41) hospitalizations per year in Queensland and New South Wales, respectively, and night driving restrictions could avert 17 (range: 7–26), 28 (range: 12–45), and 13 (range: 6–21) hospitalizations annually in Queensland, New South Wales, and Victoria. These interventions reduced fatalities by less than 1 death annually in each state. Improved vehicle safety measures could avert 0–3, 0–4, and 0–3 deaths and 3–91, 4–156, and 2–75 hospitalizations in Queensland, New South Wales, and Victoria.

Conclusions: Key elements of graduated licensing (peer passenger and night driving restrictions) along with vehicle safety interventions offer modest but practically significant reductions in road trauma for young Australians. State governments need to revise current legislation to ensure that these reductions in road trauma can be realized.     

Epidemiology of tornado destruction in rural northern Bangladesh: risk factors for death and injury

The epidemiology of tornado-related disasters in the developing world is poorly understood. An August 2005 post-tornado cohort study in rural Bangladesh identified elevated levels of death and injury among the elderly (≥ 60 years of age) (adjusted odds ratio (AOR) = 8.9 (95 per cent confidence interval (CI): 3.9-20.2) and AOR = 1.6 (95 per cent CI: 1.4-1.8), respectively), as compared to 15-24 year-olds, and among those outdoors versus indoors during the tornado (AOR = 10.4 (95 per cent CI: 5.5-19.9) and AOR = 6.6 (95 per cent CI: 5.8-7.5), respectively). Females were 1.24 times (95 per cent CI: 1.15-1.33) more likely to be injured than males. Elevated risk of injury was significantly associated with structural damage to the house and tin construction materials. Seeking treatment was protective against death among the injured, odds ratio = 0.08 (95 per cent CI: 0.03-0.21). Further research is needed to develop injury prevention strategies and to address disparities in risk between age groups and between men and women.     

Repetitive Strain in Nonrepetitive Work: A Case Study

In a Québec factory, a woman in a nontraditional job suffered from epicondylitis whereas her male coworkers were unaffected. A study was undertaken in order to enumerate the operations at risk for epicondylitis. Workers were interviewed in order to identify difficult operations and systematic observations were done over 4 work days. Although tasks were extremely varied, certain movements at risk for epicondylitis were repeated many times. Fifty-three valves were turned against resistance as part of this job, and one valve requiring a particularly difficult movement was turned 20 times in one day. There were at least 61 operations at risk for epicondylitis per day over a 4-day period. Strain on the elbow joint was particularly intense for the woman worker because the design of the workplace gave an advantage to taller workers with larger hands. Although this case study does not permit us to conclude that the worker’s epicondylitis was due to her job, it enables us to suggest that it would be wise to adapt the dimensions of relevant equipment and worksites to a wider range of potential worker sizes. We also raise some questions about the definition of repetitive strain in epidemiological studies. We suggest that it may be necessary to consider not only the cycle time but also the total of forces exerted on a joint in order to study workplace injuries to the musculoskeletal system.     

Avoiding cultural trauma: climate change and social inertia

ABSTRACT

The failure of societies to respond in a concerted, meaningful way to climate change is a core concern of the social science climate literature. Existing explanations of social inertia display little coherence. Here, a theoretical approach is suggested that integrates disparate perspectives on social inertia regarding climate change. Climate change constitutes a potential cultural trauma. The threat of cultural trauma is met with resistance and attempts to restore and maintain the status quo. Thus, efforts to avoid large-scale social changes associated with climate change constitute an effort to avoid cultural trauma, and result in social inertia regarding climate change at individual, institutional, and societal levels. Existing approaches to social inertia are reviewed. An intellectual framework utilizing the work of Pierre Bourdieu is proposed to integrate these different levels of social interaction. Social processes that maintain social order and thus avoid cultural trauma create social inertia regarding climate change.     

Association between resiliency and posttraumatic growth in firefighters: the role of stress appraisal

The purpose of this study was to establish the relation between resiliency and the level of positive changes, comprising posttraumatic growth in a group of firefighters experiencing job-related traumatic events and the mediating role of stress appraisal in this relation. The study was performed on a group of 100 firefighters from firefighting and rescue brigades, out of which 75 admitted to experiencing a traumatic event. Firefighters covered by the study were on average 31.51 years old (SD?=?6.34). A Polish version of Posttraumatic Growth Inventory, the Resiliency Assessment Scale and Stress Appraisal Questionnaire were used in the study. The results have shown that 22.7% of firefighters displayed low, 58.6% average and 18.7% high intensity of positive changes resulting from a traumatic event. Resiliency poorly correlates with posttraumatic growth expressed in changes in self-perception, and strongly correlates with stress appraisal, negatively correlates with threat and harm/loss and positively correlates with challenge. Appraisal of stress as a threat and challenge appeared to be mediators of the relationship between resiliency and posttraumatic growth.     

Networking emergency teams in Jerusalem

With the recent upsurge in terrorism, more and more attention is being directed at examining the effectiveness and efficiency of emergency teams. These teams tend to focus on their areas of expertise without necessarily communicating, cooperating or coordinating their operations. Research suggests that improved interpersonal communication and coordination enhances the overall work of each emergency team, and that their combined effort is far in excess of the sum of their individual endeavours. This paper outlines attempts made in Jerusalem to improve the performance of emergency teams and to help the helpers by holding training workshops, setting up a forum of co‐workers and encouraging dialogue among various emergency teams in the city. A planned intervention programme was designed to enable informal networking between team leaders. The programme had an impact on team workers and resulted in a more coordinated and effective service delivery during emergencies.     

救援人员的主要心理问题、相关因素与干预策略

救援人员泛指在各种紧急情况中提供救助的个体,其心理健康风险得到越来越多的关注.研究发现救援人员的心理问题主要是应激相关障碍,消极情绪以及倦怠感.不利的救援工作条件、创伤暴露与非适应性的情绪调节策略是救援人员心理健康主要的危险因素;救援工作中的有利条件、社会支持、心理弹性以及适应性情绪调节策略是心理健康的保护因素.对救援...