Augment low-field intra-operative MRI with preoperative MRI using a hybrid non-rigid registration method

Background

Preoperatively acquired diffusion tensor image (DTI) and blood oxygen level dependent (BOLD) have been proved to be effective in providing more anatomical and functional information; however, the brain deformation induced by brain shift and tumor resection severely impairs the correspondence between the image space and the patient space in image-guided neurosurgery.

Method

To address the brain deformation, we developed a hybrid non-rigid registration method to register high-field preoperative MRI with low-field intra-operative MRI in order to recover the deformation induced by brain shift and tumor resection. The registered DTI and BOLD are fused with low-field intra-operative MRI for image-guided neurosurgery.

Results

The proposed hybrid registration method was evaluated by comparing the landmarks predicted by the hybrid registration method with the landmarks identified in the low-field intra-operative MRI for 10 patients. The prediction error of the hybrid method is 1.92 ± 0.54 mm, and the compensation accuracy is 74.3 ± 5.0%. Compared to the landmarks far from the resection region, those near the resection region demonstrated a higher compensation accuracy (P-value = .003) although these landmarks had larger initial displacements.

Conclusions

The proposed hybrid registration method is able to bring preoperatively acquired BOLD and DTI into the operating room and compensate for the deformation to augment low-field intra-operative MRI with rich anatomical and functional information.     

Brain mass estimation by head circumference and body mass methods in neonatal glycaemic modelling and control

Introduction

Hyperglycaemia is a common complication of stress and prematurity in extremely low-birth-weight infants. Model-based insulin therapy protocols have the ability to safely improve glycaemic control for this group. Estimating non-insulin-mediated brain glucose uptake by the central nervous system in these models is typically done using population-based body weight models, which may not be ideal.

Method

A head circumference-based model that separately treats small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA) infants is compared to a body weight model in a retrospective analysis of 48 patients with a median birth weight of 750 g and median gestational age of 25 weeks. Estimated brain mass, model-based insulin sensitivity (S_I) profiles, and projected glycaemic control outcomes are investigated. SGA infants (5) are also analyzed as a separate cohort.

Results

Across the entire cohort, estimated brain mass deviated by a median 10% between models, with a per-patient median difference in S_I of 3.5%. For the SGA group, brain mass deviation was 42%, and per-patient S_I deviation 13.7%. In virtual trials, 87–93% of recommended insulin rates were equal or slightly reduced (Δ < 0.16 mU/h) under the head circumference method, while glycaemic control outcomes showed little change.

Conclusion

The results suggest that body weight methods are not as accurate as head circumference methods. Head circumference-based estimates may offer improved modelling accuracy and a small reduction in insulin administration, particularly for SGA infants.     

Optimization of novel spectral estimator for fractionated electrogram analysis is helpful to discern atrial fibrillation type

Introduction

Paroxysmal versus persistent atrial fibrillation (AF) can be distinguished based on differences in the spectral parameters of fractionated atrial electrograms. Maximization of these differences would improve characterization of the arrhythmogenic substrate. A novel spectral estimator (NSE) has been shown previously to provide greater distinction in AF spectral parameters as compared with the Fourier transform estimator. Herein, it is described how the differences in NSE spectral parameters can be further improved.

Method

In 10 persistent and 9 paroxysmal AF patients undergoing electrophysiologic study, fractionated electrograms were acquired from the distal bipolar ablation electrode. A total of 204 electrograms were recorded from the pulmonary vein (PV) antra and from the anterior and posterior left atrial free wall. The following spectral parameters were measured: the dominant frequency (DF), which reflects local activation rate, the DF amplitude (DA), and the mean spectral profile (MP), which represents background electrical activity. To optimize differences in parameters between paroxysmal versus persistent AF patients, the NSE was varied by selectively removing subharmonics, using a threshold. The threshold was altered in steps to determine the optimal subharmonics removal.

Results

At the optimal threshold level, mean differences in persistent versus paroxysmal AF spectral parameters were: ΔDA = +0.371 mV, ΔDF = +0.737 Hz, and ΔMP = −0.096 mV. When subharmonics were not removed, the differences were substantially less: ΔDA = +0.301 mV, ΔDF = +0.699 Hz, and ΔMP = −0.063 mV.

Conclusions

NSE optimization produces greater spectral parameter difference between persistent versus paroxysmal AF data. Quantifying spectral parameter differences can be assistive in characterizing the arrhythmogenic substrate.     

Exploring physical exposures and identifying high-risk work tasks within the floor layer trade

Introduction

Floor layers have high rates of musculoskeletal disorders yet few studies have examined their work exposures. This study used observational methods to describe physical exposures within floor laying tasks.

Methods

We analyzed 45 videos from 32 floor layers using Multimedia-Video Task Analysis software to determine the time in task, forces, postures, and repetitive hand movements for installation of four common flooring materials. We used the WISHA checklists to define exposure thresholds.

Results

Most workers (91%) met the caution threshold for one or more exposures. Workers showed high exposures in multiple body parts with variability in exposures across tasks and for different materials. Prolonged exposures were seen for kneeling, poor neck and low back postures, and intermittent but frequent hand grip forces.

Conclusions

Floor layers experience prolonged awkward postures and high force physical exposures in multiple body parts, which probably contribute to their high rates of musculoskeletal disorders.     

Variation in work tasks in relation to pinch grip strength among middle-aged female dentists

Objectives

We aimed to investigate the relationship of task variation during dental work history with pinch grip strength among dentists.

Methods

We measured pinch grip strength among 295 female Finnish dentists aged 45–63 years. Variation in dental work tasks during work history was empirically defined by cluster analysis. Three clusters of task variation emerged: low (most work time in restoration treatment/endodontics), moderate (about 50% in the former and 50% in prosthodontics/periodontics/surgery), and high (variable tasks including administrative duties). Hand radiographs were examined for the presence of OA in the wrist and each joint of the 1–3rd fingers. Information on hand-loading leisure-time activities, and joint pain was obtained by questionnaire. Glove size was used as a proxy for hand size. BMI (kg/m2) was based on measured weight and self-reported height.

Results

Dentists with low variation of work task history had an increased risk of low pinch grip strength in the right hand (OR 2.3, 95% CI 1.2–4.3), but not in the left (1.13, 0.62–2.08), compared to dentists with high task variation, independent of age, hand size, hand-loading leisure-time activities, BMI and symptomatic hand OA.

Conclusion

The dentists with the most hand-loading tasks were at an increased risk of low pinch grip strength, independent of e.g. symptomatic hand OA. It is advisable among dentists to perform as diverse work tasks as possible to reduce the risk of decreased pinch grip strength.     

Computer program in the treatment for major depression and cognitive impairment in university students

Introduction

A depressed patient presents cognitive impairment that remains in spite of depression’s remission. This study intends to evaluate the impact of cognitive training in the treatment of depression, and also of the impairment that depression causes.

Method

A program for cognitive training (Alcor) was designed for and applied to a group of patients (n = 10) with non-medicated MDD; a group (N = 10) with MDD that was treated with the program and with anti-depressants, and to another group (n = 11) that was given anti-depressors only. The impact of this intervention was assessed by applying the following instruments: Beck Depression Inventory, WAIS, Spielberger State-Trait Anxiety Inventory, Externalized Problems Assessment Scale for Adolescents and Young Adults, and Attention Problems Assessment Scale. The program was applied to University students with MDD twice a week, until they had reached adequate levels of execution.

Results

The patients of all three groups showed MDD event remission. Those who received cognitive training showed a substantial increase of intellectual performance. The cognitive treatment group increased IQ in 12.9 units and the combined group increase in 13.3 units. There was a slight decrease of 1.9 units within the anti-depressant treatment group. The changes in attention and in externalized problems showed the same trends.     

The relationship between usage intention and adoption of electronic health records at primary care clinics

Objective

Despite of emerging evidence that electronic health records (EHRs) can improve the clinical quality, enhances patient safety and efficiency. Most physicians in primary health care clinics in the Taiwan do not currently adopt EHR at their clinic practices. We aim to measure the relationship between usage intention and adoption behavior.

Study design and methods

We used structured questionnaires distributed both EHRs adopter and non-adopter group to the primary health care physicians which participated in the DOH project to establish the information exchange environment across Taiwan. The response rate of adopter and non-adopter is 54.7% and 55.0% respectively.

Measurements

EHRs adoption behavior.

Results

The EHRs adopter group has higher intention than non-adopter (p = 0.003). From the result of logistic regression analyses, we found the key factors affecting physicians’ adoption pattern were intention to use (OR: 2.85; 95% CI: 2.30–3.54). In addition, higher perceived usefulness (OR: 1.29; 95% CI: 1.06–1.56) and perceived ease to use (OR: 1.48; 95% CI: 1.22–1.79) increase adoption of EHR found.

Conclusion

The intention to use EHR, perceived usefulness and ease to use of primary care physicians were found as key factors influencing EHRs adoption. Thus, we suggest that government should promote the potential benefits of EHR and enhance physicians’ willingness to adopt the EHRs at their clinic practices.     

Infection risk in patients with rheumatoid arthritis treated with etanercept or adalimumab

Objectives

To compare the risk of infection for rheumatoid arthritis (RA) patients who took etanercept or adalimumab medication in a nationwide population.

Methods

RA patients who took etanercept or adalimumab were identified in the Taiwan's National Health Insurance Research Database. The composite outcome of serious infections, including hospitalization for infection, reception of an antimicrobial injection, and tuberculosis were followed for 365 days. A Kaplan–Meier survival curve with a log-rank test and Cox proportional hazards regression were used to compare risks of infection between the two cohorts of tumor necrosis factor (TNF)-α antagonists users. Hazard ratios (HRs) were obtained and adjusted with propensity scores and clinical factors. Sensitivity analyses and subgroup analyses were also performed.

Results

In total, 1660 incident etanercept users and 484 incident adalimumab users were eligible for the analysis. The unadjusted HR for infection of the etanercept users was significantly higher than that of the adalimumab users (HR: 1.93; 95% confidence interval (CI): 1.09–3.42; p = 0.024). The HRs were 2.04 (95% CI: 1.14–3.65; p = 0.016) and 2.02 (95% CI: 1.13–3.61; p = 0.018) after adjusting for propensity scores and for propensity scores in addition to clinical factors, respectively. The subgroup analyses revealed that HRs for composite infection was significantly higher in patient subgroups of older age, female, as well as patients who did not have DM, COPD, and hospitalization history at the baseline.

Conclusion

In this head-to-head cohort study involving a nationwide population of patients with RA, etanercept users demonstrated a higher risk of infection than adalimumab users. Results of this study suggest the possible existence of an intra-class difference in infection risk among TNF-α antagonists.     

On the reliability of mapping studies in software engineering

Background

Systematic literature reviews and systematic mapping studies are becoming increasingly common in software engineering, and hence it becomes even more important to better understand the reliability of such studies.

Objective

This paper presents a study of two systematic mapping studies to evaluate the reliability of mapping studies and point out some challenges related to this type of study in software engineering.

Method

The research is based on an in-depth case study of two published mapping studies on software product line testing.

Results

We found that despite the fact that the two studies are addressing the same topic, there are quite a number of differences when it comes to papers included and in terms of classification of the papers included in the two mapping studies.

Conclusions

From this we conclude that although mapping studies are important, their reliability cannot simply be taken for granted. Based on the findings we also provide four conjectures that further research has to address to make secondary studies (systematic mapping studies and systematic literature reviews) even more valuable to both researchers and practitioners.     

Nomophobia: Dependency on virtual environments or social phobia?

Background

The increasing use of new technologies and virtual communication involving personal computers (PCs), tablets and mobile phones are causing changes in individuals’ daily habits and behavior. We report the case of an individual with social phobia who developed a dependency on communication through virtual environments (i.e., nomophobia), and used a PC as a form of relating to the outside world to reduce stress and to avoid direct social relations. Nomophobia refers to the discomfort or anxiety caused by the non-availability of a mobile phone, PC or any another virtual communication device. Social phobia is described as an anxiety disorder of chronic evolution.

Objective

To study nomophobia as a manifest behavior that might serve as an indication of a possible anxiety disorder.

Methodology

The treatment consisted of the use of medication, cognitive-behavioral therapy (CBT) and the application of evaluation tools (interviews, scales, inventories and questionnaires).

Results

The individual responded satisfactorily to medication and CBT treatment, which reduced his time using the PC and increased his exposure to real-life situations.

Conclusion

Nomophobic behavior produces changes in daily habits and can reveal other aspects to be investigated, such as the presence of comorbid mental disorders.     

Successful implementation of user-centered game based learning in higher education: An example from civil engineering

Goal

The use of an online game for learning in higher education aims to make complex theoretical knowledge more approachable. Permanent repetition will lead to a more in-depth learning.

Objective

To gain insight into whether and to what extent, online games have the potential to contribute to student learning in higher education.

Experimental setting

The online game was used for the first time during a lecture on Structural Concrete at Master’s level, involving 121 seventh semester students.

Methods

Pre-test/post-test experimental control group design with questionnaires and an independent online evaluation.

Results

The minimum learning result of playing the game was equal to that achieved with traditional methods. A factor called “joy” was introduced, according to [Nielsen, J. (2002): User empowerment and the fun factor. In Jakob Nielsen’s Alertbox, July 7, 2002. Available from http://www.useit.com/alertbox/20020707.html.], which was amazingly high.

Conclusion

The experimental findings support the efficacy of game playing. Students enjoyed this kind of e-learning.     

Speech intelligibility measured with shortened versions of Callsign Acquisition Test (CAT)

The Callsign Acquisition Test (CAT) is a new speech intelligibility test developed by the Human Research and Engineering Directorate of the U.S. Army Research Laboratory (ARL-HRED). CAT uses the phonetic alphabet and digit stimuli combined together to form 126 test items.

Objective

The purpose of this study was to assess the reliability of data collected with shorter versions of CAT.

Design

A total of 5 shorter versions of the original list (CAT-120, CAT-60, CAT-40, CAT-30, and CAT-24) were formed and evaluated using 19 participants. Each of the subsets of CAT was presented in pink noise at signal-to-noise ratios (SNRs) of −6 dB and −9 dB.

Results

Results showed that shortened CAT lists have the capability of providing the same predictive power as the full CAT with good test-retest reliability.

Conclusions

Under the experimental conditions of this study, any of the shorter versions of the CAT can be utilized in place of the full version to reduce testing times with no effect on predictive power.     

Prevalence of carpal tunnel syndrome among employees at a poultry processing plant

Objective

To determine prevalence of carpal tunnel syndrome (CTS) among poultry processing employees while taking into account non-occupational factors and assess any association between CTS prevalence and exposure groups.

Methods

Performed a cross-sectional survey to assess CTS (n = 318). A CTS case was defined as an employee with self-reported CTS symptoms, an abnormal hand symptom diagram, and an abnormal nerve conduction study (NCS). Log-binomial regression was used to estimate prevalence ratios.

Results

Three hundred and one participants had sufficient symptom information or NCS data to be classified. 126 (42%) of 301 participants had evidence of CTS. In the adjusted analysis, the highest exposure group had CTS prevalence that was significantly higher than that for the lower exposure group [PR: 1.61; 95% CI = (1.20, 2.17)].

Conclusions

Increasing levels of hand activity and force were associated with increased CTS prevalence among participants. Recommendations were provided to reduce exposure to these risk factors.     

A low-cost real time virtual system for postural stability assessment at home

Background and objective

The degeneration of the balance control system in the elderly and in many pathologies requires measuring the equilibrium conditions very often. In clinical practice, equilibrium control is commonly evaluated by using a force platform (stabilometric platform) in a clinical environment.In this paper, we demonstrate how a simple movement analysis system, based on a 3D video camera and a 3D real time model reconstruction of the human body, can be used to collect information usually recorded by a physical stabilometric platform.

Methods

The algorithm used to reconstruct the human body model as a set of spheres is described and discussed. Moreover, experimental measurements and comparisons with data collected by a physical stabilometric platform are also reported. The measurements were collected on a set of 6 healthy subjects to whom a change in equilibrium condition was stimulated by performing an equilibrium task.

Results

The experimental results showed that more than 95% of data collected by the proposed method were not significantly different from those collected by the classic platform, thus confirming the usefulness of the proposed system.

Conclusions

The proposed virtual balance assessment system can be implemented at low cost (about 500$) and, for this reason, can be considered a home use medical device. On the contrary, astabilometric platform has a cost of about 10,000$ and requires periodical calibration. The proposed system does not require periodical calibration, as is necessary for stabilometric force platforms, and it is easy to use. In future, the proposed system with little integration can be used, besides being an emulator of a stabilometric platform, also to recognize and track, in real time, head, legs, arms and trunk, that is to collect information actually obtained by sophisticated optoelectronic systems.     

Kinematic and electromyographic differences between mouse and touchpad use on laptop computers

Background

Numerous studies have compared the postures and muscular activities induced by the various input devices available. To the authors' knowledge, no studies have yet compared upper body posture and movement, sEMG activity and muscle co-contractions induced by use of a mouse or of a touchpad.

Objective

The aim of this study was to compare posture, joint excursion and sEMG activity when using a laptop equipped with a mouse or a touchpad.

Methods

Trunk and upper arm posture, ranges of motion and muscle activities were measured in ten subjects during two standardized tasks.

Results

Mouse use induced larger shoulder abduction than touchpad use. On the other hand, when a touchpad was used, the upper arm joints were bound and fixed to a greater extent than during mouse use. Touchpad users are forced to maintain a more static posture. The upper arm electromyography results clearly indicate that touchpad use requires more stabilization than mouse use.

Conclusion

Motor tasks executed by means of the mouse allow a greater range of motions and reduce the biomechanical stress thanks to the greater postural mobility, even though the posture is less neutral. The results of our study tend to suggest that an external mouse should be preferred to the touchpad by frequent users of laptops.

Relevance to industry

This study is a suggestion for IT companies to give customers information of possible advantages using an external mouse. Furthermore our data highlight the importance of providing a mouse to all laptop users in order to reduce biomechanical risks.     

DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers: a validity and reliability study

Purpose

The disabilities of the arm, shoulder and hand (DASH) questionnaire is a self-administered region-specific outcome instrument developed as a measure of self-rated upper-extremity disability and symptoms. The aim of this study was to evaluate the reliability and the construct validity of the DASH questionnaire by establishing its correlation to the Medical Outcomes Study Short Form-36 (SF-36) in industry workers. Also we aimed to investigate whether the DASH can be used as a standardized questionnaire to evaluate the work-related musculoskeletal disorders (WMSDs) in upper extremity in industrial settings and epidemiological studies.

Material and methods

The Turkish version's reliability and construct validity were evaluated in 240 industry workers with upper-extremity musculoskeletal complaints. Workers were asked to complete a packet that included the DASH and the SF-36. Test-retest reliability was assessed in all workers who filled in the DASH questionnaire 15 days later. Construct validity was evaluated by comparing the overall and work component DASH scores with SF-36 summary and subscales.

Results

The mean DASH score for the textile workers whose duties were confection, dyeing, sewing, quality control and packaging was calculated as 65, 55, 68, 54 and 67, respectively. As a result of this study, pain intensity in shoulder, wrist and hand was significantly associated with the DASH score (p<0.05). Internal consistency of the DASH was high (Cronbach alpha 0.91). Test-retest reliability was excellent for the overall DASH (intraclass correlation coefficient (ICC) 0.92). Moderate correlations (p<0.05) were found between the overall and work component DASH and the SF-36 summary scales. Pearson correlation coefficients of the overall and work component DASH to the SF-36 subscales ranged from −0.33 to −0.82.

Conclusion

These results support that DASH is a reliable and valid instrument to measure functional disability and investigate the ergonomic risk factors in textile workers with upper-extremity musculoskeletal complaints.     

A pilot study to compare programming effort for two parallel programming models

Context

Writing software for the current generation of parallel systems requires significant programmer effort, and the community is seeking alternatives that reduce effort while still achieving good performance.

Objective

Measure the effect of parallel programming models (message-passing vs. PRAM-like) on programmer effort.

Design, setting, and subjects

One group of subjects implemented sparse-matrix dense-vector multiplication using message-passing (MPI), and a second group solved the same problem using a PRAM-like model (XMTC). The subjects were students in two graduate-level classes: one class was taught MPI and the other was taught XMTC.

Main outcome measures

Development time, program correctness.

Results

Mean XMTC development time was 4.8 h less than mean MPI development time (95% confidence interval, 2.0-7.7), a 46% reduction. XMTC programs were more likely to be correct, but the difference in correctness rates was not statistically significant (p = .16).

Conclusions

XMTC solutions for this particular problem required less effort than MPI equivalents, but further studies are necessary which examine different types of problems and different levels of programmer experience.     

Evaluation of a 3 year intervention to increase adoption of safer nursery crop production practices

Background

We conducted a 3 year intervention to increase awareness and adoption of eight more profitable nursery crop production practices that reduced certain traumatic and musculoskeletal injury hazards.

Methods

We disseminated information to nursery managers across seven states using information channels they were known to rely on (e.g. trade publications, public events, university Extension, other managers). We evaluated rolling, independent, probability samples (n = 1200) with mail questionnaires before the intervention and after each of 3 intervention years. We also evaluated samples (n = 250) from a comparison group of New Zealand nursery managers.

Results

The intervention was associated with increased awareness of four of the eight practices among US managers after year 3 compared to their baseline: zippers (20 vs. 32%, p ≤ 0.000), stools (11 vs. 22%, p ≤ 0.001), pruners (29 vs. 40%, p ≤ 0.014), and tarps (24 vs. 33%, p ≤ 0.009). There were no changes in adoption. New Zealand manager awareness was increased for hoes after year 2 compared to their baseline (35 vs. 52%, p ≤ 0.010).

Conclusions

A modest, regionwide information dissemination intervention was associated with increased awareness, but not adoption.     

A usability evaluation of medical software at an expert conference setting

Introduction

A usability test was employed to evaluate two medical software applications at an expert conference setting. One software application is a medical diagnostic tool (electrocardiogram [ECG] viewer) and the other is a medical research tool (electrode misplacement simulator [EMS]). These novel applications have yet to be adopted by the healthcare domain, thus, (1) we wanted to determine the potential user acceptance of these applications and (2) we wanted to determine the feasibility of evaluating medical diagnostic and medical research software at a conference setting as opposed to the conventional laboratory setting.

Methods

The medical diagnostic tool (ECG viewer) was evaluated using seven delegates and the medical research tool (EMS) was evaluated using 17 delegates that were recruited at the 2010 International Conference on Computing in Cardiology. Each delegate/participant was required to use the software and undertake a set of predefined tasks during the session breaks at the conference. User interactions with the software were recorded using screen-recording software. The ‘think-aloud’ protocol was also used to elicit verbal feedback from the participants whilst they attempted the pre-defined tasks. Before and after each session, participants completed a pre-test and a post-test questionnaire respectively.

Results

The average duration of a usability session at the conference was 34.69 min (SD = 10.28). However, taking into account that 10 min was dedicated to the pre-test and post-test questionnaires, the average time dedication to user interaction of the medical software was 24.69 min (SD = 10.28). Given we have shown that usability data can be collected at conferences, this paper details the advantages of conference-based usability studies over the laboratory-based approach. For example, given delegates gather at one geographical location, a conference-based usability evaluation facilitates recruitment of a convenient sample of international subject experts. This would otherwise be very expensive to arrange. A conference-based approach also allows for data to be collected over a few days as opposed to months by avoiding administration duties normally involved in laboratory based approach, e.g. mailing invitation letters as part of a recruitment campaign.Following analysis of the user video recordings, 41 (previously unknown) use errors were identified in the advanced ECG viewer and 29 were identified in the EMS application. All use errors were given a consensus severity rating from two independent usability experts. Out of a rating scale of 4 (where 1 = cosmetic and 4 = critical), the average severity rating for the ECG viewer was 2.24 (SD = 1.09) and the average severity rating for the EMS application was 2.34 (SD = 0.97). We were also able to extract task completion rates and times from the video recordings to determine the effectiveness of the software applications. For example, six out of seven tasks were completed by all participants when using both applications. This statistic alone suggests both applications already have a high degree of usability. As well as extracting data from the video recordings, we were also able to extract data from the questionnaires. Using a semantic differential scale (where 1 = poor and 5 = excellent), delegates highly rated the ‘responsiveness’, ‘usefulness’, ‘learnability’ and the ‘look and feel’ of both applications.

Conclusion

This study has shown the potential user acceptance and user-friendliness of the novel EMS and the ECG viewer applications within the healthcare domain. It has also shown that both medical diagnostic software and medical research software can be evaluated for their usability at an expert conference setting. The primary advantage of a conference-based usability evaluation over a laboratory-based evaluation is the high concentration of experts at one location, which is convenient, less time consuming and less expensive.     

Pilot task-based assessment of noise levels among firefighters

Purpose

Over one million American firefighters are routinely exposed to various occupational hazards. While efforts have been made to identify and reduce some causes of injuries and illnesses among firefighters, relatively little has been done to evaluate and understand occupational noise exposures in this group. The purpose of this pilot study was to apply a task-based noise exposure assessment methodology to firefighting operations to evaluate potential noise exposure sources, and to use collected task-based noise levels to create noise exposure estimates for evaluation of risk of noise-induced hearing loss by comparison to the 8-hr and 24-hr recommended exposure limits (RELs) for noise of 85 and 80.3 dBA, respectively.

Methods

Task-based noise exposures (n = 100 measurements) were measured in three different fire departments (a rural department in Southeast Michigan and suburban and urban departments in Northern California). These levels were then combined with time-at-task information collected from firefighters to estimate 8-hr noise exposures for the rural and suburban fire departments (n = 6 estimates for each department). Data from 24-hr dosimetry measurements and crude self-reported activity categories from the urban fire department (n = 4 measurements) were used to create 24-hr exposure estimates to evaluate the bias associated with the task-based estimates.

Results

Task-based noise levels were found to range from 82 to 109 dBA, with the highest levels resulting from use of saws and pneumatic chisels. Some short (e.g., 30 min) sequences of common tasks were found to result in nearly an entire allowable daily exposure. The majority of estimated 8-hr and 24-hr exposures exceeded the relevant recommended exposure limit. Predicted 24-hr exposures showed substantial imprecision in some cases, suggesting the need for increased task specificity and highlighting the variability of firefighting noise exposures.

Conclusions

The results indicate potential for overexposure to noise from a variety of firefighting tasks and equipment, and suggest a need for further exposure characterization and additional hearing loss prevention efforts.

Relevance to industry

Firefighters may be at risk of noise-induced hearing loss, which can affect their fitness for duty and ability to respond effectively to emergencies. The results of this study suggest that additional efforts at hearing loss prevention among firefighters are warranted.