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Head and neck
Published in Ian Greaves, Military Medicine in Iraq and Afghanistan, 2018
Noise-induced hearing loss (NIHL) is a well-recognised health problem in the UK Armed Forces. According to Defence statistics,177,178 more than 300 regular Armed Forces personnel were medically discharged between 2008 and 2013 with a principal or contributing condition of hearing loss. At the same time, 3530 personnel were recorded as having impaired hearing (H3) and a further 630 personnel recorded as having poor hearing (H4), of which 470 (1.3%) and 90 (1.4%), respectively, were attributed to NIHL. This represents a significant health burden to the UK Armed Forces but also has personal, psychological, social and wider economic implications.179–181 In the United Kingdom, hearing protection is enshrined in law as the Control of Noise at Work Regulations 2005.182 The Regulations define an ‘upper exposure action value’ as a C-weighted peak sound pressure of 137 dB, a level that is exceeded by virtually all modern weapon systems and the soundscape inherent to the combat environment.183,184 Employers are required to reduce the risk of hearing loss by limiting noise exposure where possible and taking steps that are ‘reasonably practicable’ to mitigate injury if the upper exposure thresholds are likely to be violated. At the same time, employees have an obligation to make use of any noise-control measures provided by their employer. The Ministry of Defence has complied with these Regulations by providing Personal Hearing Protection (PHP) systems and mandating their use in both training and combat operations.176
Exposure to Vibration at the Workplace
Published in Gaetano Licitra, Giovanni d'Amore, Mauro Magnoni, Physical Agents in the Environment and Workplace, 2018
Article 3 of Directive 2002/44/EC introduces two thresholds, here displayed in Table 4.1. The exposure action value is the threshold above which employers are required to control the hand-arm vibration risks of their workforce. As such, it should represent a threshold below which damage due to hand-arm vibration is rare. ISO 5349-1 states that symptoms of the hand-arm vibration syndrome are rare in persons exposed with an 8-hour energy-equivalent vibration total value, A(8), at a surface in contact with the hand, of less than 2 ms−2 and unreported for A(8) values of less than 1 ms−2. However, some recent documents argue that a level around 2.5 ms−2 is still not a safe level of exposure.
Management of OH services
Published in Greta Thornbory, Susanna Everton, Contemporary Occupational Health Nursing, 2017
There are many benefits to undertaking a health needs assessment: It provides the opportunity to identify the employees most at risk based upon risk assessment of work-related accidents or ill health in order to justify the reasons for choosing services, e.g. workers’ exposure to vibration above the exposure action value and the need for assessment for hand–arm vibration syndrome (HAVS).It assists in the implementation of OH systems within an organisation or to review those already implemented.It enables the OH nurse to understand some of the social, economic and environmental influences on worker health within the company.It identifies any potential health problems which may affect the workforce and reviews what has already been done to overcome them.It encourages partnership working with many of the service users, such as line managers or employee representatives as part of the decision-making process.It helps to improve communication by gleaning information from those service users so that OH can justify the service or offer health interventions, e.g.: health promotion activities (see Chapter 4).It promotes more efficient use of staff and resources within the OH department.
Compensating for missing data in the OHRKAN cohort study examining total leisure noise exposure among adolescents
Published in International Journal of Audiology, 2022
Johannes Wendl, Doris Gerstner, Jonas Huß, Veronika Weilnhammer, Christina Jenkac, Carmelo Pérez-Àlvarez, Thomas Steffens, Caroline Herr, Stefanie Heinze
In absence of further insights into the dose-response relationship between leisure noise exposure and health effects, using occupational thresholds is a common approach (Neitzel and Fligor 2017). This is reasonable because they rely on intensity and exposure time and not on the nature of sound (WHO 2018). According to ISO 1999:2013(E) (International Organization for Standardization 2013) and the National Institute of Occupational Safety and Health (NIOSH 1998) sound energy of high intensity over a short exposure time can be compared to low intensity over a long time with a time-intensity exchange rate of 3 dB. The equivalent continuous average sound pressure level (SPL) is usually normalised for an 8 h/5 d working week (LEQ8h). The EU noise directive (European Union 2003) states a lower exposure action value of 80 dB(A) LEQ8h and an upper exposure action value of 85 dB(A) LEQ8h for occupational settings. The former indicates the value below which nearly zero risk of hearing impairment is presumed and is also discussed as appropriate for leisure noise (Neitzel and Fligor 2017). In other studies, 90 dB(A) LEQ8h is used to indicate high noise exposure (Concha-Barrientos, Campbell-Lendrum, and Steenland 2004; Dreher et al. 2018).
A simple method to estimate noise levels in the workplace based on self-reported speech communication effort in noise
Published in International Journal of Audiology, 2019
Melanie A. Ferguson, Kezia B. Tomlinson, Adrian C. Davis, Mark E. Lutman
The results show that the method provides noise level estimates having a high probability (>90%) of being within 6 dB(A) of the actual noise level occurring within the workplace. Where noise levels are measured at ≤93 dB(A) the correspondence between estimated and measured noise levels is likely to be within 3 dB. Therefore, participants who reported the need to use a raised voice to hold a conversation with a colleague in the workplace at 1.2 m away, which equates to 87 dB(A) on the speech communication table, were highly likely to be working in levels of noise exceeding 81 dB(A). This is above the lower exposure action value of 80 dB(A) in the CNWR, above which an employer must measure noise levels, then monitor and identify risks hearing of employees. Those who reported needing to use a very loud voice (corresponding to 93 dB(A)) would have a high probability of working in noise at or above the second action level of 85 dB(A). At this level employers must ensure that hearing protection is worn and reduce noise levels at source where possible.
Lower back pain and its association with whole-body vibration and manual materials handling among commercial drivers in Sabah
Published in International Journal of Occupational Safety and Ergonomics, 2019
Khamisah Awang Lukman, Mohammad Saffree Jeffree, Krishna Gopal Rampal
Studies have also indicated significant association between LBP and manual materials handling (MMH) for loads weighing 10 kg and above, and the prevalence odds ratio ranged from 1.3 to 1.7 [17]. In Malaysia, the occupational risk factors for LBP among drivers, including WBV, have also been investigated. A study among bus drivers in Peninsular Malaysia has shown that they have been exposed to WBV at lower than the exposure action value (EAV) and the exposure limit value (ELV), which are proposed by a European Union (EU) directive; however, the prevalence of LBP in these drivers is 60.4% [18]. Nevertheless, an association between LBP and WBV could not be established [19]. In fact, there has not been any study conducted to investigate the association of LBP and WBV and MMH among drivers in Sabah, Malaysia. Commercial vehicle drivers are a group likely to experience LBP as their work usually involves exposure to back stress, due to WBV and the MMH of loads. Hence, this cross-sectional study has been conducted to determine the association between LBP and exposure to WBV, MMH and other related factors, with the aim of identifying preventable measures to reduce the prevalence of LBP among commercial vehicle drivers in the transport industry in Sabah, Malaysia.