The impact of oral health education taken by personal support workers caring for a geriatric population in a long-term care facility: A mixed-methods study.

OBJECTIVE: To evaluate the impact of an online oral health education module on personal support workers' (PSW) knowledge and beliefs in their care for long-term care (LTC) residents in one Canadian LTC residence. BACKGROUND: LTC residents are dependent on PSWs for their oral health needs. However, PSWs receive minimal to no oral health education placing residents at risk for poor oral health. METHODS: A mixed-methods convergent design comprising a before-and-after questionnaire (N = 88), focus groups (N = 23) and interviews (N = 4) exploring module learning. Analysis of each data set was followed by their amalgamation and comparison. RESULTS: The online module had limited impact on the PSWs' knowledge and beliefs regarding resident oral health care. The quantitative results demonstrated knowledge improvements in two domains and changes in two belief domains. However, the qualitative results demonstrated new knowledge was not developed or sustained in practice. Themes that emerged include the following: lack of module recall, unmet learning needs and methods for oral care delivery, and timing of oral care in a busy clinical environment. CONCLUSION: Online oral health education alone has limited impact on PSWs' knowledge and beliefs. Research evaluating multifaceted education interventions including hands-on training with a dental expert is warranted.

Benzoyl peroxide use transiently decreases Cutibacterium acnes load on the shoulder.

BACKGROUND: Cutibacterium acnes is the most common pathogen in shoulder prosthetic joint infections. Short-contact benzoyl peroxide (BPO) solutions effectively reduce C acnes loads on the shoulder preoperatively. It is unknown how long the effect of BPO lasts. We evaluated C acnes counts 1 week after BPO application. We hypothesized that BPO would decrease C acnes burden with a rebound after 1 week. METHODS: Screening of 102 healthy volunteers with no history of shoulder surgery or C acnes infection was performed to establish bacterial counts. Thirty-four participants were selected based on an established threshold. Each was given BPO 5% for 3 consecutive days of application on either the left or right shoulder as indicated by a random number generator. Deep sebaceous gland cultures were obtained with a detergent scrub technique before BPO application, after 3 days of use, and 1 week after BPO treatment commenced. RESULTS: The differences between the logarithmic reduction and the logarithmic rebound at the anterior, lateral, and posterior sites were statistically significant. Anteriorly, the average log reduction was -0.44 and the average log rebound was 0.69 (P = .003). Laterally, reduction was -0.64 and rebound was 0.74 (P = .003). Posteriorly, reduction was -0.63 and rebound was 0.78 (P = .008). At the axilla, reduction was -0.40 and rebound was 0.31 (P = .10). The differences in C acnes burden between pretreatment and 1-week counts at all sites were not statistically significant. CONCLUSION: A significant decrease in C acnes burden occurred after BPO application but was not permanent. Significant rebound occurred just 1 week later.

Neer Award 2018: Benzoyl peroxide effectively decreases preoperative Cutibacterium acnes shoulder burden: a prospective randomized controlled trial.

BACKGROUND: Benzoyl peroxide (BPO) solutions effectively reduce Cutibacterium acnes (formerly Propionibacterium acnes) on the face, neck, and back in nonoperative settings. This study compared preoperative application of BPO vs. chlorhexidine gluconate (CHG) in decreasing shoulder C acnes skin burden in surgical patients. METHODS: Eighty patients undergoing shoulder surgery were prospectively enrolled in a randomized double-blind trial at 1 institution from August 2015 to April 2017. Participants were randomized to 5% BPO or 4% CHG for 3 consecutive days. The nonoperative shoulder had no intervention and served as the negative control. Skin cultures of both shoulders were obtained via a detergent scrub technique the day of surgery at anterior, lateral, and posterior sites and the axilla. RESULTS: Fewer positive cultures were obtained from the BPO-treated side compared with the contralateral side (P = .0003), and no change was shown for the CHG group (P = .80). Shoulders treated with BPO showed a statistically significant reduction in C acnes counts compared with CHG at anterior (P = .03) and posterior (P = .005) portal sites. No significant difference was found at the axilla (P = .99) or lateral portal site (P = .08). No postoperative infections or wound complications occurred in either group. CONCLUSIONS: BPO is more effective than CHG at reducing C acnes on the shoulder. Decreasing the skin burden of C acnes may reduce intraoperative wound contamination and postoperative infection. BPO should be considered as an adjunctive preoperative skin preparation considering its potential benefit, low risk, and low cost.

Occupational noise exposure and incident hypertension in men: a prospective cohort study.

The associations between occupational noise exposure and hypertension remain controversial because of the differences in study designs, exposure assessments, and confounding controls. This prospective study investigated the relationship between noise exposure and the 10-year risk of hypertension. A cohort of 578 male workers in Taiwan was followed from 1998 to 2008. All subjects were divided into high-, intermediate-, and low-exposure groups on the basis of noise exposure assessment. Cox regression models were used to estimate the relative risks of hypertension after adjustment for potential confounders. During the 7,805 person-years of follow-up, 141 hypertension cases were identified. Significant increases of 3.2 (95% confidence interval (CI): 0.2, 6.2) mm Hg in systolic blood pressure and 2.5 (95% CI: 0.1, 4.8) mm Hg in diastolic blood pressure between the baseline and follow-up measurements were observed in the high-exposure group. Participants exposed to ≥85 A-weighted decibels (dBA) had a 1.93-fold (95% CI: 1.15, 3.22) risk of hypertension compared with those exposed to <80 dBA. There was a significant exposure-response pattern (P = 0.016) between the risk of hypertension and the stratum of noise exposure. Prolonged exposure to noise levels ≥85 dBA may increase males' systolic and diastolic blood pressure levels. This association may translate into a higher incidence of hypertension.

Oral health-related quality of life among women early postpartum: A cross-sectional study.

BACKGROUND: Periodontal diseases can negatively impact the oral health-related quality of life (OHRQoL) of pregnant women. This study investigates the association between maternal oral inflammatory load (OIL), sociodemographic characteristics, and the OHRQoL in postpartum women. METHODS: In this cross-sectional study, breastfeeding mothers were recruited from St. Michael's Hospital, Toronto within 2-4 weeks postpartum. Mothers were categorized into "Normal/low" and "High" OIL groups based on the absolute counts of oral polymorphonuclear neutrophils (oPMNs). The Oral Health Impact Profile-14 questionnaire was used to assess the impact of the maternal OIL on the OHRQoL. Multiple linear regression analyses were performed to examine the association between maternal sociodemographic factors including age, marital status, education level, employment status, parity, and their OHRQoL. RESULTS: Forty-seven mothers were included in this study. Mothers with high OIL reported higher impact on their OHRQoL (30%) than mothers with normal/low OIL (21%), but these differences were not statistically different. There was a negative relationship between the mother's education level and the extent of impact of OHRQoL on the "physical pain" dimension (p < 0.05), and between the mothers' age and employment status and the "physical disability" dimension (p < 0.05). A positive correlation was noted between multi-parity and the extent of impact of OHRQoL on the "physical disability" dimension (p = 0.009), and between the marital status and the "psychological disability" dimension (p < 0.05). CONCLUSION: This study highlighted the significant impact of sociodemographic characteristics on the OHRQoL of mothers, showcasing the importance of considering these factors when implementing targeted preventive dental care programs for mothers.

Effects of environmental noise exposure on 24-h ambulatory vascular properties in adults.

Exposure to environmental noise has been associated with hypertension, but the related mechanism of vascular structural changes is unclear. This repeated-measure study investigated the effects of noise exposure on the 24-h ambulatory vascular structural properties in 66 adults aged 18-32 years. Individual noise exposure and personal vascular parameters were measured simultaneously in all subjects. Linear mixed-effects regressions were used to estimate the effects. A 1-A-weighted decibel (dBA) increase was significantly associated with the transient effects of 1.39 (95% confidence interval: 1.07, 1.79) %mL/mmHg in arterial compliance at nighttime but -1.70 (-2.05, -1.10) kdynes·s/cm(5) in arterial resistance during the daytime and -2.38 (-3.44, -1.64) kdynes·s/cm(5) in arterial resistance at nighttime among all subjects. Such effects were observed in arterial distensibility only during the daytime after the 30-min (-1.84 [-2.61, -1.29] %/mmHg) and 60-min (-2.06 [-2.95, -1.44] %/mmHg) time-lagged noise exposures. For 24-h environmental noise, a 1-dBA increment was significantly associated with a sustained increase of 1.25 (1.10, 1.42) %mL/mmHg in arterial compliance but a decrease of 2.12 (-2.51, -1.80) kdynes·s/cm(5) in arterial resistance. Environmental noise exposure may have transient and sustained effects on adult vascular properties.

The Association between Maternal Oral Inflammation and Neutrophil Phenotypes and Poly-Unsaturated Fatty Acids Composition in Human Milk: A Prospective Cohort Study.

This prospective cohort study aimed to investigate the impact of maternal oral inflammation on human milk composition including neutrophil counts, activation state (based on cluster of differentiation (CD) markers expression), and fatty acid levels. Fifty mothers were recruited from St. Michael's hospital, Toronto, and followed up from 2-4 weeks until 4 months postpartum. Oral rinse and human milk samples were collected at both timepoints. Oral polymorphonuclear neutrophils (oPMNs) within the rinses were quantified using flow cytometry and the participants' oral health state was categorized into three groups (i.e., healthy, moderate, and severe) based on the oPMNs counts. Fatty acids were identified and quantified using a gas chromatography-flame ionization detector (GC-FID). Compared to mothers with a healthy oral health state, mothers with moderate to severe oral inflammation had a statistically significant decrease in the expression of CD64 biomarker, an increase in the expression of CD14 biomarker on human milk neutrophils and a decrease in the levels of eicosapentaenoic acid (C20:5n-3) in their human milk at follow-up compared to baseline. This study demonstrates for the first time that maternal oral inflammation can affect human milk composition. The mechanism by which these alterations can affect infant health outcomes in the long term critically needs to be considered.

High-frequency hearing loss, occupational noise exposure and hypertension: a cross-sectional study in male workers.

BACKGROUND: The association between occupational noise exposure and hypertension is inconsistent because of an exposure bias caused by outer-ear measurements of noise levels among workers. This study used hearing loss values (HLVs) measured at 4 kHz and 6 kHz in both ears as a biomarker to investigate the chronic effects of noise exposure on hypertension in 790 aircraft-manufacturing workers. METHODS: Participants were divided into a high hearing loss (HL) group (n = 214; average HLVs ≥ 30 decibel [dB] at 4 kHz or 6 kHz bilaterally; 83.1 ± 4.9 A-weighted decibel [dBA]), a median HL group (n = 302; 15 ≤ average HLVs < 30 dB at 4 kHz or 6 kHz bilaterally; 83.1 ± 4.4 dBA) and a low HL group (n = 274; average HLVs < 15 dB at 4 kHz or 6 kHz bilaterally; 82.2 ± 5.1 dBA) based on the results of pure tone audiometry. Multivariate logistic regressions were used to estimate the risk of hypertension between groups. RESULTS: The prevalence rates of hypertension were significantly higher in the high HL (43.5%; p = 0.021) and median HL (42.1%; p = 0.029) groups than in the low HL group (33.2%). The high HL and median HL workers had 1.48-fold (95% confidence interval [95%CI] = 1.02-2.15; p = 0.040) and 1.46-fold (95%CI = 1.03-2.05; p = 0.031) higher risks of hypertension relative to the low HL workers. Employment duration was significantly and positively correlated with the risk of hypertension among workers with average HLVs ≥ 15 dB at 4 kHz (p < 0.001) and 6 kHz (p < 0.001) bilaterally. CONCLUSIONS: Our findings suggest that high-frequency hearing loss is a good biomarker of occupational noise exposure and that noise-induced hearing loss may be associated with the risk of hypertension.

Effect of Qigong on quality of life: a cross-sectional population-based comparison study in Taiwan.

BACKGROUND: Qigong, similar to Tai Chi Chuan, is beneficial to health. In Taiwan, Waitankung, a type of Qigong, is as popular as Tai Chi Chuan. This population-based comparison study compares the health-related quality of life between people practicing Waitankung and their comparable community residents. METHODS: A total of 165 individuals practicing Waitankung were matched by age and sex with 660 general individuals for comparison. Information about health-related quality of life, measured by the SF-36, and other basic and health conditions was obtained from the questionnaires. This study used the linear mixed-effect regression model to examine the association between health-related quality of life and the practice of Waitankung. RESULTS: Compared with either sedentary individuals or individuals practicing other types of exercise, the Waitankung group scored higher for eight and five out of ten SF-36 components, respectively. The Waitankung group scored better in general health, vitality, and physical component summary compared to individuals participating in other types of exercise, even when considering the energy expended by exercise. CONCLUSION: The results suggest that Waitankung exercising is significantly associated with health-related quality of life. Waitankung may serve as an exercise choice for middle-aged and older people to improve overall quality of life.

Should dental schools adopt teledentistry in their curricula? Two viewpoints.

INTRODUCTION: Teledentistry is a cutting edge technology that could be used to improve access to care to underserved populations and those in remote areas. OBJECTIVES: To discuss the advantages and disadvantages of adopting teledentistry into the predoctoral dental curriculum. METHODS: Two teams of dentists reviewed the pros and cons of introducing teledentistry into the predoctoral dental curriculum. RESULTS: Viewpoint 1 produced evidence that teledentistry is a cutting-edge technology that can improve access to care for underserved populations in a practical, cost-effective manner. Viewpoint 2 showed evidence that teledentistry is too new to have an evidence base to support its widespread use, legal and regulatory requirements have not been established and there is no precedent for third party payers to reimburse for this service. CONCLUSION: The authors feel that a national teledentistry policy should be developed starting at the state level with stakeholders from the dental profession, dental education, government, patient advocates, and third party payers working together to determine the best way forward.

Sonographically guided percutaneous first annular pulley release: cadaveric safety study of needle and knife techniques.

OBJECTIVE: The purpose of this study was to assess the safety of sonographically guided percutaneous finger and thumb first annular (A1) pulley releases performed using needle and hook knife techniques in an unembalmed cadaveric model. METHODS: A single operator completed 50 (40 fingers and 10 thumbs) sonographically guided percutaneous A1 pulley releases in unembalmed cadavers using previously described needle and hook knife techniques and simulated local anesthesia. Half of the fingers and thumbs were completed with each technique. An experienced observer blinded to the technique dissected each specimen and assessed for neurovascular, flexor tendon, and A2 pulley injury. Completeness of release was also recorded as a secondary outcome. RESULTS: No neurovascular or A2 pulley injury occurred in any digit, regardless of technique. No significant flexor tendon injury was seen in any digit, although minor surface scratches were visualized in 3 cases (6%; 2 knife and 1 needle). The hook knife technique was significantly more likely to result in a complete pulley release compared to the needle technique (22 of 25 [88%] versus 8 of 25 [32%]; P < .001). CONCLUSIONS: Sonographically guided percutaneous A1 pulley releases can be performed safely using previously described needle and hook knife techniques. The safety margin for thumb releases is less than that for finger releases, particularly with respect to the radial digital nerve. These cadaveric data support recently published clinical investigations recommending consideration of sonographically guided percutaneous A1 pulley release in the management of patients with a disabling trigger finger.

Sonographically guided proximal tibiofibular joint injection: technique and accuracy.

OBJECTIVE: The purpose of this investigation was to describe a technique for sonographically guided proximal tibiofibular joint (PTFJ) injections and compare its accuracy with that of palpation guided injections in a cadaveric model. METHODS: A single experienced operator completed 12 sonographically guided and 12 palpation guided PTFJ injections in unembalmed cadavers. The injection order was randomized, and all injections were completed with diluted colored latex. Coinvestigators blinded to the injection technique dissected each specimen and graded the colored latex location as accurate (in the PTFJ), accurate with overflow (within the PTFJ but also in other regions), or inaccurate (no latex in the joint). For statistical analysis, all injections placing latex within the PTFJ were considered "accurate," whereas "inaccurate" injections resulted in no PTFJ latex. RESULTS: All 12 sonographically guided PTFJ injections accurately placed latex into the PTFJ (100% accuracy), whereas only 7 of 12 palpation guided injections (58%) placed latex within the PTFJ (P = .01). All 5 inaccurate palpation guided injections were superficial and inferior to the PTFJ. Four of 12 accurate sonographically guided PTFJ injections (33%) showed some overflow into the adjacent anterior musculature, whereas 5 of the accurate palpation guided injections (42%) resulted in overflow into the anterior musculature (1), knee joint (2), or both (2). CONCLUSIONS: This cadaveric investigation suggests that sonographic guidance can be used to inject the PTFJ with a high degree of accuracy and should be considered superior to palpation guidance. Clinicians should consider using sonographic guidance to inject the PTFJ for diagnostic or therapeutic purposes when clinically indicated.

Sonographic evaluation of the distal biceps tendon using a medial approach: the pronator window.

OBJECTIVE: The purpose of this report is to describe and demonstrate the potential advantages of a technique to image the distal biceps tendon using a medial approach: the pronator window. METHODS: Distal biceps tendon imaging via the medial approach was shown using real-time sonography on an asymptomatic volunteer as well as cadaveric anatomic dissection. RESULTS: The medial approach images the biceps tendon with minimal anisotropy while providing several potential advantages, including (1) complete visualization of the ulnarly facing radial tuberosity and the tapered distal biceps insertion, (2) increased contrast and reduced beam attenuation at the interface between the biceps tendon and overlying brachial artery, and (3) avoidance of the beam-attenuating effects of the supinator encountered when imaging the tendon from a lateral approach. CONCLUSIONS: The medial approach to image the distal biceps tendon complements previously described techniques and should be considered in the evaluation of patients presenting with distal biceps tendon disorders. Future clinical studies may elucidate the relative advantages and disadvantages of sonographic distal biceps imaging techniques in specific patient populations.

Sonographically guided popliteus tendon sheath injection: techniques and accuracy.

OBJECTIVE: The purpose of this investigation was to describe two sonographically guided popliteus tendon sheath injection techniques and determine their accuracy in a cadaveric model. METHODS: A single experienced operator completed 24 sonographically guided popliteus tendon sheath injections, 12 using a longitudinal approach and 12 using a transverse approach relative to the tendon. The injection order was randomized, and all injections were completed with diluted colored latex. Coinvestigators blinded to the injection technique dissected each specimen and graded the colored latex location as accurate (in the sheath), accurate with overflow (within the sheath but also in other regions), or inaccurate (no latex in the sheath). RESULTS: All 12 sonographically guided popliteus sheath injections using the longitudinal approach placed latex into the sheath. Eight of these injections (67%) also resulted in overflow into the knee joint. Ten of 12 transverse approach injections placed latex into the sheath (83%), with 7 of these (70%) also producing overflow into the knee joint. Two of 12 transverse injections (17%) placed latex only into the knee joint and were therefore inaccurate. CONCLUSIONS: Sonographic guidance can be used to inject the popliteus tendon sheath with a high degree of accuracy. Although the longitudinal approach is potentially more accurate, both approaches may result in injectate overflow into the knee joint, likely through the popliteus hiatus.

Characterization of volatile organic compounds in the vicinity of an optoelectronics industrial park in Taiwan.

This study aimed to determine the concentration of volatile organic compounds (VOCs) and investigate the impacts of traffic and industrial activities on the concentration of VOCs near the Central Taiwan Science Park (CTSP) in Taiwan during 2005. Twelve-hour canister sampling was performed at 10 sites near CTSP every season. Samples were analyzed by gas chromatography with a mass-selective detector. The traffic flow rate, industrial production rates, and meteorological information were also collected to assess their impacts on VOC concentrations using multiple linear regression models. The major components determined in the atmosphere were toluene (29.4-218.8 microg m(-3)), acetone (30-71.3 microg m(-3)), m/p-xylene (7.8-51.7 microg m(-3)), and ethanol (16.4-47.8 microg m(-3)); only ethanol revealed a pattern of increasing concentration from spring to winter. The log-transformed mean concentrations of toluene, acetone, and ethanol were significantly associated with the production rates of the optoelectronic companies after adjustment for traffic flow and meteorological factors (P < 0.05). There was no significant association between the total traffic flow rate and any log-transformed mean concentrations of VOCs. Each $1 million (U.S.) increase in optoelectronic sales was significantly associated with increasing mean concentrations of 1.29 +/- 1.08 microg m(-3) for toluene, 1.13 +/- 1.05 microg m(-3) for acetone, and 1.25 +/- 1.09 microg m(-3) for ethanol. The authors' findings suggest that optoelectronic industrial activities are still the predominant source for VOC emissions surrounding this industrial park.

Co-exposure to noise, N,N-dimethylformamide, and toluene on 24-hour ambulatory blood pressure in synthetic leather workers.

Independent exposure to noise, N,N-dimethylformamide (DMF), or toluene has been associated with cardiovascular effects, but the combined effects are not clear. This study investigated ambulatory systolic blood pressure (SBP) and diastolic blood pressure (DBP) in workers co-exposed to noise, DMF, and toluene. Twenty workers in a synthetic leather manufacturing company were recruited as study subjects. Personal noise exposure and ambulatory blood pressure were measured concomitantly for 24 hr; airborne co-exposure to DMF and toluene during the working period was also analyzed to identify solvents exposure. Linear mixed-effects regressions were used to estimate effects on ambulatory blood pressure by controlling potential confounders. Four high-combined-exposure workers (83 +/- 8 dBA; DMF: 3.23 +/- 2.15 ppm, toluene: 1.09 +/- 1.13 ppm) had the higher means of 16 +/- 7 mmHg in 24-hr DBP (p = 0.027) and 21 +/- 8 mmHg in working-time DBP (p = 0.048) than seven low-combined-exposure workers (73 +/- 12 dBA; DMF: 0.41 +/- 0.02 ppm, toluene: 0.12 +/- 0.01 ppm). Three high-noise-exposure workers (84 +/- 7 dBA) also had a marginal increase of 13 +/- 6 mmHg in DBP at work (p = 0.076) compared with the control group. No significant differences in SBP and DBP were found between six high-solvent-exposure workers (DMF: 1.24 +/- 1.25 ppm, toluene: 2.63 +/- 1.29 ppm) and office workers during any periods. After the Bonferroni correction, there were no significant differences in ambulatory blood pressure between three high-exposure groups and the low-exposure groups. Our findings suggest no interactive effects of co-exposure to noise, DMF, and toluene on workers' ambulatory blood pressure.

Inhalation risk assessment of exposure to the selected volatile organic compounds (VOCs) emitted from the facilities of a steel plant.

Concentrations of volatile organic compounds (VOCs) were investigated in the workplace air of four processes: sintering, cokemaking, hot forming, and cold forming in an integrated iron and steel plant. In addition, the cancer risk was measured for workers in these 4 processes. Seven VOCs (chloroform, carbon tetrachloride, 1,1,2-trichloroethane, trichloroethylene, tetrachloroethylene, benzene, and ethylbenzene) were selected for cancer risk measurement. Trichloroethylene concentrations are high in the 4 processes, and carbon tetrachloride and tetrachloroethylene concentrations are high in both the cold and hot forming processes. The sequence of the total cancer risk of the 7 species was as follows: cokemaking > sintering > cold forming congruent with hot forming. About 66-93% of the cancer risk of the four processes was caused by trichloroethylene. The cancer risks (3.7 x 10(-3)-30 x 10(-3)) of the average VOC concentrations suggest that improvement of workplace air quality and protection of workers are necessary to reduce cancer risks.

Risk factors for increased shoulder Cutibacterium acnes burden.

BACKGROUND: Cutibacterium acnes is the primary cause of shoulder surgery infections, but the predisposition to larger skin counts and potentially higher risk for postoperative infection remains unclear. This study aimed to quantify risk factors influencing endogenous C. acnes burden and to compare counts among 4 shoulder sites. METHODS: C. acnes counts were quantified via a detergent scrub technique for 173 participants. Bivariate and multivariable stepwise linear regression statistical analyses were used to investigate the association of sex, age, ethnicity, degree of hirsutism, diabetes, smoking status, body mass index, and location with counts. A separate Wilcoxon rank-sum test was performed analyzing counts of East/Southeast Asians vs. all other ethnicities. RESULTS: Sex, age, degree of hirsutism, diabetes, smoking status, and body mass index were included in the multivariable stepwise linear regression analysis. The multiple regression analysis isolated individuals <40 years with the highest burden (P = .001). Males had a 191% increase in C. acnes counts compared with females (P = .001). Increased hirsutism was further indicated to be a risk factor for the male sex although not in a dose-dependent manner (P = .027). Wilcoxon rank-sum test results found that East/Southeast Asians had the lowest load (P = .019), although not significant in the multivariate model. CONCLUSION: Surgical site C. acnes infections occur more frequently in younger males, and males <40 years with shoulder-specific hirsutism have the highest preoperative burden. East/Southeast Asians have lower raw counts of C. acnes compared with other ethnicities that may be related to less hirsutism.

Effects of environmental noise exposure on ambulatory blood pressure in young adults.

Epidemiological studies have demonstrated that environmental noise exposure is associated with hypertension in middle-aged and older populations, but the relationship in the young subpopulation and between the genders is still unclear. This panel study investigated effects of environmental noise exposure on 24-h ambulatory blood pressure in 60 adults aged 18-32 years. Individual noise exposure and personal blood pressure were measured simultaneously for 30 males and 30 females. Linear mixed-effects regression models were applied to estimate effects. Total subjects (56.6+/-16.5A-weighted decibels (dBA)) had transient elevations of 1.15 (95% CI=0.86-1.43)mmHg SBP and 1.16 (0.93-1.38)mmHg DBP at daytime, as well as 0.74 (0.21-1.26)mmHg SBP and 0.77 (0.34-1.20)mmHg DBP at nighttime, significantly associated with a 5-dBA increase in noise exposure. Such effects on SBP and DBP still persisted at the 30- and 60-min time-lagged noise exposure. Per 5-dBA increase in 24-h average noise exposure was significantly associated with sustained increments of 1.15 (0.76-1.54)mmHg SBP and 1.27 (0.96-1.58)mmHg DBP in males (57.4+/-16.0dBA), as well as the higher levels of 1.65 (1.36-1.94)mmHg SBP and 1.51 (1.27-1.75)mmHg DBP in females (55.9+/-17.0dBA). We found that environmental noise exposure may have elevated effects on adults' blood pressure. Young females are more susceptible to noise exposure than males.

Effects of shift work on noise-induced hearing loss.

Evidence has accumulated concerning the adverse effects of noise on hearing acuity, but it is not clear whether working shifts may decelerate the effects of hearing loss. The objective of this study is to assess the effects of shift work on hearing loss in a noisy work environment. A sample of 218 male workers recruited at a semiconductor factory with no known occupational hazards that affected hearing acuity other than noise was chosen. The subjects worked either in an eight-hour or 12-hour shift. A standardized audiometric procedure was performed by a qualified audiologist to measure pure-tone hearing thresholds at 0.5 kHz, 1 kHz, 2 kHz, 3 kHz, 4 kHz, 6 kHz and 8 kHz in both ears. Using multiple linear regression adjusted for age, smoking habits, and work duration, the results showed that the severity of hearing loss in both ears was significantly lower in subjects who worked a 12-hour shift. In conclusion, working a 12-hour shift followed by a day off is best for workers and hearing protection should be provided in high noise areas.