Changes in Infection Prevention Practices and Occurrence of Skin Symptoms among Healthcare Workers, Cleaners and Day-care Workers in Norway during the COVID-19 Pandemic.

The COVID-19 pandemic has resulted in increased attention on infection prevention measures. This study aims to assess whether changes in hand hygiene procedures, use of personal protective equipment and moisturizers during the first year of the COVID-19 pandemic were associated with changes in the occurrence of skin symptoms among healthcare workers, cleaners, and day-care workers. A total of 602 participants (40%) responded to an electronic questionnaire, including questions on previous and current occupational exposure and skin problems. Increased frequency of hand washing, use of hand disinfectants, use of disposable gloves and moisturizers were all associated with an increased symptom score on the hands, wrists, forearms. Participants who increased their use of masks or respirators had a higher risk of facial skin symptoms, compared with those with non-increased occupational exposure. In conclusion, a change of behaviour among healthcare workers, cleaners and day-care workers during the first year of the COVID-19 pandemic, with an increase in occupational exposures and use of moisturizers, was associated with higher occurrence of facial skin symptoms and symptoms on the hands, wrists and forearms.

Hearing loss in the Royal Norwegian Navy: A longitudinal study.

The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy's (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS.

Noise and exposure of personnel aboard vessels in the Royal Norwegian Navy.

Despite awareness of noise aboard vessels at sea, few studies have reported measured noise levels aboard ships. This study aimed to describe the noise levels aboard vessels in the Royal Norwegian Navy (RNoN), and to assess the noise exposure of personnel aboard RNoN vessels. In 2012/2013 noise measurements were conducted aboard 14 RNoN vessels from four different vessel classes (frigates, coastal corvettes, mine vessels, and coast guard vessels) which were included in this study. Mean and median A-weighted noise levels (L p,A) in decibel (dB(A)) were calculated for different locations in each vessel class. The noise exposure of RNoN personnel was assessed by dosimeter measurements, and with a task-based (TB) strategy. The TB strategy used means of area measured noise levels in locations and the personnel's mean reported time spent in the respective locations to estimate the exposure. Area measurements of noise during sailing with typical operating modes, showed that for all vessel classes the noise levels were high in engine rooms with median L p,A ranging from 86.4 to 105.3 dB(A). In all the other locations the vessel class with the highest noise levels (coastal corvettes) had a median L p,A ranging from 71.7 to 95.0 dB(A), while the vessel class with the lowest noise levels (coast guard vessels) had a median L p,A ranging from 41.5 to 57.8 dB(A). For all vessel classes the engineers and electricians had amongst the highest 24-hour noise exposure (L p,A,24h), both before and after adjusting for estimated use of hearing protective devices (L p,A,24h > 67.3 dB(A)). The vessel class with the highest personnel exposure levels (coastal corvettes) had L p,A,24h ranging from 76.6 to 79.3 dB(A). The vessel class with the lowest personnel exposure levels (coast guard vessels) had an L p,A,24h ranging from 47.4 to 67.3 dB(A). In general, the dosimeter measurements gave higher exposure levels than those estimated with the TB strategy. All vessel classes, except the coast guard vessels, had noise levels exceeding the RNoN standard's recommended maximum noise levels. The area measured noise levels and the personnel's exposure estimates indicate that navy personnel aboard RNoN vessels are at risk of acquiring adverse health effects from exposure to noise, and that a program to reduce the noise levels should be implemented.

Hearing loss in the royal Norwegian Navy: a cross-sectional study.

OBJECTIVES: Prior studies have indicated a high prevalence of noise-induced hearing loss (NIHL) among Navy personnel; however, it is not clear whether this is caused by work on board. The present study aimed to assess the prevalence of hearing loss among Navy personnel in the Royal Norwegian Navy (RNoN), and to investigate whether there is an association between work on board RNoN vessels and occurrence of hearing loss. METHODS: Navy personnel currently working on board RNoN vessels were recruited to complete a questionnaire on noise exposure and health followed by pure tone audiometry. Hearing loss was defined as hearing threshold levels ≥25 dB in either ear at the frequencies 3,000, 4,000 or 6,000 Hz. Hearing thresholds were adjusted for age and gender using ISO 7029. RESULTS: The prevalence of hearing loss among Navy personnel was 31.4 %. The work exposure variables: years of work in the Navy, years on vessel(s) in the Navy and years of sailing in the Navy were associated with reduced hearing after adjusting for age, gender and otitis as an adult. Among the work exposure variables, years of sailing in the Navy was the strongest predictor of reduced hearing, and significantly reduced hearing was found at the frequencies 1,000, 3,000 and 4,000 Hz. CONCLUSIONS: Our results indicate that time spent on board vessels in the RNoN is a predictor of reduced hearing.

Noise exposure and cognitive performance: A study on personnel on board Royal Norwegian Navy vessels.

Prior research shows that work on board vessels of the Royal Norwegian Navy (RNoN) is associated with noise exposure levels above recommended standards. Further, noise exposure has been found to impair cognitive performance in environmental, occupational, and experimental settings, although prior research in naval and maritime settings is sparse. The aim of this study was to evaluate cognitive performance after exposure to noise among personnel working on board vessels in the RNoN. Altogether 87 Navy personnel (80 men, 7 women; 31 ± 9 years) from 24 RNoN vessels were included. Noise exposure was recorded by personal noise dosimeters at a minimum of 4 h prior to testing, and categorized into 4 groups for the analysis: <72.6 dB(A), 72.6-77.0 dB(A), 77.1-85.2 dB(A), and >85.2 dB(A). The participants performed a visual attention test based on the Posner cue-target paradigm. Multivariable general linear model (GLM) analyses were performed to analyze whether noise exposure was associated with response time (RT) when adjusting for the covariates age, alertness, workload, noise exposure in test location, sleep the night before testing, use of hearing protection device (HPD), and percentage of errors. When adjusting for covariates, RT was significantly increased among personnel exposed to >85.2 dB(A) and 77.1-85.2 dB(A) compared to personnel exposed to <72.6 dB(A).

Effects of Interventions to Prevent Work-Related Asthma, Allergy, and Other Hypersensitivity Reactions in Norwegian Salmon Industry Workers (SHInE): Protocol for a Pragmatic Allocated Intervention Trial and Related Substudies.

BACKGROUND: Workers in the salmon processing industry have an increased risk of developing respiratory diseases and other hypersensitivity responses due to occupational exposure to bioaerosols containing fish proteins and microorganisms, and related allergens. Little is known about effective measures to reduce bioaerosol exposure and about the extent of skin complaints among workers. In addition, while identification of risk factors is a core activity in disease prevention strategies, there is increasing interest in health-promoting factors, which is an understudied area in the salmon processing industry. OBJECTIVE: The overall aim of this ongoing study is to generate knowledge that can be used in tailored prevention of development or chronification of respiratory diseases, skin reactions, protein contact dermatitis, and allergy among salmon processing workers. The main objective is to identify effective methods to reduce bioaerosol exposure. Further objectives are to identify and characterize clinically relevant exposure agents, identify determinants of exposure, measure prevalence of work-related symptoms and disease, and identify health-promoting factors of the psychosocial work environment. METHODS: Data are collected during field studies in 9 salmon processing plants along the Norwegian coastline. Data collection comprises exposure measurements, health examinations, and questionnaires. A wide range of laboratory analyses will be used for further analysis and characterization of exposure agents. Suitable statistical analysis will be applied to the various outcomes of this comprehensive study. RESULTS: Data collection started in September 2021 and was anticipated to be completed by March 2023, but was delayed due to the COVID-19 pandemic. Baseline data from all 9 plants included 673 participants for the health examinations and a total of 869 personal exposure measurements. A total of 740 workers answered the study's main questionnaire on demographics, job characteristics, lifestyle, health, and health-promoting factors. Follow-up data collection is not completed yet. CONCLUSIONS: This study will contribute to filling knowledge gaps concerning salmon workers' work environment. This includes effective workplace measures for bioaerosol exposure reduction, increased knowledge on hypersensitivity, allergy, respiratory and dermal health, as well as health-promoting workplace factors. Together this will give a basis for improving the work environment, preventing occupational health-related diseases, and developing occupational exposure limits, which in turn will benefit employees, employers, occupational health services, researchers, clinicians, decision makers, and other stakeholders. TRIAL REGISTRATION: ClinicalTrials.gov NCT05039229; https://www.clinicaltrials.gov/study/NCT05039229. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/48790.

Macrosomia: mode of delivery and pregnancy outcome.

OBJECTIVE: To assess associations between birthweight and selected adverse outcomes in vaginal and cesarean deliveries and to clarify to which extent macrosomic births are delivered by cesarean section or are centralized to larger maternity units. DESIGN: Cohort study. SETTING: National study based on the Medical Birth Registry of Norway. POPULATION: All births in Norway for the duration 1999-2005 comprising 304,968 vaginal and 47,702 cesarean deliveries. METHODS: Rates of adverse pregnancy outcomes by birthweight in vaginal and cesarean deliveries were compared by odds ratios (ORs) obtained in logistic regression analysis with birthweight 2,500-3,999 g as the reference and adjusted for maternal age, birth order and size of maternity unit. MAIN OUTCOME MEASURES: Analgesia, interventions, complications and neonatal outcomes. RESULTS: For all the adverse outcomes, the ORs increased continuously from the reference group up to > or =5,000 g in which the highest adjusted ORs were observed for shoulder dystocia [64.2 (confidence interval 55.7-74.0)] and plexus injuries [47.7 (confidence interval 35.7-62.4)]. The proportion of adverse outcomes attributable to macrosomia (birthweight > or =4,500 g) ranged from 56.8% of all shoulder dystocia cases to 0.5% of all stillbirths. Macrosomic births were not centralized to larger maternity units and planned cesarean delivery was not more frequent in macrosomic births. CONCLUSIONS: Macrosomic births involved excess risks of a series of adverse pregnancy outcomes, the births were not centralized to larger maternity units and planned cesarean section was not more frequent in macrosomic births.