Pre-employment hearing threshold levels of 59,601 Australian male coal miners compared to an otologically normal international male population (ISO7029:2019).

OBJECTIVE: This study compared the pre-employment median hearing threshold level (HTL) distribution from a population of coal miners from New South Wales (NSW), Australia, to an otologically normal, age-matched population described by the International Standards Organisation (ISO) ISO 7029:2019, to determine any differences. DESIGN: This was an observational, retrospective, repeated cross-sectional study. STUDY SAMPLE: De-identified audiometric records of 59,601 male employees entering NSW coal mining in three representative five-year periods between 1991 and 2015 were utilised. RESULTS: The median HTL deviation of the mining population was statistically significantly different (p < 0.05) from the ISO population, for almost all analyses. Overall, the mining population cohorts have higher (worse) median HTLs compared to the ISO population. The greatest difference occurs at 4 kHz in older age groups, likely indicating noise-induced hearing loss. CONCLUSION: These findings indicate that some NSW coal mine workers commence their careers with evidence of pre-existing hearing loss (HL), in an industry with excessive noise exposures. These results provide Australian mining and other noisy industries with evidence to support a review of hearing conservation strategies to improve mitigation of hearing loss across the working lifespan.

The coal mining industry in Australia typically employs 20,000­30,000 workers annually. These workers are potentially exposed to noise levels between 80 dB(A) and 120 dB(A) whilst at work, and thus at high risk of developing noise induced hearing loss (NIHL). NIHL is the most compensated, occupational disease for coal mining in Australia, costing the Australian State of New South Wales (NSW) up to $4 million each year. And yet: NIHL is entirely preventable.This is the second of two studies of Australian coal mining, analysing a database containing de-identified mandatory audiometric testing results. Evidence of hearing loss within this population was determined in the first study, and the aim of this follow-up study was to determine if there were differences in the median hearing threshold levels in the mining population compared to an otologically normal, international population (ISO7029). The results indicate that the mining population HTLs for males are significantly different (worse) compared to an age and gender matched otologically normal population, specifically at 4 kHz for older workers. Evidence of age-related hearing loss was also found.From a workplace perspective, employers need to consider appropriate workplace interventions to promote hearing loss prevention strategies across the workforce. This information can be used to inform future noise and hearing policies and procedures within this, as well as other noisy industries, to prevent and reduce further exposure of workers to excessive noise.

Hearing threshold levels of Australian coal mine workers: a retrospective cross-sectional study of 64196 audiograms.

OBJECTIVE: This study examined the hearing threshold levels (HTL) of workers commencing employment in Australian coal mines in the State of New South Wales (NSW). The aim was to establish if some degree of hearing loss was identifiable in the mandatory pre-employment audiograms of workers. DESIGN: This was an observational, retrospective, repeated cross-sectional study. STUDY SAMPLE: De-identified audiometric records of 64196 employees entering NSW coal mining in three representative five-year periods between 1991-2015 were utilised. RESULTS: Although HTLs were lower (better) in more recent years, the results showed clinically significant hearing loss (≥25dBHL) for older workers, 45-60 years. Pure tone average (PTA) hearing losses were greater at the higher frequencies associated with excessive noise exposure (3-6 kHz), than at the speech frequencies (0.5-4 kHz). Hearing loss in the left ears were higher compared to the right ears, with higher prevalence of audiometric notches in males. CONCLUSION: Almost a fifth (14.8-20.1%) of male workers commencing work in NSW coal mines presented with an audiometric notch at 4 kHz. Further research is required to determine if these notches represent true NIHL, and how the residual hearing of workers may be conserved.

Psychometric properties of the Eating Attitude Test-26 for female Iranian students.

OBJECTIVE: The main purpose of the present study was to assess the factor structure, the convergent and divergent validity, and the reliability of the Eating Attitude Test (EAT-26) in a sample of female Iranian students. METHOD: After a rigorous translation and back-translation of the EAT-26, 561 female students from the Tonekabon branch of the Islamic Azad University completed the EAT-26, the Binge Eating Scale (BES), the Beck Depression Inventory-II (BDI-II) and the Beck Anxiety Inventory (BAI). Six weeks later, 74 of these students participated in a test-retest procedure. RESULTS: The exploratory factor analysis resulted in a five-factor solution that accounted for 50% of the total variance. The factors included "drive for thinness", "restrained eating", "perceived social pressure to eat", "oral control", and "bulimia". These factors demonstrated satisfactory concurrent validity, acceptable to high internal consistency (0.76-0.92), and low test-retest reliability (0.26-0.64). The factors effectively identified the students who were currently on a diet, and those who had never participated in a weight reduction program. CONCLUSION: The results provide mixed support for the reliability and validity of the EAT-26 for a non-clinical Iranian population. However, its discriminant validity makes it a useful measure for screening purposes and identifying women at risk for developing disordered eating or eating disorders. Future research should replicate this study in both non-clinical and clinical settings in Iran.

Association between perceived addiction and cessation behaviours among users of smokeless or combustible tobacco in India.

INTRODUCTION: Addiction to tobacco is one of the main drivers of continued tobacco use. This study explored whether perceived addiction, type of tobacco and demographic characteristics were associated with past quit attempts (PQA), intention and self-efficacy to quit among combustible tobacco (CT) or smokeless tobacco (SLT) users in India. METHODS: A cross-sectional survey was conducted among adult tobacco users (N = 607) attending an out-patient department in Mumbai. Logistic regression analysis was used to investigate the association between demographic characteristics, type of tobacco, addiction perceptions and cessation behaviours. RESULTS: Being 'a little addicted' (adjusted odds ratio, AOR [95% confidence interval, CI] 2.75 [1.83, 4.11], P < 0.0001) or 'quite addicted' (AOR [95% CI] 2.93 [1.53, 5.62], P < 0.0012) was associated with lower odds of making a PQA compared to 'not addicted at all'. Being a SLT user (AOR [95% CI] 0.64 [0.41, 0.99], P = 0.047) and female (AOR [95% CI] 0.46 [0.26, 0.81], P = 0.0068) was associated with lower odds of making a PQA. There was a significant decrease in the odds of intention to quit as age increased by 1 year (AOR [95% CI] 0.98 [0.97, 0.99], P = 0.0018). Being identified as 'a little addicted' (AOR [95% CI] 0.28 [0.14, 0.55], P = 0.0003), 'quite addicted' (AOR [95% CI] 0.16 [0.07, 0.39], P < 0.0001) or 'very addicted' (AOR [95% CI] 0.09 [0.04, 0.19], P < 0.0001) was associated with lower odds of self-efficacy to quit compared to 'not addicted at all'. DISCUSSION AND CONCLUSION: Lack of awareness about addiction may inhibit cessation, particularly among less educated and female users of SLT and CT products.

Addiction perceptions among users of smokeless or combustible tobacco attending a tertiary care hospital in India.

INTRODUCTION: Addiction plays a key role in continued tobacco use. The study assessed association of perceived personal addiction and the perceived addictiveness of different forms of tobacco with type of tobacco product used, demographic characteristics and socio-cultural factors. METHODS: A cross-sectional survey of 607 adult tobacco users with age 18 years and above attending a general medicine out-patient department was conducted. Participants were asked questions on perceived personal addiction to tobacco use and perception of addiction on tobacco products. Logistic regression was applied to investigate the association between demographic characteristics, type of tobacco, socio-cultural factors and addiction perceptions. RESULTS: The odds of perceived addiction (PA) were lower among smokeless tobacco (SLT) users [OR (95% CI): 0.57 (0.37, 0.89) P = 0.01]. An increase in the odds of PA was seen as age increased [OR (95% CI):1.02 (1.00, 1.03) P = 0.01] and participants with secondary education and above had higher odds of PA compared to participants with no formal education [OR (95% CI): 1.68 (1.09, 2.58) P = 0.02]. The odds of perceiving SLT products to be addictive was lower among SLT users [OR (95% CI): 0.48 (0.30, 0.75) P = 0.002)] compared to combustible tobacco users. The odds of perceiving SLT products to be addictive was lower [(OR (95% CI): 0.35 (0.18, 0.67) P = 0.002)] among females. Participants with secondary education and above had higher odds of perceiving combustible [OR (95% CI): 1.80 (1.17, 2.77) P = 0.008)] and SLT products [OR (95% CI): 1.98 (1.20, 3.30) P = 0.008)] to be addictive compared to no schooling. DISCUSSION AND CONCLUSIONS: There is a need to raise awareness in India of the addictiveness of tobacco, particularly for users of SLT, younger people and those with less education.

Patient perceptions of surgical telehealth consultations during the COVID 19 pandemic in Australia: Lessons for future implementation.

INTRODUCTION: Prior studies of telehealth report high levels of patient satisfaction, but within carefully selected clinical scenarios. The COVID-19 pandemic led to telehealth replacing face-to-face care for many surgical consultations across a variety of situations. More evidence is needed regarding patient perceptions of telehealth in surgery, in particular, exploring barriers and facilitators associated with its sustained implementation beyond the pandemic. METHODS: Survey invitations were emailed to a convenience sample of surgical patients by their surgeon following a telehealth consultation during the COVID-19 pandemic. Surgeons were recruited from a sample (n = 683) who completed a survey on telehealth (distributed via email to all Australian Fellows of the Royal Australasian College of Surgeons). Mixed methods analysis was performed of the patient survey data. RESULTS: A total of 1166 consultations were captured: 50% routine reviews, 17% initial appointments and 20% post-operative reviews. Video-link was used in 49% of consultations. The majority of patients (94%), were satisfied with the quality of their surgical telehealth consultation and 75% felt it delivered the same level of care as face-to-face encounters. Telehealth was convenient to use (96%) and led to cost savings for 60% of patients. When asked about future appointment preferences after the pandemic, 41% indicated they would prefer telehealth (24% video-link and 17% telephone) over face-to-face appointments. There was a perception by patients that telehealth consultation fees should be less than face-to-face consultation fees. CONCLUSION: Patient satisfaction with surgical telehealth consultations is high. Barriers to more widespread implementation include financial, clinical appropriateness, technical and confidentiality concerns.