Daniel G. Samo

Reliability of three lumbar sagittal motion measurement methods: surface inclinometers.

Three surface methods for measuring lumbar sagittal motion (LSM) were tested for reliability. The three methods used were the Pleurimeter V double inclinometer, the carpenter double inclinometer, and the computerized single sensor inclinometer. In this study, 30 volunteers were examined independently by three occupational health professionals. Each volunteer rotated twice through three stations at which LSM was measured by each of the three methods. The intra- and interexaminer reliabilities in identifying the skin levels of T12 and S1 were acceptable, having intraclass correlation coefficients (ICC) greater than or equal to 0.75. With a single exception, all ICC values for the intraexaminer reliability of LSM measurements fell below 0.90 (a clinically desirable level). The interexaminer reliability was poor, with all ICC values below 0.75. The largest source of measurement error was attributable to the examiner and its associated factors. We concluded that the intra- and interexaminer reliabilities varied greatly, limiting the clinical usefulness of the three surface methods.

Hazardous decibels: hearing health of firefighters.

Noise-induced hearing loss ranks among the most significant occupational health problems. In the united states, more than 1 million firefighters are at risk for noise-induced hearing loss due to exposure to hazardous levels of intermittent noise from sirens, air horns, and engines of emergency vehicles and fire trucks. Although irreversible, noise-induced hearing loss is entirely preventable through both engineering controls and personal protective equipment. This article describes occupational noise exposure, hearing loss, and strategies to prevent noise-induced hearing loss among firefighters.

Hearing loss and use of hearing protection among career firefighters in the United States

Objective: To determine the prevalence and characteristics of noise-induced hearing loss (NIHL) and the use of hearing protection devices (HPDs) among career firefighters. Methods: A Web-based survey and a standard audiometric test were performed with 425 firefighters from three states in the United States. Results: More than 40% showed hearing loss in the noise-sensitive frequencies (4 and 6 kHz). The left ear showed significantly poorer hearing than the right ear. Firefighters having longer years of work in fire services demonstrated significantly worse hearing. Reported use of HPDs was 34% of the time that was needed. Firefighters who used HPDs less were significantly more likely to have hearing loss. Conclusions: This study demonstrated a considerable NIHL problem and low use of HPDs in firefighters. More comprehensive hearing conservation programs should be implemented to reduce NIHL for firefighters.

Reimbursement profile of a private toxicology practice.

This article presents two years of billing and collection data for a bedside toxicology consultation service. The collections rate was 34% or

Effect of firefighter masks on monocular and binocular peripheral vision.

26.19 per hour of consultative time. There was an inverse correlation between collection rates and patient acuity.

Cause, type, and workers' compensation costs of injury to fire fighters

Peripheral vision can impact essential job functions of firefighters and other workers who use Self-Contained Breathing Apparatus and other full face masks. It is important for physicians to know how these masks alter peripheral vision. Also, one must understand the effect of monocular vision on peripheral vision. Using the Goldman Perimeter Machine we measured peripheral vision in the monocular and binocular state, with and without two different types of masks. The results show that monocularity causes an average loss of 23° in the nasal meridian. The use of the masks did not affect this difference. Also, the masks caused an average loss of 28° of peripheral vision in the inferior meridian. How these losses affect the ability of the users of the masks to perform their essential job functions still needs to be researched.