Delbert M. Raymond

Effectiveness of a tailored intervention to increase factory workers' use of hearing protection.

BackgroundIn the United States it is estimated that more than 30 million workers are exposed to harmful levels of noise on the job. When engineering or administrative controls cannot be used to reduce noise, workers should always use hearing protection devices (HPDs) when exposed to loud noise to prevent noise-induced hearing loss (NIHL). Previous research has shown that workers do not always use HPDs when required; therefore, it is essential that workers assume personal responsibility for preventing NIHL by increasing their use of HPDs. ObjectivesThis study tested the effectiveness of an individually tailored multimedia intervention to increase use of HPDs by factory workers. MethodsA randomized controlled design was used to compare the effects of a tailored intervention (n = 446) with two other interventions (a nontailored predictor-based intervention (n = 447) and a control intervention (n = 432)) on workers’ self-reported use of HPDs 6 to 18 months following the intervention. ResultsOnly those workers receiving the tailored intervention significantly increased their use of HPDs from pretest to posttest. However, this increase significantly differed from the nontailored group but not from the control group. ConclusionsIndividually-tailored interventions offer promise for changing behavior. In light of the similarity between the results for the tailored intervention and the control intervention groups, further research is needed to understand barriers to HPD use and how to maximize the benefits of individually tailored interventions in this setting.

Geospatial relationships of air pollution and acute asthma events across the Detroit-Windsor international border: Study design and preliminary results

The Geospatial Determinants of Health Outcomes Consortium (GeoDHOC) study investigated ambient air quality across the international border between Detroit, Michigan, USA and Windsor, Ontario, Canada and its association with acute asthma events in 5- to 89-year-old residents of these cities. NO2, SO2, and volatile organic compounds (VOCs) were measured at 100 sites, and particulate matter (PM) and polycyclic aromatic hydrocarbons (PAHs) at 50 sites during two 2-week sampling periods in 2008 and 2009. Acute asthma event rates across neighborhoods in each city were calculated using emergency room visits and hospitalizations and standardized to the overall age and gender distribution of the population in the two cities combined. Results demonstrate that intra-urban air quality variations are related to adverse respiratory events in both cities. Annual 2008 asthma rates exhibited statistically significant positive correlations with total VOCs and total benzene, toluene, ethylbenzene and xylene (BTEX) at 5-digit zip code scale spatial resolution in Detroit. In Windsor, NO2, VOCs, and PM10 concentrations correlated positively with 2008 asthma rates at a similar 3-digit postal forward sortation area scale. The study is limited by its coarse temporal resolution (comparing relatively short term air quality measurements to annual asthma health data) and interpretation of findings is complicated by contrasts in population demographics and health-care delivery systems in Detroit and Windsor.

A pilot study of occupational injury and illness experienced by classical musicians.

Limited attention is paid to the hazards experienced by orchestra musicians in the occupational health and safety literature. Within that literature, the primary focus has been on noise exposure. A focus on this area is warranted because high sound pressure levels are a product of this work environment. However, in addition to being at risk for noise-induced hearing loss, workers are also at risk for musculoskeletal injury and illness related to stressful body postures held for prolonged work periods. The socio-political forces of employment may place workers at risk for mental health disorders (e.g., depression). The researchers distributed an anonymous survey to classical orchestra musicians in the southwestern United States. The survey inventoried several areas related to occupational health risks. Results suggest low health care-seeking behaviors relative to self-reported signs and symptoms of morbidity. Musicians also reported limited formal training and education regarding occupational health risks. Risk information was provided late in their professional development. This is a particular concern because of the young age at which music training is initiated.

Prevalence of hearing loss and accuracy of self-report among factory workers

Noise represents one of the most common occupational health hazards. A Healthy People 2020 objective aims to reduce hearing loss in the noise-exposed public. The purpose of this study was to describe and compare perceived and measured hearing, and to determine the prevalence of hearing loss among a group of factory workers. Data collected as part of an intervention study promoting hearing protector use among workers at an automotive factory in the Midwest were used. Plant employees (n=2691) provided information regarding their perceived hearing ability, work role, and other demographics. The relationships among audiograms, a single-item measure of perceived hearing ability, and demographic data were explored using chi-square, McNemars test, Mann-Whitney U-test, sensitivity, and specificity. The prevalence of hearing loss among noise-exposed factory workers was 42% (where hearing loss was defined as >25 dB loss at the OSHA-recommended frequencies of 2, 3, and 4 kHz in either ear). However, 76% of workers reported their hearing ability as excellent or good. The difference in perceived hearing ability was significant at each tested frequency between those with and without measured hearing loss. Self-reported hearing ability was poorly related to results of audiometry. Although this group of workers was employed in a regulated environment and served by a hearing conservation program, hearing loss was highly prevalent. These findings, together with national prevalence estimates, support the need for evaluation of hearing conservation programs and increased attention to the national goal of reducing adult hearing loss.

Impacting health through the worksite

The achievement of the Healthy People 2010 objectives will require community involvement of health care providers. The worksite remains the best place to access the adult population for health promotion and disease prevention. In addition, it is essential that non-worksite primary care services be attuned to the effects of work on health and illness. Given the frequency and duration of exposure, the significance of a worksite health history for the primary care provider cannot be overstated. To effectively serve clients, health histories should include assessment for the presence of hazardous worksite exposures and consideration of organizational climate. Further, when considering the provision of health promotion programs in the community, offering programs at the worksites within the community can be particularly effective. There should be increased efforts by health care providers to promote lifestyle modification through client and community interventions. The worksite offers an excellent setting as well as an opportunity to collaborate with employers to facilitate health promotion programs. Recognizing the significance of the occupational environment, an increasing number of worksite intervention studies have been reported. However, continued growth in this area is still needed. Research on worksite health promotion and disease prevention intervention is still in its infancy. Nurses can make a unique contribution to research on worksite lifestyle modification programs, and in enhancing the health status of the nation.

Self-Reported Asthma in Chaldeans, Arabs, and African Americans: Factors Associated with Asthma

Although the prevalence of asthma is increasing worldwide, there are striking, and largely unexplained differences across various racial and ethnic groups. The current study looks at the prevalence of asthma and risk factors between Chaldeans, Arabs, and African Americans. We used Health Assessment Survey data representing 3,136 respondents. Prevalence across the three ethnic groups were compared using unadjusted and adjusted odds ratios, accounting for multiple risk factors. There were significant socio-demographic differences across all ethnic groups. Asthma prevalence was significantly lower in Arabs (9.4%) and Chaldeans (5.4%) than in Non-Middle Eastern Whites (14.4%). African American prevalence was 14.4%. The significantly lower prevalence of asthma among Chaldean and Arabs, as compared to African Americans, were not explained by traditional risk factors included in our models. We therefore, suggest that future studies should explore the possible role of ethnic-specific differences in gene × environmental interactions in the precipitation and/or exacerbation of asthma.

Promoting Colorectal Cancer Awareness in Undergraduate Community Health Nursing Education: A Community–Academic Collaboration

An innovative collaborative partnership between bachelor of science nursing (BSN) students and local public schools was developed in response to a call for increasing awareness of colorectal cancer (CRC) screening in Michigans underserved populations; through this partnership, community health nursing students provide health education for middle- and high-school aged students who became colon health ambassadors and delivered important messages about the importance of colorectal cancer screenings for their significant others age 50 and older. At the completion, the program reached approximately 1,800 school-age students and their family members. The program provides nursing students with unique service-learning experience while improving their theoretical knowledge and clinical skills in health disparities and community health nursing. The purpose of this article is to describe the development and implementation of this community-academic collaboration and discuss the evaluation of educational outcomes as community health nursing experience.