Kahlia McCausland

Health priorities and perceived health determinants among Western Australians attending the 2011 LGBTI Perth Pride Fairday Festival

ISSUE ADDRESSED Although data exist demonstrating poorer health indicators on a range of health outcomes for lesbian, gay, bisexual, transsexual and intersex (LGBTI) people, there is little information as to how this group perceives the relative importance of different health issues or what the underlying reasons behind poorer health may be. METHOD A self-completed survey was administered to people attending the October 2011 LGBTI Perth Pride Fairday Festival. Three hundred and fifty-one people completed the survey, resulting in a total of 335 useable surveys. One hundred and seventy-eight participants identified as female, 145 as male, four as transgender and eight as other genders. RESULTS Depression, anxiety, excessive worry or panic attacks and problems in family relationships were reported as the most important individual health issues, whereas depression, suicide and HIV/AIDS were seen as the most important health issues affecting the LGBTI community. Discrimination was rated the most important social factor impacting on the health and well being of this community. CONCLUSIONS When members of the LGBTI community were asked to rank health issues of importance both individually and as a community, the results indicate that mental health issues are of prime concern. Discrimination and the stress of living as part of this minority group were seen as contributing to this. Health promotion and public health need to be responsive to these issues if real gains are to be made in reducing the health inequities affecting this group. So what? This research highlights the link between social justice, social inclusion and health outcomes. The health of LGBTI people is rarely considered by mainstream agencies, despite poorer health outcomes. Sensitive and targeted public health interventions that resonate with the community and that acknowledge the impact of being part of this marginalised group are required.

The messages presented in online electronic cigarette promotions and discussions: a scoping review protocol

Introduction Electronic cigarettes have become increasingly popular over the last 10 years. These devices represent a new paradigm for tobacco control offering smokers an opportunity to inhale nicotine without inhaling tobacco smoke. To date there are no definite conclusions regarding the safety and long-term health effects of electronic cigarettes; however, there is evidence that they are being marketed online as a healthier alternative to traditional cigarettes. This scoping review aims to identify and describe the breadth of messages (eg, health, smoking-cessation and price related claims) presented in online electronic cigarette promotions and discussions. Methods and analysis A scoping review will be undertaken adhering to the methodology outlined in The Joanna Briggs Institute Manual for Scoping Reviews. Six key electronic databases will be searched to identify eligible studies. Studies must be published in English between 2007 and 2017, examine and/or analyse content captured from online electronic cigarette promotions or discussions and report results for electronic cigarettes separately to other forms of tobacco delivery. Studies will be screened initially by title and abstract, followed by full-text review. Results of the search strategy will be reported in a PRISMA flow diagram and presented in tabular form with accompanying narrative summary. Ethics and dissemination The methodology consists of reviewing and collecting data from publicly available studies, and therefore does not require ethics approval. Results will be published in a peer reviewed journal and be presented at national/international conferences. Additionally, findings will be disseminated via social media and online platforms. Advocacy will be key to informing policy makers of regulatory and health issues that need to be addressed. Registration details The review was registered prospectively with The Joanna Briggs Institute Systematic Reviews database.

Questionnaire-based algorithm for assessing occupational noise exposure of construction workers

Objectives Occupational noise exposure is a major cause of hearing loss worldwide. In order to inform preventative strategies, we need to further understand at a population level which workers are most at risk. Methods We have developed a new questionnaire-based algorithm that evaluates an individual worker’s noise exposure. The questionnaire and supporting algorithms are embedded into the existing software platform, OccIDEAS. Based on the tasks performed by a worker during their most recent working shift and using a library of task-based noise exposure levels, OccIDEAS estimates whether a worker has exceeded the full-shift workplace noise exposure limit (LAeq,8h≥85 dBA). We evaluated the validity of the system in a sample of 100 construction workers. Each worker wore a dosimeter for a full working shift and was then interviewed using the OccIDEAS software. Results The area under the receiver operating characteristic curve was 0.81 (95% CI 0.72 to 0.90) indicating that the ability of OccIDEAS to identify construction workers with an LAeq,8h≥85 dBA was excellent. Conclusion This validated noise questionnaire may be useful in epidemiological studies and for workplace health and safety applications.

The messages presented in electronic cigarette related social media promotions and discussions: A scoping review (Preprint)

Background There has been a rapid rise in the popularity of electronic cigarettes (e-cigarettes) over the last decade, with growth predicted to continue. The uptake of these devices has escalated despite inconclusive evidence of their efficacy as a smoking cessation device and unknown long-term health consequences. As smoking rates continue to drop or plateau in many well-developed countries, transnational tobacco companies have transitioned into the vaping industry and are now using social media to promote their products. Evidence indicates e-cigarettes are being marketed on social media as a harm reduction alternative, with retailers and manufacturers utilizing marketing techniques historically used by the tobacco industry. Objective This study aimed to identify and describe the messages presented in e-cigarette–related social media (Twitter, YouTube, Instagram, and Pinterest) promotions and discussions and identify future directions for research, surveillance, and regulation. Methods Data sources included MEDLINE, Scopus, ProQuest, Informit, the Journal of Medical Internet Research, and Google Scholar. Included studies were published in English between 2007 and 2017, analyzed content captured from e-cigarette–related social media promotions or discussions, and reported results for e-cigarettes separately from other forms of tobacco and nicotine delivery. Database search ceased in October 2017. Initial searches identified 536 studies. Two reviewers screened studies by title and abstract. One reviewer examined 71 full-text articles to determine eligibility and identified 25 studies for inclusion. This process was undertaken with the assistance of the Web-based screening and data extraction tool—Covidence. The review was registered with the Joanna Briggs Institute (JBI) Systematic Reviews database and followed the methodology for JBI Scoping Reviews. Results Several key messages are being used to promote e-cigarettes including as a safer alternative to cigarettes, efficacy as a smoking cessation aid, and for use where smoking is prohibited. Other major marketing efforts aimed at capturing a larger market involve promotion of innovative flavoring and highlighting the public performance of vaping. Discussion and promotion of these devices appear to be predominantly occurring among the general public and those with vested interests such as retailers and manufacturers. There is a noticeable silence from the public health and government sector in these discussions on social media. Conclusions The social media landscape is dominated by pro-vaping messages disseminated by the vaping industry and vaping proponents. The uncertainty surrounding e-cigarette regulation expressed within the public health field appears not to be reflected in ongoing social media dialogues and highlights the need for public health professionals to interact with the public to actively influence social media conversations and create a more balanced discussion. With the vaping industry changing so rapidly, real-time monitoring and surveillance of how these devices are discussed, promoted, and used on social media is necessary in conjunction with evidence published in academic journals.

Challenges Facing Asian Sex Workers in Western Australia: Implications for Health Promotion and Support Services

Introduction: Asian sex workers are a significant part of the Australian sex industry. Criminal laws, racism, isolation, poor English language skills and stigma and discrimination combine to increase the vulnerability of Asian sex workers in Australia. To inform service delivery and potential legislative reform, we undertook a study of sex worker health and safety in Western Australia with a focus on Asian sex workers. Methods: This was a mixed methods study in which peer researchers played an essential role. We undertook a survey (available online and in paper form and translated into three languages other than English), semi-structured interviews with sex workers, and interviews with key advisors. Results: In our study, Asian sex workers were older, had lower levels of education, more likely to have sex work as their main source of income, work longer hours and work exclusively in a shop-front massage parlor compared to their non-Asian counterparts. The vast majority of Asian sex workers in our study said they had poor English language skills and the greatest proportion spoke Chinese languages. Sex work had a positive impact on the well-being of many respondents, and their level of psychological distress was similar to the general Australian population. Stress and “bad clients” were common negative impacts of sex work. Asian study participants were less likely than their non-Asian counterparts to smoke, undertake risky drinking or use illicit drugs. A similar proportion of Asian sex workers reported being assaulted compared to their non-Asian counterparts. Discussion/Conclusion: The major challenges facing Asian sex workers in WA seem to be stigma and discrimination, stress, social isolation, and confusion about their legal standing leading to a fear of authorities, particularly the police. Our findings support the need for enhanced targeted peer-based health promotion outreach services for Asian sex workers, increased Asian language services in sexual health clinics and decriminalization of sex work.

E-Cigarettes: Implications for Health Promotion in the Asian Pacific Region

Since their introduction to the United States in 2007, electronic cigarettes (e-cigarettes) use has grown exponentially. This rapid growth in e-cigarette use has been heralded by some as a potential important public health measure that could ultimately replace tobacco cigarettes, while others recommend a cautionary approach until there is clear evidence they will not become “new tobacco” bringing a possible myriad of other problems. E-cigarettes may have real benefits, however they do expose users and those nearby to organic compounds, solvents and particulate matter, with there being limited data relating to their health impact. It is unclear as to whether this relatively new device has the potential to exacerbate nicotine addictions, or play a part in reducing harm and smoking cessation. The fundamental requirement of public health practice is to do no harm and from the inconclusive evidence we have to date on e-cigarettes, it appears a cautious approach is warranted. This commentary reviews evidence that supports a cautious approach to e-cigarette availability in Australia and the Asian Pacific region.

0351 National prevalence of occupational noise exposure

Noise-induced hearing loss (NIHL) is common and is one of the major costs to occupational compensation schemes. NIHL can also result in reduced quality of life and employment opportunities for the worker. Despite this considerable burden, there is little understanding of occupational noise exposure on a national scale. Recognition of occupational noise exposure is particularly important for small businesses which employ the majority of workers, and are less likely to monitor occupational health concerns. We undertook a national phone survey of nearly 5000 workers in Australia using our validated online application, OccIDEAS. In order to mirror a dosimeter survey, each person was asked about their last working day. Each worker was allocated one of 52 job-specific modules which contained questions about relevant tools, tasks and the time spent on each tool/task. The answers were linked to a custom database containing typical noise levels for each tool/task. Partial noise exposures were calculated, added and normalised to an eight hour shift. On their previous working day, 16% of respondents (23% of males and 7% of females) had an estimated exposure (LAeq,8h) equal to or over the recommended exposure limit of 85 dB. Of those exposed above the limit, 80% were males. A substantial proportion of those exposed above the exposure limit reported that they did not wear hearing protection at all during the day. These results can be used to target interventions at particular occupational and demographic groups to reduce the incidence of NIHL in the future.

P101 Validation of an occupational noise questionnaire

Better estimates of the extent of noise exposure and the relative contribution of different sources of noise across the working population will inform preventive strategies in this area. However, assessing occupational noise exposure with dosimeters is expensive and time consuming. A questionnaire which estimates noise exposure over the same period as a dosimeter would be useful not only in epidemiological studies, but also in practice. We recruited 100 construction workers from a range of different trades including electricians, carpenters and labourers with median age of 32 years (range 17 to 62 years). Noise exposure for the construction workers was estimated using a job-specific questionnaire within OccIDEAS, an online exposure assessment system. The questionnaire asks participants about tasks performed and tools used in the previous working shift and the duration of time these tools were used. Algorithms combine this information to produce an averaged 8-hour equivalent continuous A-weighted sound pressure level (LAeq8h) for the working shift. We compared the results from OccIDEAS for each worker with the results from dosimeters worn over the same work shift. The estimated LAeq8h by OccIDEAS ranged from 63 dB to >104 dB and the readings from dosimeters ranged from 71 dB to 101 dB. The correlation between the two measures was moderate using a continuous variable of noise exposure with r(Pearson) = 0.56. Bland-Altman limits of agreement were 75.8 dB to 94.2 dB at the occupational limit of 85 dB. However, the ability of the OccIDEAS questionnaire to discriminate between participants exposed and not exposed at the LAeq8h occupational limit of 85 dB was close to excellent with an area under the curve of 0.793 (95% confidence interval 0.704 to 0.881). The OccIDEAS noise questionnaire is a valid measurement of occupational noise exposure which will be a useful tool, especially in large epidemiological studies.