Sally L. Lusk

Acute Effects of Noise on Blood Pressure and Heart Rate

The authors assessed the acute effects of exposure to noise on systolic and diastolic blood pressure, and heart rate, among 46 workers in a midwestern auto assembly plant. Workers wore ambulatory blood pressure monitors and personal noise dosimeters during one work shift. After adjustment for covariates of cardiovascular function, systolic and diastolic blood pressure, along with heart rate, were shown to be significantly positively associated with noise exposure. Although the long-term effect of these associations is not known, results from other studies suggest that they may be harmful. Replication of this study with a larger number of subjects, monitored for several days and in a variety of work settings, is recommended to verify these findings. The results of this and other studies imply that reducing acute noise exposure reduces cardiovascular stress.

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.

Factors influencing use of hearing protection among farmers: a test of the pender health promotion model.

BackgroundMost farmers are exposed to potentially hazardous noise levels through many of their work activities, such as operating tractors, grain dryers, and chain saws. Rates of noise-induced hearing loss in this group are high. Although this condition is preventable through the use of hearing protection, rates of protective device use are low. Understanding factors influencing the use of hearing protection devices will provide direction for programs to increase their use and decrease risk of noise-induced hearing loss. ObjectivesA study was designed using the Pender Health Promotion Model to identify factors affecting farmers’ use of hearing protection devices. MethodModel testing was conducted with a convenience sample of 139 farmers. Prior to model testing, existing instruments designed to measure concepts from the Health Promotion Model were modified for use with farmers through interviews, validity testing with an expert panel, and reliability testing with first a small (n = 36) then a second larger (n = 139) convenience sample of farmers. Instruments measuring cognitive and affective factors related to hearing protection device use were administered to farmers at a regional farm show in the Midwest. ResultsA logistic regression analysis identified interpersonal support, barriers, and situational influences as statistically significant predictors of this health behavior, correctly predicting 78% of the cases. Results of model testing were consistent with results of previous studies of Health Promotion Model variables with other worker groups’ use of hearing protection. ConclusionsInformation from this study can be used to design and evaluate interventions to promote hearing protection device use among farmers and reduce the level of noise-induced hearing loss in this high-risk and underserved worker group.

Effectiveness of an Intervention to Increase Construction Workers' Use of Hearing Protection

In this project we tested the effectiveness of a theory-based intervention (video, pamphlets, and guided practice session) to increase the use of hearing protection devices (HPDs) among Midwestern construction workers and a national group of plumber/pipefitter trainers. Posttest measures were collected 10--12 months following this intervention. Penders Health Promotion Model (1987) provided the conceptual basis for development of the training program. A total of 837 highnoise- exposed workers were included in the analysis: 652 regional Midwestern construction workers and 185 national plumber/pipefitter trainers. Effectiveness of the intervention was determined through the sequence of analyses recommended by Braver and Braver (1988) for the Solomon Four-Group Design. Analysis of variance and covariance of postintervention use and intention to use HPDs and a meta-analytic test were done. These analyses indicated that the intervention significantly increased use of HPDs but had no effect on intention to use HPDs in the future. Pretesting had no effect on use. Actual or potential applications of this research include guidance in the development of successful theorybased interventions to increase use of HPDs.

Chronic effects of workplace noise on blood pressure and heart rate

Abstract Environmental noise levels in the United States are increasing, yet there are few studies in which the nonauditory effects of workplace noise are assessed. In the current study, the authors examined chronic effects of noise on blood pressure and heart rate in 374 workers at an automobile plant. Data were collected from subjects prior to the start of their workshift. Participants completed questionnaires about diet, alcohol use, lifestyle, noise annoyance, use of hearing protection, noise exposure outside of the work environment, personal and family health histories, and demographic information. Resting blood pressure, heart rate, and body mass index were obtained. Noise exposure levels were extracted retrospectively from company records for each participant for the past 5 yr. Summary statistics were generated for each variable, and the authors performed bivariate correlations to identify any unadjusted associations. The authors then completed statistical modeling to investigate the effects of noise on blood pressure and heart rate, after they controlled for other variables (e.g., gender, race, age). The authors controlled for confounding variables, after which use of hearing protection in high-noise areas was a significant predictor of a decrease in both systolic and diastolic blood pressures. The results suggested that the reduction of noise exposure by means of engineering controls or by consistent use of hearing protection by workers may positively affect health outcomes.

Explaining Mexican American workers' hearing protection use with the health promotion model

BackgroundMexican American workers are vulnerable to noise-induced hearing loss, the most common occupational disease in the United States. ObjectivesThe purpose was to test the applicability of the Health Promotion Model to Mexican American workers’ use of hearing protection devices. MethodA correlational descriptive design and path analysis were used to determine the relationships between cognitive-perceptual factors, modifying factors and use of hearing protection devices. A questionnaire was completed by a total of 119 workers in three garment manufacturing plants. Interviews were conducted with the occupational health nurse or safety director in each plant to determine the policy regarding hearing protection also. ResultsFactors that directly influenced the use of hearing protection devices were a clinical definition of health, benefits of and barriers to use of hearing protection devices, self-efficacy in the use of hearing protection devices and perceived health status (R2 = .25, p < .01). An exploratory analysis allowing a direct relationship of modifying factors with the dependent variable explained additional variance in use of hearing protection devices through the contribution of situational factors (R2 = .55, p < .01). ConclusionsImportant factors related to Mexican American workers’ use of hearing protection devices were identified to provide direction for nursing interventions. Future research should further test the explanatory capabilities of the Health Promotion Model, explore the importance of situational influences on health behavior, and ensure reliable measures of all model components for this population.

Predictors of hearing protection use among workers: implications for training programs.

In this study, we used the conceptual Health Promotion Model to identify predictors of hearing protection use among blue-collar workers (N = 504). The strongest predictors were self-efficacy, benefits, value, and barriers. Items in the barriers scale were most strongly correlated with use and had the greatest potential for change. Therefore, items from this scale are being used as the primary basis for development of a training intervention program.

Health-promoting lifestyles of blue-collar, skilled trade, and white-collar workers.

The health-promoting lifestyles of blue-collar, skilled trade, and white-collar workers were examined. Specific purposes included determining differences in health-promoting behaviors, especially according to worker category, as well as ethnic identification, age, gender, education, and marital status. A convenience sample of 638 workers in a midwestern automotive components plant completed the Health-Promoting Lifestyle Profile (HPLP) and demographics questionnaire. In a multivariate analysis of variance (MANOVA) including all demographic variables, significant differences were found in the mean scores on subscales of the HPLP by job category (2 subscales), age (3), gender (2); and education (4). Prior to including education in the MANOVA, significant differences were found by job category on 5 subscales of the HPLP. The effects of education eliminated the majority of the effects of job category.

Applying the Health Promotion Model to Development of a Worksite Intervention

Introduction. Consistent use of hearing protection devices (HPDs) decreases noise-induced hearing loss, however, many workers do not use them consistently. Past research has supported the need to use a conceptual framework to understand behaviors and guide intervention programs; however, few reports have specified a process to translate a conceptual model into an intervention. Purpose. The strongest predictors from the Health Promotion Model were used to design a training program to increase HPD use among construction workers. Subjects/Setting. Carpenters (n = 118), operating engineers (n = 109), and plumber/pipefitters (n = 129) in the Midwest were recruited to participate in the study. Design. Written questionnaires including scales measuring the components of the Health Promotion Model were completed in classroom settings at worker trade group meetings. Measures. All items from scales predicting HPD use were reviewed to determine the basis for the content of a program to promote the use of HPDs. Three selection criteria were developed: (1) correlation with use of hearing protection (at least .20), (2) amenability to change, and (3) room for improvement (mean score not at ceiling). Results. Linear regression and Pearsons correlation were used to assess the components of the model as predictors of HPD use. Five predictors had statistically significant regression coefficients: perceived noise exposure, self-efficacy, value of use, barriers to use, and modeling of use of hearing protection. Using items meeting the selection criteria, a 20-minute videotape with written handouts was developed as the core of an intervention. A clearly defined practice session was also incorporated in the training intervention. Conclusion. Determining salient factors for worker populations and specific protective equipment prior to designing an intervention is essential. These predictors provided the basis for a training program that addressed the specific needs of construction workers. Results of tests of the effectiveness of the program will be available in the near future.

Noise exposures. Effects on hearing and prevention of noise induced hearing loss

1. Over 30 million workers are exposed to hazardous noise on the worksite. Continual exposure to high noise levels damages and destroys hearing cells within the ear, making noise induced hearing loss an irreversible impairment. 2. Hearing conservation programs are required by law for workers in industrial settings where noise exposures equal or exceed 85 dB(A). Many workers, such as those in construction and agricultural industries, are not covered by these programs. 3. Reducing noise through engineering or administrative controls is the first line of defense. When this is not sufficient, two types of personal hearing protection devices are available: passive hearing protection devices such as ear muffs, canal caps, and ear plugs, which reduce noise mechanically; and active noise reduction devices, which electronically cancel sound waves at the ear. 4. The most effective hearing protection devices are those with which the worker is most comfortable will use 100% of the time. The occupational health nurse has a major role in promoting increased use of hearing protection devices through continued contact with workers, administrators, and safety personnel.