Noise characterization of “effective quiet” areas on a U.S. Navy aircraft carrier

The purpose of this investigation was to characterize noise levels in spaces designated as “effective quiet” areas on a U.S. Navy aircraft carrier. Noise dosimetry samples were collected in 15 designated spaces, representing 15 noise measurements, while at-sea during airwing carrier qualifications. Equivalent sound level (L_eq) measurements were collected during flight operations (L_{eq (flt ops)}), non-flight operations (L_{eq (non-flt ops)}), and over 24-hr periods (L_{eq (24-hr)}). These data were compared to the 70 dBA American Conference of Governmental Industrial Hygienists (ACGIH^®) Threshold Limit Value (TLV^®) for “effective quiet” areas intended for temporary threshold shift recovery when personnel live and work in a potentially noise hazardous environment for periods greater than 24?hr. The monitored areas were selected based on personnel occupancy/use during off-duty time periods. Areas were classified by either (1) leisure areas that included mess (eating areas), gyms, lounges, an internet cafe, and the fantail social area or (2) berthing (sleeping) areas. The L_eq measurements in decibels “A” weighted (dBA) were compared to determine significant differences between L_{eq (flt ops)}, L_{eq (non-flt ops)}, and L_{eq (24-hr)} and were compared between leisure area and berthing area. Measured noise levels according to time period ranged as follows: (1) L_{eq (24-hr)}: 70.8–105.4 dBA; (2) L_{eq (flt ops)}: 70–101.2 dBA; and (3) L_{eq (non-flt ops)}: 39.4–104.6 dBA. All area measurements over the 24-hr period and during flight operations and 46.7% of the areas during the non-flight operation time period exceeded the “effective quiet” 70 dBA ACGIH TLV. Mean L_eqs were 15 dBA higher during flight operations compared to non-flight operations in “effective quiet” areas (p?=?0.001). The L_eqs in leisure areas were significantly higher than berthing areas by approximately 21 dBA during non-flight operation periods (p?=?0.001). Results suggest noise levels in “effective quiet” areas frequented by aircraft carrier personnel during off-duty hours when at-sea may inhibit auditory recovery from occupational noise exposures that occur on-duty.     

Noise at sea: Characterization of extended shift noise exposures among U.S. Navy aircraft carrier support personnel

The purpose of this investigation was to characterize 12-hr on-duty, 12-hr off-duty, and 24-hr noise exposures among U.S. Navy aircraft carrier support personnel. Noise dosimetry samples were collected for 47 aircraft carrier support personnel while at sea during airwing carrier qualifications. L_eq measurements during 12-hr on-duty, 12-hr off-duty, and over 24-hr periods were compared to Threshold Limit Values. Four similar exposure groups (SEGs) were created based upon departmental assignment and similarity of work tasks: (1) Administration/Religious Ministries/Legal/Training, (2) Combat Systems/Operations, (3) Medical/Dental, and (4) Supply. Equivalent sound level (Leq) measurements in decibels “A” weighted (dBA) were compared to determine significant differences between each group according to 12-hr on-duty, 12-hr off-duty, and 24-hr periods. Mean 24-hr noise levels ranged from 69–88 dBA with 22% exceeding the 80 dBA Threshold Limit Value. Twelve-hr on-duty noise levels ranged from 71–90 dBA with 17% exceeding the 83 dBA 12-hr on-duty Threshold Limit Value. Twelve-hr off-duty noise exposure ranged from 68–84 dBA with 95% exceeding the 70 dBA American Conference of Governmental Industrial Hygienists threshold classified as effective quiet to allow for temporary threshold shift recovery. Welch Analysis of Variance and Dunnett T3 post hoc tests revealed SEG 2 had significantly higher 24-hr noise exposures than SEG 3 (p?=?0.019) and SEG 4 (p?=?0.045). SEG 2 had significantly higher 12-hr on-duty noise exposure than SEG 3 (p?=?0.030). One Way Analysis of Variance revealed no significant differences between 12-hr off-duty noise exposures according to SEG (p = .096). Some aircraft carrier support personnel had 12-hr on-duty and 24-hr noise exposures exceeding Threshold Limit Values with a large proportion exceeding the 70 dBA effective quiet limit during 12-hr off-duty periods. Results suggest personnel that are typically considered low risk for hazardous noise exposure (<85 dBA) during 8-hr shifts may have a greater risk of noise exposure when considering full 12-hr and 24-hr shifts when working and living in close proximity.     

Respirable silica and noise exposures among stone processing workers in northern Thailand

Silica and noise are highly prevalent occupational exposures in the stone processing industry. Monitoring for silica and noise are expensive tasks that may be especially difficult to perform in low-resource settings, but exposure awareness is vital for protecting worker health. This study evaluated personal noise and silica measurements at a stone processing facility in northern Thailand to investigate the differing exposure potentials and risk for overexposure among the varying job categories. Our research team performed repeated personal noise and respirable silica measurements on 46 workers, over three separate workshifts for each of 46 workers. While 36.2% of noise measurements exceeded the recommended exposure limit of 85 dBA, only three silica measurements (2.4%) were above the threshold limit value (TLV) of 25 µg/m³. Self-reported personal protective equipment use was low, with only 27.5% of participants wearing hearing protection in noisy environments during their monitored shift and 29.7% of workers wearing respiratory protection during dusty portions of their shift. We identified a significant positive correlation between measured noise and silica levels (r = 0.54, p < 0.01), with stone loaders having the highest average noise (mean = 89 dBA, standard deviation = 4.9 dBA) and silica (geometric mean = 6.4 µg/m³, geometric standard deviation = 1.8) exposure levels. In a multivariate model, the stone loader job category was a significant predictor of exposure to detectable levels of respirable silica (p < 0.01). These results provide useful guidance regarding the need for noise and silica exposure interventions in order to reduce incidences of workplace disease in the stone processing industry.     

Impact of a participatory program to reduce noise in a neonatal unit

This study evaluated the impact of a participatory program to reduce noise in a neonatal intermediate care unit of a university hospital. A time-series quasi-experimental design was used, in which sound pressure levels were measured before and after the intervention was implemented using the Quest-400 dosimeter. Non-parametric statistical tests were used to compare noise with the level of significance fixed at 5%. Results showed significant reduction of sound pressure levels in the neonatal unit after the intervention program was implemented (p<0.0001). The average Leq before the intervention was 62.5dBA and was reduced to 58.8dBA after the intervention. A reduction of 7.1dBA in the average Lmax(from 104.8 to 87.7dBA) and of 30.6dBA in the average Lpeak(from 138.1 to 107.5dBA) was observed. The program was proven to be effective in significantly reducing noise levels in the neonatal unit, although levels were still more intense than recommended.     

Assessment and characterization of sound pressure levels in Portuguese neonatal intensive care units

In the NICU, systematic exposure to sound-pressure above the recommended level can affect both neonates and staff. This study aimed to evaluate the sound pressure levels in three Portuguese NICUs and the noise perceptions of staff. The measurements were performed with a sound-level meter, considering the location of the main sources of noise and the layout of the units. A questionnaire was applied to assess noise perceptions of professionals. Among the staff, 41.1% classified the environment (regarding noise) as “slightly uncomfortable”; 48.4% considered it as “acceptable.” The majority (55.5%) considered “equipment” the most annoying source of noise. The results showed that noise levels were excessive in all the evaluated areas of the NICUs, exceeding international guidelines, with levels ranging between 48.7 dBA to 71.7 dBA. Overall, there is a need for more research to verify the effectiveness of some actions and strategies to reduce the effect of noise in the NICU.     

Causes and Consequences of Interrupted Enteral Nutrition

Background: Malnutrition and underfeeding are major challenges in caring for critically ill patients. Our goal was to characterize interruptions in enteral nutrition (EN) delivery and their impact on caloric debt in the surgical intensive care unit (ICU). Materials and Methods: We performed a prospective, observational study of adults admitted to surgical ICUs at a Boston teaching hospital (March–December 2012). We categorized EN interruptions as “unavoidable” vs “avoidable” and compared caloric deficit between patients with ≥1 EN interruption (group 1) vs those without interruptions (group 2). Multivariable logistic regression was used to investigate the association of EN interruption with the risk of underfeeding. Poisson regression was used to investigate the association of EN interruption with length of stay (LOS) and mortality. Results: Ninety‐four patients comprised the analytic cohort. Twenty‐six percent of interruptions were deemed “avoidable.” Group 1 (n = 64) had a significantly higher mean daily and cumulative caloric deficit vs group 2 (n = 30). Patients in group 1 were at a 3‐fold increased risk of being underfed (adjusted odds ratio, 2.89; 95% confidence interval [CI], 1.03–8.11), had a 30% higher risk of prolonged ICU LOS (adjusted incident risk ratio [IRR], 1.27; 95% CI, 1.14–1.42), and had a 50% higher risk of prolonged hospital LOS (adjusted IRR, 1.53; 95% CI, 1.41–1.67) vs group 2. Conclusions: In our cohort of critically ill surgical patients, EN interruption was frequent, largely “unavoidable,” and associated with undesirable outcomes. Future efforts to optimize nutrition in the surgical ICU may benefit from considering strategies that maximize nutrient delivery before and after clinically appropriate EN interruptions.     

Exposure to noise on board locomotives

Personal and area noise dosimetry measurements were taken in the cabs of leading and trailing locomotives on 48 trips, under winter and summer conditions, on 9 different routes. The mean equivalent sound level (L(EQ), 3 dB exchange rate, 50 dBA threshold) of the engineers and conductors was 84 dBA during winter and 88 dBA during summer. The corresponding time-weighted average levels (L(TWA), 5 dB exchange rate, 80 dBA threshold) were 80 and 84 dBA respectively. The L(EQ) of 56% of the engineers sampled was > or =85 dBA and of 13% was > or =90 dBA. Plots of L(EQ) time history show that under normal operating conditions L(EQ) reaches its steady-state value in about 3 hours. The mean noise levels in the trailing cabs were lower than the personal exposure levels of the engineers and conductors. The mean L(EQ) on the engineer and conductor sides was 80 dBA during winter, and 85 dBA during summer. Locomotive configuration has a significant effect on the noise levels in the trailing cab. The forward-backward configuration resulted in higher noise levels than the forward-forward configuration. Octave and one-third octave band spectra taken during a variety of locomotive operating conditions are presented. The octave band centered at 31.5 Hz contains nearly 46% of the acoustical energy, and those centered at and below 250 Hz contain nearly 99% of the acoustical energy. Wheel-rail interaction appears to be the predominant source of the low frequency noise. Recommendations for controlling exposure are made.     

Noise characterization of oil and gas operations

In cooperation with The Colorado Oil and Gas Conservation Commission, researchers at Colorado State University performed area noise monitoring at 23 oil and gas sites throughout Northern Colorado. The goals of this study were to: (1) measure and compare the noise levels for the different phases of oil and gas development sites; (2) evaluate the effectiveness of noise barriers; and (3) determine if noise levels exceeded the Colorado Oil and Gas Conservation Commission noise limits. The four phases of oil and gas development include drilling, hydraulic fracturing, completion and production. Noise measurements were collected using the A- and C-weighted sound scales. Octave band analysis was also performed to characterize the frequency spectra of the noise measurements.

?Noise measurements were collected using noise dosimeters and a hand-held sound-level meter at specified distances from the development sites in each cardinal direction. At 350 ft (107 m), drilling, hydraulic fracturing, and completion sites without noise barriers exceeded the maximum permissible noise levels for residential and commercial zones (55 dBA and 60 dBA, respectively). In addition, drilling and hydraulic fracturing sites with noise barriers exceeded the maximum permissible noise level for residential zones (55 dBA). However, during drilling, hydraulic fracturing, and completion operations, oil producers are allowed an exception to the noise permissible limits in that they only must comply with the industrial noise limit (80 dBA). It is stated in Rule 604.c.(2)A. that: “Operations involving pipeline or gas facility installation or maintenance, the use of a drilling rig, completion rig, workover rig, or stimulation is subject to the maximum permissible noise levels for industrial zones (80dBA).”^[8] “Aesthetic and Noise Control Regulations,” Colorado Oil and Gas Conservation Act, 800 Series Rule, September 30, 2014. [Google Scholar] Production sites were within the Colorado Oil and Gas Conservation Commission permissible noise level criteria for all zones. At 350 ft (107 m) from the noise source, all drilling, hydraulic fracturing, and completion sites exceeded 65 dBC.

?Current noise wall mitigation strategies reduced noise levels in both the A- and C-weighted scale measurements. However, this reduction in noise was not sufficient to reduce the noise below the residential permissible noise level (55 dBA).     

“The Fullness of Time in Epidemiology”

In this study, we investigated the role of occupational noise exposure and blood pressure among workers at 2 plants. A noise-exposed plant (plant 1, ≥ 89 dBA) and a less-noise-exposed plant (plant 2, ≤ 83 dBA) were chosen. Exposure was based on department-wide average noise measures; on the basis of job location and adjusting for layoffs during their employment at the plant, a cumulative time-weighted average noise level was calculated for each worker. The study population comprised 329 males in plant 1 and 314 males in plant 2. Their ages ranged from 40 to 63 y (mean ages = 49.6 and 48.7, respectively), and they had worked at least 15 y at the plant. The clinical examination was administered prior to the workday and measured height, weight, pulse, and blood pressure. In addition, we noted medical and personal-habits histories, including alcohol intake and cigarette smoking patterns. We used a questionnaire to determine in-depth occupation, military history, noisy hobbies, and family history of hypertension. When individuals who took blood-pressure medication were removed from the analysis, t tests for differences in average blood pressure between plants showed a mean systolic blood pressure of 123.3 mm Hg in plant 1 versus 120.8 mm Hg in plant 2 (p = .06) and a mean diastolic blood pressure of 80.3 mm Hg versus 77.8 mm Hg in Plant 1 and 2, respectively (p = .014). On the basis of data from the combined plants, multivariate analysis revealed that age, body mass index, cumulative noise exposure, current use of blood pressure medications, and alcohol intake were significant predictors for systolic blood pressure. Cumulative noise exposure was a significant predictor of diastolic blood pressure in plant 1 but not in plant 2, possibly reflecting a threshold effect.     

Noise exposure assessment among groundskeepers in a university setting: A pilot study

Approximately 870,000 U.S. workers are employed as landscaping and groundskeeping workers who perform various tasks and use a variety of tools that expose them to high noise levels, increasing their risk to noise-induced hearing loss (NIHL). Several studies on noise exposure and NIHL in other job sectors have been published, but those on groundskeepers are very limited. This study aims to characterize the noise exposure of groundskeepers. Participants were monitored over their entire work shift for personal noise exposure by wearing noise dosimeters at shoulder level, 4 in from the ear. Using two different dosimeter settings (OSHA and NIOSH), the time-weighted averages (TWAs) and 1-min averages of noise exposure levels in decibels (dBA) were obtained. The participants were also asked to fill out an activity card daily to document their tasks, tools used, location and noise perception. Sound pressure levels (SPLs) produced by various groundskeeping equipment and tools were measured at full throttle near the ear of the operator using a sound level meter. These measurements were used to assess worker noise exposure profiles, particularly the contributing source of noise. The overall mean OSHA and NIOSH TWA noise exposures were 82.2±9.2 (range of 50.9–100 dBA) and 87.8±6.6 dBA (range of 67.2–102.9 dBA), respectively. Approximately 46% of the OSHA TWAs exceeded the OSHA action limit of 85 dBA. About 76% of the NIOSH TWAs exceeded 85 dBA, and 42% exceeded 90 dBA. The SPLs of equipment and tools measured ranged from 75– 106 dBA, most of which were at above 85 dBA and within the 90–100 dBA range. Hand-held power tools and ride-on equipment without enclosed cab may have contributed significantly to worker noise exposure. This study demonstrates that groundskeepers may be routinely exposed to noise levels above the OSHA and NIOSH exposure limits, and that the implementation of effective hearing conservation programs is necessary to reduce their risk to NIHL.     

Exploring nighttime road traffic noise: A comprehensive predictive surface for Toronto,Canada

Road traffic noise can adversely impact the health of city residents, particularly when it occurs at night. The objective of this study was to evaluate nighttime traffic ambient noise in Toronto, Canada using measured and model-estimated noise levels. Road traffic noise was measured at 767 locations over 3 seasonal sampling campaigns between June 2012 and October 2013 to fully capture noise variability in Toronto. Temporal and campaign-specific spatial models, developed using the noise measurements, were used to build a final predictive surface. The surface was capable of estimating noise across the city over a 24-hr time frame. Measured and surface-estimated noise levels were compared with guidelines from the World Health Organization and the Province of Ontario to identify areas where noise may pose a health risk. Measured mean nighttime noise in Toronto exceeded World Health Organization (40 dBA) guidelines and mean daytime noise exceeded provincial (55 dBA) guidelines. The final predictive surface, incorporating spatial variables and daily cycles in noise levels, provides noise estimates geocoded for the entire study area. This tool could be used for epidemiological studies and to inform noise mitigation efforts. Based on surface-estimated noise levels during the quietest time of night (2 a.m.–2:30 a.m.), 100% of Toronto has nighttime noise exceeding 40 dBA (mean = 57 dBA, range = 49–110 dBA). A predictive surface was developed to estimate geocoded noise levels and facilitate further study of noise in Toronto. This tool can be used to assess road traffic noise, particularly at night, as an environmental health hazard.     

Occupational exposures to noise resulting from the workplace use of personal media players at a manufacturing facility

This study examined the contribution of noise exposures from personal media player (PMP) use in the workplace to overall employee noise exposures at a Colorado manufacturing facility. A total of 24 workers' PMP and background noise exposures were measured. Twelve PMP users worked in high-background-noise exposure (HBNE) areas, and 12 worked in low-background-noise exposure (LBNE) areas. The self-selected PMP listening level of each worker was measured using an ear simulator, and the background noise of each employee workstation was measured using a sound level meter. Workers' self-reported PMP duration of use, PMP listening exposure levels, and background noise levels were used to estimate the daily occupational noise exposures. Measured background noise levels averaged 81 dBA for HBNE workers and 59 dBA for LBNE workers. Measured, free-field equivalent listening exposure levels were significantly greater for HBNE workers (85 dBA) compared with LBNE workers (75 dBA) (p = 0.0006). Estimated mean daily noise exposures for both groups were below the ACGIH threshold limit value for noise of 85 dBA8-hr time weighted average (TWA), specifically 84 dBA TWA for HBNE workers and 72 dBA TWA for LBNE workers. Three of 12 (25%) HBNE workers had estimated exposures greater than 85 dBA TWA when only background noise was considered, yet when PMP use was also considered, 6 of 12 (50%) had estimated exposures greater than 85 dBA TWA, suggesting that PMP use doubled the number of overexposed workers. None of the LBNE workers had estimated exposures greater than 85 dBA TWA. The contribution of PMP use to overall noise exposures was substantially less among HBNE workers than LBNE workers due to the disproportionate selection of noise-attenuating headsets among HBNE workers compared with LBNE workers. It is recommended that the facility management either restrict workplace PMP use among HBNE workers or require output-limiting technology to prevent occupational noise-induced hearing loss.     

Performance Status,Prognostic Scoring,and Parenteral Nutrition Requirements Predict Survival in Patients with Advanced Cancer Receiving Home Parenteral Nutrition

We describe a cohort of Home Parenteral Nutrition (HPN) patients with advanced cancer in order to identify factors affecting prognosis. Demographic, anthropometric, biochemical and medical factors, Karnofsky Performance Status (KPS), Glasgow Prognostic Score (GPS), and PN requirements were recorded. Univariate and multivariate analyses were performed including Kaplan–Meier curves, Cox Regression, and correlation analyses. In total, 107 HPN patients (68 women, 39 men, mean age 57 yr) with advanced cancer were identified. The main indications for HPN were bowel obstruction (74.3%) and high output ostomies (14.3%). Cancer cachexia was present in 87.1% of patients. The hazard ratio (HR) for upper gastrointestinal and “other” cancers vs. gynaecological malignancy was 1.75 (p = 0.077) and 2.11 (p = 0.05), respectively. KPS score, GPS, PN volume, and PN potassium levels significantly predicted survival (HR_{KPS ≥50 vs <50} = 0.47; HR_{GPS = 2 vs. GPS = 0} = 3.19). In multivariate analysis, KPS and GPS remained significant predictors (p < 0.05), whilst PN volume reached borderline significance (p = 0.094). Survival was not significantly affected by the presence of metastatic disease, previous or concurrent surgery, chemo-radiotherapy, or indication for HPN (p > 0.05). Most patients passed away in their homes or hospice (77.9%). Performance status, prognostic scoring, and PN requirements may predict survival in patients with advanced cancer receiving HPN.     

Pilot study of patron sound level exposure in loud restaurants,bars, and clubs in New York city

Visiting restaurants, bars, clubs, and lounges is a regular part of urban cultural life for residents and tourists alike; however, anecdotal reports and diner surveys suggest that sound levels are excessive and diners dislike them. High sound levels in these venues can contribute to both patron and employee overexposure, and young people may be particularly at risk. To supplement the paucity of literature and data on noise in urban venues, patron noise exposure was measured inside a sample of loud New York City restaurants, bars, clubs, and lounges. Sound level measurements were obtained in 59 venues. Field staff conducted one 20–162 minute visit per venue on a Thursday, Friday, or Saturday evening. The equivalent continuous sound pressure level on the A-scale (L_Aeq) was calculated for each visit. Median and mean L_Aeq among all venues sampled were both 92 decibels (dBA). Clubs and lounges had a higher mean L_Aeq than restaurants and bars (97 vs. 91 dBA, p < 0.05). A greater number of patrons was associated with a higher L_Aeq. Higher L_Aeq values were observed during later hours of the evening (9 PM and later). For 80% (N = 47) of the venues, the L_Aeq was above 85 dBA. In 49% (N = 29) of the venues, the visit exceeded the maximum allowable daily noise dose based on National Institute of Occupational Safety and Health (NIOSH) Recommended Exposure Limit (REL) of 85 dBA 8-hr Time-Weighted Average (TWA). Venues should assess indoor sound levels including employee exposure and aim to maintain sound levels that are within NIOSH guidelines.     

Do we really know how much we are feeding our patients?

Background: Nutrition support is important in critical illness, and accurate recording is particularly important to determine whether nutritional goals are met both from a caloric and volume perspective. Objective: To assess accuracy of enteral feeding records, to increase nursing education and to improve nutritional documentation. Methods: An uncontrolled, prospective, pre- and post-intervention study was completed as part of a quality improvement initiative. This study was performed in a 950-bed university hospital (Philadelphia, Pennsylvania) and focused in a 25-bed, closed intensive care unit (ICU) with a multidisciplinary rounding team of intensivist, nurse, pharmacist, dietitian and respiratory therapist. Nurse researchers reviewed 188 patient electronic medical records (EMR) and compared the data to volume data saved on enteral feeding pump. Data analysis revealed inconsistencies between the pump readings and EMR. The need for a prospective intervention was recognized and implementation of this intervention included pump calibration and teaching modules aimed at improving enteral feeding protocols. During post-intervention, another 234 records were reviewed. Results: The intervention of an education program reduced the documented discrepancy between the pump readings and charted volumes from 44 to 33%. A correlation analysis also showed a tighter relationship post-intervention (r_post = 0.84 vs. r_pre = 0.76, both had a p < 0.01). Conclusion: This study highlights the importance of accurate nutritional monitoring in the ICU and demonstrates that educational interventions can improve enteral feeding protocols. Pump calibrations, frequent interrogation and vigilant nutritional documentation can improve enteral nutrition delivery. Future studies are needed to determine if the effects are sustainable and if further education will further improve documentation and delivery.     

The short-term effect of patient health status assessment in a health maintenance organization

This study was designed to test the short-term effects of health assessment on the process of care and patient satisfaction. The 29 Chart physicians used the Dartmouth COOP Charts to measure their adult patients' health status during a single clinical encounter; the 27 control clinicians used no measure of health status. We compared the change between baseline and post-intervention information for a sample of all study clinicians' patients. Most of the patients were female (67%), well educated (70% had at least a college education) and young (approximately 90% were aged 59 years or younger). We found that the ordering of tests and procedures for women was increased by exposure to the COOP Charts (52% vs. 35%; p<0.01); the effect in men was not as significant (37% vs. 23%: p=0.06). Although women reported no change in satisfaction with care, men claimed that the clinician helped in the management of pain (p=0.02). We conclude that the use of health status measures during a single clinical encounter in an HMO changes clinician test ordering behaviour and may improve the help male patients receive for pain conditions. The long-term impact of these management changes is not known.This grant was supported by the henry J. Kaiser Family Foundation.     

The prevalence and associated risk factors of elder abuse among older people applied to the family health center in the rural district of Turkey

ABSTRACT

In this study, face-to-face interviews were conducted with older people who applied to the family health center (N = 152) in the traditional rural district of Turkey. Although the prevalence rate was 23%, the mean value of “Characteristics of the elder that make him or her vulnerable to abuse” subscale (X? = .37) was highest among other subscales. The mean values for “Characteristics of potentially abusive situations” (X? = .06) and “Overt violation of personal rights and direct abuse” (X? = .05) were quite low. The majority of the elder abuse prevalence was composed of participants who were vulnerable to elder abuse. The rural area makes older individuals vulnerable to abuse. Also, risk factors associated with elder abuse in rural areas were interaction with family (p = .000), interaction with neighbors/friends (p = .001), chronic diseases (p = .002), psychiatric diseases (p = .007), gender and marital status (p = .008), and additional income (p = .028), respectively. The only predictor of elder abuse in rural areas was family interaction. There was a significant negative relationship between rural elder abuse and family interaction (T= ?4.239, p < .001).     

Chicago transit authority train noise exposure

To characterize noise exposure of riders on Chicago Transit Authority (CTA) trains, we measured noise levels twice on each segment of 7 of the 8 CTA train lines, which are named after colors, yielding 48 time-series measurements. We found the Blue Line has the highest noise levels compared to other train lines, with mean 76.9 dBA; and that the maximum noise level, 88.9 dBA occurred in the tunnel between the Chicago and Grand stations. Train segments involving travel through a tunnel had significantly higher noise levels than segments with travel on elevated and ground level tracks. While 8-hr doses inside the passenger cars were not estimated to exceed occupational exposure limits, train operators ride in a separate cab with operational windows and may therefore have higher noise exposures than riders. Despite the low risk of hearing loss for riders on CTA trains, in part because transit noise accounts for a small part of total daily noise exposure, 1-min average noise levels exceeded 85 dBA at times. This confirms anecdotal observations of discomfort due to noise levels, and indicates a need for noise management, particularly in tunnels.     

Contributions of non-occupational activities to total noise exposure of construction workers

This paper describes how exposures received during routine and episodic non-occupational activities contribute to total noise exposure in a group of occupationally exposed workers. Two-hundred and sixty-six construction apprentices enrolled in a longitudinal hearing loss study and completed questionnaires at 1 yr of follow-up to determine their episodic activities (e.g. concert attendance, power tool use, firearms exposure). Noise exposure levels for these episodic exposures were determined from the published literature. Routine activities were assessed using activity cards filled out over 530 subject-days, along with noise dosimetry measurements made over 124 subject-days of measurement. Equivalent Leq exposure levels were then calculated for specific activities. These activity-specific Leq values were combined into estimated individual annual Leq exposure levels for the 6760 nominal annual non-occupational hours in a year (LAeq6760h), which were then transformed into equivalent levels for a 2000 h exposure period (LA2000hn) for comparison with occupational noise exposure risk criteria. The mean non-occupational LAeq6760h exposure values for the cohort ranged from 56 to 87 dBA (equivalent LA2000hn 62-93 dBA). At the mid range of the routine and episodic activity exposure level distribution, the mean LAeq6760h was 73 dBA (LA2000hn 78 dBA). Nineteen percent of the LA2000hn non-occupational exposures exceeded 85 dBA, the generally recommended occupational limit for a 2000 h workyear, at the mid-range of exposure levels. Due to a lack of available data, firearms use could not be incorporated into the total noise exposure estimates. However, firearms users reported more exposure to other noisy non-occupational activities and had statistically significantly higher estimated exposure levels even without including their firearms exposure than did non-shooters. When compared with the high levels of occupational noise found in construction, non-occupational noise exposures generally present little additional exposure for most workers. However, they may contribute significantly to overall exposure in the subset of workers who frequently participate in selected noisy activities.