Effects of Interventions to Prevent Work-Related Asthma, Allergy, and Other Hypersensitivity Reactions in Norwegian Salmon Industry Workers (SHInE): Protocol for a Pragmatic Allocated Intervention Trial and Related Substudies

Background: Workers in the salmon processing industry have an increased risk of developing respiratory diseases and other hypersensitivity responses due to occupational exposure to bioaerosols containing fish proteins and microorganisms, and related allergens. Little is known about effective measures to reduce bioaerosol exposure and about the extent of skin complaints among workers. In addition, while identification of risk factors is a core activity in disease prevention strategies, there is increasing interest in health-promoting factors, which is an understudied area in the salmon processing industry. Objective: The overall aim of this ongoing study is to generate knowledge that can be used in tailored prevention of development or chronification of respiratory diseases, skin reactions, protein contact dermatitis, and allergy among salmon processing workers. The main objective is to identify effective methods to reduce bioaerosol exposure. Further objectives are to identify and characterize clinically relevant exposure agents, identify determinants of exposure, measure prevalence of work-related symptoms and disease, and identify health-promoting factors of the psychosocial work environment. Methods: Data are collected during field studies in 9 salmon processing plants along the Norwegian coastline. Data collection comprises exposure measurements, health examinations, and questionnaires. A wide range of laboratory analyses will be used for further analysis and characterization of exposure agents. Suitable statistical analysis will be applied to the various outcomes of this comprehensive study. Results: Data collection started in September 2021 and was anticipated to be completed by March 2023, but was delayed due to the COVID-19 pandemic. Baseline data from all 9 plants included 673 participants for the health examinations and a total of 869 personal exposure measurements. A total of 740 workers answered the study’s main questionnaire on demographics, job characteristics, lifestyle, health, and health-promoting factors. Follow-up data collection is not completed yet. Conclusions: This study will contribute to filling knowledge gaps concerning salmon workers’ work environment. This includes effective workplace measures for bioaerosol exposure reduction, increased knowledge on hypersensitivity, allergy, respiratory and dermal health, as well as health-promoting workplace factors. Together this will give a basis for improving the work environment, preventing occupational health-related diseases, and developing occupational exposure limits, which in turn will benefit employees, employers, occupational health services, researchers, clinicians, decision makers, and other stakeholders.publishedVersio

Effects of noise exposure among navy personnel. Hearing loss and cognitive performance

Background. Due to concerns regarding safety and health in the work environment of the Royal Norwegian Navy (RNoN), a questionnaire-based survey was conducted (2002 – 2003) to assess work-related risk factors and health problems among Navy personnel. Results from this questionnaire study showed noise exposure as an important risk factor, and impaired hearing as an important health problem among Navy personnel. Also foreign navy studies point at noise exposure as a prevalent risk factor and hearing loss as a common health complaint among navy personnel. However, the literature concerning noise exposure and hearing loss in the navy is sparse and the issue has not been systematically investigated. The RNoN has experienced several accidents at sea. These accidents have been found to be associated with cognitive requirements regarding navigational task performance. Prior literature has indicated deleterious effects of noise exposure on cognitive performance. Thus, an association between RNoN navigation accidents and impaired cognitive performance due to noise exposure has been questioned. However, research on noise exposure and cognitive performance in naval and maritime settings is limited and shows contradicting results. Objectives. The main objective of this thesis was to gain more knowledge regarding the effects of noise exposure among navy personnel. The specific objectives of paper I were to assess the prevalence of hearing loss among Navy personnel and to examine the association between work on board vessels in the RNoN and hearing loss among Navy personnel. In paper II we aimed at investigating the incidence of significant threshold shift (STS) among Navy personnel between 2012 and 2014 and to identify determinants of STS among Navy personnel. The objective of paper III was to assess cognitive performance subsequent to noise exposure among Navy personnel on board RNoN vessels. Material and methods. 938 officers, enlisted and civilian Navy personnel from 48 vessels were invited to participate in a study on the relationship between noise and hearing loss. The study was conducted between 2012 and 2014 and comprised two examinations per person, i.e. at baseline and follow-up. Two separate questionnaires on noise exposure and health were prepared, one for each examination. Hearing was assessed by pure tone audiometry. At baseline, hearing loss was defined as hearing thresholds ≥ 25 dB in either ear at 3000, 4000 or 6000 Hz. At follow up, impaired hearing was defined as a STS, i.e. an average change in hearing thresholds between the two examinations ≥ + 10 dB at 2000, 3000 and 4000 Hz in either ear. Two to five Navy personnel on board 24 RNoN vessels were selected to participate in a study on the effects of noise exposure on cognitive performance. Noise exposure was assessed by personal noise dosimeter measurements, while cognitive performance was evaluated by using a visual attention test in which response time (RT) was measured. In order to assess possible confounding factors, the participants completed a log book. Results. The prevalence of hearing loss among Navy personnel at baseline was 31.4 %. Work on board RNoN vessels was significantly associated with reduced hearing after adjusting for age, gender and otitis as an adult. The incidence of STS from baseline to follow-up was 23.0 %. The noise exposure determinants ‘current exposure to loud noise > 15 hours/week during work on board’ and ‘number of gun shots during the last year’ were significantly associated with a higher risk of STS. A significantly increased RT was found among participants with the highest noise exposure (>85.2 dB(A)) and the next highest noise exposure (77.1 – 85.2 dB(A)) compared to participants with the lowest exposure ( 15 hours/week on board RNoN vessels. We also found a significant association between STS and number of gun shots during the last year. The Navy personnel with the highest noise exposure performed poorer on a cognitive performance test than personnel with the lowest noise exposure. It is likely that noise exposure on RNoN vessels causes hearing loss and affects cognitive performance among the Navy personnel on board

Hearing loss in the royal Norwegian navy: a cross-sectional study

Objectives Prior studies have indicated a high prevalence of noise-induced hearing loss (NIHL) among Navy personnel; however, it is not clear whether this is caused by work on board. The present study aimed to assess the prevalence of hearing loss among Navy personnel in the Royal Norwegian Navy (RNoN), and to investigate whether there is an association between work on board RNoN vessels and occurrence of hearing loss. Methods Navy personnel currently working on board RNoN vessels were recruited to complete a questionnaire on noise exposure and health followed by pure tone audiometry. Hearing loss was defined as hearing threshold levels ≥25 dB in either ear at the frequencies 3,000, 4,000 or 6,000 Hz. Hearing thresholds were adjusted for age and gender using ISO 7029. Results The prevalence of hearing loss among Navy personnel was 31.4 %. The work exposure variables: years of work in the Navy, years on vessel(s) in the Navy and years of sailing in the Navy were associated with reduced hearing after adjusting for age, gender and otitis as an adult. Among the work exposure variables, years of sailing in the Navy was the strongest predictor of reduced hearing, and significantly reduced hearing was found at the frequencies 1,000, 3,000 and 4,000 Hz. Conclusions Our results indicate that time spent on board vessels in the RNoN is a predictor of reduced hearing

Hearing loss in the Royal Norwegian Navy: A longitudinal study

The aims of this longitudinal study were to investigate a significant threshold shift (STS) among personnel working on board the Royal Norwegian Navy′s (RNoN) vessels between 2012 and 2014 and to identify possible determinants of STS. Hearing thresholds were measured by pure tone audiometry in two consecutive examinations (n = 226). STS was defined as an average change in hearing thresholds ≥ + 10 dB at 2,000 Hz, 3,000 Hz, and 4,000 Hz in either ear. Determinants of STS were assessed through a questionnaire. The incidence of STS was 23.0%. Significant determinants of STS were the number of episodes of temporary threshold shifts (TTS) in the Navy, exposure to continuous loud noise during work on board, and the number of gun shots (in the Navy, hunting, and sports). This study indicated a significant association between noise exposure on board Navy vessels and development of STS

Changes in Infection Prevention Practices and Occurrence of Skin Symptoms among Healthcare Workers, Cleaners and Day-care Workers in Norway during the COVID-19 Pandemic

The COVID-19 pandemic has resulted in increased attention on infection prevention measures. This study aims to assess whether changes in hand hygiene procedures, use of personal protective equipment and moisturizers during the first year of the COVID-19 pandemic were associated with changes in the occurrence of skin symptoms among healthcare workers, cleaners, and day-care workers. A total of 602 participants (40%) responded to an electronic questionnaire, including questions on previous and current occupational exposure and skin problems. Increased frequency of hand washing, use of hand disinfectants, use of disposable gloves and moisturizers were all associated with an increased symptom score on the hands, wrists, forearms. Participants who increased their use of masks or respirators had a higher risk of facial skin symptoms, compared with those with non-increased occupational exposure. In conclusion, a change of behaviour among healthcare workers, cleaners and day-care workers during the first year of the COVID-19 pandemic, with an increase in occupational exposures and use of moisturizers, was associated with higher occurrence of facial skin symptoms and symptoms on the hands, wrists and forearms