2015-01-01 12:00 - Messages

Audit ergonomique en réanimation polyvalente

Bruit ambiant, alarmes et impact sur le travail
Matériel et méthodes: Les données recueillies lors des enquêtes PRESST-NEXT et SESMAT ont permis d'évaluer la perception de l'exposition au bruit des soignants européens et médecins français et leur score d'épuisement professionnel. Le travail infirmier en réanimation est caractérisé par des observations ergonomiques dont deux analysées à l'aide du logiciel KRONOS-ACTOGRAM (Octares). Des mesures de bruit ambiant ont été réalisées au poste central de surveillance et dans une chambre. L'exposition au bruit des soignants a été mesurée à l'aide de dosimètres de bruit. L'enregistrement de certaines alarmes a permis d'analyser le spectre et la variation du niveau sonore en fonction du temps (LAF-A-weighted, Fast, Sound Level-sur 1 sec).
Résultats: Deux tiers des anesthésistes-réanimateurs et urgentistes et près de la moitié des paramédicaux français (en particulier dans les services d'urgence et de réanimation/bloc opératoire) s'estiment exposés ou très exposés au bruit. Plus les soignants déclarent être exposés au bruit, plus le score de burnout est élevé. Le travail infirmier en réanimation est complexe, les échanges d'information continuels et les interruptions par les alarmes fréquentes (487 alarmes dont seulement 259 concernant directement l'infirmier observé). Il en résulte un niveau d'exposition quotidien (Lex,8h) de 73,9 dBA. Les mesures de bruit ambiant effectuées au niveau du poste de surveillance donnent un niveau équivalent moyen de 57,8 dBA et 59,9 dBA.
Discussion: Les mesures de bruit confirment la prégnance de la gêne observée au cours du travail infirmier et rapportée par les soignants. Des mesures correctives sont proposées : ergonomie participative lors de la conception des locaux, élaboration de spécifications ergonomiques de confort d'usage des équipements de surveillance, mesures organisationnelles…

Source: D. Raffier-Peres, M. Estryn-Behar. Archives des Maladies Professionnelles et de l'Environnement, December 2014.
http://dx.doi.org/10.1016/j.admp.2014.09.003

Dose - response relationship between noise exposure and the risk of occupational injury

Many workers worldwide experience fatality and disability caused by occupational injuries. This study examined the relationship between noise exposure and occupational injuries at factories in Korea. A total of 1790 factories located in northern Gyeonggi Province, Korea was evaluated. The time-weighted average levels of dust and noise exposure were taken from Workplace Exposure Assessment data. Apart occupational injuries, sports events, traffic accidents, and other accidents occurring outside workplaces were excluded. The incidences of occupational injury in each factory were calculated by data from the Korea Workers' Compensation and Welfare Services. Workplaces were classified according to the incidence of any occupational injuries (incident or nonincident workplaces, respectively). Workplace dust exposure was classified as <1 or ≥1 mg/m 3 , and noise exposure as <80, 80-89, or >90 dB. Workplaces with high noise exposure were significantly associated with being incident workplaces, whereas workplaces with high dust exposure were not. The odds ratios (95% confidence intervals) derived from a logistic regression model were 1.68 (1.27-2.24) and 3.42 (2.26-5.17) at 80-89 dB and ≥90 dB versus <80 dB. These associations remained significant when in a separate analysis according to high or low dust exposure level. Noise exposure increases the risk of occupational injury in the workplace. Furthermore, the risk of occupational injury increases with noise exposure level in a dose-response relationship. Therefore, strategies for reducing noise exposure level are required to decrease the risk of occupational injury.

Source: Yoon JH, Hong JS, Roh J, Kim CN, Won JU. Noise Health, 2015; 17: 43-47.
http://dx.doi.org/10.4103/1463-1741.149578

Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk?

OBJECTIVE: To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk.
DESIGN: Retrospective analysis. Study sample: The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available.
RESULTS: Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk.
CONCLUSION: These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.

Source: Cantley LF, Galusha D, Cullen MR, Dixon-Ernst C, Tessier-Sherman B, Slade MD, Rabinowitz PM, Neitzel RL. Int. J. Audiol, 2014.
http://dx.doi.org/10.3109/14992027.2014.981305

Use of the Speech Transmission Index for the assessment of sound annoyance in open-plan offices

In open-plan offices, employees often have to work despite being distracted by multiple sources of speech close to them. This disturbance is even more severe when the surrounding conversations are intelligible. For this reason the disruptive power of such babble-like noises can be quantified by measuring speech intelligibility. As such, the Speech Transmission Index is usually used to assess the quality of open-plan offices. In this article, the STI is used to evaluate the nuisance potential of sound environments in an open-plan office. 57 subjects were confronted with a serial memory task in four STI conditions (from 0.25 to 0.65). Noise annoyance was assessed objectively by measuring performance, and subjectively using the NASA-TLX questionnaire for measuring cognitive load. A very strong inter-individual variability appeared in performance measurements. Approximately half of the panel was made of high performing subjects, who proved to be insensitive to speech intelligibility. For the other half, performance was reduced when STI increased, as shown in previous studies, with a plateau for STI greater than 0.45. This strong inter-individual variability can explain the discrepancy between results observed in previously published studies. The NASA-TLX questionnaire proved to give useful complementary results. For example, high-performing subjects related a higher workload in the condition of maximum speech intelligibility.

Source: Ange Ebissoua, Etienne Parizetb, Patrick Chevreta. Applied Acoustics, Volume 88, February 2015, Pages 90–95.
http://dx.doi.org/10.1016/j.apacoust.2014.07.012

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