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OCCUPATIONAL HAZARDS – Noise-induced loss of hearing

The Occupational Safety and Health Administration estimates that 9.4 million U.S. workers (7.9 million active and 1.5 million retired) are or have been in jobs where noise-exposure levels are 80 decibels (dBA) or higher. Increased risk of hearing loss due to occupational noise generally begins at this level. As a result, about 1.6 million workers (17%) may have at least mild hearing loss resulting from this occupational noise exposure, 1.1 million (11%) may have measurable hearing loss, and nearly 0.5 million may have moderate-to-severe loss. These estimates generally agree with the findings of surveys by NIOSH, which indicate that one of four persons 55 years of age or older exposed to an average of 90 dBA over a working lifetime has experienced a significant loss of hearing.

Occupational noise-induced hearing loss is preventable. The PHS has stated that by 1990 the prevalence of occupational noise-induced hearing loss should be reduced by 415,000 cases.

NIOSH has developed a program with three goals for reducing noise-induced hearing loss: 1) to establish baseline data on occupational noise-induced hearing loss by monitoring the history of hearing-loss claims, 2) to determine the relative hazards from different types of noise and to define the interactions between noise and other hazards in the workplace, and 3) to develop initiatives in environmental controls and behavioral methods that foster hearing conservation.

OCCUPATIONAL HAZARDS – Typical A-weighted noise levels in decibels"

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'The decibel is a logarithmic measure of sound intensity; the "A-weighted scale" is used to weigh the various frequency components of the noise to approximate the response of the human ear.

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Dermatologic conditions of occupational origin were estimated to account for more than 40% of all reported occupational illnesses each year from 1972 through 1981. As much as 1% of the workforce may be affected by occupational skin disease at any given time. Although comprehensive and reliable surveillance data are lacking, the estimated cost in lost productivity from all occupational skin disease is nearly $10 million annually.

Efforts are under way to create an increased awareness of the toxicity of substances found in the workplace and to improve the protection afforded to workers. NIOSH is particularly concerned with the degree of protection afforded by commercially available chemical protective clothing materials and products. The basic thrust of the NIOSH chemical protective clothing program is to provide users with information on which to base decisions for selecting and using such clothing.

OCCUPATIONAL HAZARDS

Investigating problems with respirators

The Federal Mine Safety and Health Amendments Act of 1977 authorizes a program for approving respirators. It is carried out jointly by NIOSH and the Mine Safety and Health Administration (MSHA). This program is conducted in accordance with requirements published in the Code of Federal Regulations, Title 30, Part 11 (30 CFR 11). The Occupational Safety and Health Administration and several other federal regulatory agencies require that respirators used in industry be approved by NIOSH and MSHA.

NIOSH receives reports of problems identified in approved respirators from respirator users and from investigations carried out by manufacturers. Such problems may be due to faulty design and/or function. From July 1, 1983, through June 30, 1984, NIOSH received 35 reports of problems with respirators. Investigations revealed that 21 (60%) of these involved self-contained breathing devices; nine showed deficiencies that were classified as lifethreatening or likely to cause illness or injury.

When serious problems are found, i.e., deficiencies that could affect health and safety, users are alerted immediately. If a manufacturer is unable to identify and notify the purchasers of defective respirators, NIOSH will issue a general warning to users of respirators and to other interested persons.

PEDIATRIC NUTRITION - Percentage of children screened with low or high anthropometric nutrition indices, by age and ethnic group, 31 states, United States, 1984

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7.6

6-9 Years White

10.108

6.4

2.1 Black

7,836
2.9

3.5

5.6 Hispanic

417
11.5

2.6

12.2 American Indian

96 Asiant

60 *Total does not equal 610,439 because of unknown or missing data for some variables and the exclusion of states with date errors. Data for Asians include data from an unknown number of recent Southeast Asian refugees. Sinsufficient data.

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The Pediatric Nutrition Surveillance System, coordinated by CDC, uses nutrition-related data collected by local health departments as part of the routine delivery of child health services. During 1984, initial visit (screening) data were submitted for 610,439 children ranging in age from birth through 9 years. These data represent the results of examination of new patients at 2,464 clinics in 31 states, the District of Columbia, and Puerto Rico. The data include records received by the Division of Nutrition through the end of August 1985. Of the total records submitted, data from several areas have been excluded because of problems with the recording of dates.

The data consist primarily of identifying and demographic information, height (length or stature), weight, birth weight, and hemoglobin and/or hematocrit determinations. Anthropometric data on height, weight, and age are converted to percentiles of height-for-age and weightfor-height, using the National Center for Health Statistics reference population. Values that fall below the 5th percentile of height-for-age or weight-for-height and above the 95th percentile of weight-for-height are reported as potentially abnormal values. Results based on these cutoff points are shown above.

'National Center for Health Statistics, NCHS growth curves for children, birth-18 years, United States. Rockville, Md., National Center for Health Statistics, 1977. (Vital and health statistics, Series II, Data from the National Health Survey, No. 165).

Several levels of hematocrit and/or hemoglobin are currently being used to define anemia in the United States. Most clinics providing data to the Pediatric Nutrition Surveillance System use cutoff levels that are adjusted to reflect the increases in hematocrit and hemoglobin that occur with age and altitude. For hematocrits at sea level, at present these values are 31% for children 6-23 months old, 34% for 2- to 5-year-olds, and 37% for 6- to 9-year-olds. For hemoglobins at sea level, the values are 10.0 g/100 ml, 11.0 g/100 ml, and 12.0 g/100 ml for the respective age groups. The top table on the next pages lists, by age and ethnic group. three alternative cutoff points for hematocrit.

Similarly, data on the prevalence of hemoglobin values below four selected cutoff points are presented in the bottom table on the next page. Preliminary age- and sex-specific percentile curves were developed at CDC with hematologic data from the 1971-1974 National Health and Nutrition Examination Survey (NHANES 1).* The prevalence of hematocrit and hemoglobin values below the 5th percentile curve are included in the tables to provide an additional reference point for the evaluation of hematologic data.

*Centers for Disease Control. Reference curves for anemia screening. Atlanta, Ga.: CDC, 1982. (Nutrition Surveillance Annual Summary 1980) (HHS Publication No. CDC 78-8295).

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