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Background: Transportation road maintenance and repair workers, or "maintainers," are exposed to hazardous and variable noise levels and often rely on hearing protection devices (HPD) to reduce noise‐exposure levels. We aimed to improve upon HPD use as part of the HearWell program that used a Total Worker Health, participatory approach to hearing conservation. Methods: Full‐shift, personal noise sampling was performed during the routine task of brush cutting. Work activities and equipment were recorded and combined with 1‐min noise measures to summarize personal noise‐exposure levels by equipment. Using noise‐monitoring results, HPD noise reduction ratings, and input from worker‐based design teams, a noise‐hazard scheme was developed and applied to the task and equipment used during brush cutting. Results: Average (standard deviation) and maximum Leq 1‐minute, personal noise‐exposure levels recorded during brush cutting included chainsaws at 92.1 (7.6) and max of 111 dBA, leaf blowers at 91.2 (7.5) and max 107 dBA, and wood chipper at 90.3 (7.3) and max of 104 dBA. The worker‐designed noise‐hazard scheme breaks down noise exposures into one of three color bands and exposure ranges: red (over 105 dBA), orange (90‐105 dBA), or yellow (85‐90 dBA). The scheme simplifies the identification of noise levels, assessment of noise‐hazard, and choice of appropriate hearing protection for workers. Conclusion: Combining noise‐exposure assessment with intervention development using participatory methods, we characterized noise exposure and developed an intervention to educate and assist in protecting workers as they perform noisy tasks. [ABSTRACT FROM AUTHOR]

In recent years, significant attention has been given to polycyclic aromatic hydrocarbons (PAHs) exposures given their mutagenic and carcinogenic properties. However, levels of exposure and the key determinants of exposure are not well defined for the trucking industry. We measured ultrafine particle characteristics at 10 trucking terminals of varying operating size and location in the Northeast region of the United States using particle concentration counter and a surface area analyzer. Multivariate mixed-effects linear regression models were used to assess determinants of the concentration of total bound PAHs (tPAH), the total aerosol active surface area (AS), and the ratio tPAH/AS overall and individually within docks, trucking cabs, and administrative offices. Associations between PAH measures with integrated measures of elemental carbon (EC), organic carbon (OC), and particulate matter (PM)2.5 were assessed by Spearman rank correlation. In adjusted models, tPAH, AS, and tPAH/AS average concentrations (95% confidence interval) were significantly higher in truck cabs compared to office locations (1.26 (ng m-3) (1.18, 1.35); 0.99 (mm² mm-3) (0.91, 1.08); 0.26 (ng mm-2) (0.18, 0.33), respectively). In the loading dock, AS concentrations were significantly higher than in the office (0.67 (0.61, 0.71), while the tPAH/AS was not (-0.63 (-0.67, -0.58). In each location, average tPAH concentrations were moderately but significantly correlated with EC (r = 0.47-0.63) and with tPAH/AS (r = 0.34-0.40) in the truck cabs and loading docks. In conclusion, key predictors of tPAH, AS, and tPAH/AS within the trucking industry are work location (in particular truck cabs and terminal docks) and terminal characteristics (size). The association of tPAH and tPAH/AS with EC concentrations in dockworkers and pick-up and delivery drivers is consistent with occupational exposure attributable to vehicle exhaust. Therefore, measurement of tPAH, AS, and tPAH/AS to characterize ultrafine particles and bound PAH concentrations provide additional information regarding exposures in the trucking industry not captured by integrated measures by EC, OC, and PM2.5. [ABSTRACT FROM AUTHOR]

Daptomycin use is a known cause of rhabdomyolysis; its role in liver injury is less certain. We report a case of daptomycin-induced rhabdomyolysis with liver injury. This report indicates a role for liver function monitoring while receiving daptomycin, as well as the importance of promptly considering drug toxicities in acute and emergency care settings. [ABSTRACT FROM AUTHOR]