Chengcheng Hu

Noise exposures and hearing loss in the mining industry continue to be a major problem, despite advances in noise control technologies. This study evaluated the effectiveness of engineering, administrative, and personal noise controls using both traditional and in-ear dosimetry by job task, work shift, and five types of earplug. The noise exposures of 22 miners performing deep shaft-sinking tasks were evaluated during 56 rotating shifts in an underground mine. Miners were earplug-insertion trained, earplug fit-tested, and monitored utilizing traditional and in-ear dosimetry. The mean TWA8 noise exposure via traditional dosimetry was 90.1 ± 8.2 dBA, while the mean in-ear TWA8 was 79.6 ± 13.8 dBA. The latter was significantly lower (p 0.05) than the Mine Safety and Health Administration (MSHA) personal exposure limit (PEL) of 90 dBA. Dosimetry mean TWA8 noise exposures for bench blowing (103.5 ± 0.9 dBA), jumbo drill operation (103.0 ± 0.8 dBA), and mucking tasks (99.6 ± 4.7 dBA) were significantly higher (p 0.05) than other tasks. For bench blowing, cable pulling, grinding, and jumbo drill operation tasks, the mean in-ear TWA8 was greater than 85 dBA. Those working swing shift had a significantly higher (p 0.001) mean TWA8 noise exposure (95.4 ± 7.3 dBA) than those working day shift. For percent difference between traditional vs. in-ear dosimetry, there was no significant difference among types of earplug used. Reflective of occupational hearing loss rate trends across the mining industry, this study found that, despite existing engineering and administrative controls, noise exposure levels exceeded regulatory limits, while the addition of personal hearing protection limited excessive exposures.

Out-of-hospital hypotension has been associated with increased mortality in traumatic brain injury. The association of traumatic brain injury mortality with the depth or duration of out-of-hospital hypotension is unknown. We evaluated the relationship between the depth and duration of out-of-hospital hypotension and mortality in major traumatic brain injury.

The hormonal metabolite of vitamin D, 1,25-dihydroxyvitamin D(1,25D), binds to the vitamin D receptor (VDR) and promotes heterodimerization of VDR with a retinoid-X-receptor (RXR) to genomically regulate diverse cellular processes. Herein, it is revealed for the first time that VDR is post-translationally acetylated, and that VDR immunoprecipitated from human embryonic kidney (HEK293) cells displays a dramatic decrease in acetylated receptor in the presence of 1,25D-ligand, sirtuin-1 (SIRT1) deacetylase, or the resveratrol activator of SIRT1. To elucidate the functional significance of VDR deacetylation, vitamin-d-responsive-element (VDRE)-based transcriptional assays were performed to determine if deacetylase overexpression affects VDR/VDRE-driven transcription. In HEK293 kidney and TE85 bone cells, co-transfection of low amounts (1-5ng) of a SIRT1-expression vector elicits a reproducible and statistically significant enhancement (1.3- to 2.6-fold) in transcription mediated by VDREs from the CYP3A4 and cyp24a1 genes, where the magnitude of response to 1,25D-ligand is 6- to 30-fold. Inhibition of SIRT1 via EX-527, or utilization of a SIRT1 loss-of-function mutant (H363Y), resulted in abrogation of SIRT1-mediated VDR potentiation. Studies with a novel, non-acetylatable VDR mutant (K413R) showed that the mutant VDR possesses enhanced responsiveness to 1,25D, in conjunction with reduced, but still significant, sensitivity to exogenous SIRT1, indicating that acetylation of lysine 413 is relevant, but that other acetylated residues in VDR contribute to modulation of its activity. We conclude that the acetylation of VDR comprises a negative feedback loop that attenuates 1,25D-VDR signaling. This regulatory loop is reversed by SIRT1-catalyzed deacetylation of VDR to amplify VDR signaling and 1,25D actions.

Although retraining and repeat fit-testing are needed for respirator users, the optimal frequency is uncertain. The persistence of proper respirator donning/doffing techniques and changes in quantitative fit factor over 6 months after initial training were measured in this study. Initial training was designed for rapid rollout situations in which direct contact with well-trained occupational health professionals may be infeasible. Subjects (n = 175) were assigned randomly to use either a filtering facepiece N95 (FFR) or dual cartridge half facemask (HFM) respirator. Each was assigned randomly to one of three training methods-printed brochure, video, or computer-based training. Soon after initial training, quantitative fit and measures of proper technique were determined. These measurements were repeated 6 months later. In the six-month followup, subjects were randomized to receive either a brief reminder card or a placebo card. Total performance score, major errors, and quantitative fit all became significantly worse at 6 months. An individual's result soon after training was the most important predictor of performance 6 months later. There was a marginal not statistically significant tendency for those initially trained by video to have better protection 6 months later. The study suggests that persons who use respirators intermittently should be thoroughly retrained and reevaluated periodically. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resource: Additional statistical analyses.