Optimum Noise levels for class room teaching

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Everyday exposure to noise over time has an impact upon our ability to hear and on the degree of hearing loss that develops. Continuous exposure to sounds above 85 db can cause progressive hearing loss. Noise-induced hearing loss is the most common and obvious outcome of noise pollution. It is also an important occupational health concern due to high workplace noise levels. However, noise pollution has also been associated with other health problems such as stress, anxiety, high blood pressure, increases heart rate, heart disease. It may manifest as disturbed sleep/ insomnia, headache, fatigue, irritability, loss of concentration and decreased work efficiency.

Noise levels are also an increasing concern in class rooms. The source of noise can be external such as street traffic, playground noise, airplanes, etc. The source of noise can be indoor, such as hallway noises, noise from other rooms etc. or noise within the classroom itself such as conversation, noise from fans, lights, paper, etc. Noise in a class room is not conducive to learning. Background noise in classroomsinterferes with auditory communication and adversely affects speech perception and speech recognition. It interferes with language and reading development and hampers academic performance. Attention and memory are also adversely affected.

Speech intelligibility or understanding is determined by the signal to noise ratio, which should be at least 15dB i.e. the teacher should speak at least 15 db louder than the noise in the classroom for the student to optimally comprehend what he/she is hearing. For clear speech perception the background noise levels should not exceed 35 dB in schools as recommended by the WHO. The reverberation time in the classroom should be about 0.6 sec. Reverberation time is the length of time required for sound to decay 60 db from its initial level in a room. A longer reverberation time together with background noise increases noise levels and makes speech perception even more difficult.

Hospitals are noisy and high stress work environment places.

Because of high background noise, such as in emergency dept. and OTs, the conversation has to be conducted at higher dbs for clear speech communication (normal conversation is between 60-70 db).

Noise can interfere with oral communication leading to mediation errors as a result of orders that are misunderstood.

A noisy environment affects performance of any complex task in a hospital as it reduces concentration. It has been shown that “mental activities requiring a lot of working memory, such as paying attention to a variety of different cues or performing a complex analysis, are especially noise-sensitive”. Failure to hear a warning signal or alarm over the general background noise in an ICU may have potentially catastrophic outcome.

Noise affects effectiveness of health care. Hence, hospitals too should have similar noise levels as educational institutes.

Schools and hospitals are “silence zones”. Silence zone is an area comprising not less than 100 m around hospitals, educational institutions, courts, religious places or any other area as per the Noise Pollution (Regulation and Control) Rules, 2000.

Every effort should be made to reduce noise levels in hospitals for optimum delivery of health care.

Air pollution increases risk of heart disease by lowering the good cholesterol

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Air pollution is a reality today and has been a subject of much discussion recently. Several studies have demonstrated the association of poor air quality with diseases such as respiratory and heart diseases, global warming making it a major public health problem of concern.

Yet another new study reported in the journal Arteriosclerosis, Thrombosis, and Vascular Biology has highlighted the increased risk of cardiovascular diseases due to traffic-related air pollution and proposed an explanation for the relationship between air pollution and cardiovascular disease.

The study says that traffic-related air pollution may increase risk of developing heart diseases via its effects on the good high-density lipoprotein cholesterol (HDL-C).

The study involving more than 6000 middle-aged and older adults in the United States found that people who live in areas with high levels of air pollution, especially traffic-related air pollution, have lower levels of the good HDL-C. Over a period of one year, those with higher exposure to black carbon, emitted from vehicles, had considerably lower levels of HDL-C compared to those with lower exposure to black carbon. Higher particulate matter exposure over three months was associated with a lower HDL particle number. Compared to men, women had much lower levels of HDL-C.

Keep your total cholesterol lower than 160mg/dL. HDL is good cholesterol, keep it more than 40mg/dL. LDL is bad cholesterol and should be kept as low as possible; keep it lower than 80 mg/dL. A 1% rise in bad cholesterol increases the chances of heart attack by 2% and 1% reduction in good HDL-C reduces the chances of heart attack by 3%.

(Source: AHA news release, April 13, 2017)

Dr KK Aggarwal
National President IMA & HCFI

Sedentary time associated with higher waist circumference & increased cardiovascular risk

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The negative health effects of a sedentary lifestyle are well known. Yet another study has shown a sedentary lifestyle to be associated with increased risk of heart disease.

In a new study from UK published January 31, 2017 in the International Journal of Obesity led by Dr William Tigbe from Warwick Medical School, University of Warwick, workers who had desk jobs were found to have higher waist circumference and increased risk of heart disease.

The study included 111 healthy non-smoking postal workers from Glasgow and randomized them into two groups: 55 were office workers and 56 walked/delivered post. The waist circumference was 2 cm higher in those who had desk jobs; 97 cm vs 94 cm, respectively. The risk of heart diseases was also higher in the workers who had desk jobs. 2.2% compared to 1.6% over 10 years. With each extra hour of sitting from five hours a day, the LDL ‘bad’ cholesterol increased and HDL ‘good’ cholesterol reduced.

The various health benefits of walking are well recognized. It has been shown in a study published earlier this year in the American Journal of Epidemiology that lack of exercise affects the human body right up to the cellular level. Elderly women who sit for more than 10 hours a day with low physical activity had cells that were biologically older by eight years compared to women who are more active.

Hence, physical activity is recommended for all ages.

Getting people to move more is a key strategy for reducing the burden of NCDs, as outlined in WHO’s Global Action Plan for the Prevention and Control of NCDs 2013-2020. The plan calls for a 10% relative reduction in insufficient physical activity by the year 2025 to achieve the Sustainable Development Goals (SDGs).

White collar workers or people who have desk jobs spend most of their working hours sitting in chairs. Interventions that encourage walking and physical activity in the workplace are needed to counter the negative health effects of sedentary behavior.

The IMA initiative ‘Move, Move and Move’ is a campaign to increase awareness about the benefits of physical activity and to encourage people to be more active at work and cut down on sedentary time.

(Source: Medical News Today)

Dr KK Aggarwal
National President IMA & HCFI

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