Study Objectives: To determine the association between obstructive sleep apnea (OSA), health-related factors and the likelihood of heavy vehicle crashes in Western Australia (WA). Methods: This case-control study included 100 longhaul heavy vehicle drivers who were involved in a policereported crash in WA during the study period (cases) and 100 long-haul heavy vehicle drivers recruited from WA truck stops, who were not involved in a crash during the past year (controls). Driver demographics, health, and fatiguerelated characteristics were obtained using an interviewer administered questionnaire. Drivers were tested for OSA using a diagnostic Flow Wizard. Logistic regression was used to determine health-related factors associated with crash involvement among long distance heavy vehicle drivers. Results: Heavy vehicle drivers diagnosed with OSA through the use of the FlowWizard were over three times more likely to be involved in a crash than drivers without OSA (adjusted OR: 3.42, 95% CI: 1.34-8.72).
Asbestos-containing materials (ACMs) were used extensively throughout much of the 20th century and can still be found in many Australian homes. Therefore, we developed a mobile application (“app”), called ACM Check, which guides users through a home inspection to identify and assess certain types of in situ ACM. A cross-sectional study was conducted using the app to collect data on the type and condition of in situ asbestos in Australian residential settings. Since being released in June 2017, we have received data for 702 home inspections. Of these, 578 (82.3%) houses contained a total of 1895 in situ materials categorised as positive for asbestos by the app. The most prevalent ACMs were used for the backing board to electrical meter boxes (50% of homes), eaves and soffit linings (44.2% of homes), and fencing (28.1% of homes). While the majority of ACMs were categorised as ‘very low’ or ‘low’ priority for removal or remediation, 6.6% of all ACMs were considered to be of ‘high’ priority. Mobile apps offer a platform to help increase people’s awareness of possible health hazards found in the residential environment, such as asbestos, while also being used to collect data for public and environmental health research.
Background Asbestos-containing materials (ACMs) can still be found in many homes in Australia and other countries. ACMs present a health risk when they are damaged or disturbed, such as during do-it-yourself home renovations. However, community members lack knowledge and awareness about asbestos identification and its safe management in residential settings. Objective The objective of our study was to describe the process of developing a mobile phone app, ACM Check, that incorporates a questionnaire designed to identify and assess ACMs located in residential settings. Methods A multidisciplinary team was involved in the formative development and creation of the mobile phone app. The formative development process comprised 6 steps: defining the scope of the app; conducting a comprehensive desktop review by searching online literature databases, as well as a wider online search for gray literature; drafting and revising the content, questionnaire, conditional branching rules, and scoring algorithms; obtaining expert input; manually pretesting the questionnaire; and formulating a final content document to be provided to the software development company. We then constructed ACM Check on the iOS platform for use in a validation study, and then updated the app, replicated it on Android, and released it to the public. Results The ACM Check app identifies potential ACMs, prioritizes the materials based on their condition and likelihood of disturbance, and generates a summary report for each house assessed. Conclusions ACM Check is an initiative to raise community members’ awareness of asbestos in the residential environment and also serves as a data collection tool for epidemiologic research. It can potentially be modified for implementation in other countries or used as the basis for the assessment of other occupational or environmental hazards.
In situ asbestos in the built environment is a remaining source of exposure in countries that have prohibited the manufacture and use of asbestos. However, it is difficult to identify in situ asbestos-containing material in residential settings. The objective of this study was to evaluate the accuracy of the mobile phone application ("app"), ACM Check, in identifying in situ asbestos located inside and outside of homes compared with onsite inspections conducted by an experienced environmental consultant. A cross-sectional study was undertaken that involved participants completing ACM Check on their homes built pre-1990 and located throughout metropolitan Perth, Western Australia, and an onsite inspection conducted at each home by an environmental consultant. Cohen's kappa statistic was calculated to evaluate the strength of agreement between the two methods. The 40 houses sampled were built between 1898 and 1988 with a median year of 1966. Thirty-eight (95%) homes had at least one type of material categorized as positive for asbestos by both ACM Check and the environmental consultant (κ = 1.00). Agreement between the two methods differed when categorizing specific materials as positive or negative for asbestos with substantial agreement for fencing (κ = 0.918), outbuilding walls (κ = 0.844), backing board to electrical meter box (κ = 0.826), exterior wall cladding (κ = 0.771), and interior walls (κ = 0.754), and fair agreement for outbuilding roofs (κ = 0.375) and interior flooring (κ = 0.304). ACM Check is a tool that can be used by tradespeople, home renovators, and householders to screen residential settings for the presence of in situ asbestos-containing material. Mobile phone apps have the potential to be developed or modified for use in other countries to help users identify asbestos and reduce their risk of asbestos exposure.
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