Humorous science: Work health and safety

As the world continues to struggle with the COVID-19 pandemic, this paper highlights humorous research investigating medical and musical mysteries, with a focus on applying scientific methods to support work health and safety and our general wellbeing.

Volker Janssen Publications Officer, Association of Public Authority Surveyors (APAS), New South Wales, Australia

This is the sixth and last in a series of papers celebrating some of the weird and wonderful research findings hidden amongst the scientific literature. It aims to ensure that we remember the funnier side of science and provides answers to questions we may have been too afraid to ask. This study was conducted entirely in the author’s spare time and is in no way related to his employer. Here, we examine selected research relating to work health and safety and our general physical and mental wellbeing. It is much appreciated that some journals, such as the BMJ (British Medical Journal), CMAJ (Canadian Medical Association Journal) and MJA (Medical Journal of Australia), routinely include humorous papers in their December issues.

Alonso et al. (2017) investigated the frequency, reasons, perceived risk and punishment of shouting and cursing while driving based on a questionnaire administered to 1,000 drivers in Spain. It was found that 26% of drivers recognise that they shout or insult at the wheel, while 66% say they have never or almost never displayed this type of behaviour. The main reasons for yelling and cursing were in reaction to another driver not meeting their standards or causing them to face a dangerous manoeuvre or stressful situation. Not surprisingly, drink driving and speeding were the main factors perceived to cause a higher risk of accidents. Drivers who often shout and curse were also those who perceive the lowest risk in doing so. While virtually all drivers believed that driving at an excessive or inappropriate speed, with an elevated alcohol level or without insurance are punishable behaviours, not keeping a safe distance and shouting and insulting were not regarded as such by a significant proportion (25% and 65%, respectively).

Hodgetts and Liu (2006) illustrated the impact that even brief exposure to leisure noise can have on a person’s hearing. Cumulative sound exposure was measured with a noise dosemeter collecting data at 1 Hz during three games of the ice hockey Stanley Cup final series. It was found that goal scoring showed obvious spikes in the noise level, roughly equivalent to a jet taking flight (Figure 1). Even during the intermissions, the noise remained at a level that would require hearing protection to be worn by law in an equivalent 8 hour/day workplace environment. The maximum allowable daily noise dose was reached in only 6 minutes, i.e. each person not wearing hearing protection received about 8,100% of their daily allowable noise dose over the 3 hours. Hearing tests on two spectators revealed mild ringing tinnitus after the game, and their hearing thresholds deteriorated by 5-10 dB for most frequencies (but up to 20 dB at 4,000 Hz, the frequency known to be most susceptible to noise damage). While this temporary threshold shift usually disappears in a few days, it may become permanent following further noise exposure before full recovery. This emphasises the importance of considering hearing protection not only during work hours but also when attending sporting events, rock concerts or karaoke.

Moving on to the brain, Maguire et al. (2000) investigated the navigation-related structural change in the hippocampus (the part of the brain that is crucial for learning and memory) of taxi drivers. MRI brain scans of 16 London taxi drivers were analysed using 3D image analysis and compared with those of 50 age- and gender-matched people lacking such extensive navigation exposure. Although no difference was detected in the overall hippocampus volume, its structure in taxi drivers was found to be significantly different, and the regional distribution of its volume correlated with the amount of time spent as a taxi driver. This indicated that the hippocampus stores a spatial representation of the environment and can expand regionally to accommodate people with a high dependence on navigational skills.

Employing statistical analysis of various behavioural tests in addition to MRI brain scans, Maguire et al. (2006) later confirmed these findings by ruling out the potential influence of self-motion, driving experience and stress on the observed pattern of grey matter volume distribution in taxi drivers. This was achieved by comparing a new cohort of 18 London taxi drivers with 17 bus drivers who were matched for age, gender, education, intelligence, driving experience and stress level but differed in that they follow a constrained set of routes.

Head injuries

Consequently, head injuries are of obvious concern to spatial professionals. Kamp et al. (2011) investigated traumatic brain injuries based on more than 700 head injuries occurring in the Asterix comic books. They performed a neurological examination for each head-injured character and correlated the clinical data with information regarding trauma mechanism (mostly blunt force), sociocultural background of victims and offenders, and the circumstances of the trauma to identify specific risk factors. Not surprisingly, the Romans suffered the most head injuries, mainly inflicted by Asterix and Obelix. Injuries were most severe when helmets were not used, emphasising the importance of wearing personal protective equipment (PPE). Astonishingly, no character suffered long-term consequences or death. Characters who took the magic potion caused significantly more severe head injuries, and administration of this drug after sustaining such an injury led to a prompt recovery.

Head injuries in nursery rhymes were examined by Giles and Shea (2003), including ‘Humpty Dumpty’, ‘Hush-abye- Baby’, ‘Ten Little Monkeys’, ‘Jack and Jill’, ‘It’s Raining, It’s Pouring’ and ‘Ring Around the Rosie’. It was noted that no single character category appears to avoid injury, i.e. babies, teenagers, old men, primates and nondescript characters all suffered. The study found evidence of a dangerous subtext in children’s literature as several popular nursery rhymes portray head injuries as inevitable events not requiring medical follow-up. Issues raised included the appropriateness of the response to injury, the importance of seeking a medical opinion, the need for clarity about the events leading up to the injury, and the need to use precise medical terminology. To address these shortcomings, the authors offered a medically sound nursery rhyme providing a realistic and medically accurate account of what happens when a head injury is sustained.

Cyr et al. (2004) studied a unique case of delayed personal development. Tintin, the young reporter whose stories were published between 1929 and 1976, was about 14-15 years old when introduced (with the height of a 7- or 8-year-old), so would have been 60 years old during his final adventure. An exhaustive assessment of Tintin’s stories found that he suffered many significant head injuries causing unconsciousness. For each incident, they identified the cause of the trauma, the length of losing consciousness (calculated by the number of frames before Tintin returns to normal activity) and the severity of the trauma (indicated by the number of objects revolving above his head). Never did Tintin shave, grow taller or exhibit signs of pubertal development, suggesting that he suffered from growth hormone deficiency, caused by repeated head traumas leading to injury of the pituitary gland, which regulates growth hormone release. It should be noted that the first two authors are the third author’s children, providing an excellent example of engaging young children with science.

Focussing on forensic medicine, Bolliger et al. (2009) determined whether full or empty beer bottles are sturdier and if their fracture-threshold is sufficient to break the human skull. Using multi-slice computed tomography, the thickness of standard European 0.5-litre bottles was measured to be between 2.0 mm and 3.6 mm. They fixed a small pinewood board to one side of the bottles using a thin layer of modelling clay, which not only served as fixing material but also as a substitute for the soft tissues of the scalp. The bottles were then fixed horizontally to the bottom of a baby-bathtub, and a 1 kg steel ball was dropped from different heights (between 2 and 4 m) onto the beer bottles in a drop tower specifically designed for the testing of materials (Figure 2). Despite the small sample size, this showed that empty beer bottles are sturdier, tolerating more energy before breaking due to beer being an almost incompressible and carbonated fluid. Regardless of being full or empty, they are easily capable of fracturing the human skull and inflicting serious head injuries. This knowledge may be of particular interest to spatial professionals regularly visiting pubs while conducting field work for several days at a time.

Evolving workplace procedures

Hanley and Hanley (2000) investigated the efficiency of stethoscope placement when not in use. They compared the traditional method of wearing it like a tie (earpieces around the back of the neck) to the contemporary, cool method of wearing it like an open scarf (earpieces and chest piece resting on opposite shoulders). Measuring the time taken by 100 healthcare professionals in each group to transfer the stethoscope to its functional position revealed that the cool group was 1.3 seconds slower despite their younger age (mean time of 3.2 and 1.9 seconds, respectively, with standard deviations of about 1 second in both cases). Furthermore, two hands were required by the cool group, while the traditional group usually achieved a onehanded transfer (leaving the other hand free to fend off or hold down disobedient patients). By extrapolation across medical practitioners and students in Canada and assuming that the cool position is favoured by 80% of these, it was shown that this wasted time could cause a substantial loss of productivity and financial burden on the healthcare system. This illustrates that evolving workplace procedures do not always improve their practical application, serving as a reminder to policy makers that their actions often have unexpected and undesired consequences downstream.

Noting the importance of information provided to patients being comprehensive, accurate and understandable (to them), Jones et al. (2007) examined the accuracy of comparing bone quality to chocolate bars for patient information purposes. The use of confectionary visual aids in patient education is widespread, e.g. when comparing healthy bone to the finely honeycombed structure of a Crunchie chocolate bar and abnormal, osteoporotic bone to the coarser structure of an Aero bar. The authors studied the fracture risk for each chocolate bar by dropping samples from increasing heights onto a typical, tiled kitchen floor (assumed to be representative of the home environment where many fractures occur). Despite the apparently more robust structure of a Crunchie, it was more likely to fracture than an Aero (Figure 3). They concluded that using these chocolate bars to explain bone structure and fracture risk to patients is visually attractive but inaccurate. This study highlights the difficulty of conveying scientific information to a general audience by simplification and generalisation without losing the accuracy and correctness of technical content.

Shah et al. (2011) compared the travel time between hospital floors using stairs or elevators. Four people aged between 26 and 67 years completed 14 walking trips each, ranging from one to six floors both ascending and descending, and a total of 336 elevator trips. Statistical analysis determined that the mean travel time between floors was 13 seconds by stairs and 36.5 seconds by elevator, the difference being caused by waiting for the elevator’s arrival. Not surprisingly, elevator travel time varied depending on the time of day and day of the week. All participants were able to continue their duties without resting after taking the stairs, so fatigue was not an issue. Acknowledging the small sample size, it was concluded that taking the stairs can save 15 minutes each day, which could translate into improved productivity and increased fitness. Obviously, these findings can also be applied to other workplaces, albeit with the likely assumption of fewer trips per day. This should encourage us all to use the stairs whenever possible.

In a very timely contribution, Chapman and Thamrin (2020) characterised how the working arrangements and productivity of Australian medical researchers changed during the COVID-19 pandemic, with particular attention to wearing pyjamas. Over a 3-week period, more than 160 staff and students at five medical research institutes in Sydney selfassessed their productivity and mental health. The most frequent working-fromhome arrangements were the kitchen or dining table (42%) and individual (28%) or shared (22%) home offices, while five respondents (3%) resorted to working in their bathroom. Interruptions to teleconferences included internet problems, children, other household members, pets, the doorbell, phone calls, toilet breaks and one instance of sleepwalking. Only a few participants confessed to wearing pyjamas while working, which was not associated with lower productivity but linked with poorer mental health (Figure 4). People working at home with young children reported lower productivity but no deterioration in mental health, and early career researchers were less productive than established researchers. Hopefully, these findings will help remove the stigma attached to wearing pyjamas during work hours and improve flexible working policies. A broader promotion of National Pyjama Day in the workplace may be a good starting point in this regard.

Musical mysteries

Aside from being a profession, playing and listening to music is an important component of our mental wellbeing and can even be used to improve certain medical disorders. For example, Puhan et al. (2006) showed that regular didgeridoo playing is an effective alternative treatment for snoring and obstructive sleep apnoea syndrome (intermittent airflow blockage during sleep). Four months of didgeridoo playing (participants practised an average of 6 days a week for 25 minutes) reduced daytime sleepiness in patients and sleep disturbance in their partners. This was explained by didgeridoo playing effectively training the muscles of the upper airways, which control airway dilation and wall stiffening. One of the challenges in the treatment of sleep disorders is poor compliance, thus new treatments not only need to be effective but motivate people enough to use them (which didgeridoo playing seemed to do).

Focussing on musicians and noting that a seemingly unusual number of them have died at age 27, Wolkewitz et al. (2011) examined whether 27 really is a dangerous age for famous musicians. Estimating the mortality risk by age of musicians that had a number 1 album in the UK using a flexible spline, they identified three deaths at age 27 amongst 522 musicians at risk, showing no evidence of a peak in risk at this age. Instead, the smoothed death rate showed a peak at age 32. The mythical ‘27 club’ therefore appears to exist by chance, being an example of confirmation bias where people focus on results that support their hypothesis and ignore those that oppose it. However, it was noted that the mortality risk for famous musicians throughout their 20s and 30s was 2-3 times higher than for the general UK population (Figure 5), which may be attributed to the excesses of fame.

Using tools from experimental economics, Oxoby (2009) attempted to determine who may be the better singer of the rock band AC/DC (Bon Scott versus Brian Johnson) in regard to affecting efficient decision making among listeners. In an ultimatum game, individuals were randomly paired and assigned the roles of either proposer or responder. Proposers were allocated a sum of money from which they had to choose an amount to extend as an offer to the responder. Upon learning of this offer, the responder could either accept or reject the offer. If the offer was accepted, the responder received the offer (in cash), and the proposer was given the original sum of money less the offer. If the offer was rejected, both participants received nothing.

However, as discussed by Janssen (2019), the design of the experiment undertaken to conclude in favour of Brian Johnson was not ideal because the two participating groups were treated to different songs. To rigorously determine a singer’s ability to implement efficient behavioural outcomes among listeners, the same song should have been played to both groups (using live versions as Bon Scott died in 1980, aged 33). Additional tests could have investigated the effects of song tempo (bluesy versus hard rocking) and how song lyrics may influence business decisions.

Janssen (2019) went on to analyse the AC/DC phenomenon by examining song lyrics, the band’s work rate, the passion of hardcore fans and the marketing of the AC/ DC brand. He found that the word ‘rock’ is by far the most prominent in AC/DC song titles but lyrically almost half of all songs revolve around sexual encounters. While the frequency of album releases slowed considerably over time, the band generally played 150 live gigs following each studio album in increasingly larger venues. Bon Scott songs continue to make up 45% of typical AC/DC concert setlists, demonstrating the immense respect for his contribution, the quality of the early song material and the timelessness of AC/ DC’s music. Hardcore fans generally preferred the older material, experienced their first gig during early adulthood and enjoyed up to 124 gigs since. Applying scientific rigour to an entertaining topic, this paper demonstrated how one can collect, analyse, interpret and present data by effectively utilising tables, pie charts, time series, histograms and maps.

Finally, Fancourt et al. (2016) investigated the role of music in the operating theatre, using the surgical board game Operation. After a brief introduction, 352 participants were randomised to listen through noisecancelling headphones to either the sound of an operating theatre, rock music (AC/ DC) or classical music (Mozart) while removing three organs from the board game patient using surgical tweezers. Statistical analysis revealed that rock music led to significantly slower operating speed and more surgical mistakes in men, while women appeared unaffected. Classical music was associated with lower perceived distraction, but this effect was weakened when factoring in how much people liked the music as generally only people who particularly liked Mozart found it beneficial.

Conclusion

While not directly related to surveying, mapping and the spatial sciences, the methods applied to collect, process and analyse data to investigate the medical and musical mysteries presented here are similar. The highlighted studies address important work health and safety issues and help improve our general physical and mental wellbeing. Furthermore, most findings discussed can be equally applied to other professions, tongue in cheek or not.

References

Alonso F., Esteban C., Serge A. and Ballestar M.L. (2017) Shouting and cursing while driving: Frequency, reasons, perceived risk and punishment, Journal of Sociology and Anthropology, 1(1), 1-7.

Bolliger S.A., Ross S., Oesterhelweg L., Thali M.J. and Kneubuehl B.P. (2009) Are full or empty beer bottles sturdier and does their fracture-threshold suffice to break the human skull? Journal of Forensic and Legal Medicine, 16(3), 138-142.

Chapman D.G. and Thamrin C. (2020) Scientists in pyjamas: Characterising the working arrangements and productivity of Australian medical researchers during the COVID-19 pandemic, Medical Journal of Australia, 213(11), 516-520.

Cyr A., Cyr L.-O. and Cyr C. (2004) Acquired growth hormone deficiency and hypogonadotropic hypogonadism in a subject with repeated head trauma, or Tintin goes to the neurologist, CMAJ, 171(12), 1433-1434.

Fancourt D., Burton T.M.W. and Williamon A. (2016) The razor’s edge: Australian rock music impairs men’s performance when pretending to be a surgeon, Medical Journal of Australia, 205(11), 515-518.

Giles S.M. and Shea S. (2003) Head injuries in nursery rhymes: Evidence of a dangerous subtext in children’s literature, CMAJ, 169(12), 1294-1296.

Hanley W.B. and Hanley A.J.G. (2000) The efficacy of stethoscope placement when not in use: Traditional versus “cool”, CMAJ, 163(12), 1562-1563.

Hodgetts W.E. and Liu R. (2006) Can hockey playoffs harm your hearing? CMAJ, 175(12), 1541-1542.

Janssen V. (2019) Let there be rock: The AC/DC phenomenon, Proceedings of Association of Public Authority Surveyors Conference (APAS2019), Pokolbin, Australia, 1-3 Apr, 106-125.

Jones P., Jones S. and Stone D. (2007) Accuracy of comparing bone quality to chocolate bars for patient information purposes: Observational study, BMJ, 335(7633), 1285-1287.

Kamp M.A., Slotty P., Sarikaya-Seiwert S., Steiger H.-J. and Hänggi D. (2011) Traumatic brain injuries in illustrated literature: Experience from a series of over 700 head injuries in the Asterix comic books, Acta Neurochirurgica, 153(6), 1351-1355.

Maguire E.A., Gadian D.G., Johnsrude I.S., Good C.D., Ashburner J., Frackowiak R.S.J. and Frith C.D. (2000) Navigationrelated structural change in the hippocampi of taxi drivers, PNAS, 97(8), 4398-4403.

Maguire E.A., Woollett K. and Spiers H.J. (2006) London taxi drivers and bus drivers: A structural MRI and neuropsychological analysis, Hippocampus, 16(12), 1091-1101.

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Puhan M.A., Suarez A., Lo Cascio C., Zahn A., Heitz M. and Braendli O. (2006) Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: Randomised controlled trial, BMJ, 332(7536), 266.

Shah S., O’Byrne M., Wilson M. and Wilson T. (2011) Elevators or stairs? CMAJ, 183(18), E1353-E1355.

Wolkewitz M., Allignol A., Graves N. and Barnett A.G. (2011) Is 27 really a dangerous age for famous musicians? Retrospective cohort study, BMJ, 343(7837), d7799