三氯乙烯与噪声对职业接触人群听力损害联合作用的研究

STUDY ON THE JOINT EFFECTS OF TRICHLORETHYLENE AND NOISE ON THE HEARING IMPAIRMENT OF THE OCCUPATIONAL CONTACT CROWD

[目的]探讨三氯乙烯(TCE)与噪声对职业接触人群听力损害的联合作用。[方法]采用自行设计的调查表对TCE职业接触人群逐项进行问卷调查和尿中三氯乙酸(TCA)浓度及听力的测定。[结果]接触组中工龄≥2a或尿中TCA浓度≥50mg/L的调查对象,在8KHz频段纯音气传导听阈值与对照组的差异有统计学意义(P﹤0.05或P﹤0.01);在接触组内,工龄≥2a的调查对象在4、6和8KHz高频段听阈值均明显高于工龄﹤2a者(P﹤0.05或P﹤0.01)。接触组中工龄≥2a的调查对象高频听力损失的检出率明显高于对照组(P﹤0.05)。[结论]TCE存在听力毒性,降低工作环境中TCE浓度与缩短TCE的接触时间是预防TCE听力毒性的重要手段;在职业健康监护中开展对TCE职业接触人群听力测试(主要是高频段),对于发现早期TCE中毒患者,预防TCE职业危害具有一定的现实意义。

[Objective] To probe into the joint effects of trichloroethylene （TCE） and noise on the hearing impairment of the occupational contact crowd. [ Methods ] Investigation was undertook item by item according to the self-designed questionnaire, concentration of trichloroacetic acid （TCA） in the urine and hearing were determinated in occupational contact crowd with TCE. [Results] The threshold value of hearing for pure sound and air conduction at the frequency of 8KHz was significantly different （P〈 0.05 or P〈 0.01） from the reference group, for the investigated people among the contact group whose length of service was greater than or equal to 2a or the concentration of TCA in the urine was greater than or equal to 50 mg/L; among the contact group, the threshold value of hearing at the high frequency of 4, 6 and 8 KHz for investigated people whose length of service was greater than or equal to 2a was significantly higher than those whose length of service was less than 2a （P 〈 0.05 or P 〈 0.01 ） . The detection rate of hearing loss at high frequency for the investigated people whose length of service was greater than or equal to 2a among the contact group was significantly higher than that of the reference group （P 〈 0.05） . [Conclusions] There is hearing toxicity in TCE. Lowering the concentration of TCE in working environment and reducing the duration of ＂ICE contact are important means for the prevention of ＂ICE hearing toxicity; undertaking hearing detection （mainly at the high frequency） to occupational TCE contact crowd during the occupational health monitoring is of realistic significance in finding out early patients of ＂ICE toxicity and preventing the occupational damage of TCE.