噪声所致工人听力损失与高血压的关系

Relationship between noise-induced hearing loss and hypertension in steel workers

目的研究某钢铁企业工人噪声暴露与高血压的关系。方法选择2014年1-7月底参加职业体检单纯接触噪声工人2061例,按照高频听力损失严重程度分组,即在4000 Hz或者6000 Hz,低听力损失组平均听力损失值（HLVs）〈15 dB（A）660例,噪声40 h等效声级为（74.69±11.97）dB（A）;中听力损失组,15 dB（A）≤HLVs〈30 dB（A）741例,噪声40 h等效声级为（84.38±11.57）dB（A）;高听力损失组,HLVs≥30 dB（A）660例,噪声40 h等效声级为（88.03±14.08）dB（A）。比较三组高血压患病率的差异。结果工人4000 Hz和6000 Hz时,左、右和两耳平均的HLVs值与平均噪声暴露水平显著相关（P〈0.05）。高血压患病率中听力损失组（29.5%）和高听力损失组（36.1%）明显高于低听力损失组（23.8%）（P〈0.05）。多因素Logistic回归分析显示,在调整了年龄、心率（HR）、甘油三酯（TG）、噪声40 h等效声级、糖尿病、吸烟、饮酒、体育锻炼等影响因素后,中听力损失组和高听力损失组患高血压的风险较高,其OR值分别为2.14（1.21-3.79）、2.58（1.44-4.62）。结论钢铁企业工人高频噪声引起的听力损失与患高血压的风险有关。

Objective To investigate the relationship between noise-induced hearing loss and hypertension of steel workers.Methods 2061 workers of Tangshan Iron and Steel Company who participated the occupational health examination during January 2014 to July 2014 and only exposed noise were selected as survey objects. They were divided into three groups ： low HL（hearing loss） group [ n = 660,bilateral average HLVs〈 15 dB（A）,at 4 k Hz or 6 k Hz,noise equivalent sound level（40h） was（74. 69 ± 11. 97） dB（A）]; median HL group [n = 741,bilateral average HLVs ≥15 dB（A）,but 〈30 dB（A） at 4 k Hz or 6 k Hz,noise equivalent sound level（40h） was（84. 38 ± 11. 57） dB（A）]and high HL group [n = 660,bilateral average HLVs ≥30 dB（ A） at 4 k Hz or 6 k Hz,noise equivalent sound level（40h） was（88. 03 ± 14. 08） dB（ A）]based on the measure result by pure tone audiometry,then compare the differences in prevalence rate of hypertension among three groups. Results The results showed that whether HLVs of left,right ear or average HLVs of both ears were all significantly correlated with average noise exposure levels at 4 k Hz and 6 k Hz bilaterally（ P〈0. 05）; the prevalence rates of hypertension of median HL group（29. 5%,P = 0. 001） and high HL group（36. 1%,P = 0. 001） were all significantly higher than that of low HL group（23. 8%）,multivariate Logistic regression analysis further showed that after adjusting various effects such as age,HR,TC,TG,FBG,diabetes,smoking,drinking,physical exercise etc,the hypertension risk was still both median HL and high HL groups,their OR values were 2. 14（1. 21 —3. 79） 、2. 58（1. 44—4. 62）,respectively. Conclusion The result suggested the occupational noise-induced hearing loss was correlated with hypertension of steel workers.