职业噪声暴露与神经衰弱症关系的meta分析

META-ANALYSIS OF THE CORRELATION BETWEEN OCCUPATIONAL NOISE EXPOSURE AND NEURASTHENIA

目的对国内1979-2014年10月公开发表的职业噪声对暴露人群神经衰弱症发病影响的研究结果进行Meta分析,用不同强度的噪声暴露与神经衰弱症的关系作剂量-效应分析,探讨噪声导致神经衰弱症的规律。方法系统检索《中国生物医学文献数据库》及《中文生物医学期刊文献数据库》,按照纳入排除标准筛查文献,提取数据进行分析,用meta分析方法合并不同噪声暴露所致神经衰弱症的患病率,并进行统计检验。结果检索筛选后获得职业噪声相关的流行病学横断面调查文献17篇,meta分析结果表明,接触职业噪声(平均声压级>80 d B(A))后神经衰弱症发病相对危险度(RR值)为2.65,提示噪声接触与神经衰弱症之间存在显著相关性。以噪声声压级进行亚组分析结果表明,暴露在声压级越高的噪声环境中,患神经衰弱症的相对危险度越高;以工龄进行亚组分析结果表明,暴露时间越长患神经衰弱症的相对危险度越高,但是工龄20年之后的相对危险度反而有所回落。结论接触声压级80 d B(A)以上的噪声可以导致神经衰弱症患病风险显著增加,因而,80 d B(A)以上的噪声暴露可被认为是神经衰弱症的一种危险因素,二者之间存在一定的因果关系。

Objective Through documental meta- analysis of the effect of occupational noise on neurasthenia domestically published since 1979 to 2014,to analyze the dose- response relationship between noise exposure and neurasthenia,and to investigate the regular pattern of noise impact on neurasthenia. Methods Systematic literature retrieval was performed to collect the published documents in CBMDISC and CMCC. The documents were then screened according to the inclusion and exclusion criteria. Relative Data were extracted and analyzed; meta-analysis was performed to merge the morbidity of neurasthenia under different noise exposure. Results A total of 17 articles about cross- sectional study on occupational noise exposure were included after the literature retrieval and screening. Meta- analysis revealed that the relative risk of the incidence of neurasthenia after occupational noise exposure（ 80 d B（ A）） was 2. 65,which meant that there was a significant correlation between noise exposure and neurasthenia. Subgroup analysis by sound press level of the noise revealed that the higher level of the noise exposed led to higher relative risk of the incidence of neurasthenia. Subgroup analysis by working age in the occupational noise condition revealed that the longer length of working led to higher relative risk of the incidence of neurasthenia,however,the relative risk fell back when the length of working was longer than 20 years. Conclusion Exposure to noise sound pressure level higher than 80 d B（ A） can lead to increased relative risk of the incidence of neurasthenia,and may be considered as a risk factor of neurasthenia. There is a causal relationship between the two.