职业性噪声聋诊断标准的实践探索

Research on Diagnostic Criteria of Occupational Noise Induced Hearing Loss

目的探讨GBZ49—2014职业性噪声聋诊断标准的科学性，为国家标准进一步改进提供参考。方法收集421名每天在等效连续噪声暴露8个小时工作工人的基本资料，进行纯音测听检查，运用χ^2检验和相关性分析方法进行统计学分析，以P〈0．05计为有统计学意义。结果2014年和 2007年两版诊断标准下，337名工龄3年及以上工人的噪声聋患病率有统计学差异（P〈0．05）；84名1-2年工龄工人中听力损失达到噪声聋标准人数也有统计学差异（P〈0．05）；GBZ49-2014诊断标准下，工龄与噪声聋的患病率的相关系数r=0．883，呈强正相关（P=0．002〈0．05）；而在GBZ49-2007诊断标准下，工龄与噪声聋的患病率的相关系数r=0．632，没有相关性（P=0．13〉0．05）。结论2014年版国家标准比2007年版国家标准更加科学可靠，但还需要进一步研究。

Objective To explore the scientific nature of the diagnostic criteria of GBZ49-2014 occupational noise induced hearing loss,and to provide reference for the further improvement of the national standard.Methods Collect the basic information of 421 workers who work eight hours per day and have equivalent continuous noise exposure.Conduct pure tone audiometry examination and using Z2 test and correlation analysis for statistical analysis.Results 337 workers who service great than or equal to 3 years,there were significant differences in the prevalence rate of noise induced hearing loss in 2014 and 2007 two diagnostic standards（P〈0.05）;84 workers who service less than 2 years,the number of whose hearing loss reached the standard had significant difference in two diagnostic standards（P〈0.05）. In GBZ49-2014 standard, the correlation coefficient of service years and prevalence rate of noise induced hearing loss is 0.883, showed a strong positive correlation （P=0.002〈0.05）; while the GBZ49-2007 standard, the correlation coefficient is 0.632,showed no correlation （P=0.13〉0.05）. Conclusion The 2014 edition of the national standard is more scientific and reliable than the 2007 edtion, but need for further research.