某水泥厂噪声作业工人听力损失相关因素分析

Influencing factors for hearing loss in workers exposed to noise in a cement plant

目的探讨某水泥厂噪声作业工人噪声性听力损失（NIHL）患病情况并分析其影响因素。方法于2015年10月，采用整群抽样的方法对河南省某水泥厂噪声作业工人进行问卷调查和健康检查，分析接触噪声工人的人口学特征、生活习惯、累积噪声暴露量（CNE）、高血压和高血脂与NIHL的关系。结果该水泥厂作业场所的噪声以中高频为主，NIHL的患病率为18．4％，男性NIHL的患病率高于女性（xz=28．09，P〈0．01）；随着年龄的增加，NIHL的患病率明显增加（χ^2趋势=25．54，P〈0．01）；随着文化程度的增加，NIHL的患病率明显降低（χ^2趋势=8．55，P〈0．01）；吸烟者NIHL的患病率高于不吸烟者，差异有统计学意义（χ^2=14．15，P〈0.01）；饮酒者NIHL的患病率高于不饮酒者，差异有统计学意义（χ^2=7．95，P〈0．01）；未佩戴耳塞者NIHL的患病率高于佩戴耳塞者，差异有统计学意义（χ^2=19．93，P〈0．01）；随着CNE的增加，NIHL患病率增加（χ^2趋势=57．81，P〈0．01）；高血脂组NIHL患病率高于无高血脂组，差异有统计学意义（χ^2=12．43，P〈0．01）。多因素logistic回归分析结果显示，男性（OR=5．06，95％CI：1．68～15．26）、年龄≥50岁（OR=1．91，95％CI：12～3．27）、CNE为97．01—103．00dB（A）·年（OR=16．10，95％CI：4．65～55．69）、CNE为103．01～118．37dB（A）·年（OR=20．27，95％CI：5．14～79．92）、高血脂（OR=2．83，95％CI：1．25～6．43）是NIHL的危险因素，而高中文化程度（OR=0．22，95％CI：0．09～0．56）、大专文化程度（OR=0.16，95％CI：0．41-0．59）、佩戴耳塞（OR=0．36，95％CI：0．19—0．71）是NIHL的保护因素。结论水泥厂噪声作业工人NIHL患病率较高，CNE、性别、年龄、文化程度、佩戴耳塞和高血脂是NIHL的影响因素。

Objective To investigate the incidence of noise-induced hearing loss （NIHL） and related influencing factors in workers exposed to noise in a cement plant. Methods In October 2015, cluster sampling was used for questionnaire investigation and health examination of workers exposed to noise in a cement plant in Henan Province, China. The association of demographic features, living habits, cumulative noise exposure （CNE）, hypertension, and hyperlipidemia with NIHL was analyzed. Results There was mainly medium-or high- frequency noise in the working place of this cement plant. The prevalence rate of NIHL was 18.4%, and male workers had a significantly higher prevalence rate than female workers （χ^2=28.09, P〈0.01 ）. The prevalence rate of NIHL increased with the increasing age （χ^2=25.54, P〈0.01） and deereasedwith the increasing degree of education（χ^2trend=8.55, P〈0.01）. The workers who smoked had a significantly higher prevalence rate of NIHL than those who did not smoke （χ^2=14.15, P〈0.01 ）, and the workers with a drinking habit had a significantly higher prevalence rate of NIHL than those without such habit （χ^2=7.95, P〈0.01 ）. The workers who did not wear earplugs had a significantly higher prevalence rate of NIHL than those who wore earplugs （χ^2=19.93, P〈0.01）. The prevalence rate of NIHL increased with the increasing CNE （χ^2trend=57.81, P 〈0.01 ）. The workers with hyperlipidemiahad a significantly higher prevalence rate of NIHL than those without hyperlipidemia （χ^2=12.43, P〈0.01 ）. The multivariate logistic regression analysis showed that male sex （OR=5.06, 95%CI 1.68-15.26）, age ≥50 years（OR=1.91, 95%CI 1.12-3.27）, CNE 97.01-103 dB（A）·year（OR=16.10, 95%CI4.65-55.69）, CNE 103.01-118.37dB（A）.year（OR=20.27, 95%C15.14-79.92）, and hyperlipidemia（OR=2.83, 95%CI 1.25-6.43） were risk factors for NIHL, while high school education （OR=0.22, 95%CI 0.09-0.56）, junior college diploma （OR=0.16, 95%CI 0.41-0.59）, and use of earplugs （OR=0.36, 95%CI 0.19-0.71） were protective factors against NIHL. Conclusion The workers in a cement plant have a high prevalence rate of NIHL, and CNE, sex, age, degree of education, use of earplugs, and hyperlipidemia may be influencing factors for NIHL.