吸烟和饮酒对职业性噪声暴露对工人听力的影响

Smoking, Alcohol Consumption and Occupational Noise and Hearing Impairment

目的探讨吸烟、饮酒、职业性噪声暴露对工人听力的影响。方法选取某重型装备制造厂中噪声暴露环境下工人作为研究对象,问卷调查其噪声暴露史、吸烟史、饮酒史等,并在隔音室内进行纯音测听检查,将PTA0.25-3>25d BHL记为低频听力损失,PTA4-8>40d B HL记为高频听力损失。根据吸烟史、饮酒史将受试者分为不吸烟不饮酒组(C0A0)、吸烟不饮酒组(C1A0)、饮酒不吸烟组(C0A1)、吸烟饮酒组(C1A1),以不吸烟不饮酒组(C0A0)为对照组统计分析各组听力情况的区别。并应用Logistic回归分析吸烟、饮酒、噪声的不同暴露时间(0-5年、5-10年、10-15年、≥15年)对听力的影响。结果 C1A0、C0A1、C1A1各组中听力损失工人的听力阈值及各组听力损失率与C0A0组的差异无统计学意义。Logistic回归分析显示相对于噪声暴露0-5年的工人,噪声暴露5-10年、10-15年、≥15年的工人发生低频听力损失的优势比分别为1.736、1.954、3.975,发生高频听力损失的优势比分别为1.517、2.257、1.627;相对于不饮酒人群,不同饮酒时间工人发生高频听力损失的优势比为1.777、1.814、2.402、3.134。结论饮酒可能会增加噪声暴露下工人听力受损的危险性,应在加强工人个人防护的基础上劝诫工人养成良好的生活习惯;而吸烟可能并不是造成听力损失的主要危险因素。

Objective To investigate the impact of smoking, alcohol consumption and noise exposure on hearing.Methods Noise exposed workers in a large heavy industry factory were selected as the subjects of the study. Questionnaire survey was used to collect their history of smoking and alcohol consumption. Their pure tone threshold average in the sound-proofed environment was evaluated. Low-frequency hearing loss（LFHL） was defined as PTA〉 25 d B HL at 0.25-3k Hz, and high-frequency hearing loss（HFHL） as PTA 〉40 d B HL at 4-8 k Hz. Using history of smoking and drinking, subjects were divided into a non-cigarette non-alcohol group（C0A0, or control）, a cigarette smoking without alcohol group（C1A0）, an alcohol consuming without cigarette group（C0A1）, and a cigarette smoking and alcohol consuming group（C1A1）. The duration of cigarette smoking, alcohol consuming and noise exposure was evaluated using a logistic regression model. Results Differences in PTA between each group and the control group were not statistically significant, nor were hearing loss types. Logistic regression analysis showed adjusted odds ratios for HFHL at 1.736, 1.954 and 3.975 and for LFHL at 1.517, 2.257 and 1.627 for workers with noise exposure of 5-10 years, 10-15 years and ≥15 years, respectively. Smoking had no effect on hearing loss types, and adjusted odds ratios for HFHL were 1.777, 1.814, 2.402 and 3.13 for workers with alcohol consumption of 0-5 years, 5-10 years, 10-15 years and ≥15years, respectively. Conclusions Alcohol consumption may increase the risk of hearing impairment in workers exposed to noise. In addition to hearing protection measures,workers should be counseled on healthy living habits. Smoking, however, does not appear to be a critical factor in causing hearing impairment.