2015年南通市作业工人中噪声对血压影响的现况调查

Cross-sectional investigation on effect of noise on blood pressure among exposed workers in Nantong City in 2015

目的了解噪声对作业工人血压的影响,为更好地加强管理、保护作业工人身心健康和积极预防相关疾病的发生提供参考依据。方法将南通市2015年参加职业健康检查的在岗期间的6 568名噪声接触者作为调查对象,以听力损失作为累计噪声暴露量的替代指标,比较不同年龄、性别和工龄的工人高血压的发病情况。结果接触噪声的作业工人的高血压患病率为21.1%。以听力损失为指标进行人口特征学分类后,有噪声所致的听力损失者的高血压患病率(27.1%)明显高于听力正常的工人(17.7%),差异有统计学意义(χ~2=74.250,P<0.01)。对接噪的作业工人进行年龄分层后,进一步进行logistic回归分析发现,有噪声所致的听力损失者的高血压患病风险增高仅出现在≤45岁的年龄组(男性P<0.01,OR=1.294,95%CI为1.093~1.531;女性P<0.01,OR=2.524,95%CI为1.512~4.216),而在>45岁的年龄组未发现这种相关性。线性回归分析发现,仅在≤45岁的年龄组中,与听力正常者比,男性及女性工人中均出现听力损失者收缩压和舒张压升高。以接噪工龄作为指标进行人口特征学分类后,仅在≤45岁的年龄组中接噪工龄与高血压有关,随着接噪工龄的增加,男女工人的高血压患病率均明显增加。logistic回归分析发现,与接噪工龄≤1 a组比,工龄6~10和>10 a组的男女工人的高血压患病风险明显增加。线性回归分析发现,仅在≤45岁的年龄组中,与接噪工龄≤1 a组比,工龄6~10和>10 a组的男女工人的收缩压和舒张压均明显升高。结论≤45岁的年龄组作业工人中噪声致听力损失与高血压有关,需重点关注。

[Objective] To understand the effect of noise on blood pressure among exposed workers,provide a reference for strengthening the management, protecting the physical and mental health of workers and preventing related diseases.[Methods]6568 noise-exposed workers who received the occupational health examination in Nantong City in 2015 were enrolled in the study. Hearing loss was regarded as an indicator of cumulative noise exposure,and the incidence rates of hypertension in workers of different age,gender and working age were compared.[Results]The prevalence rate of hypertension in noise-exposed workers was 21.1%. The demographic classification was performed according to hearing loss,the prevalence rate of hypertension in people with noise induced hearing loss（27.1%）was higher than that in those with normal hearing（17.7%）,and the difference was statistically significant（χ~2 =74.250,P〈 0.01）.Logistic regression analysis was performed while the noise-exposed workers were grouped according to age,the results showed that the increased risk of hypertension was observed in workers below 45 years old（male P0.01,OR=1.294,95%CI：1.093-1.531;female P0.01,OR=2.524,95%CI：1.512-4.216）,and this correlation was not found in workers over 45 years old. Linear regression analysis showed that the results of increased systolic and diastolic blood pressure were observed in noise-exposed workers below 45 years old（both males and females）as compared with those with normal hearing.When the demographic classification was performed according to noise exposure years,the prevalence rate of hypertension was related to noise exposure years among workers below 45 years old,and the prevalence rate of hypertension increased with the increasing working years in both males and females. Logistic regression analysis showed that the risk of hypertension in workers with noise exposure of 6-10 years and over 10 years was higher than that in workers with noise exposure less than 1 year. Linear regression analysis showed that levels of systolic and diastolic blood pressure in workers（both males and females） with noise exposure of 6-10 years and over 10 years were higher than that in workers with noise exposure less than 1 year,and the results were observed only in workers below 45 years old.[Conclusion]There is a correlation between noise induced hearing loss and hypertension in exposed workers below 45 years old,which special attention should be paid to.