吸烟对噪声性高频听力损失影响的病例对照研究

Control study on effect of smoking on noise induced high frequency hearing loss

目的探讨吸烟对噪声性听力损失的影响,为预防听力损失提供科学依据。方法选取某造船企业中接触噪声出现高频听力损失的1 251名男性工人作为观察组,接触噪声未出现高频听力损失的3 013名男性工人作为对照组,通过现场调查、个体噪声剂量检测、问卷调查、纯音测听等方法获得相关资料,采用卡方检验和Logistic回归模型分析高频听力损失的影响因素。结果观察组中吸烟人数占5188%。卡方检验显示,观察组累积噪声暴露剂量(CNE)、吸烟率与对照组的差异具有统计学意义(P<005)。Cochran-Armitage趋势检验分析显示,在吸烟工人中,随着每日吸烟量的增加,高频听力损失的发生率由1834%增加到2851%(P<005);随着烟龄的增长,高频听力损失的发生率由1448%增加到3513%(P<005)。多因素Logistic回归分析显示,对年龄、 CNE等因素进行调整后,相比于不吸烟人群,吸烟行为使高频听力损失发生的风险增加到1398倍(95%CI1216~1608)。结论吸烟是高频听力损失的危险因素,且随着每日吸烟量的增加和烟龄的增长高频听力损失的发生率呈增高趋势,应加大对接噪人员的控烟教育,以保护劳动者听力。

Objective To explore the impact of smoking on noise-induced hearing loss, thereby provide a scientific basis for prevention of hearing loss.Methods A total of 1 251 male noise-exposed workers with high-frequency hearing loss in a shipbuilding enterprise were selected as case group, and 3 013 male noise-exposed workers without high-frequency hearing loss served as control group. The relevant data were obtained by field investigation, individual noise dose detection, questionnaire survey,pure tone audiometry, etc. The Chi-square test and Logistic regression model were used to analyze the influencing factors of highfrequency hearing loss.Results Among the workers with high-frequency hearing loss, 51 88% of them smoked;Chi-square test showed that the cumulative noise exposure(CNE) dose and smoking rate in case group had significantly differences with that of control group(P<0 05). Cochran-Armitage trend analysis showed that the incidence of high-frequency hearing loss increased from 1834% to 2851%(P<0 05) with the increase of daily smoking, and increased from 14 48% to 35 13%(P<0 05) as well with the increase of smoking age. Multivariate Logistic regression analysis showed that smoking increased the risk of high-frequency hearing loss by 1398(95%CI1 216~1 608) compared with non-smoking workers after adjusting for age, CNE and other factors.Conclusion Smoking is a risk factor for high-frequency hearing loss by noise, the incidence shows an increasing trend with the daily smoking and smoking age. Therefore, it is necessary to further strengthened the smoking-control education forhearing.