2015—2019年重庆市涪陵区职业性噪声危害及影响因素分析

Analysis on hazard and influencing factors of occupational noise in Fuling District of Chongqing from 2015-2019

目的调查重庆市涪陵区噪声作业工人职业危害水平,探讨听力损失的影响因素。方法从"职业病与职业卫生信息监测系统"中导出2015—2019年噪声作业在岗期间职业健康检查个案卡和职业病报告卡,分析近5年噪声作业人员噪声危害趋势,采用单因素分析和多因素分析方法分析噪声作业人员听力损害影响因素。结果 2019年度涪陵区噪声作业工人在岗期间职业健康检查共计8 276人,双耳高频平均听阈损失异常率为10.66%。2015—2019年,涪陵区共报告职业性噪声聋6例,噪声作业人员在岗期间职业健康检查人数总体呈上升趋势(R2=0.927,F=38.016,P<0.05),检出双耳高频听阈损失人数逐年升高(R2=0.854,F=17.489,P<0.05)。单因素分析表明,双耳高频平均听阈损失与非损失人员在性别、年龄、接噪工龄、用人单位行业和经济类型方面差异均有统计学意义(均P<0.05)。多因素分析表明,男性较女性更易发生高频平均听阈损失(OR=3.416,95%CI 2.687~4.343),企业经济类型为私有经济(OR=1.666,95%CI 1.114~2.493)和劳动者年龄(OR=1.073,95%CI 1.063~1.084)是本研究人群双耳高频平均听阈损失的危险因素。结论涪陵区职业性噪声危害形势不容乐观,未来职业卫生工作应重点关注私有制经济企业中劳动者的噪声职业危害,同时加强对男性劳动者的职业健康教育,同时适当把控噪声作业岗位劳动者年龄。

Objective To investigate the occupational hazard level of noise-exposed workers in Fuling District of Chongqing,discuss the influencing factors of hearing loss. Methods Occupational health examination case card during the noise-exposed period and occupational disease report card from 2015-2019 were exported from the "Occupational Disease and Occupational Health Information Monitoring System". The trend of noise hazard of exposed workers in recent five years was analyzed,and the influencing factors of hearing impairment of noise-exposed workers were explored by single and multivariate analysis. Results In 2019,8 276 noise-exposed workers in Fuling District received the in-service occupational health examination,and the abnormal rate of binaural high-frequency average hearing threshold loss was 10.66%. From 2015-2019,a total of 6 cases of occupational noise deafness were reported in Fuling District,and the number of noise-exposed workers receiving in-service occupational health examinations showed an overall trend of increase(R2=0.927,F=38.016,P<0.05),and the number of workers with binaural highfrequency hearing threshold loss increased year by year(R2=0.854,F=17.489,P<0.05). Univariate analysis showed that there were statistically significant differences in gender,age,length of service exposed to noise,employer industry and economic type between the workers with and without binaural high-frequency hearing threshold loss(all P<0.05). Multivariate analysis showed that males were more likely to have high-frequency average hearing loss than females( OR = 3. 416, 95 % CI : 2. 687-4. 343). Enterprise with private economic(OR=1.666,95%CI:1.114-2.493)and age of workers(OR=1.073,95%CI:1.063-1.084) were the risk factors of binaural high-frequency average hearing threshold loss in this study. Conclusion The situation of occupational noise hazards in Fuling District is not optimistic.In the future,occupational health work should focus on the occupational noise hazards of workers in private economic enterprises,strengthen occupational health education for male workers,and properly control the age of workers in noise-exposed jobs.