职业性噪声作业工人双耳高频平均听阈与血压的关系

Relationship between binaural high frequency average hearing threshold and blood pressure in workers exposed to occupational noise

目的了解噪声作业工人双耳高频平均听阈与血压的关系。方法选择2019年1-12月参加噪声职业健康检查的1 360名工人进行问卷调查、血压测量和纯音测听检查,应用χ2检验、单因素分析、多元线性回归分析影响血压的相关因素,调整可能的混杂因素后,通过多元回归分析高频听阈与血压的独立的量化作用,通过平滑曲线拟合和进行阈值饱和效应分析。结果调整年龄、性别、防护耳塞使用、BMI、抽烟、喝酒、体育锻炼、饮食偏好、耳机使用、电话、嘈杂地方时间,以及高血压家族史后,多元回归分析结果显示,高频平均听阈增加一个单位,收缩压提高0.1 mmHg[95%CI(0.01,0.19),P=0.026],舒张压提高0.08 mmHg[95%CI(0.01,0.19),P=0.036]。平滑曲线拟合后,收缩压和舒张压均随双耳高频平均听阈的增加而提高,且具有阈值效应;双耳高频平均听阈在19 dBHL以上时,舒张压增加显著[β=0.1,95%CI(0.0,0.2),P=0.014]。在双耳高频平均听阈<42 dBH时,收缩压增加显著[β=0.2,95%CI(0.1,0.4),P=0.003]。结论双耳高频平均听阈与血压相关,血压随着双耳高频平均听阈的增加而提高,且存在阈值效应。

Objective To investigate the relationship between binaural high frequency average hearing threshold and blood pressure in workers exposed to noise. Methods 1 360 workers who took part in noise occupational health examination from January to December in 2019 were selected for questionnaire survey, blood pressure measurement and pure tone audiometry.χ^(2) test, univariate analysis and multiple linear regression were used to analyze the relevant factors affecting blood pressure.After adjusting the possible confounding factors, the independent quantitative effect of high frequency hearing threshold and blood pressure was analyzed by multiple regression, and the threshold saturation effect was analyzed by smooth curve fitting. Results After adjusting for age, sex, use of protective earplugs, BMI,smoking, drinking, physical exercise, dietary preferences, headset use, telephone, noisy place time, and family history of hypertension, multiple regression analysis showed that the high frequency average hearing threshold increased by one unit.Systolic blood pressure increased 0.1 mmHg[95%CI(0.01,0.19),P=0.026],diastolic blood pressure increased 0.08 mmHg[95%CI(0.01,0.19),P=0.036].After smooth curve fitting, both systolic and diastolic blood pressure increased with the increase of binaural high frequency average hearing threshold, and there is a threshold effect.When the binaural high-frequency average hearing threshold was above 19 dBHL,the diastolic blood pressure increased significantly[β=0.1,95%CI(0.0,0.2),P=0.014].When the binaural high-frequency average hearing threshold was less than 42 dBH,the systolic blood pressure increased significantly[β=0.2,95%CI(0.1,0.4),P=0.003]. Conclusion The binaural high frequency average hearing threshold is related to blood pressure, and the blood pressure increases with the increase of binaural high frequency average hearing threshold, and there is a threshold effect.