累积噪声暴露量与高频听力损失剂量反应关系的Meta分析

Cumulative noise exposure and the risk of high-frequency hearing loss relationships

目的探索累积噪声暴露量(CNE)与高频听力损失间的剂量反应关系,为控制噪声的职业危害提供依据。方法于2020年1月在国内生物医学期刊上发表的有关累积噪声暴露量与高频听力损失关系的文献进行剂量反应关系Meta分析。结果Meta分析初步合并剂量反应关系OR值为1.10(1.08~1.12),由于Begg’s漏斗图和Egger’s检验表明存在发表偏倚(t=5.97,P<0.01),故采用剪补法进行调整,调整后的OR值为1.09(1.07~1.12);敏感性分析表明,本次Meta分析结果具有较高的稳定性;亚组分析表明,稳态噪声组和非稳态噪声组的OR值分别为1.10(1.08~1.12)和1.14(1.07~1.21),采用高频听损旧标准组和新标准组的OR值分别为1.10(1.08~1.12)和1.11(1.00~1.24)。非线性剂量反应关系曲线表明,CNE达到95 dB(A)·年后高频听损风险快速增加。结论CNE与高频听损间存在确定的剂量反应关系,能用于噪声作业工人发生高频听损的风险预测。

Objective To explore the dose-response relationship between cumulative noise exposure and high-frequency hearing loss,and further to provide a basis for the control of occupational hazards of noise.Methods A Meta-analysis of dose-response relationships was performed on the data of eligible literatures published in China from January 2000.1 to December 2019.12.Results The initial combined Odds Ratio(OR)and its 95%CI in the Meta-analysis were 1.10(1.08-1.12).As the Begg's funnel plot and Egger's test indicated publication bias(t=5.97,P<0.01),the Trim-and-Fill Method was used for OR value adjustment.The adjusted-OR was 1.09(1.07-1.12);sensitivity analysis showed that the results of this Meta-analysis have high stability;subgroup analysis indicated that the ORs of the steady-state noise group and the non-steady-state noise group were 1.10(1.08-1.12)and 1.14(1.07-1.21),the ORs of the old standard group and the new standard group were 1.10(1.08-1.12)and 1.11(1.00-1.24),respectively.The nonlinear dose-response relationship curve demonstrated that the risk of high-frequency hearing loss increases rapidly after CNE reaches 95 dB(A)·years.Conclusion There is a definite dose-response relationship between CNE and high-frequency hearing loss,which can be used to predict the risk of high-frequency hearing loss in noisy workers.