制造业工人噪声暴露特征与高频听力损失关系

Relationship between noise exposure characteristics and high-frequency hearing loss in manufacturing workers

目的探讨制造业工人噪声暴露特征与高频听力损失的关系。方法采用典型抽样法,选择浙江省5家制造业工厂755名噪声作业工人为研究对象,测量其接触的8h等效声级(L_(EX,8h))并记录噪声波形,计算累积噪声暴露量(CNE)和峰度;测试双耳纯音气导听阈。结果研究对象的高频听力损失患病率(HFHL%)为19.3%(146/755),且HFHL%均随着CNE和峰度的增加而升高(P值均<0.01)。研究对象高频噪声诱发永久性听阈位移中位数为23.0dB,其与CNE、L_(EX,8h)和峰度均呈正相关(相关系数分别为0.24、0.19、0.17,P值均<0.01)。多因素Logistic回归分析结果显示,在排除性别和年龄等混杂因素的影响后,CNE、峰度均可导致罹患高频听力损失的风险增加[比值比及其95%可信区间分别为2.59(1.84~3.65)、1.53(1.20~1.95),P值均<0.01]。结论制造业工人噪声暴露特征与其高频听力损失呈剂量-反应关系;除能量指标L_(EX,8h)和CNE外,峰度也是影响高频听力损失的关键因素。

Objective To explore the relationship between noise exposure characteristics and high-frequency hearing loss in manufacturing workers.Methods A total of 755 employees from five manufacturing factories in Zhejiang Province were selected as research subjects by typical sampling method.The normalization of equivalent continuous A-weighted sound pressure level to a nominal 8 hours working day(L_(EX,8h))and noise waveforms were detected,and cumulative noise exposure(CNE),and kurtosis were calculated.The pure tone air conduction audiometry was measured.Results The total prevalence of high-frequency hearing loss(HFHL%)was 19.3%(146/755),and the HFHL%increase with the increase of CNE and kurtosis(all P<0.01).The median of noise-induced permanent threshold shift at frequencies of 3,4,and 6 kHz was 23.0 dB,and it was positively correlated with CNE,L_(EX,8h) and kurtosis(Spearman correlation coefficient were 0.24,0.19,and 0.17,respectively,all P<0.01).Multiple logistic regression showed that both the CNE and kurtosis had higher prevalence of high-frequency hearing loss[the odds radio and 95%confidence interval were 2.59(1.84-3.65)and 1.53(1.20-1.95),respectively,P<0.01]after controlling for confounding factors such as gender and age.Conclusion There is a dose-response relationship between high frequency hearing loss and noise exposure characteristics in manufacturing workers.In addition to energy indicators(L_(EX,8h) and CNE),the kurtosis is also a key factor affecting high-frequency hearing loss.