浙江省五家汽车制造企业接噪工人听力损失的流行病学特征

Epidemiological characteristics of noise-induced hearing loss among workers in five automobile manufacturing enterprises in Zhejiang Province

[背景]噪声是汽车制造业中存在最广泛、接触人数最多的职业危害因素。汽车制造业是噪声性听力损失的高危行业。[目的]了解汽车制造业接触噪声工人听力损失流行病学特征,并探讨听力损失的影响因素。[方法]对5家汽车制造企业的噪声接触工人(n=656)开展问卷调查、个体噪声录音和纯音测听,获取年龄、性别、工龄、噪声强度、峰度、听力等数据,统计高频听力损失(HFNIHL)检出率和语频听力损失(SFNIHL)检出率。比较是否HFNIHL人群的各相关因素水平。对不同年龄、性别、工龄、8 h等效连续A计权声压级(LAeq,8h)以及峰度分组与HFNIHL检出率进行卡方检验和趋势性分析。采用logistic回归分析HFNIHL和SFNIHL的影响因素。[结果]非稳态噪声接触率为73.6%。HFNIHL检出率为32.6%(214人),SFNIHL检出率为6.7%(44人)。HFNIHL组年龄、男性构成比、工龄、噪声强度(LAeq,8h)以及峰度均高于非HFNIHL组(P<0.05)。HFNIHL检出率随着年龄、工龄、噪声强度以及峰度的增加均呈现上升趋势(χ2趋势-年龄=49.25,P<0.001;χ2趋势-工龄=22.19,P<0.001;χ2趋势-噪声强度=6.91,P=0.009;χ2趋势-峰度=8.56,P=0.003)。logistic回归显示年龄(OR=2.13,95%CI:1.67~2.71,P<0.001)、性别(OR=2.29,95%CI:1.44~3.62,P<0.001)、工龄(OR=1.43,95%CI:1.11~1.85,P=0.006)、LAeq,8h(OR=1.37,95%CI:1.08~1.76,P=0.011)以及峰度(OR=1.37,95%CI:1.14~1.63,P=0.001)与HFNIHL发生风险相关,而仅有年龄与SFNIHL发生风险相关(OR=2.15,95%CI:1.33~3.33,P=0.001)。[结论]汽车制造行业噪声接触工人听力损失风险高,年龄、性别、工龄、噪声强度以及峰度均是高频听力损失的重要影响因素。

[Background]Noise is the most common occupational hazard in the automobile manufacturing industry with the most worke rs exposed.Automobile manufa cturing industry is a high-risk industry for noise-induced hearing loss.[Objective]To understand the epidemiological characteristics of noise-induced hearing loss among workers in automobile manufa cturing industry and explore related influencing factors.[Methods]A questionnaire survey,individual noise recording,and pure tone audiometry were conducted among workers(n=656)exposed to noise from five automobile manufacturing enterprises.The data on age,sex,exposure duration,noise intensity,kurtosis,and hearing loss were obtained.The positive rates of high-frequency noise-induced hearing loss(HFNIHL)and speechfrequency noise-induced hearing loss(SFNIHL)were calculated,and each factor was compared between workers with and without HFNIHL.Chi-square test and analysis of trend were conducted among different groups of age,sex,exposure duration,A-weighted equivalent continuous sound pressure level normalized to a nominal 8-hour working day(LAeq,8h),and kurtosis.Logistic regression analysis was conducted to analyze the factors influencing the positive rates of HFNIHL and SFNIHL.[Results]The exposure rates of non-Gaussian noise was 73.6%.The positive rates of HFNIHL and SFNIHL were 32.6%(214 workers)and6.7%(44 workers),respectively.The HFNIHL workers showed older age,higher proportion of male,longer exposure duration,higher noise intensity(LAeq,8h),and increased kurtosis than those without HFNIHL(P<0.05).The positive rates of HFNIH L increased with the increase of age,exposu re duration,LAeq,8h,and ku rtosis(χ~2trend-age=49.25,P<0.001;χ~2trend-duration=22.19,P<0.001;χ~2trend-LAeq=6.91,P=0.009;χ~2trend-kurtosis=8.56,P=0.003).The results of logistic regression showed that age(OR=2.13,95%CI:1.67-2.71,P<0.001),sex(OR=2.29,95%CI:1.44-3.62,P<0.001),exposure duration(OR=1.43,95%CI:1.11-1.85,P=0.006),LAeq,8h(OR=1.37,95%CI:1.08-1.76,P=0.011),and kurtosis(OR=1.37,95%CI:1.14-1.63,P=0.001)were factors associated with the risk of HFNIHL,while only age was associated with the risk of SFNIHL(OR=2.15,95%CI:1.33-3.33,P=0.001).[Conclusion]Workers exposed to noise in automobile manufacturing industry are at a high risk of hearing loss.Age,sex,exposure duration,LAeq,8h,and kurtosis are key influencing factors of hearing loss.