某汽车零部件制造企业工人护听器防护效果及其与噪声性听力损失的关系研究

A study on the protective effect of hearing protectors on workers in an automotive parts manufacturing enterprise and its relationship with noise-induced hearing loss

目的 了解某汽车零部件制造企业的工人听力健康现状,探讨听力损失的可能影响因素。方法检测个体接触噪声强度;测量个人声衰减值(personal attenuation rating,PAR);开展双耳6个频段(0.5~6.0 kHz)的气导纯音听阈测试;并使用问卷开展作业人员噪声接触情况和护听器使用情况调查。采用χ^(2)检验分析不同特征分组人群的听力损失发生率,构建logistic回归模型分析听力损失的影响因素。结果共调查某汽车零部件制造企业的281名噪声作业工人,个体接触噪声强度(normalization of equivalent continuous A-weighted sound pressure level to a nominal 8h working day,L_(EX,8h))范围为80.1~94.5 dB(A)。分析不同使用情况分组的工人之间的基线PAR,发现有无接受培训、是否知道正确佩戴方法、日常是否正确佩戴的工人的基线PAR比较,差异无统计学意义(P>0.05)。基线PAR未通过测试有35人,未通过率为12.4%。高频听阈提高检出55人,检出率为19.6%。男性工人年龄≥30岁、工龄≥10年、佩戴护听器后的噪声接触水平≥80 dB(A)的工人高频听阈提高发生较高(χ^(2)=3.064、17.103、2.933,P<0.1);工龄≥10年发生高频听阈提高的风险是工龄<10年者的4.224倍(OR=4.224,95%CI:1.920~9.297,P<0.01)。结论工龄是汽车零部件制造业工人听力健康的影响因素,部分工人佩戴护听器的防护效果不佳,部分工人高估了自己使用护听器的能力,企业应进一步加强培训。

Objective To understand the current situation of hearing health among workers in the automobile parts manufacturing factory and explore possible influencing factors of hearing loss.Methods A questionnaire survey,individual noise exposure level,and pure tone audiometry were conducted among workers(n=281)exposed to noise.The personal attenuation rating(PAR)of workers wearing hearing protection devices(HPD)was measured.Chi-square tests were used to analyze the prevalence of high-frequency hearing threshold improvement in different feature groups,and the logistic regression model was conducted to analyze the influencing factors of high-frequency hearing threshold improvement.Results The noise exposure level(normalization of equivalent continuous A-weighted sound pressure level to a nominal 8 h working day,L_(EX,8h))had a range from 80.1 to 94.5 dB(A).Through analyzing the baseline PAR among workers grouped under different usage conditions,it was found that there was no statistically significant difference in the baseline PAR between workers who had or had not received training,knew or did not know the correct wearing methods,and wore HPD whether correctly on daily work(P>0.05).Thirty-five workers failed the baseline PAR test,with a failure rate of 12.4%.The detection rate of high-frequency hearing threshold improvement was 19.6%(55/281).Comparing the detection rate of high-frequency hearing threshold improvement in different feature groups,workers aged equal to or higher than 30 years,with service year of greater than or equal to 10 years,and those whose noise exposure level after wearing hearing protection devices was greater than or equal to 80 dB(A)had a higher rate of high-frequency hearing threshold improvement(χ^(2)=3.064、17.103、2.933,P<0.1).The logistic regression results showed that the risk of high-frequency hearing threshold improvement in workers with service year of greater than or equal to 10 years was 4.224 times higher than that of those with service year of less than10 years(OR=4.224,95%CI:1.920~9.297,P<0.01).Conclusion The service year affects workers'hearing health in the auto parts manufacturing industry.The protective effect of some workers wearing hearing protection devices is not good and needs further training and improvement.