Evaluation of Digits-in-Noise Test and Hearing Handicap Inventory for Adults Screening in Patients with Occupational Noise-Induced Hearing Loss

Objective:To explore the clinical evaluation role of the Digits-in-Noise(DIN)test and Hearing Handicap Inventory for Adults Screening(HHIA-S)for patients with occupational noise-induced hearing loss and to observe and analyze their application values.Methods:Fifty patients with suspected occupational noise-induced hearing loss were randomly selected from the Department of Otolaryngology at the hospital as the research target.The collection period for the research cases spanned from January 2022 to November 2023,and all patients had a history of noise exposure.The DIN test and HHIA-S were used for hearing examinations,with clinical,comprehensive diagnosis serving as the gold standard to study their diagnostic performance.Results:The compliance rate of the DIN test was 88.00%,the HHIA-S’s compliance rate was 80.00%,and the combined compliance rate was 94.00%.The compliance rate of the DIN test and the combined compliance rates of the patients were statistically significant compared to the clinical gold standard data(P<0.05),while there was no difference between the compliance rate of the HHIA-S and the gold standard(P>0.05).The data shows that the sensitivity of the combined diagnosis is significantly higher than the sensitivity data of the DIN test and HHIA-S examination alone(P<0.05).Its specificity is 100.00%,and the accuracy data of the joint diagnosis in the degree were higher than those of the DIN test alone(P>0.05)and the HHIA-S alone(P<0.05).Conclusion:For patients with occupational noise-induced hearing loss,the joint evaluation of the DIN test and HHIA-S can significantly improve their diagnostic value with high sensitivity and accuracy.

The Effect of a High-Frequency-Hearing-Threshold Weighted Value on the Diagnosis of Occupational-Noise-Induced Deafness

Objective: In order to provide a theoretical basis for the revision of the current diagnostic criteria for occupational noise-induced deafness (ONID), we evaluated the degree of ONID by analyzing different high-frequency-hearing- threshold-weighted values (HFTWVs). Methods: A retrospective study was conducted to evaluate the diagnosis of patients with ONID from January 2016 to January 2017 in Guangdong province, China. Based on 3 hearing tests (each interval between the tests was greater than 3 days), the minimum threshold value of each frequency was obtained using the 2007 edition’s diagnostic criteria for ONID. The speech frequency and the HFTWVs were analyzed based on age, noise exposure, and diagnostic classi-fication using SPSS21.0. Results: 168 patients in total were involved in this study, 154 males and 14 females, and the average age was 41.18 ± 6.07. The diagnosis rate was increased by the weighted value of the high frequencies and was more than the mean value of the pure speech frequency (MVPSF). The diagnosis rate for the weighted 4 kHz frequency level increased by 13.69% (χ2 = 9.880, P = 0.002), the weighted 6 kHz level increased by 15.47% (χ2 = 9.985, P = 0.002), and the weighted 4 kHz + 6 kHz level increased by 15.47% (χ2 = 9.985, P = 0.002). The differences were all statistically significant. The diagnostic rate of the different thresholds showed no obvious difference between the genders. The age groups were divided into less than or equal to 40 years old (group A) and 40 - 50 years old (group B). There were several groups with a high frequency: high frequency weighted 4 kHz ( group A χ2 = 3.380, P = 0.050;group B χ2 = 4.054, P = 0.032), high frequency weighted 6 kHz (group A χ2 = 6.362, P = 0.012;group B χ2 = 4.054, P = 0.032), weighted 4 kHz + 6 kHz (group A χ2 = 6.362 P = 0.012;B χ2 = 4.054, P = 0.032) than those of MVPSF in the same group on ONID diagnosis rate. The differences between the groups were statistically significant. There was no significant difference between the age groups (χ2 = 2.265, P = 0.944). The better ear’s (the smaller hearing threshold weighted value) MVPSF and the weighted values for the different high frequencies were examined in light of the number of working years;the group that was exposed to noise for more than 10 years had significantly higher values than those of the average thresholds of each frequency band in the groups with 3 - 5 years of exposure (F = 2.271, P = 0.001) and 6 - 10 years of exposure (F = 1.563, P = 0.046). The differences were statistically significant. The different HFTWVs were higher than those of the MVPSF values, and the high frequency weighted 4 kHz + 6 kHz level showed the greatest difference, with an average increase of 2.83 dB. The diagnostic rate that included the weighted high frequency values was higher for the mild, moderate, and severe cases than those patients who were only screened with the pure frequency tests. The results of the comparisons of the diagnosis rates for mild ONID were as follows: the weighted 3 kHz high frequency level (χ2 = 3.117, P = 0.077) had no significant difference, but the weighted 4 kHz level (χ2 = 10.835, P = 0.001), 6 kHz level (χ2 = 9.985, P = 0.002), 3 kHz + 4 kHz level (χ2 = 6.315, P = 0.012), 3 kHz + 6 kHz level (χ2 = 6.315, P = 0.012), 4 kHz + 6 kHz level (χ2 = 9.985, P = 0.002), and 3 kHz + 4 kHz + 6 kHz level (χ2 = 7.667, P = 0.002) were significantly higher than the diagnosis rate of the mean value of the PSF. There was no significant difference between the 2 groups for the moderate and severe grades (P > 0.05). Conclusion: Different HFTWVs increase the diagnostic rate of ONID. The weighted 4 kHz, 6 kHz, and 4 kHz + 6 kHz high frequency values greatly affected the diagnostic results, and the weighted 4 kHz + 6 kHz high frequency hearing threshold value has the maximum the effect on the ONID diagnosis results.

疑似职业性噪声聋患者心理健康与应对方式相关性分析

目的探讨疑似职业性噪声聋患者心理健康与应对方式相关性。方法采用随机整群抽样方法,选择2017年10月~2019年4月我院收治的疑似职业性噪声聋患者168例。所有患者入院后均采用症状自评量表(SCL-90)与简易应对方式问卷(SCSQ)完成问卷调查,以健康体检者100例为对照组;采用Pearson相关性分析软件对患者心理健康与应对方式进行相关性分析。结果疑似职业性噪声聋患者敌对(1.76±0.51)分、焦虑(1.61±0.42)分、人际关系敏感(1.62±0.43)分、躯体化(1.74±0.49)分、强迫(1.75±0.49)分、恐怖(1.69±0.43)分、精神性(1.66±0.34)分、偏执评分(1.77±0.23)分及抑郁评分(1.70±0.21)分,均高于对照组(t=4.918、5.671、4.092、5.678、8.451、6.856、9.392、5.492、7.471,P均<0.05);疑似职业性噪声聋患者积极应对评分为(1.63±0.39)分、消极应对评分(1.23±0.46)分,均低于对照组(t=6.392、7.791,P <0.05);Pearson相关性分析结果表明:疑似职业性噪声聋患者敌对、焦虑、人际关系敏感、躯体化、强迫、恐怖、精神性、偏执及抑郁评分与应对方式呈负相关性(P <0.05)。结论疑似职业性噪声聋患者心理健康水平相对较差,且与应对方式存在紧密的联系,应重视患者的心理干预与健康教育,提高患者心理健康水平。

疑似职业性噪声聋患者职业防护依从性调查及应对措施研究

目的探讨疑似职业性噪声聋患者职业防护依从性调查及应对措施研究。方法选择2018年6月~2019年6月疑似职业性噪声聋患者102例,对防护的依从性进行调查,并采取相应的措施进行干预。对接触不同噪声剂量下听力损伤情况、患者依从性进行比较。结果接触噪声剂量的不同,发生听力损伤的人数各不相同,其听力损伤主要在100~135dB之间,以Ⅰ级听力损伤为主,差异有统计学意义(P<0.05);疑似职业性噪声聋患者干预后,各方面的依从率高于干预前(P<0.05)。结论疑似职业性噪声聋患者的防护依从性较差,通过采取积极、合理的干预措施,能够提高患者的防护依从性,减少对患者的损害,降低不良影响。

株洲市噪声作业工人听力监测分析

目的了解噪声作业工人听力损失现状,为制定有效的预防控制策略提供科学依据。方法于2018年1月1日至10月31日,通过作业场所职业病危害申报与备案管理系统和职业健康检查系统,收集株洲市136家企业7806名噪声作业工人的基本信息和体检信息以及企业行业、类型、规模等相关信息,采用χ^2检验对辖区内噪声作业工人的职业健康监护数据和企业信息进行分析。结果株洲市7806名噪声作业工人年龄为(36.1±9.3)岁,工龄为7.0(3.0,11.0)年;检出听力损失工人1270人,检出率为16.27%;疑似职业性噪声聋51人,检出率为0.65%;噪声聋1人,检出率为0.01%。男性听力损失检出率明显高于女性,听力损失和疑似职业性噪声聋检出率均随着年龄和工龄的增加而增加(P<0.05);不同工种工人听力损失和疑似职业性噪声聋检出率差异均有统计学意义(P<0.05);不同行业、企业规模噪声作业工人听力损失检出率差异均有统计学意义(P<0.05),非金属矿采选行业工人的听力损失检出率较高(33.33%,14/42),小型企业工人的听力损失检出率较高(19.32%,296/1532);不同经济类型企业噪声作业工人疑似职业性噪声聋检出率差异有统计学意义(P<0.05),私营企业工人的疑似职业性噪声聋检出率较高(1.29%,36/2782)。结论株洲市噪声作业危害严重,应加强非金属矿采选行业和小型、私营企业的职业卫生防护措施,加大职业卫生执法力度,保护劳动者健康。

长沙市某电子设备制造企业噪声作业人群听力损失现状及趋势分析

目的了解长沙市某电子设备制造企业噪声作业人群听力损失现状及趋势,为企业和职业卫生管理部门后续开展职业卫生工作提供依据。方法收集2016-2018年长沙市某电子设备制造企业共14871名噪声作业在岗期间健康检查人员相关信息,采用Excel 2010、SPSS 22.0进行数据整理及统计分析。结果2016-2018年长沙市某电子设备制造企业疑似职业性噪声聋检出率分别为0.4%(15/4278)、0.3%(14/5171)和0.04%(2/5422);职业禁忌证检出率分别为2.3%(97/4278)、3.0%(156/5171)和3.5%(191/5422);复查检出率分别为13.4%(574/4278)、17.4%(899/5171)和15.2%(823/5422)。不同职业病危害因素接触类型员工疑似职业性噪声聋检出率比较,差异有统计学意义(P<0.01)。2018年长沙市某电子设备制造企业不同年龄组、工龄组、职业病危害因素接触类型和工种员工职业禁忌证检出率比较,差异均有统计学意义(均P<0.01)。<25岁年龄组职业禁忌证检出率较高(4.9%)。<1年工龄组职业禁忌证检出率最高(4.0%)。不同年龄组、职业病危害因素接触类型和工种员工复查检出率比较,差异均有统计学意义(均P<0.01)。2016-2018年不同年份员工疑似职业性噪声聋、职业禁忌证和复查检出率比较,差异均有统计学意义(均P<0.01),职业禁忌证检出率、复查检出率整体呈上升趋势。结论长沙市某电子设备制造企业噪声在岗作业人员听力损失随年份增加有上升趋势,低年龄组和短工龄组噪声作业工人的职业禁忌证检出率较高。

2020年江西省47915名在岗期间噪声作业工人职业健康检查结果分析

目的分析2020年江西省噪声作业人员在岗期间听力异常情况及其影响因素,为制定有效的预防控制策略提供参考依据。方法依据GBZ 188—2014《职业健康监护技术规范》和GBZ 49—2014《职业性噪声聋的诊断》,收集2020年江西省1384家企业47915名在岗期间职业噪声作业工人健康检查个案资料,对检查结果进行判定,分析听力异常检出率和疑似职业性噪声聋检出率的影响因素。结果47915名在岗期间噪声作业工人中男性36116人(占75.4%)、女性11799人(占24.6%),平均年龄为(42.3±9.6)岁;工龄中位数为3年。听力损失检出率为11.1%;疑似职业性噪声聋检出率为0.2%。女性听力损失和疑似职业性噪声聋检出率均低于男性,差异均有统计学意义(均P<0.05);听力损失和疑似职业性噪声聋检出率都随年龄的增加而升高,差异均有统计学意义(均P<0.05);听力损失检出率随工龄的增加而升高,差异有统计学意义(P<0.05),疑似职业性噪声聋检出率在各工龄组别中的差异有统计学意义(P<0.05),11~<21年工龄检出率最高,为0.4%;在地区分布中,上饶市听力损失检出率最高,赣州市疑似职业性噪声聋检出率最高;不同行业、经济类型、企业规模在岗期间噪声作业工人听力损失检出率比较,差异均有统计学意义(均P<0.05),分别以建筑业、股份制企业和微型企业检出率最高,分别为20.3%、15.0%和14.6%;不同经济类型和企业规模在岗期间噪声作业工人疑似职业性噪声聋比较,差异均有统计学意义(均P<0.05),经济类型以私营经济企最高,企业规模以小型企业最高。结论2020年江西省噪声作业危害引起的职业健康损伤不容乐观,引起的听力异常与作业工人的人口学特征及企业类型直接相关,应加大对微小企业、私营企业、建筑行业等高危企业的职业卫生防护措施,加大职业卫生执法力度,完善健康监护,切实保护劳动者身心健康。

深圳市77 319名噪声作业员工听力监测结果分析

[目的]了解深圳市噪声作业员工职业健康状况,为该市预防与控制职业性噪声聋提供科学依据。[方法]按照《国家重点职业病监测与职业健康风险评估工作方案》要求,收集深圳市噪声作业员工重点职业病监测数据进行统计学分析。[结果]2017年深圳市所监测的噪声作业员工为77 319人,监测对象听力损失检出率为9.48%,疑似职业性噪声聋检出率0.28%,职业性噪声聋检出率0.17%。男性听力损失、疑似职业性噪声聋和职业性噪声聋检出率均高于女性,差异有统计学意义(P<0.05)。听力损失、疑似职业性噪声聋和职业性噪声聋检出率均有随年龄增长和工龄增长而升高的趋势(P<0.05)。来自不同规模、不同经济类型企业的员工听力损失、疑似职业性噪声聋和职业性噪声聋检出率差异均有统计学意义(P<0.05)。听力损失检出率以大型企业最低,港、澳、台商投资企业的听力损失、疑似职业性噪声聋和职业性噪声聋检出率均较低。不同行业类型企业听力损失异常率、疑似职业病检出率的差异有统计学意义(P<0.05),均以建筑行业噪声作业企业员工最高。[结论]深圳市噪声作业员工职业健康状况不容乐观。亟须加强对中型及以下规模企业、建筑行业等重点企业的专项调查与职业健康风险评估,采取有针对性的预防控制对策,预防职业性听力损失的发生。

上海市某医院进行健康检查职工的电测听结果

目的研究职业性噪声聋诊断相关的听力异常的影响因素,并对疑似职业性噪声聋待确诊者与非疑似者之间的差异进行研究。方法 2016年9月—2017年9月,本研究选取了上海市中冶医院进行职工健康检查的29 144名职工为研究对象,采用χ2检验和二分类logistic回归分析了各因素对职业性噪声聋诊断相关听力异常的影响。结果在29 144名行电测听检查的职工中,高频听损率约13.5%,较好耳语频(500、1 000、2 000 Hz)与高频4 000 Hz听阈加权值异常率约7.9%,达到职业性噪声聋听力异常率约5.3%;男性、饮酒、高血压、接触职业暴露(噪声、粉尘和烟尘)、职业暴露未接触高温、体质指数越大以及年龄越大可能是职业性噪声聋诊断中听力异常的危险因素(P<0.05)。病例对照结果表明,饮酒及年龄较大是发生疑似职业性噪声聋的危险因素(P<0.01)。结论饮酒和年龄较大是职业性噪声聋诊断中听力异常以及疑似职业性噪声聋发生的危险因素,提示应加强职工对噪声的防护,对职工进行健康知识普及并按时进行健康监护。