天津市职业性噪声暴露人群健康状况及其影响因素

目的了解天津市职业性噪声暴露人群健康状况,分析其影响因素,为指导和实施干预措施提供科学依据。方法采用χ~2检验和Logistic回归分析对天津市11 643名职业性噪声暴露人群健康资料及所在288家企业工作场所噪声监测数据进行分析。结果天津市职业性噪声暴露人群高频听力损失检出率33.81%,高血压检出率19.81%,心电图异常检出率12.11%,男性高频听力损失明显高于女性。高噪声暴露组工人高频听力损失检出率、女性工人心电图异常率均高于低暴露组(P0.05);随噪声接触工龄延长,高频听力损失检出率增加(P0.05).Logistic回归结果表明,年龄增加、工龄延长和高噪声暴露均为高频听力损失的独立危险因素(OR1.00,P0.05);高噪声暴露情况下作业工人高频听力损失率增加42.00%(男性)和29.00%(女性),工龄每增加5年作业工人听力损失率增加23.00%(男性)和147.00%(女)。此外,高噪声暴露可增加男性高血压和女性心电图异常的发病风险(OR1.00,P0.05)。结论天津市职业性噪声暴露人群高频听力损失较为严重,高噪声暴露是高频听力损失、男性高血压发病和女性心电图异常的危险因素,应当引起重视,采取积极措施,预防疾病的发生。     

噪声与甲苯、二甲苯联合暴露作业人员听力损失特征及其影响因素

目的 探索噪声与甲苯、二甲苯联合暴露导致的作业人员听力损失特征及其影响因素，为制定有针对性的防控策略与措施提供科学依据。方法 选择石油加工业、化学制品制造业、印刷业各1家大型企业，将2020—2021年作业人员分为噪声与甲苯、二甲苯联合暴露组（以下简称“联合暴露组”）和单纯噪声暴露组（以下简称“噪声组”）；两组均开展职业健康体检、问卷调查及作业岗位甲苯、二甲苯及噪声危害因素检测，共计纳入研究对象1 144名。使用EpiData 3.1软件录入问卷，使用R 3.6.1软件包进行χ2检验、t检验，Logistic回归分析研究对象听力损失特征和影响因素。结果 1 144名研究对象中，检出高频听力损失236人，听力损失总检出率为20.63%，联合暴露组高频听力损失率高于噪声组（P<0.05），高频听力损失者接噪工龄［（10.87±6.32）年］短于噪声组［（13.16±8.42）年］（P<0.05）。现场监测显示，联合暴露岗位噪声声级水平和甲苯、二甲苯浓度水平均未超过国家职业接触限值。多因素Logistic回归分析显示，工龄、吸烟、经常使用耳机、高血压、高血糖、高胆固醇血症、低密度脂蛋白胆固醇浓度升高以及甲苯、二甲苯暴露为噪声作业人员高频听力损失的危险因素（P<0.05），文化程度高、A和AB血型（较O型）、高密度脂蛋白胆固醇浓度升高为噪声作业人员高频听力损害的保护因素（P<0.05）。结论 噪声作业人员高频听力损失是多种影响因素共同作用的结果，在制定相应防控措施和工作场所职业病危害因素接触限值时应考虑此类因素的协同作用。     

噪声习服对听觉系统保护作用的研究进展

根据等能量假说 ,噪声引起的听力损失程度与接受的刺激声音强度和持续时间成正比。但是 ,近年来的研究结果却与此假说产生分歧 ,研究表明在特定暴露条件下的听力损失中 ,部分是由受试对象以前的噪声暴露史决定的 ,噪声的暴露史可能是决定噪声性听力损伤易感性的一个因素 ,它可以使机体逐渐适应 ,从而提高机体对噪声的耐受性。在一定强度的同一噪声中重复暴露 ,随着暴露的继续 ,每天的暂时性听阈位移 (ｔｅｍｐｏ ｒａｒｙｔｈｒｅｓｈｏｌｄｓｈｉｆｔ ,ＴＴＳ)逐渐减小 ,这种现象被称为“习服”(ｃｏｎｄｉ ｔｉｏｎｉｎｇ)。而且 ,观察组 …     

苯系物与噪声联合暴露对听力影响的Meta分析

噪声主要对听觉系统有特异的损伤作用,且在我国也开展了大量关于噪声对工人听力影响的流行病学调查研究.在许多工作场所,噪声不是唯一的职业病危害因素,噪声与其他职业病危害因素往往同时存在,其中单独苯系物暴露或与噪声相互作用造成职业性听力损失越来越引起大家的关注,但是,不同研究所得出的结论受时间、地区、研究的样本量等因素的限制,误差较大.因此,本文中我们收集1990至2011年关于苯系物与噪声联合暴露对听力影响的文献进行Meta分析,以探讨苯系物是否可加重噪声对听力的影响,为今后苯系物噪声联合暴露状况下劳动者听力保护研究提供依据.     

噪声所致工人听力损失与高血压的关系

目的研究某钢铁企业工人噪声暴露与高血压的关系。方法选择2014年1~7月底参加职业体检单纯接触噪声工人2061例,按照高频听力损失严重程度分组,即在4000 Hz或者6000 Hz,低听力损失组平均听力损失值(HLVs)15 d B(A)660例,噪声40 h等效声级为(74.69±11.97)d B(A);中听力损失组,15 d B(A)≤HLVs30 d B(A)741例,噪声40 h等效声级为(84.38±11.57)d B(A);高听力损失组,HLVs≥30 d B(A)660例,噪声40 h等效声级为(88.03±14.08)d B(A)。比较三组高血压患病率的差异。结果工人4000 Hz和6000 Hz时,左、右和两耳平均的HLVs值与平均噪声暴露水平显著相关(P0.05)。高血压患病率中听力损失组(29.5%)和高听力损失组(36.1%)明显高于低听力损失组(23.8%)(P0.05)。多因素Logistic回归分析显示,在调整了年龄、心率(HR)、甘油三酯(TG)、噪声40 h等效声级、糖尿病、吸烟、饮酒、体育锻炼等影响因素后,中听力损失组和高听力损失组患高血压的风险较高,其OR值分别为2.14(1.21~3.79)、2.58(1.44~4.62)。结论钢铁企业工人高频噪声引起的听力损失与患高血压的风险有关。     

噪声所致听力损失与高血压相关性的队列研究

目的 研究噪声对高血压发生发展的影响.方法 采用噪声所致听力损失作为研究对象接触噪声的特异性暴露指标,对有或无高频听力损失者间高血压发生率的差异进行卡方检验,再利用非条件logistic回归对影响高血压的因素进行筛选.结果 研究对象以男性为主,占92.8％,年龄为(43.14±7.47)岁,工龄为(10.73±2.56...     

高血糖水平与工业噪声致听力损失的研究进展

糖尿病可引起微血管病变和周围神经病变, 从而引起糖尿病性听力损失。工业噪声则是通过早期的机械性损伤和继发性的组织改变、自由基生产过多、噪声性耳蜗免疫炎症反应等原因引起噪声性听力损失。两种听力损失同为感音神经性听力损失, 以高频听力损失为主要表现, 病变部位在耳蜗。国内外研究表明两种危害因素对听力的影响可能存在一定协同作用。因此, 从糖尿病与听力损失、噪声与听力损失、噪声与血糖升高致听力损失关联性研究三个角度, 对高血糖水平和噪声的关联性研究进行综述。     

江苏省某发电厂接噪作业工人噪声听力损失分析及影响因素

目的 了解某发电厂接噪作业工人听力损失情况并探讨其影响因素.方法 以2019年江苏某发电厂涉及噪声工作的作业工人作为研究对象,进行职业健康检查及问卷调查,分析其听力损失情况及相关因素.结果 纳入研究的833名噪声作业工人中,高频听力损失率为35.89％,多因素logistic回归分析显示,性别(OR=0.526,95％ CI:0.326～0.848)、年龄(OR=1.418,95％ CI:1.091～1.842)、血压(OR =1.096,95％CI:0.757～1.588)和血型(与O型血比较,AB型,OR=0.431,95％CI:0.226～0.823)是影响作业工人听力损失的因素(P值均＜0.05).结论 该厂存在作业工人噪声听力损伤,性别、年龄、高血压、血型与噪声听力损失存在相关性.     

秦皇岛地区噪声作业人员听力状况及其影响因素

目的调查秦皇岛地区噪声暴露下作业人员听力状况,分析其影响因素。方法选取2016年9月—2017年5月在秦皇岛市疾病预防控制中心进行职业健康检查的秦皇岛地区9家企业中合计914名噪声作业人员,根据GBZ 188-2014《职业健康监护技术规范》中相关规范与要求确定检查项目,对作业人员进行纯音听阈检测,采集相关人员基本信息,对检测数据及信息资料进行χ~2检验和logistic回归分析。结果经健康检查发现,噪声暴露下存在听力损失的作业人员有266例,总检出率为29.10%;工龄1～5、6～10和10年作业人员听力损失检出率分别为21.63%、31.94%和35.93%,组间比较差异具有统计学意义(P0.05);听力损失检出率受年龄、性别、婚姻状况、是否采用防护措施、工龄、外伤、噪声状态及噪声是否超标8个因素的影响,将8个因素进行赋值后采用多因素logistic回归分析发现,工龄6～10和10年、噪声指标超标是听力损失发生的危险因素(P0.05),而防护措施则是听力损失发生的保护性因素(P0.05)。结论秦皇岛地区噪声暴露下作业人员听力损失发生率较高,相关影响因素中工龄6～10和10年、噪声指标超标是听力损失发生的危险因素,而防护措施则是听力损失发生的保护性因素,应强化企业噪声监管工作,重视健康检查,加强作业人员的防护措施与质量。     

噪声暴露人员听力损失风险评估分析

目的 分析噪声暴露人员听力损失的相关因素,为制定噪声性听力损失预防措施提供参考。方法 选择本市某橡胶塑料模具厂、某机械设备生产厂、某汽车制造厂共231名接触噪声超过1 a的工人作为研究对象。按照WS/T 69-1996《作业场所噪声测量规范》对噪声场所进行噪声强度测量,计算累积噪声暴露量（CNE）;按照GB/T 7582-2004《声学听阈与年龄关系的统计分布》要求进行纯音气导听阈测试,判断被调查人员是否存在听力损失。自制问卷,调查对象的年龄、CNE、噪声相关知识培训、文化程度、接噪工龄、噪声防护设备使用情况、家族性耳聋史、毒性药物史、吸烟史等情况。先后行单因素及多因素回归分析,筛查影响职业噪声暴露人员听力损失的相关因素。结果 被调查对象工作场所噪声强度为68.0～105.4 dB（A）,8 h等效声级(L_EX.8h)为80.1～95.4 dB（A）,CNE为80.2～112.3 dB（A）;231名工人中发生听力损失者共83名;多因素logistic回归分析结果提示,年龄≥40岁、接噪工龄≥3 a、家族性耳聋史以及吸烟是听力损失的独立危险因素,而噪声相关知识培训...     

Arterial hypertension among oil-drilling workers exposed to noise]

A cross-sectional study with a retrospective component was conducted to evaluate occupational noise exposure as a potential risk factor for arterial hypertension among 775 workers from an oil-drilling industry. Hypertension was defined as >/= 140/90mmHg. Occupational noise exposure was measured as: (1) exposure to sound pressure levels >/= 85dbA for 10 years or more and (2) moderate-to-severe noise-induced hearing loss (NIHL). The effects of age, education, shift work, and obesity were evaluated by stratification and logistic regression analysis. A positive association between occupational noise exposure and hypertension was found, using both the level/duration of noise exposure (RP = 1.8; 95% CI: 1.3-2.4) and NIHL (RP = 1.5; 95% CI: 1.1-2.0) as exposure indicators. Considering the study limits, long-term occupational noise exposure thus appears to be a risk factor for arterial hypertension.     

Relationship between styrene exposure and hearing loss: review of human studies

Styrene is an aromatic solvent belonging to the alkylbenzene family. Occupational exposure to styrene occurs mainly in the manufacturing of fiberglass-reinforced polyester products, e.g. reinforced plastics and composites. Since 1988, nine studies have been published on the relationship between occupational exposure to styrene and hearing loss. All studies were the cross-sectional epidemiological studies or clinical studies from occupational health clinics. A total of more than 1000 workers exposed to styrene, both with and without concurrent noise exposure, were examined using different outcome measures for hearing loss. Exposure assessment was usually based on styrene measurements in the breathing zone during several hours of one working day. Some of the studies employed also the biological monitoring of styrene exposure based on determination of its urinary metabolites. The current exposures to styrene varied between 2 and 35 ppm. In some studies, lifetime exposure was calculated using company records and questionnaire data. The current exposure to noise was estimated by noise dosimetry or standard noise measurements. Lifetime noise exposure was assessed using questionnaire data and occupational noise estimates. In many studies, noise-exposed groups were used as controls together with the unexposed workers. Of the nine studies, seven show some effects on the auditory system that were associated with styrene-alone exposure. These effects are examined using different outcome measures such as pure tone audiometry, high frequency hearing loss, and central hearing tests. In some studies, an increased risk for hearing loss was associated with exposure estimates.     

某电解铝企业综合车间噪声暴露作业人员连续3年听力损伤调查

目的了解某电解铝企业综合车间噪声作业人员听力损伤的特点,为控制和消除职业性听力损伤的发生提供依据。方法对某电解铝企业综合车间的56个噪声作业点现场噪声强度进行检测,根据作业人员作业性质和暴露时间计算其8h等效连续A声级（LAeq,8h）,并结合该车间103名噪声暴露作业人员连续3年职业健康体检结果,分析其噪声特性和双耳纯音听力损伤的特点。结果103名噪声作业人员按工作性质分为9个生产岗位,高频听力损伤高于语频听力损伤,且LAeq,8h噪声暴露水平高的岗位,听力损伤程度大于噪声暴露水平高低的岗位。这表明噪声暴露水平与听力损伤之间存在剂量-反应关系（r=0.994,P〈0.05）。身处非稳态噪声工作场所中的流动性工作岗位作业人员听力损伤率（85.71%）高于身处稳态噪声工作场所中（即工作位置相对固定）的作业人员听力损伤率（24.72%）。结论非稳态噪声、高频噪声引起的听力损伤比稳态的中、低频噪声引起的听力损伤严重。     

某己内酰胺合成企业噪声暴露致听力损失的风险评估

  目的  对南京市某己内酰胺合成企业生产性噪声进行暴露风险评估和听力损失风险分级,提出噪声职业病危害风险管理措施。
  方法  测量作业人员个体噪声接触水平,依据GBZ/T 229.4—2012《工作场所职业病危害作业分级第4部分:噪声》评估噪声作业等级;运用ISO 1999:2013方法,计算各岗位听阈级变化、听力损失风险,并依据AQ/T 4276—2016《噪声职业病危害风险管理指南》进行风险分级。
  结果  25人噪声检测结果超过80 dB（A）,为噪声作业岗位。硫铵装置、磷酸羟胺法（hyam-phoshate oximation,HPO）老线、HPO新线、己内酰胺（caprolactam,CPL）老线外操工岗位噪声危害作业分级为Ⅰ级,轻度危害;各噪声岗位员工工作到50、60岁时发生高频听力损失风险概率均低于6%,属于可接受的风险。3种护听器正常使用下能够满足噪声的防护要求。
  结论  对生产性噪声职业接触情况及时进行调查与风险评估,根据风险评估结果正确使用护听器,能够有效预防听力损失。
     

Hearing loss associated with smoking and occupational noise exposure in a Japanese metal working company

The effects of smoking on hearing loss within the context of atherosclerosis was assessed, and the statistical interaction of occupational noise evaluated. A cross-sectional study was conducted in 397 Japanese males working at a metal factory, aged 21–66 years, in a periodical health checkup. The following information was obtained: two smoking indices of smoking status and Brinkman index, occupational noise exposures and atherosclerotic risk factors (body mass index, blood pressure, serum cholesterol, hemoglobin A1c, atherosclerosis index). Hearing acuity was measured at 4 kHz using a pure-tone audiometer in a quiet room. Among the total subjects, 55 (13.9%) were identified as having hearing loss at 4 kHz, and 151 (38.0%) were currently exposed to occupational noise. When adjusted for age and occupational noise exposure, odds ratios (95% confidence intervals) of hearing loss were 3.16 (1.04, 9.62) for past smokers and 3.39 (1.05, 11.01) for heavy smokers (Brinkman index >750 cigarettes per day × number of years), compared with never-smokers. Statistical interaction of occupational noise exposure was insignificant with the association between smoking and hearing loss. When including atherosclerotic risk factors in a multiple model, there were no significant associations between hearing loss and either smoking or any other factors (i.e., occupational noise and atherosclerotic factors). Smoking was found to be associated with hearing loss beyond occupational noise exposure, and this association seemed to be masked by atherosclerotic factors, suggesting that the direction of the atherosclerotic effect on the relationship might need to be explored between smoking and hearing impairment.     

The ototoxicity of styrene: a review of occupational investigations

Objectives: The objective of this study was to review critically a number of occupational investigations of the exposure and effect relation between inhaled styrene vapour and hearing loss. There is concern that workers’ hearing may be impaired by exposure to styrene, as used in industries making plastics and fibreglass-reinforced products. Methods: Seven occupational studies, each dealing with the ototoxicity of styrene, were examined. Factors assessed included the experimental design and number of subjects within exposure groups, measurement of the styrene-in-air concentration, confirmation of the styrene exposure by blood or urine analysis, determination of the hearing threshold levels for the exposure and control groups, and measurement of any occupational noise in the subjects’ workplaces. Consideration was also given to statistical relations between high-frequency hearing loss and lifetime exposure indices for styrene and noise. Results: The results are equivocal. Four investigations failed to find any effect of styrene on hearing thresholds. In contrast, other investigations claimed to have demonstrated styrene-induced hearing loss in industrial populations, with synergism between styrene and noise. However, these reports exhibited shortcomings of experimental design and data analysis. Conclusions: Considering the body of evidence as a whole, hearing deficits due to occupational exposure to styrene at low concentrations have not been demonstrated by scientifically reliable argument. There is some suggestion of an association between styrene exposure, occupational noise, and hearing dysfunction. Further studies in humans are necessary to clarify this question.     

2010—2012年某印刷厂噪声作业人员听力损失调查

目的 探讨生产性噪声对印刷厂车间噪声作业工人听力损失的连续性影响,为保护噪声职业接触者身体健康,控制职业病危害因素提供依据。 方法 回顾性分析某印刷厂车间噪声接触人员连续三年的纯音听阈测试结果,结合15个噪声监测点的现场噪声强度,分析连续3年听力损失的动态变化及其影响因素。 结果 随着噪声接触时间的延长,4.0 kHz及6.0 kHz频率听力损失的差异有统计学意义(F=1.333、1.045,P<0.01)。10年及以上工龄组工人听力损失率(46.51%)高于10年以下工龄组(14.48%)。性别、噪声强度、工龄、年龄是听力损失发生的独立危害因素,男性高于女性,85 dB (A)以上的噪声强度下及10年以上工龄者听力损失发生的风险较高,年龄≥ 50岁组发生听力损失的风险较<50岁组高(OR值分别为2.721、2.376、2.044、2.816)。 结论 噪声暴露剂量和听力损失存在一定的剂量-反应关系。     

听力损伤的累积噪声暴露阈值研究

目的根据不同累积噪声暴露量与工人语频听力损伤发生率间的关系,探讨和评价引起职业性听力损失的临界累积噪声暴露阈值.方法应用Logistic回归模型分析1 435名不同累积噪声暴露强度的听阈数据.结果语频损伤和高频损失发生率随暴露水平而增高;累积噪声暴露量与语频损伤发生率的Logistic回归分析显示,听阈水平随累积噪声暴露量增高而上升并有明显相关性;预测模型显示语频损伤的临界累积噪声暴露阈值为100dB(A).结论听力损伤的临界累积噪声暴露阈值100dB(A)与我国现执行的噪声卫生标准具有一致性,可探讨作为对个体职业噪声暴露危害程度警告的阈值指标.