Title:

Exploring risk prediction model of hearing impairment among workers exposed to noise in oil and gas drilling and extraction industry

作者：

王娟¹, 黄磊², 孙敏¹

王娟¹，黄磊²，孙敏¹

Author(s):

WANG Juan*, HUANG Lei, SUN Min

WANG Juan*, HUANG Lei, SUN Min

单位:

1. 四川大学华西公共卫生学院/华西第四医院健康管理中心，四川 成都 610041；
2. 四川大学华西公共卫生学院/华西第四医院职业危害评价科，四川 成都 610041

Unit:

*Health Management Center, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China

关键词:

噪声; 听力损害; 风险模型; 探索

噪声；听力损害；风险模型；探索

Keywords:

Noise; Hearing impairment; Risk model; Exploration

分类号:

R135.8

DOI:

10.20043/j.cnki.MPM.202203212

文献标识码:

A

摘要:

目的 根据某石化企业噪声作业人群听力损害情况，并结合作业现场噪声暴露水平，探索个人听力损害风险模型，用于预测噪声作业人群听力损害风险。方法 采用横断面研究方法，采取随机整群抽样，利用问卷调查某石化企业263名作业工人人口学特征、职业特征、生活方式和听力健康知识信念行为（knowledge attitude practice，KAP），使用MIDMATE622纯音听力计进行纯音听阈测试，并利用个体噪声测量仪进行噪声暴露监测，采用χ2检验、多因素logistic回归分析筛选出听力损害的影响因素，建立风险预测模型。结果 多因素回归分析发现，研究对象噪声损害效应与KAP得分、累积噪声暴露（cumulative noise exposure，CNE）剂量和接噪工龄的OR值分别是0.97（95%CI：0.94～1.00）、2.37（95%CI：1.18～4.76）、2.33（95%CI：1.45～3.74），是引起噪声性听力损害的主要风险因素，基于上述风险因素建立了噪声性听力损害的风险预测模型。结论 企业可根据由KAP得分、CNE剂量和接噪工龄建立的噪声性听力损害风险模型，对噪声作业人群制定针对性的健康管理措施，减少噪声引起的听力损害。

Abstract:

Objective To explore the risk model of individual hearing damage based on the data of hearing damage of workers exposed to noise in a petrochemical enterprise, combined with the noise exposure level at the work site for predicting the risk of hearing damage in workers exposed to noise. Methods A cross-sectional study was conducted to investigate the demographic characteristics, occupational characteristics, lifestyle, and hearing health knowledge attitude practice(KAP) of 263 workers in a petrochemical enterprise. The MIDMATE 622 pure tone audiometer was used to test the pure tone hearing threshold, and the individual noise meter was used to monitor the noise exposure. Chi-square test and multivariate logistic regression analysis were used to select the influencing factors of hearing impairment, so as to establish the risk prediction model. Results Multivariate regression analysis showed that the OR values of noise damage effect and KAP score, cumulative noise exposure (CNE) dose and noise exposure length of service were 0.97 (95%CI: 0.94-1.00), 2.37 (95%CI:1.18-4.76) and 2.33 (95%CI: 1.45-3.74), which were the main risk factors of noise induced hearing impairment. Based on the above risk factors, a risk prediction model of noise induced hearing impairment was established. Conclusion According to the risk model of noise induced hearing impairment established by KAP score, CNE dose and noise exposure length of service, the enterprise can formulate targeted health management measures for noise workers to reduce noise induced hearing impairment.

参考文献
/References:

[ 1 ]施文庆.浅谈钻井作业中的噪声防护[J].石油化工安全环保技术，2009，25（5）：53 - 55.Shi WQ. Noise protection in drilling operation[J]. Petrochemical Safety and Environmental Protection Technology, 2009, 25(5): 53 - 55.
[ 2 ]杨静波.大庆油田钻井工人健康现状及影响因素分析[D].长春：吉林大学，2010.Yang JB. Analyses on the health status and its influencing factors among the drilling workers in Daqing oilfield[D]. Changchun: Jilin University, 2010.
[ 3 ]王慧，时海波.噪声致听觉系统损害的研究进展[J].临床耳鼻咽喉头颈外科杂志，2019，（8）：700 - 703.Wang H, Shi HB. Auditory health effects induced by noise exposure[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery, 2019, (8): 700 - 703.
[ 4 ]李秀婷，曹敬莲，钟丽，等.职业性噪声聋的发病危险因素研究进展[J].环境与职业医学，2015，32（2）：175 - 180.Li XT, Cao JL, Zhong L, et al. Research progress on risk factors of occupational Noise - Induced deafness[J]. Journal of Environmental & Occupational Medicine, 2015, 32(2): 175 - 180.
[ 5 ]徐宏伟.噪声职业病的危害分析与相应预防措施探析[J].中国卫生产业，2019，16（30）：150 - 151.Xu HW. Analysis of the hazards of noise occupational diseases and corresponding preventive measures[J]. China Health Industry, 2019, 16(30): 150 - 151.
[ 6 ]鲍二宝，苏艺伟，薛昌红，等.某汽车制造企业噪声作业工人听力损失影响因素分析[J].职业卫生与应急救援，2019，37（2）：122 - 125.Bao EB, Su YW, Xue CH, et al. Risk factors related to occupational noise - induced hearing loss among workers in an automobile manufacturing enterprise[J]. Occupational Health and Emergency Rescue, 2019, 37(2): 122 - 125.
[ 7 ]Weinstein ND. Individual differences in reactions to noise: A longitudinal study in a college dormitory[J]. Journal of Applied Psychology, 1978, 63(4): 458 - 466.
[ 8 ]丘晓玲，梁灿坤，符传东，等.噪声作业人员听力损失防治知信行问卷的编制[J].职业与健康，2020，36（12）：1590 - 1592, 1598.Qiu XL, Liang CK, Fu CD, et al. Development of questionnaire on knowledge - attitude - practice of prevention and treatment of hearing loss for noise - exposed workers[J]. Occupation and Health, 2020, 36(12): 1590 - 1592, 1598.
[ 9 ]陈祖耀.聚类特征选择方法的研究和应用[D].无锡：江南大学，2009.Chen ZY. The research and Annlication of clustering feature selection methods[D]. Wuxi: Jiangnan University, 2009.
[ 10 ]高婷，吴锡南.某钢铁公司轧钢职工噪声暴露与听力损失的调查[J].中国药物与临床，2010，10（9）：1017 - 1019.Gao T, Wu XN. Investigation of noise exposure and hearing loss among steel rolling workers in a steel company[J]. Chinese Remedies& Clinics, September, 2010, 10(9): 1017 - 1019.
[ 11 ]宋军芬，谯凤英.噪声性听力损失及防范措施[J].职业与健康，2016，32（14）：2009 - 2012.Song JF, Qiao FY. Noise - induced hearing loss and preventive measures[J]. Occupation and Health, 2016, 32(14): 2009 - 2012.
[ 12 ]徐宇虹，边阳甫，叶森德.某发电厂噪声作业工人职业性听力损害情况分析[J].浙江预防医学，2012，24（6）：50 - 51.Xu YH, Bian YF, Ye SD. Analysis of occupational hearing impairment in workers at a power plant in noisy operations[J]. Zhejiang Preventive Medicine, 2012, 24(6): 50 - 51.
[ 13 ]谢红卫，张美辨，全长健.累计噪声暴露量与人听力损失的剂量反应关系研究[J].浙江预防医学，2014，26（4）：340 - 344, 348.Xie HW, Zhang MB, Quan CJ. A study on dose - response relationship between cumulative noise exposure and human hearing loss[J]. Zhejiang Journal of Preventive Medicine, 2014, 26(4): 340 - 344, 348.
[ 14 ]张望珍，顾缨缨，林海，等.武汉市某钢铁公司冷轧和条材厂噪声作业工人听力检查结果[J].职业与健康，2014，30（4）：451 - 453.Zhang WZ, Gu YY, Lin H, et al. Hearing test results of workers exposed to noise in the cold strip rolling mill of a steel enterprise in Wuhan City[J]. Occupation and Health, 2014, 30(4): 451 - 453.
[ 15 ]刘芳军，王改仙，张玉润.企业职工职业病防治知识知晓率调查[J].中国健康教育，2005，21（5）：384 - 386.Liu FJ, Wang GX, Zhang YR. Survey on knowledge about occupational disease prevention among workers in enterprises[J]. Chinese Journal of Health Education, 2005, 21(5): 384 - 386.
[ 16 ]吕建华，汤冬梅，戴春生，等.北京市大兴区部分企业员工职业病防治知识知晓情况调查[J].职业与健康，2007，23（7）：495 - 497.Lv JH, Shang DM, Dai CS, et al. Investigation of the witting rate of the occupational disease prevention and treatment among the enterprise staff in Daxing district of Beijing[J]. Occupation and Health, 2007, 23(7): 495 - 497.
[ 17 ]朱令兴，赵鹏.工人的防护意识在预防噪声危害中的作用[J].中国工业医学杂志，2001，14（4）：254 - 255.Zhu LX, Zhao P. The effect of workers’ self - protection consciousness on prevention of noise hazard[J]. Chinese Journal of Industrial Medicine, 2001, 14(4): 254 - 255.
[ 18 ]陈利杰.瓶装饮料灌装噪声暴露与作业工人高频听力损失的关系[J].中华劳动卫生职业病杂志，2017，35（4）：286 - 288.Chen LJ. The relationship between bottled beverage filling noise exposure and high - frequency hearing loss in operational workers[J]. Chinese Journal of Industrial Hygiene and Occupational Diseases, 2017, 35(4): 286 - 288.
[ 19 ]彭丽华，郑建如，徐增光.累积噪声暴露量与听力损害的剂量反应关系[J].公共卫生与预防医学，2005，16（1）：58 - 59.Peng LH, Zheng JR, Xu ZG. Dose - response relationship between cumulative noise exposure and hearing damage[J]. Journal of Public Health and Preventive Medicine, 2005, 16(1): 58 - 59.
[ 20 ]郑文慧，王志平，柴鹏飞，等.接触非稳态噪声与听力损伤的剂量 - 反应关系研究[J].工业卫生与职业病，2013，（1）：36 - 39.Zheng WH, Wang ZP, Chai PF, et al. Dose - response relationship of the unsteady noise exposure and hearing loss[J]. Industrial Health and Occupational Diseases, 2013, (1): 36 - 39.

备注/Memo:

作者简介：王娟（1985－），女，硕士，主治医师，研究方向：职业健康
通信作者：黄磊，E-mail：hlst0610@163com