冲床噪声与稳态噪声致工人高频听力损害的对比研究

目的 了解冲床噪声对工人高频率段听力的影响,并与稳态噪声进行对比.方法 接触冲床噪声的38名锻压车间工人为冲床噪声接触组,62名接触稳态噪声的拉丝、磨粉等工人为稳态噪声组.用个人声暴露计采集工作期间噪声暴露数据,计算40h等效声级(LEX,W)和累积噪声暴露量(CNE).按GBZ 49-2007《职业性噪声聋诊断标准》对工人测试听力并计算和判定结果.结果 冲床噪声接触组CNE[(97.0±6.4) dB (A)·年]与稳态噪声接触组CNE [(97.6±5.7)dB(A)·年]比较,差异无统计学意义(P＞0.05).冲床噪声接触组高频听力损失率(55.3％)明显高于稳态噪声(32.3％),差异有统计学意义(CMHX2=6.928,P=0.0085);冲床噪声接触组于CNE 95～104 dB(A)·年内损失率(13/19,68.4％)明显高于稳态噪声组( 13/37,35.1％),差异有统计学意义(P=0.018).logistic回归模型显示,冲床噪声组、稳态噪声组CNE与高频听力损失率均呈剂量-反应关系(P＜0.01).结论 应用个体噪声暴露数据计算时,在能量相同的情况下,冲床噪声所致高频听力损失的危害大于稳态噪声.     

某城市中小企业职业性噪声聋与累积噪声暴露剂量的相关性研究

目的分析累积噪声暴露剂量(CNE)与职业性噪声聋的发生及发展规律的关系。方法对作业环境噪声进行监测,对调查对象进行纯音听阈测定;进行相关指标分析并计算CNE。结果听阈提高与基础听阈相关(P<0.01);当CNE由(96.9±5.9)dB(A)年提高到(102.1±3.4)dB(A)年时,语频损失与高频损失的发生率分别由8.4%和7.3%上升到21.1%;职业性噪声聋的发生率及严重程度与CNE相关,并以100dB(A)年为阈值;各频率听阈特别是高频听阈提高且具统计学意义(P<0.01)。结论早期发现听阈异常特别是早期高频听阈改变者,控制职业噪声暴露者CNE;并按规定调离噪声作业。     

某钢管制造企业生产性噪声危害调查

目的调查某钢管制造企业劳动者噪声暴露及听力损失情况,探讨该行业作业场所噪声特点、危害及防护措施。方法选择某钢管生产车间106名工人进行8 h个体噪声暴露测量和纯音听力测试。结果高频听力损失率28.30%;同一车间不同岗位间LAeq.8h差异无统计学意义(P0.05);高频听力损失发生率与吸烟、累计噪声暴露量(CNE)以及高频焊接工种有关。结论钢管制造行业噪声呈非稳态形式;采用CNE衡量作业人员的噪声暴露更合理;合理的设备和岗位布局可降低生产性噪声。     

某汽车座椅制造企业噪声暴露水平调查及听力损失风险评估

目的 分析某汽车作业制造企业噪声暴露水平和劳动者听力损失情况，评估噪声所致听力损失的风险。方法 对某汽车座椅制造企业开展现场调查，以548名工人作为研究对象，开展纯音听阈测试和个体噪声检测（LEX,8 h），计算累积噪声暴露量（cumulative noise exposure,CNE），分析不同工种、工龄和CNE工人的听力损失差异，并应用《噪声职业病危害风险管理指南》计算各岗位在接噪工龄20～40年的听阈变化及噪声致听力损失风险。结果 2022年9—12月，548名工人年龄中位数39岁，接噪工龄中位数15年，36.6%的工作岗位噪声8 h等效声级超过85 dB(A)，平均为86.1 dB(A)，平均CNE为96.6 dB(A)·年。检出高频听力损失51例（检出率9.31%）；高频合并语频听力损失15例（检出率2.74%）；听力损失总检出率为12.05%。听力损失检出率随工人接噪工龄的增加呈现上升趋势（P <0.01），工龄> 15年的工人听力损失检出率最高。随着CNE的增加，听力损失的比例也逐步增加（P <0.05）,CNE> 100 dB(A)·年组的听力损...     

非稳态噪声累积暴露量与听力损失的关系

[目的]分析基于个体噪声8 h等效连续A声级(LAeq.8h)(暴露水平)的累积噪声暴露量(cumulation noise exposure,CNELAeq.8h)与非稳态噪声所致听力损失的关系,探讨CNELAeq.8h能否有效评估非稳态噪声接触水平。[方法]选择轧钢厂和钢结构厂98名接触非稳态噪声工人为研究对象。采用个人声暴露计测量工人LAeq.8h,并与接触噪声工龄合并计算CNELAeq.8h,同时对工人进行问卷调查和听力测试。[结果]经噪声分层分析和趋势卡方检验,高频听力损失检出率随CNELAeq.8h的增加而升高;经logistic回归分析,CNELAeq.8h是工人高频听力损失和语频听力损失的危险因素,OR值分别为1.261和1.109(P<0.01)。CNELAeq.8h、LAeq.8h、工龄、高频、语频听力程度之间均呈明显相关(P<0.01);经多因素回归分析,CNELAeq.8h进入高频听力损失的多因素回归模型(P<0.01)。[结论]CNELAeq.8h与工人高频听力损失呈良好剂量-效应关系,能有效评估非稳态噪声接触水平。     

水力发电工人职业性噪声聋与累积噪声暴露剂量的关系

目的 分析职业性噪声聋的发生、发展规律及与累积噪声暴露剂量(CNE)的关系.方法 对调查对象进行纯音听阈测定,对作业环境噪声进行监测;计算CNE并进行相关指标分析.结果 当CNE由(97.5±5.4)dB(A)年提高到(102.4±2.9)dB(A)年时,语频损伤及高频损失的发生率分别由4.6%和11.5%上升到10....     

接触非稳态噪声与听力损伤的剂量-反应关系研究

目的为评价接触非稳态噪声与听力损伤的剂量-反应关系和探索非稳态噪声接触剂量的描述指标提供科学依据。方法通过问卷调查收集调查对象的基本信息,用个人噪声剂量计记录噪声接触水平,并对调查对象进行纯音听力测试。结果204名机械作业工人接触噪声符合非稳态特征,LAeq.8h为80.6～112.3dB(A);语频听力损伤患病率为17.2%,高频听力损伤患病率为59.3%。接触非稳态噪声与高频、语频听力损伤患病率均呈现剂量-反应关系(趋势卡方检验P<0.01)。Logistic回归分析显示,SLAeq.2s、RLAeq.2s、四分位数间距LAeq.2s与高频损伤,SLAeq.2s指标存在统计学关联(P<0.01),而RLAeq.2s、四分位数间距LAeq.2s与高频听力损伤无关联(P>0.01)。结论接触非稳态噪声较稳态噪声对语频听力损伤更为敏感;累计噪声接触量指标同样适用于非稳态噪声,用于评价噪声接触、预测听力损伤水平;今后研究中可以尝试采用SLAeq.2s作为描述不同性质的非稳态噪声波动性指标。     

机场地勤人员噪声暴露与高血压患病率的剂量-反应关系

目的探讨机场地勤人员噪声暴露与高血压患病率之间的关系。方法以某机场长期接触噪声的463名地勤人员为研究对象,将其工作内容和工作性质相似的分为一组,每组抽取3~5人用噪声个体计量仪测量等效A声级(LAeq),按等能量原理将LAeq和噪声作业工龄合并计算累积噪声暴露量(CNE)。高血压判定按WHO/ISH(1999)标准:收缩压≥140 mm Hg(18.6 kPa)和/或舒张压≥90 mm Hg(12.0 kPa)者为高血压,已确诊高血压并服降压药者均按高血压统计。结果机场地勤人员8 h等效声级LAeq.8h为(89.3±4.0)dB(A),97%地勤人员的LAeq.8h高于85 dB(A)。体检发现高血压患者91人,高血压患病率19.7%。单因素分析表明工龄、年龄、体重指数(BMI)以及父母高血压史均与高血压患病率呈正相关关系(P<0.05),CNE与高血压患病率之间存在典型的剂量-反应关系(P<0.01)。多元Logistic回归显示,年龄(OR=1.062)、BMI(OR=1.280)、父母高血压史(OR=1.945)是高血压患病的独立危险因素,CNE的OR值为1.040(P=0.197)。结论CNE与高血压患病率之间存在典型的剂量-反应关系,调整混杂因素影响后CNE每增加1 dB(A)地勤人员高血压发病的危险增加约4%,但差异尚无统计学意义。     

噪声暴露水平对SOD2单核苷酸多态性与噪声性高频听力损失易感性关联性的影响

目的探讨噪声暴露强度和累积噪声暴露量(cumulative noise exposure,CNE)对SOD2靶向定位序列rs4880单核苷酸多态性(single nucleotide polymorphisms,SNPs)与噪声性高频听力损失易感性关联的影响。方法利用病例对照研究,通过比较同一噪声暴露强度作业人员的左耳3 000 Hz频段听阈位移情况,筛选出听阈位移最大的10%个体作为本研究的易感人群组,共201例,听阈位移最小的10%个体作为耐受人群组,共202例,并进行相关的职业卫生调查和问卷调查。噪声暴露强度的检测根据《工作场所物理因素测量噪声》(GBZ/T189.8—2007),抽取易感人群和耐受人群空腹外周静脉血5 ml用于常规方法抽提基因组DNA,TaqMan探针法化学荧光等位基因鉴别试验检测SNP。结果在噪声暴露强度85～92 dB(A)组以及>92 dB(A)组,SOD2基因rs4880 SNP与噪声性高频听力损失的患病风险有关,携带CC+CT基因型与TT基因型相比OR值分别为2.38(1.27,4.46)和3.67(1.10,12.30)。CNE分层分析发现,CNE位于82～92dB(A)组时,SOD2基因rs4880 SNP与噪声性高频听力损失的患病风险有关,携带CC+CT基因型与TT基因型相比,患噪声性高频听力损失的风险更高,OR值为2.59,95%CI为(1.14,5.90)。结论噪声暴露水平可影响SOD2靶向定位序列rs4880单核苷酸多态性与噪声性高频听力损失易感性的关联。     

听力对噪声的易感性在噪声所致高血压中的作用

目的　探讨听力对噪声易感者是否在长期噪声暴露后易患高血压。方法　以 15 93名化肥厂生产工人为研究对象 ,按常规方法收集噪声暴露、听力和血压资料。根据等能量原理将工人的噪声暴露水平和暴露时间合并为累积噪声暴露量 (CNE)。按ISO1999:1990附录A提供的数据对工人的听阈作年龄、性别校正 ,以双耳 3、4、6kHz的校正听阈的平均值为平均高频听阈。以CNE为自变量、平均高频听阈为应变量建立线性回归模型 ,计算高频平均听阈值与线性模型预测值的差值 ,绘制个体易感性分布图。结果　在 15 93名工人中有高血压 193人 ,高血压患病率 12 .1%。高血压患病率随CNE增大而升高 ,差异有显著性 (P <0 .0 1)。个体听力对噪声暴露的易感性为左偏态单峰分布 ,差值范围在- 2 9.8～ 6 4 .8dB之间 ,峰值在 - 5～ 0dB ,中位数为 - 1.8dB。将个体易感性由低至高分组 ,高血压患病率分别为 7.8%、9.0 %、13.3%、18.4 % ,经趋势 χ2 检验 ,差异有显著性 (P <0 .0 1)。多元Logistic回归模型校正了年龄、性别等混杂因素影响后 ,可以观察到CNE的OR值为 1.0 2 5 ,P =0 .0 2 3;在模型中加入个体易感性项目后 ,CNE的OR值为 1.0 31,P =0 .0 0 7,个体易感性高于 5 0 %组的OR值为 1.4 5 4 ,P =0 .0 35。前进法观察OR值发现 ,个体易感性     

两种测量方法评价稳态噪声暴露与高频听力损伤的剂量-反应关系

目的 比较环境噪声水平、个体噪声暴露和累积噪声暴露量评价稳 态噪声所致听力损伤剂量－反应关系的优劣。方法 用个体计量仪采集8小时工作期间挡车工的噪声暴露数据,并将数据传输至微机存储和分析。选择细砂、布机车间使用不同类型机器的4组工人作为观察对象,每组选择3－5人,分别在早、中、晚班各测量1个班次的个体噪声暴露数据;用网格法和普通声级计测量每组工人工作环境的噪声水平,同时对该纺织厂接触稳态噪声的163名工人进行了问卷和听力检查。结果 经年龄、性别校正后的高频听力损伤患病率为64．4％;语频听力损伤患病率为2．5％,其中高频听力损伤患病率随噪声暴露的剂量增大而升高,呈现典型的剂量－反应关系。经趋势卡方检验和和Logistic回归模型拟合,累积噪声暴露量评价剂量－反应关系的效果优于噪声级,个体噪声暴露的效果优于环境噪声水平。结论 个体噪声暴露和累积噪声暴露量是评价稳态噪声暴露与高频听力损伤剂量－反应关系最好的暴露评价指标。     

脉冲与稳态噪声引起工人听力损伤的差异

对接触脉冲噪声和稳态噪声的７７１名工人调查发现，年龄性别校正后的高频听力损伤患病率为６０．４％、语频为５．４％。听力损伤患病率随噪声暴露的剂量增大而升高，有剂量—反应关系。接触脉冲噪声工人的高频听力损伤患病率（６２．４％，３４５／５５３）高于稳态噪声（５５．５％，１２１／２１８），但无显著差异；而语频听力损伤患病率（６．７％，３７／５５３）明显高于稳态噪声（２．３％，５／２１８）。脉冲噪声引起的听力损伤曲线出现左移，表明它对听觉系统的危险性高于稳态噪声。     

深圳龙岗区职业性噪声与听力损失的流行病学研究

目的 对调查深圳市龙岗区噪声企业工人听力损失的评价指标进行探讨。方法 采用横断面流行病学调查方法，对深圳市龙岗区6家企业的稳态噪声作业环境进行调查，对386名接触噪声人员进行职业卫生学调查和听力测定，听力测定参照《职业性听力损伤诊断标准》（GBZ49—2002），并计算累积噪声暴露量（CNE）。结果 386名噪声作业人员高频听力损伤发生率为74．09％，语频听力损伤发生率为50．52％；随CNE增加，听力损伤发生率有增高趋势（P〈0．05）；Logistic回归分析表明，高频、语频听损发生率与CNE呈显著相关，而与工龄的相关性不明显。结论 在特区经济模式下CNE作为听力健康的评价指标比工龄史敏感。     

Hearing loss in workers exposed to toluene and noise

In this study we investigated the risk of hearing loss among workers exposed to both toluene and noise. We recruited 58 workers at an adhesive materials manufacturing plant who were exposured to both toluene and noise [78.6-87.1 A-weighted decibels; dB(A)], 58 workers exposed to noise only [83.5-90.1 dB(A)], and 58 administrative clerks [67.9-72.6 dB(A)] at the same company. We interviewed participants to obtain sociodemographic and employment information and performed physical examinations, including pure-tone audiometry tests between 0.5 and 6 kHz. A contracted laboratory certified by the Council of Labor in Taiwan conducted on-site toluene and noise exposure measurements. The prevalence of hearing loss of >or=25 dB in the toluene plus noise group (86.2%) was much greater than that in the noise-only group (44.8%) and the administrative clerks (5.0%) (p<0.001). The prevalence rates were 67.2, 32.8, and 8.3% (p<0.001), respectively, when 0.5 kHz was excluded from the estimation. Multivariate logistic regression analysis showed that the toluene plus noise group had an estimated risk for hearing loss>or=25 dB, 10.9 times higher than that of the noise-only group. The risk ratio dropped to 5.8 when 0.5 kHz was excluded from the risk estimation. Hearing impairment was greater for the pure-tone frequency of 1 kHz than for that of 2 kHz. However, the mean hearing threshold was the poorest for 6 kHz, and the least effect was observed for 2 kHz. Our results suggest that toluene exacerbates hearing loss in a noisy environment, with the main impact on the lower frequencies.     

广州市部分企业噪声作业工人听力损失现况分析

目的对广州市部分企业噪声作业工人听力损失现况进行分析,以达到保护工人听力的目的。方法以部分企业长期接触噪声的440名工人为研究对象,测量等效A声级(LAeq)。按等能量原则将LAeq和噪声作业工龄合并计算累积噪声暴露量(CNE);用logistic回归模型分析听力损失的相关因素。结果作业环境噪声强度超标率为41.20%,噪声强度均值为(89.30±4.57)dB(A)。440例噪声作业工人听力损失检出率为23.86%,听力损失与耳塞防护、工龄、年龄和CNE存在正相关关系(P0.05)。非条件logistic回归分析结果显示,年龄、工龄可能是听力损失的危险因素(偏回归系数为正值,OR值1)。结论在有佩戴耳塞防护的情况下,CNE作为听力损失的评价指标不敏感,佩戴耳塞仍是目前最好的防护措施。     

瓶装饮料制造企业工人噪声暴露及高频听力损失关系分析

目的 调查珠三角某市瓶装饮料制造企业生产线工人噪声暴露情况，分析高频听力损失的影响因素。方法 选择该市7家瓶装饮料制造企业中接噪工龄≥1年的569名工人为研究对象，调查工人的噪声暴露情况、累积噪声暴露量（cumulative noise exposure,CNE）和高频听力损失（high-frequency hearing loss,HFHL）检出情况，用二元logistic回归模型分析不同个体特征和职业特征对接噪工人HFHL的影响。结果 该市瓶装饮料制造企业生产线噪声声级为72.3～96.7 dB(A),38.49%岗位噪声水平超过国家职业卫生标准限值，工人HFHL双耳高频听力损失为109人，检出率为19.16%，高频听力损失组工人（n=109）的接噪声级、CNE、接噪工龄、年龄均高于听力正常组（n=460）(P <0.01)。存在噪声危害的岗位主要有包装岗位、灌装岗位、配料投料岗位、吹瓶岗位，灌装岗位、吹瓶岗位工人的接噪声级、累积噪声暴露量（CNE）均高于其他岗位工人（P <0.05）。logistic回归分析结果显示：年龄每增加1岁、CNE每增加1 dB(A)·年，工...     

The accuracy of self-reported high noise exposure level and hearing loss in a working population in Eastern Saudi Arabia

Objective: To determine the accuracy of questions in identifying subjects occupationally exposed to high noise level and those with hearing loss using noise dosimeter and pure-tone air conduction audiometry as the gold standards.Design: A cross-sectional study involving 259 noise-exposed workers selected randomly from two factories in Eastern Saudi Arabia. Personal noise exposure was determined using a noise dosimeter. The hearing impairment for each subject was assessed using otoscopic examination and audiometry. Each subject completed a comprehensive questionnaire including questions about noise exposure and hearing loss.Results: Eighty five percent of the total workers reported exposure to high noise level, compared to 76% found to be exposed to a high noise level defined as more than 85dB (A) as determined by noise dosimeter. The prevalence of audiometric hearing loss (threshold average of 25dB HL or more in any ear) was 32.4% for the low frequency average (0.5, 1 and 2kHz), 47.9% for the all frequency average (0.5, 1, 2. 4 and 8kHz) and 65.6% for the high frequency average (4 and 8kHz). However, the percentage of the subjects who reported hearing loss ranged between 3.9% and 85.3% depending on the question used as indicator of hearing loss.The question “Do you consider the noise level where you are working now high?” was the most sensitive in correctly identifying subjects exposed to a noise level of more than 85dB (A) (sensitivity=93.4%) and subjects with hearing loss (sensitivity>86%) compared with other questions evaluated. However, it overestimated the prevalence rate determined by audiometryConclusion: We conclude that in industries where facilities for an objective assessment of noise exposure and hearing loss are not available, questions addressing noise exposure and hearing loss might be a useful alternative means for screening subjects exposed to high noise level and those with hearing loss for the purpose of designing and implementing hearing conservation program.     

噪声作业对生产工人听力影响的调查与分析

本文对1083 名稳态噪声作业、135名脉冲噪声作业及467 名非噪声作业职工进行了听力检查,结果表明: 稳态噪声、脉冲噪声作业职工听力损伤发生率分别是47.8% 、65.9% , 听损检出率显著高于对照组 (8.1% ), P< 0.01; 脉冲组听损检出率显著高于稳态组(P< 0.01)。听力损伤检出率随噪声暴露水平、累积噪声暴露量及接噪工龄的增长而增高, 均表现为正相关关系 (r= 0.9211～0.9874, P< 0.05), 呈明显的剂量反应关系     

Air blast circuit breaker noise and hearing loss: a multifactorial model for risk assessment

The assessment of the risk to hearing from impulse noise exposure may be a problem for the occupational physician because existing legislative and international noise exposure standards deal primarily with continuous noise, and are not valid in excess of the peak exposure limit of 200 pa (140 dB). Noise exposure in excess of this level, for example that due to firearms, is frequently perceived as harmful, but this is not necessarily the case, as impulse noise standards do, in fact, allow exposure with a maximum in the order of 6.3 kPa (170 dB). To illustrate this, a cross-sectional group of electrical transmission workers have been studied who were exposed to significant levels of impulse noise from air blast circuit breakers and firearms. Important hearing loss factors have been identified by means of a specially designed questionnaire. Using the Health & Safety Executive definition, the risk of hearing loss was determined by calculating prevalence odds ratios (ORs) for exposure to these factors. The OR for those with fewer than eight unprotected air blast circuit breaker exposures was 2.27 (95% confidence interval (CI), 1.01-5.08), whilst for those with more than eight exposures the OR was 2.10 (95% CI, 0.97-4.54). For firearm exposure, ORs of 1.61 (95% CI, 0.95-2.74) were noted in the medium exposure group and 2.05 (95% CI, 1.08-3.86) in the high exposure group. When all the factors were included in the model, the most significant factor was age. The study gives support to the impulse noise exposure criteria, confirming the borderline risk from air blast circuit breaker noise exposure and the relative safety of moderate gunfire exposure.     

Hearing loss in workers exposed to carbon disulfide and noise

Simultaneous exposure to carbon disulfide and noise may have a combined effect on hearing impairment. In this study we investigated hearing loss in 131 men with exposure to noise [80-91 A-weighted decibels; dB(A)] and CS(2) (1.6-20.1 ppm) in a viscose rayon plant. These men were compared with 105 men in the adhesive tape and electronic industries who were exposed to noise only and with 110 men employed in the administrative office of the rayon plant who were exposed to low noise and no CS(2). We conducted interviews to obtain sociodemographic information and exposure assessments, and we performed physical examinations, including hearing tests. Results showed that the prevalence of hearing loss of > 25 dB hearing loss (dBHL) in rayon workers (67.9%) was much higher than that in administrative workers (23.6%) and in the adhesive tape and electronic industrial workers (32.4%). Hearing loss occurred mainly for speech frequencies of 0.5, 1, and 2 kHz. When the CS(2) exposure was measured by the product of CS(2 )exposure level and employment years, the adjusted odds ratios of hearing loss of > 25 dBHL in rayon workers, compared with administrative workers, were 3.8 [95% confidence interval (CI), 1.5-9.4] for those with the exposure of 37-214 year-ppm, 14.2 (95% CI, 4.4-45.9) with 215-453 year-ppm exposure, and 70.3 (95% CI, 8.7-569.7) with exposure of > 453 year-ppm. The study suggests that CS(2) exposure enhances human hearing loss in a noisy environment and mainly affects hearing in lower frequencies.