累积噪声暴露与听力损伤的相关性调查

目的 探讨噪声对作业工人健康影响职业危害剂量问题,提供噪声暴露与听力损失的剂量－－反应关系资料。方法 对１７０名生产噪声作业工人听力检查,引用累积噪声暴露量（ＣＮＥ）进行分析。结果 随累积噪声暴露量的增加,听力 人随之增加,二者间有高度正相关性（Ｒ＝０．９５７６）,且随累积噪声暴露量的增加,持续接触噪声和间断接触噪声对呼力损失影响的差异显著性（Ｐ〈０．０５或Ｐ〈０．０１）。结论 累积噪声暴露量在噪     

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...     

惠州市直属企业职业噪声暴露与听力损失的关系

目的探讨噪声暴露对作业场所工人听力损失的影响。方法采用横断面调查,对惠州市直属五金、印刷、食品、电子等行业8个工厂进行噪声作业场所调查,并对噪声作业工人进行职业卫生调查及纯音听力测定。另选择相应办公室不接触噪声的职工164人作为对照组。结果听力损失率随着接触噪声的工龄增加而增高,随着接触噪声强度的增加,呈现出明显的时间剂量-反应关系。听力损失率接触毒物和噪声组明显高于噪声组(P<0.05)。结论噪声强度、接噪工龄是影响作业工人听力的主要因素,毒物与噪声联合作用加重听力损害。     

江阴市2家现代化涉外企业作业人员职业噪声暴露分析

目的分析江阴市涉外企业职业性噪声危害状况,为其防治措施提供依据,以达到保护工人听力的目的。方法测定所调查企业各作业场所中噪声强度,对1 202名噪声作业人员进行纯音听阈测试,并对其听力损失与噪声强度的关系进行统计学分析。结果江阴市2家现代化涉外企业109个噪声监测点中,噪声强度均值为（89.30±4.57）dB（A）,噪声作业点超标率为86.2%,超标点作业人群占89.9%;高频损伤和语频损伤总检出率为20.7%,在得到有效防护措施的保护情况下,长时间暴露在严重超标的噪声环境中是造成工人听力损失的主要原因。结论噪声是涉外企业主要的职业危害因素之一,加强＂三同时＂管理和个人防护措施的落实,提高工人自我保护意识,是预防涉外企业职业性噪声危害的主要措施。     

职业应激对金属制造行业噪声性听力损失的影响

目的探讨职业应激对金属制造行业噪声性听力损失(noise-induced hearing loss,NIHL)的影响。方法选择中山市某铁制品金属制造企业噪声(L_EX,8h≥85dB(A))超标岗位作业者作为研究对象。采用SV104IS无线个体噪声剂量计测定生产岗位噪声强度,问卷调查法获得研究对象的基本情况和职业应激水平,纯音听力检查获得研究对象的听力水平,二分类logistic回归法分析NIHL与职业应激的关系。结果该企业共有4个车间、7个生产岗位噪声强度(L_EX,8h)超标,噪声强度(L_EX,8h)均值为(87.06±1.68)dB(A)。研究共获得281名研究对象,其中听力正常者169名,NIHL患者112名。NIHL患者的职业应激任务问卷(ORQ)、个体紧张反应问卷(PSQ)人均总得分高于听力正常者,但差异无统计学意义(P>0.05)。NIHL患者的个体应对资源问卷(PRQ)人均得分低于听力正常者(P<0.01),其中娱乐休闲、自我保健人均得分低于听力正常者(P<0.01)。二分类logistic...     

有机溶剂与噪声联合暴露致听力损失的职业流行病学研究进展

随着生产环境日趋复杂、有机溶剂在工业生产中广泛使用,存在噪声的工作场所中,往往伴随有机溶剂。二者联合暴露对劳动者听力的影响引起国内外学者的广泛关注。然而现有研究结论并不一致,且国内近年来相关研究较少。本文就现有研究较多的几种有机溶剂与噪声联合暴露致听力损失的职业流行病学研究及进展进行综述,为推进噪声和有机溶剂联合暴露致劳动者的听力损害研究、保障职业人群健康及修订职业卫生和职业病诊断标准提供基础资料和理论依据。     

石化聚酯装置生产性噪声职业暴露调查及风险评估

目的 通过对生产性噪声职业暴露进行定量风险评估,探讨其在职业病危害评价工作中的主要内容和步骤,从而提高职业病危害评价水平.方法 以某石油化工聚酯装置的短丝及聚酯生产车间为对象,通过对其生产工艺过程噪声职业暴露调查,分析劳动者职业暴露的特点、检测工作环境的噪声强度并对频谱特性进行分析,对个人使用的防噪耳塞防护效果进行分析...     

职业性噪声暴露对心血管系统影响研究进展

噪声普遍存在于生产劳动环境中,人们有很多机会接触噪声.噪声是一种频率与强度变化毫无规律的随机组合的声音,对人体造成的危害是多种多样的,尤其是工业噪声,噪声性听力损失（noise-induced hearing loss,NIHL）是最主要的职业危害之一,也是职业卫生研究的热点.除此外,研究还发现噪声暴露对作业人员心血管系统有影响.现就近期职业性噪声暴露对心血管系统影响的研究情况综述如下.     

汽车发动机制造业噪声暴露所致听力损失的风险评估

对某汽车发动机制造企业进行职业卫生现场调查,收集接噪工人基本信息,采用ISO 1999:2013对接噪工人进行听力损失风险评估。结果显示,预测各岗位人员在40、50、60岁时发生职业性噪声聋风险均为可接受等级;预测保全岗位人员50、60岁及组装岗位人员60岁时发生高频听力损失风险等级为中等,其余岗位均为可接受等级。提示积极的职业健康管理措施可有效降低职业性噪声聋的发生,职业卫生服务机构应采用多种方法对噪声危害进行评估。     

鞋材制造业噪声作业工人听力损失的职业卫生调查分析

鞋材制造业噪声作业工人听力损失的职业卫生调查分析陈美芳徐尚斌随着改革开放的深入,我市“三资”企业的数量不断增加。但部分“三资”企业由于对职业卫生工作不够重视,职业危害事故时有发生。１９９５年６月广州某合资鞋材有限公司,在只有１０人作业的鞋材制造的打磨...     

An assessment of occupational noise exposures in four construction trades

Three hundred thirty-eight noise exposure samples were collected from 133 construction workers employed in 4 construction trades: carpenters, laborers, ironworkers, and operating engineers. Four sites using a variety of construction techniques were sampled at least 12 times on a randomly chosen date over a 22-week period. Up to 10 volunteer workers were sampled for an entire work shift on each sampling day using datalogging noise dosimeters, which recorded both daily time-weighted averages (TWAs) and 1-min averages. Workers also completed a questionnaire throughout the workday detailing the tasks performed and tools used throughout the day. Regression models identified work characteristics associated with elevated exposure levels. Comparisons were made between exposures measured using the Occupational Safety and Health Administration (OSHA) exposure metric and the 1996 draft National Institute for Occupational Safety and Health/International Organization for Standardization (NIOSH/ISO) metric to examine the effects of differing exchange rates and instrument response times on construction noise exposures. The mean OSHA TWA for 338 samples was 82.8 dBA +/- 6.8 dBA, whereas the mean NIOSH/ISO TWA for 174 samples was 89.7 dBA +/- 6.0 dBA. Forty percent of OSHA TWAs exceeded 85 dBA, and 13% exceeded 90 dBA, the OSHA permissible exposure limit. The tasks and tools associated with the highest exposure levels were those involving pneumatically operated tools and heavy equipment. Trade was a poor predictor of noise exposure; construction method, stage of construction, and work tasks and tools used were found to be better exposure predictors. An internal validation substudy indicated excellent agreement between worker self-reporting and researcher observation. These data provide substantial documentation that construction workers in several key trades are frequently exposed to noise levels that have been associated with hearing loss, and demonstrate the need for targeted noise reduction efforts and comprehensive hearing conservation programs in the industry.     

Validity of self-reported occupational noise exposure

In all epidemiological studies the validity of self-reported questionnaire data is an important issue as the exposure assessment based on such data is a major source of bias in the risk estimation. A validation study was conducted based on a case–control study including 94 acoustic neuroma cases and 191 matched controls from the German Interphone Study to investigate the level of agreement between self-reported occupational noise exposure and a job-exposure-matrix (JEM) on noise exposure derived from a lifetime occupation calendar. The JEM was generated based on measurement data collected in the literature for various occupations. Level of agreement was investigated by using sensitivity, specificity, kappa coefficient and the Youden-Index. The receiver operating characteristics curve yielded an optimal cut point of 80 decibel(Acoustic) (dB(A)) to dichotomize noise exposure, displaying a moderate agreement between self-reported exposure and the JEM-based exposure (kappa of 0.53) that was slightly higher for cases than controls (kappas of 0.62 and 0.48). The agreement was only slightly lower if the longest held job or the last held job were used instead of the loudest job of the lifetime job history. The cut point of 80 dB(A) corresponds with regulations for workers safety with a recommendation to wear noise protection. The good levels of agreement between self-reported high occupational noise exposure compared with JEM-data, together with no substantial differences between cases and controls, suggest that self-reported data on occupational noise exposure is a valid exposure metric. Noise exposure appears to be appropriate if only exposure information on the last or the longest held job is available.

噪声作业场所环境危险因素对噪声性听力损失的影响

目的 探讨噪声作业场所除噪声外其他环境危险因素对个体听力损失的影响,从环境因素出发寻找噪声性听力损失(NIHL)的高危易感人群.方法 采用病例对照研究方法,选择南方某市某大型空调生产企业连续性噪声暴露强度在75～120 dB范围内2400名作业工人为研究对象,比较同一噪声暴露组内噪声作业人员的左耳3000 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202例;听阈位移最小的10%个体作为耐受人群组,共204例.并对两组人群进行作业场所职业卫生调查和问卷调查,通过单因素和多因素分析环境因素对噪声性听力损失的影响.结果 单因素logistic回归分析发现,噪声作业人员中吸烟、饮酒、工作接触有机溶剂、接触重金属、接触高温、接触粉尘人群是NIHL的高危易感人群.进一步的多因素分析发现,仅工作过程中接触高温是NIHL的高危因素,噪声暴露中同时接触高温的NIHL危险度是单纯噪声暴露的1.804倍(95%CI:1.101～2.958).结论 噪声作业同时有高温暴露的人群是NIHL的高危易感人群.     

95名医务人员职业暴露监测分析

目的 探讨医务人员职业暴露的危险因素,提高医务人员职业防护意识,减少医务人员职业暴露的发生.方法对2010年1月-2011年12月发生职业暴露的95名医务人员的监测资料进行统计分析.结果 职业暴露主要是锐器伤,发生率为88.42％;护士职业暴露发生率最高,占63.16％,医师次之占17.89％;发生职业暴露的主要场所是病区和手术室,分别占61.05％和23.16％;操作后整理物品、拔针最易发生锐器伤,分别占29.47％、24.21％;致伤器具主要是注射器针头和输液器针头,所占比例为34.74％和28.42％;暴露源前3位是乙型肝炎病毒、不明原因、梅毒,分别占58.95％、21.05％、11.58％;经过及时正确的伤口处理和必要的预防用药及随访无1例发生感染.结论 制定严格的规章制度强医务人员职业安全培训、提高职业防护意识、规范操作行为、改善工作环境、严格执行“标准预防”是减少医务人员职业暴露的有效措施,对暴露者暴露部位及时处理和针对性的预防用药是降低暴露后感染的有效手段.     

An exploratory study of noise exposures in educational and private dental clinics

Exposures to noise and resulting noise-induced hearing loss (NIHL) are not well understood in the dental profession. Previous studies have focused primarily on practicing dental professionals, and have often evaluated hearing loss in the absence of adequate noise exposure assessment. This study was conducted to evaluate exposures among students and staff working in four clinics within a major U.S. university dental school, and to compare these exposures to those among dental professionals in a private general-practice clinic. We measured equivalent continuous average (L_EQ) noise exposure levels at 3.75-min intervals across a variety of procedures in the evaluated clinics, and also had participants complete a brief survey with questions on their experience and perceptions of noise exposure.

We collected 79 partial- or full-shift Time-Weighted Average (TWA) dosimetry measurements on 46 individuals. The mean 3.75-min interval L_EQ level was 63.6 ± 13.3 dBA, while the highest 3.75-min interval L_EQ was 103.5 dBA. Students from the dental school clinics had the highest variability in average exposure levels, while the pediatric clinic evaluated had the highest average and maximum exposures. Nearly 4% of standardized 8-hr TWA measurements exceeded the 85 dBA Recommended Exposure Limit established by the National Institute for Occupational Safety and Health. Concerns about the potential effects of dental noise on participants' hearing were significantly correlated with metrics of TWA noise exposure, as well as variability of exposure (as assessed by the SD of the 3.75-min L_EQ levels). Our results suggest that dental students and staff may have some risk of developing noise-induced hearing loss, particularly in pediatric clinical settings.     

Noise at sea: Characterization of extended shift noise exposures among U.S. Navy aircraft carrier support personnel

The purpose of this investigation was to characterize 12-hr on-duty, 12-hr off-duty, and 24-hr noise exposures among U.S. Navy aircraft carrier support personnel. Noise dosimetry samples were collected for 47 aircraft carrier support personnel while at sea during airwing carrier qualifications. L_eq measurements during 12-hr on-duty, 12-hr off-duty, and over 24-hr periods were compared to Threshold Limit Values. Four similar exposure groups (SEGs) were created based upon departmental assignment and similarity of work tasks: (1) Administration/Religious Ministries/Legal/Training, (2) Combat Systems/Operations, (3) Medical/Dental, and (4) Supply. Equivalent sound level (Leq) measurements in decibels “A” weighted (dBA) were compared to determine significant differences between each group according to 12-hr on-duty, 12-hr off-duty, and 24-hr periods. Mean 24-hr noise levels ranged from 69–88 dBA with 22% exceeding the 80 dBA Threshold Limit Value. Twelve-hr on-duty noise levels ranged from 71–90 dBA with 17% exceeding the 83 dBA 12-hr on-duty Threshold Limit Value. Twelve-hr off-duty noise exposure ranged from 68–84 dBA with 95% exceeding the 70 dBA American Conference of Governmental Industrial Hygienists threshold classified as effective quiet to allow for temporary threshold shift recovery. Welch Analysis of Variance and Dunnett T3 post hoc tests revealed SEG 2 had significantly higher 24-hr noise exposures than SEG 3 (p?=?0.019) and SEG 4 (p?=?0.045). SEG 2 had significantly higher 12-hr on-duty noise exposure than SEG 3 (p?=?0.030). One Way Analysis of Variance revealed no significant differences between 12-hr off-duty noise exposures according to SEG (p = .096). Some aircraft carrier support personnel had 12-hr on-duty and 24-hr noise exposures exceeding Threshold Limit Values with a large proportion exceeding the 70 dBA effective quiet limit during 12-hr off-duty periods. Results suggest personnel that are typically considered low risk for hazardous noise exposure (<85 dBA) during 8-hr shifts may have a greater risk of noise exposure when considering full 12-hr and 24-hr shifts when working and living in close proximity.     

职业性噪声暴露对男性钢铁工人高血压患病的影响

目的分析职业性噪声暴露对男性钢铁工人高血压的影响。方法以某钢铁集团公司2015年5月—2016年7月进行职业健康查体的7725名一线在职工人为研究对象。通过问卷调查收集钢铁工人的一般情况、噪声暴露等职业因素信息,通过标准方法测量血压等。采用卡方检验分析不同累积噪声暴露量的高血压患病情况,应用限制性立方样条模型(restrictive cubic spline,RCS)结合多因素非条件Logistic回归模型分析噪声暴露及其他因素对高血压的影响。结果噪声暴露者高血压患病率高于噪声非暴露者(P<0.001)。在调整年龄、文化程度等因素后,经限制性立方样条模型分析结果显示,累积噪声暴露量(cumulative noise exposure,CNE)与高血压间存在非线性剂量-反应关系(整体关联性检验χ²=75.76,P<0.001,非线性检验χ²=24.17,P<0.001)。以CNE最低剂量组的钢铁工人为对照, CNE为82～94、95～107[dB(A)×年]的工人高血压患病风险分别是低剂量噪声暴露组的1.81倍(95%CI 1...