吸烟对噪声性听力损伤影响的调查

吸烟对噪声性听力损伤影响的调查北京市宣武区卫生防疫站（１０００５３）刘和平，杜德宽，赵艳华，卢渝军北京医科大学第三医院赵一鸣噪声是我国工业生产中危害最广泛的职业因素之一。长期接触噪声可以引起听力损伤。我们在工作中发现工人中吸烟的比例很高。吸烟可以引起...     

镁对噪声性听力损伤的影响及研究进展

Mg2 浓集于细胞内,协助Na 、K 、Ca2 通过细胞膜进行细胞内外的转运,是人体内重要的阳离子。镁也是近325种酶的激活剂,包括腺甘酸环化酶、Na /K -ATP酶,磷脂酶C等,并参与碳水化合物、脂质和蛋白质代谢,是人类生存不可缺少的元素。一些临床和动物实验表明,噪声和镁之间存在重要联系,镁在噪声性听力损伤(NIHL)进展过程中起一定作用,决定NIHL的程度。现就近年来有关镁影响NIHL的研究进展作一概述。1暴露噪声后体内镁的变化国内徐庆华等发现,大鼠暴露于120 dB SPL(声压级)白噪声下,血清镁浓度呈上升趋势[1]。Mocci等收集25名某工厂健…     

噪声性听力损伤的治疗观察

对具有不同程度听力损伤患者（共２０例耳）,在不脱产情况下,口服赛鲨力补氧胶囊２５天（１１．２ｇ／ｄ）观察治疗前后其听力和静脉血中的铜蓝蛋白酶、超氧化物珐化酶（ＳＯＤ）活性及过氧化脂质（ＬＰＯ）含量的变化,结果表明,口服赛鲨力补氧胶囊后,患者静脉血中的铜蓝蛋白酶、超氧化物歧化酶活性显著升高：语频段听力恢复的有效率为７１．４％,高频有效率为７８．９％。因此,鲨烯不仅可以改善体内的代谢物清除水平,而且能     

噪声性听力损伤及防治

噪声是工业生产存在的主要职业危害因素之一,可对听觉器官产生特异性损伤,听力损伤的机制复杂,且受多个因素的影响。有关损伤机制和防治方面的研究较多,进行总结以找到有效的综合防治措施,防止或减轻听力损害。     

苯和噪声联合作用对听力损伤的影响

为某制药厂噪声伴有低浓度苯车间工人103人，与单纯接触噪声工人169人、后勤人员69人进行听损检查，结果噪声伴有低浓度苯车间工人听损检出率明显高于单纯接噪组及对照组，与两组比较差异有显著性。同时还观察到，噪声伴有低浓度苯接触组与单纯接噪组比较，差异随工龄增加而增加，8年以上P＜0．05，10年以上P＜0．01。     

铅烟与噪声对听力损伤的联合影响

对同时接触沿烟与噪声的某钢铁厂８２名男性炼铁炉前工进行听力测试，当噪声强度一样时，铅烟吸入加重了接噪工人的损伤，且随着体内铅负荷的增高，工人听阈位移更为明显。提示铅与噪声对工人听力损伤有协同作用。     

职业性噪声对工人听力的影响

目的：了解职业性噪声对工人听力的影响。方法：选择500名噪声作业工人及对其工作环境进行劳动卫生学调查，另将500名非噪声作业的人员设为对照组，分析2组研究对象听力水平的差异。结果：接触组的听损检出率为（22．4％），与对照组（4．2％）差异有显著性（x^2=71．81，P〈O．01）；听损检出率与噪声暴露水平和接噪工龄有关。结论：听损检出率随噪声暴露水平和接噪工龄的增加而增高。     

噪声对听力损伤与对心功能影响之间的关系探讨

本文对69名接触相同水平工业噪声的工人,进行了听力损伤和心功能变化的比较研究。结果显示,噪声聋组与非耳聋组相比,等容收缩时间(ICT)、射血前期时间(PEP)延长,ICT/LVET和PEP/LVET比值增高,心脏射血分数降低,两组间有显著差异,提示噪声对听力与心功能的影响吴平行关系。     

军事噪声性听力损伤的流行病学调查

军事噪声是军队成员常见的职业性危害。听力调查是研究军事噪声性听力损伤防治的基础。我们于1988年两次赴战区,对参战炮兵进行军事噪声性听力损伤的流行病学调查研究。     

大学生耳机使用状况及对噪声性听力损伤影响

目的 了解在校大学生耳机使用状况及其对噪声性听力损伤的影响,为噪声性听力损伤的预防和干预提供科学依据。方法 采用分层随机抽样方法抽取河南省新乡医学院的3 826名在校大学生进行问卷调查。结果 调查的3 826名在校大学生中,使用耳机3 819人,耳机使用率达99.8%;其中有噪声性听力损伤者1 070例,占28.0%;有慢性耳鸣者510例,占13.4%;有眩晕/恶心者313例,占8.2%;有听力下降者384例,占10.1%;多因素Logistic回归分析结果表明,国外耳机品牌、每日佩戴耳机≥1 h、耳机类型为耳塞式和挂耳式及耳机音量≥70 dB是噪声性听力损伤的主要危险因素;女生是噪声性听力损伤的保护因素。结论 在校大学生普遍使用耳机;不科学的耳机使用方式是造成在校大学生噪声性听力损伤的主要影响因素。     

噪声性听力损失易感基因的研究进展

噪声性听力损失是现阶段全球最主要的职业性损伤之一.以往的研究显示,噪声的易感性存在个体差异,本文综述报道目前国内外关于基因多态性与噪声性听力损失之间关系的现有研究状况.     

Individual Risk Factors in the Development of Noise-Induced Hearing Loss

We have analysed the association of noise-induced hearing loss with various risk factors among 685 workers in forest, shipyard, and paper mills. Occupational histories, health, environmental factors, and noise exposures of each worker were retrieved from the database of NoiseScan, our expert program on hearing. The mean hearing level at 4 kHz was 21.5 dB +/- 20.3 dB HL. It correlated significantly with age, noise emission level and noise exposure level. However, these factors could only explain about 2 dB HL of the variation in hearing level. Impulse noise in the shipyard work caused increase in hearing level of 12 dB HL at 4 kHz when compared to steady state noise exposure of forest work. Hearing level correlated with serum cholesterol levels, use of analgesics, blood pressure and smoking. An elevated cholesterol level increased hearing loss in both the high- and low-exposure groups. The use of analgesics did not increase a permanent threshold shift in the low-exposure group, but did in the high-exposure group. Systolic blood pressure, smoking, cholesterol level and the use of painkillers explained 36 % of the variation in hearing level at 4 kHz, whereas noise exposure alone explained 25 % of the corresponding variation.     

Detection and Clinical Diagnosis of Noise-Induced Hearing Loss by Otoacoustic Emissions

The purpose of this study was to explore the application of the click-evoked and distortion products otoacoustic emissions (CEOAEs and DPOAEs, respectively) in the diagnosis and detection of noise-induced hearing loss (NIHL). The study group consisted of 283 noise-exposed subjects and 176 subjects with a history of noise exposure but with a normal audiogram. Findings were also compared with those in 310 young military recruits with no reported history of noise exposure and normal bilateral audiogram. In general, the features of noise-induced emissions loss (NIEL) closely resembled the behavioural NIHL parameters: both were bilateral and both affected primarily the high frequencies, with a "notch" at around 3 kHz in the DPOAEs. On average, CEOAEs were recorded up to 2 kHz, indicating that up to this frequency range (speech area), cochlear functioning is intact and the hearing threshold s better than 25 dBHL. A clear association between the OAEs and the severity of the NIHL was noted. As the severity of NIHL increased, the emissions range became narrower and the amplitude smaller. OAEs were found to be more sensitive to noise damage than behavioural audiometry. NIEL was found in subjects with normal audiograms but with a history of noise exposure. Owing to their objectivity and sensitivity, OAEs may sometimes provide indispensable information in medico-legal cases, in which the configuration of the audiometric threshold is needed to obtain an accurate diagnosis of NIHL and compensation is proportional to the severity of NIHL. Furthermore, OAE testing between ears with and without NIHL revealed a high sensitivity (79 - 95%) and specificity (84 - 87%). This study shows that OAEs provide objectivity and greater accuracy, complementing the behavioural audiogram in the diagnosis and monitoring of the cochlear status following noise exposure.     

某冶金企业噪声作业人员听力损伤的特点

目的为进一步了解太钢噪声作业人员听力损伤的特点,为控制和消除职业性噪声聋的发生提供依据。方法对15个生产厂256个噪声作业点进行现场监测。并对1 628名噪声作业人员进行健康体检,分析其噪声特性和双耳纯音听力损伤的特点。结果1 628名噪声作业人员按其接触噪声性质不同分为6个工种,听力损伤以轧钢系统岗位最严重,其次为流动性岗位,辅助性岗位最低。同时非稳态噪声听力损伤比稳态噪声严重。结论非稳态噪声、高频噪声引起的听力损伤比稳态/中、低频噪声引起的听力损伤严重。     

The Consequences of Noise-Induced Hearing Loss on Dairy Farm Communities in New Zealand

ABSTRACT

The objective of this study was to investigate how noise-induced hearing loss (NIHL) or noise injury (NI) affects individuals and others of dairy farm communities in New Zealand. Using “grab” or opportunistic sampling at DairyNZ discussion groups and a recreational function, a survey questionnaire was completed by 74 participants from two dairy farming communities in New Zealand. Self-reported hearing difficulties were highlighted by 48% (42) of the 74 participants. The effects of NI on individuals and others included communication difficulties leading to the development of coping strategies, social isolation; decreased employment opportunities, loss of productivity, and increased effort and adjustments by family and work colleagues. Frustration, anxiety, stress, resentment, depression, and fatigue are also negative consequences that may contribute to a loss of quality of life and contribute to further health costs. Increased lateness, absenteeism, sickness and other behavioral aspects were not expressed as normal issues in the workplace, as the majority of the individuals are/were self-employed or working in a family business. This study shows that each year in New Zealand NI results in significant negative social, psychological, and economic consequences for those individuals affected, along with their families, friends, and work colleagues.     

Distortion-Product Otoacoustic Emissions as a Screening Tool for Noise-Induced Hearing Loss

Noise-induced hearing loss includes both temporary (TTS) and permanent (PTS) threshold shifts. Although TTS and PTS have many similarities, their underlying mechanisms are different. Both TTS and PTS are seen in hearing-conservation programs, making it important to consider both when making physiological measurements of inner-ear damage in applied settings. There are many ways that physiological mechanisms could be useful in screening for NIHL. Can normal-hearing and NIHL ears be differentiated from one another? Can the physiological measure be used in place of behavioural hearing-threshold measures of TTS and PTS? Can it be used to indicate sub-clinical damage (i.e., noise-induced permanent alterations to the inner ear without a corresponding hearing decrement)? Can it be used to indicate pre-clinical hearing loss (i.e., the sub-clinical damage eventually turns into hearing loss)? Finally, can the physiological measure be used to predict susceptibility to NIHL? Evoked otoacoustic emissions (EOAEs) depend on normal outer hair cells for their generation. Because this is the site in the inner ear in humans that is most susceptible to noise, there has been considerable interest in the application of EOAEs to NIHL screening. In this review, the application of distortion-product EOAEs (DPOAEs) is considered for this purpose, emphasizing work from our laboratory, but including that of others as well. Wherever possible, we compare the performance of DPOAEs as a screening tool to transient-evoked otoacoustic emissions (TEOAEs). We emphasize the importance of how well DPOAEs perform in screening for NIHL in individuals rather than for groups of people; the importance of using large numbers of subjects; and the importance of longitudinal studies.     

Evidence of a Common Pathway in Noise-Induced Hearing Loss and Carboplatin Ototoxicity

In spite of the differences in the nature of the insult, the hearing loss from ototoxic drugs and noise exposure share a number of similarities in cochlear pathology. This paper explores the common factors between noise-induced hearing loss and ototoxicity by experimentally manipulating cochlear glutathione (GSH). In the first experiment, chinchillas were treated with a drop of saline (50 &mgr;l) on the round window of one ear and a drop of buthionine sulfoximine (BSO, 50 &mgr;l of 200 mM) on the other ear. BSO is a drug that blocks GSH synthesis and it was hypothesised that GSH-depressed ears would be more vulnerable to noise. Six hours after treatment, the animals were exposed to a 105 dB 4 kHz octave band noise for 4 hours, then a second dose of BSO was applied 2 hours later. The BSO treated ears showed more temporary threshold shifts and reduced GSH staining at day 4 post exposure, but there was no BSO effect in terms of greater permanent threshold shift (PTS) or hair cell loss. In the second experiment, chinchillas were pretreated with BSO and 3 days later were given either a single dose of carboplatin (25 mg/kg i.p.), a double dose (day 3 and 7) or only BSO. Chinchillas that received BSO and the double dose of carboplatin had significantly greater loss of inner and outer hair cells than the carboplatin chinchillas. In addition, the BSO and carboplatin chinchillas also had larger decreases in evoked response amplitudes suggesting that GSH depletion potentiated the ototoxicity of carboplatin. These results are discussed in terms of the role of reactive oxygen species in creating hearing loss and the potential protective role of glutathione.     

The Influence of Superoxide Dismutase and Glutathione Peroxidase Deficiencies on Noise-Induced Hearing Loss in Mice

One consequence of noise exposure is increased production of reactive oxygen species (ROS), such as superoxide, hydrogen peroxide, and hydroxyl radicals, in the cochlea. ROS can cause oxidative damage to diverse cellular components, including membranes, proteins, and DNA, if they are not "neutralised" by antioxidant defences. Two important enzymes of the cochlear antioxidant defense system are cytosolic copper/zinc superoxide dismutase (SOD1) and selenium-dependent glutathione peroxidase (GPx1). These metalloenzymes work together to regulate ROS production in virtually every cell in the body, and they may be important for limiting cochlear damage associated with aging and acoustic overexposure. In this chapter, we describe a series of experiments using mice with targeted deletions of Sod1 or Gpx1, the mouse genes that code for SOD1 and GPx1, respectively, to study the cellular mechanisms underlying noise-induced hearing loss (NIHL). The results from Sod1 and Gpx1 knockout mice provide insights into the link between endogenous levels of antioxidant enzymes and susceptibility to NIHL.