甲苯与职业性噪声联合暴露加重男工听力损失

目的探讨职业性噪声和甲苯联合暴露对男性作业工人听力系统的影响。方法对接触甲苯与噪声的167名工人(实验组),仅接触噪声的153名工人(对照Ⅰ组)以及行政人员160名(对照Ⅱ组)进行调查。采用个体采样法对作业场所中的噪声、甲苯进行测定,对工人进行左、右耳0.5~6 kHz 6个频率的纯音气导听阈测试。分析噪声和甲苯对听力的影响以及两者的联合作用。结果实验组高频听力损失的发生率(50.30%)明显高于对照Ⅰ组(37.25%)和对照Ⅱ组(11.25%);实验组语频听力损失发生率为4.79%,与对照Ⅰ组(2.61%)间差异无统计学意义(P0.05)。实验组和对照Ⅰ组在3 kHz听阈位移开始高于对照Ⅱ组,并在高频段持续增大,于6 kHz处达到最大值,组间差异有统计学意义(t=5.54,P0.01)。多因素logistic回归分析显示,与对照Ⅱ组相比,对照Ⅰ组和实验组发生高频听力损失的风险分别增加3.96倍和7.48倍,各组间发生高频听力损失的风险均匀增加(χ2=0.06,P=0.81)。作业工龄是高频听力损失发生的独立危险因素(OR=1.11)。结论同时接触噪声与甲苯会增加男工高频听力损失的发生率,对语频听力损失的发生率尚无明显影响。     

低浓度铬接触与噪声共同作用对听力影响

目的 探讨低浓度铬及其无机化合物与噪声共同作用对听力损失的影响。 方法 以某汽车制造企业中同时接触低浓度铬与噪声的419名男性员工为接触组,以接触噪声但不接触铬的766名男性员工为对照组,检测工作场所职业病危害因素,结合职业健康检查结果进行分析。 结果 接触组高频听力损失的检出率为10.73%,对照组为4.31%,两组比较,差异有统计学意义(χ2=18.221,P<0.05),接触组听力损失发生的相对危险度是对照组2.49倍。 结论 同时接触低浓度铬和噪声可使听力损失发生的风险增高。     

手臂振动与噪声联合作用对听力影响的调查

本文调查分析了１１４名井下钻煤工听力损失情况。结果表明，钻工组所接触的振动、噪声虽均未超标，却导致了明显的听力改变，听力下降以４、６ｋＨｚ凹陷及轻度的高频听损为主，早期（～５年工龄）即可产生明显的听力损失，高频段比语频段敏感，并随着工龄的延长逐渐加重，与对照组比较有显著性差异（Ｐ＜０．０１）。因此认为，手臂振动和嗓声联合作用比等强度单纯嗓声对听力的损害可能要严重，并以加重高频听损为主，有待进一步证实。     

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...     

甲苯致听力损失研究进展

近年来,随着苯等高毒化学品的限制使用,甲苯等替代产品的产量和消费量日益增加,甲苯的毒性作用以及健康效应引起了国内外职业卫生领域的广泛关注。现阶段甲苯的健康效应研究主要集中在高浓度甲苯暴露导致中枢神经系统功能障碍和皮肤黏膜刺激症状等,但随着医学科学的发展,越来越多的研究包括动物实验和人群研究均表明甲苯可能对听力系统产生潜在危害,本文对甲苯致听力损失的研究进展进行综述。     

噪声联合高温作业对从业者听力的影响

目的了解噪声联合高温作业对工人听力的影响。方法选择某企业同时接触噪声和高温作业人员291人为观察组，另选择同企业单纯接触噪声作业人员296人为对照组。结果观察组听力损失人数明显高于对照组，χ^2=4．49，P〈0．05；但两组听力损失的程度无统计学意义。结论观察组听力损失检出人数明显高于对照组。可能是噪声和高温共同影响，造成内耳耳蜗缺血、缺氧进一步加重。但两组听力损失的程度无显著差异，考虑为受检人员接噪工龄较短的原故。     

高温和低频噪声联合作用对听力损失的影响

为了解高温是否能增强低频噪声引起的听力损失。以豚鼠为实验对象，研究了单独或复合暴露于低频噪声及高温后引起的听力阈移和毛细胞缺失率。结果表明，２８℃或３７℃暴露２小时不能引起听力阈移，但可增加低频噪声引起的暂时性听力阈移；暴露于同样的温度下４周，每周６天，每天２小时也不能引起听力阈移及增加低频噪声引起的永久性听力阈移和毛细胞缺失。提示高温不能加重噪声性听力损失，可能与长时间暴露后，动物对热产生习服有关。     

噪声与苯乙烯联合接触对听力损失的影响及相关因素分析

探讨噪声与苯乙烯联合接触对作业人员听力损失的影响。选择甘肃省某公司单纯接触苯乙烯的121人为苯乙烯组,单纯接触噪声的126人为噪声组,同时接触噪声和苯乙烯的140人为联合组,不接触噪声和苯乙烯的90人为对照组,比较各组作业人员听力损失情况。结果显示,各组听力损失人数噪声组>联合组>苯乙烯组>对照组,差异有统计学意义(χ^(2)=87.75,P<0.01);噪声组高频听力损失检出率明显高于对照组(χ^(2)=48.526,P<0.01);苯乙烯组高频听力损失检出率与对照组比较,差异无统计学意义(χ^(2)=0.687,P=0.407);联合组高频听力损失率明显高于对照组(χ^(2)=33.398,P<0.01)。工龄是高频听力损失的危险因素,工龄越长,听力损失的风险越高(OR=21.52)。提示,苯乙烯对噪声所导致的听力损失应进一步研究,应加强多因素联合作用对听力损失影响的职业防护。     

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。     

二硫化碳与噪声联合作用对劳动者听力的影响

目的研究二硫化碳与噪声联合作用对劳动者听力的影响.方法采用横断面抽样,对所选工厂进行劳动卫生学调查,对作业场所职业病危害因素进行检测,对劳动者进行问卷调查和健康检查,分析各组暴露因素对劳动者所致听力损伤的差异.结果二硫化碳与噪声接触组劳动者听力损害发生率较二硫化碳组、噪声组及对照组明显增加(P＜0.05).结论二硫化碳与噪声对劳动者听力均有影响,且具有协同作用.     

饮酒与职业噪声暴露对听力损失的联合作用

目的 探讨饮酒与听力损失的关系以及饮酒和职业性噪声对听力损失的联合作用.方法 利用回顾性队列研究,选择广州市某大型空调生产企业连续性噪声作业人员2.44名男性饮酒者为饮酒组,在相同的噪声暴露环境中选择140名男性不饮酒者为对照组,两组间除饮酒外,其他均均衡可比.按照<作业场所噪声测量规范>(WS/T 69-1996)要求对噪声暴露作业场所进行测点选择和噪声强度测量[dB(A)],并计算累积噪声暴露量(CNE).按GB7583-87要求,对工人进行左、右耳500～6000Hz内6个频率的纯音气导听阈测试,并问卷调查其一般情况、个人生活史、职业史、噪声暴露史、家族性耳聋史以及耳毒性药物使用史等.利用t检验、有序多分类logistic回归分析、卡方检验分析噪声和饮酒对听力的影响以及两者的联合作用.结果 同一噪声暴露环境下,在4 000 Hz频段,饮酒组左、右耳听阈位移分别为(29.9±12.9)dB和(30.0±13.5)dB;6000Hz听闻位移为(26.9±11.8)dB和(27.3±15.3)dB,均高于对照组(P<0.05).饮酒组听力损失的发生率为21.7%,对照组为10.7%,两组比较差异有统计学意义(P<0.01),年饮酒量达32L及以上听力损失发生的相对危险度是不饮酒的2.632倍(P<0.05).累积噪声量达80 dB(A)及以上时,饮酒和职业噪声听力损失的RR值分别为3.353和4.643,饮酒与职业噪声联合作用的RR值(9.662)大于两个变量独立作用之和.结论 大量饮酒可导致听力损失发生率增高,在高强度噪声暴露情况下,饮酒和职业噪声暴露对听力损失存在协同作用.     

某饮料制造企业岗位噪声暴露及职业性听力损失情况调查

  目的  了解饮料制造企业噪声暴露情况，探讨该行业作业工人噪声性听力损失（noise-induced hearing loss，NIHL）的影响因素。
  方法  选择广州市某饮料制造企业符合条件的182名接触噪声的作业工人为调查对象，对其进行纯音听阈测试，并对工作场所进行噪声检测，分析工人NIHL影响因素。
  结果  该饮料制造企业工作场所噪声超标率为70.59%，超标岗位主要集中在瓶装饮料线以及纯净水线。84名（46.15%）接触噪声作业工人被检出NIHL。logistic回归分析结果显示:作业人员年龄> 35岁发生NIHL的危险度是20~30岁的2.647倍（P < 0.05）；接触噪声工龄> 10年发生NIHL的危险度是接触噪声工龄 < 5年的2.853倍（P < 0.05）；所在岗位为纯净水线发生NIHL的危险度是辅助设施岗位的9.000倍（P < 0.05）。
  结论  该饮料制造行业噪声水平较高，企业应采取工程控制措施控制噪声危害，加强职业卫生管理。
     

Effect of combined occupational exposure to noise and organic solvents on hearing

Noise exposure has been commonly regarded as the main hazard of occupational hearing loss. Recent studies indicate that several chemicals, including organic solvents have ototoxic effects. This study aimed at evaluating the hearing of workers exposed to both noise and a mixture of organic solvents at concentrations anticipated as safe. The study comprised three groups. The first one included 70 workers exposed to noise only, the second group consisted of 93 workers exposed to organic solvents and noise, and the control group included 59 individuals exposed to neither noise nor organic solvents. The three groups were matched for age, socioeconomic status, and smoking habit. The results of this study revealed that there was no statistically significant difference between the two exposed groups as regards the duration of exposure. There was a highly statistically significant difference between the two exposed groups as regards the different types of hearing loss (conductive deafness, sensory neural hearing loss, and mixed type) compared with the control one. Our study reported that sensory neural hearing loss occurred earlier in subjects with combined exposure to noise and solvents at a mean duration of exposure (16.38?±?9.44 years) compared to (24.53?±?9.59 years) the subjects with sole exposure to noise. The difference between the two groups was statistically significant regarding this type of hearing impairment (p < 0.05). There was a positive significant correlation between hearing impairment and duration of exposure in the two exposed groups. As regards the results of the environmental monitoring, both noise exposure levels (dB) and levels of different organic solvents measured (mg/m(3)) in different work departments were less than the levels recommended by Egyptian Environmental Law No. 4 for 1994. It is recommended that in the case of combined exposure, noise and solvent levels should be lowered than the permissible limits recommended for either alone.     

Suggested guidelines for studying the combined effects of occupational exposure to noise and chemicals on hearing

The present document, which describes recommended standardized procedures, aims to assist individual investigators plan a study on the effects of industrial chemicals on the auditory system, collect and analyze environmental and hearing sensitivity data that are accurate and comparable to data acquired by others. This draft document is currently being reviewed by the NoiseChem Research Group. In this peer review stage we are currently accepting critiques and suggestions to this proposal. Investigations on the aforementioned topic are necessary since there is strong evidence that occupational hearing loss may be caused not only by noise but also by exposure to certain chemicals in the work environment. Since some industrial chemicals are known to be ototoxic, it is plausible to expect that if these chemicals occurred in high enough concentrations in the workplace they could affect hearing. Laboratory studies have yielded a finding not expected, namely that when simultaneous exposure to noise and chemicals occur, the hearing loss observed was greater than the expected hearing loss from noise added to the expected hearing loss from the chemical. If this synergism is verified in humans, then changes will be required in the limits that are set for occupational hazards in order to prevent occupational hearing loss.     

某大型汽车制造企业噪声暴露与听力损失的调查

收集2018年度广州市某汽车制造企业4 723名噪声作业工人纯音听阈测试结果与工作场所现场噪声暴露水平资料,分析噪声暴露情况与听力损失状况及影响因素。结果显示,噪声作业工人听力损失检出率为29.8%(1 406/4 723),以高频听阈升高为主,占28.9%;作业环境噪声总超标率为38.1%(238/624),焊装车间噪声超标率均高于其他车间。听力损失检出率随年龄、接噪工龄增长呈增高趋势(趋势χ²=42.263,P<0.001;趋势χ²=20.039,P<0.001)。多因素Logistic回归分析模型提示,与<20岁年龄组相比,≥20岁可能是听力损失的危险因素(20～<30岁OR=1.53、≥30岁OR=2.55,P<0.001)。该企业噪声作业工人听力损失检出率较高,工作场所噪声超标率较高,企业应加强工作场所噪声治理,做好职业健康监护工作。     

Sensory-neural hearing loss during combined noise and vibration exposure

Summary A detailed analysis of risk factors for the development of sensory-neural hearing loss (SNHL) was carried out on 122 forest workers. These forest workers were selected from a larger group (n = 217) by restricting the age range to 30–55 years. The hearing threshold of the left ear at 4000 Hz was measured and the effect of age, exposure, systolic and diastolic blood pressure (DBP), presence of vibration-induced white finger (VWF), tobacco smoking and use of earmuffs were evaluated in multiple linear regression analysis. Robinson's nonlinear model was used to evaluate the rate of hearing loss. Aging was the major risk factor and it explained 15.4% of the variance of the SNHL. The presence of VWF was the second most important single risk factor and explained a further 5.2% of the SNHL. Elevation of DBP correlated significantly with SNHL and explained an additional 4.1% of the SNHL. These main factors were able to explain about 26% of the spread of SNHL. Additional factors in the analysis, e.g. smoking, systolic blood pressure, did not significantly contribute to the genesis of SNHL. When Robinson's model was applied to the SNHL data, on a group basis, we did not observe any exaggerated risk of hearing loss due to combination of noise and vibration. In combined exposure subjects with VWF as well as subjects with enhanced DBP will run a higher risk for SNHL.     

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.     

Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers

Background: Evidence has accumulated concerning the adverse effects of smoking on hearing acuity, but it is not clear whether smoking modifies the association between exposure to noise and hearing loss.

Aims: To examine the synergistic effect of these variables on hearing.

Methods: Data used were derived from periodic health examinations for 4624 steel company workers in Japan and included audiometry testing and information on smoking habits. Occupational exposure to noise was determined based on company records. Logistic regression was used to examine the dose-response association between smoking and hearing loss. The Cochran-Mantel-Haenszel method was used to calculate the prevalence rate ratio (PRR) of hearing loss for each combination of smoking and noise exposure factors, taking non-smokers not exposed to occupational noise as a reference. The interaction between smoking and noise exposure was assessed using a synergistic index, which equals 1 when the joint effect is additive.

Results: Smoking was associated with increased odds of having high frequency hearing loss in a dose-response manner. The PRR for high frequency hearing loss among smokers exposed to occupational noise was 2.56 (95% CI 2.12 to 3.07), while the PRR for smokers not exposed to noise was 1.57 (95% CI 1.31 to 1.89) and the PRR for non-smokers exposed to noise was 1.77 (95% CI 1.36 to 2.30). The synergistic index was 1.16. Smoking was not associated with low frequency hearing loss.

Conclusions: Smoking may be a risk factor for high frequency hearing loss, and its combined effect on hearing with exposure to occupational noise is additive.