南京市噪声作业人员听力损失情况及其影响因素分析

目的 分析南京市噪声岗位作业人员职业健康体检的纯音听力测试(pure tone audiometry,PTA)结果,以期对职业性噪声聋的防治提供科学依据。方法 以2020年1月1日至10月31日在南京市职业病防治院进行职业健康体检并进行PTA的6 614名噪声作业人员为研究对象,询问一般情况、职业史和病史,进行体格检查、PTA、实验室检查等。双耳各频阈值比较采用t检验,双耳各频异常检出率比较采用χ²检验,采用二元Logistic回归分析噪声性听力损失(noise-induced hearing loss,NIHL)的危险因素。结果 6 614名噪声作业人员中,听阈测试异常1 779例,占26.90%。NIHL有678例,占10.25%。不同性别、合并有害因素、吸烟、饮酒的噪声作业人员NIHL检出率差异均有统计学意义(均P<0.01),NIHL检出率随着年龄、接噪工龄增加而增加(均P<0.01),而血压正常组和血压异常组检出率差异无统计学意义(P>0.05)。二元Logistic回归分析结果显示,男性(OR=2.305)、年龄≥31岁(OR=2.1...     

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。     

Hearing loss among older construction workers: Updated analyses

Background

A prior study of this construction worker population found significant noise‐associated hearing loss. This follow‐up study included a much larger study population and consideration of additional risk factors.

Methods

Data included audiometry, clinical chemistry, personal history, and work history. Qualitative exposure metrics for noise and solvents were developed. Analyses compared construction workers to an internal reference group with lower exposures and an external worker population with low noise exposure.

Results

Among participants (n = 19 127) an overall prevalence of hearing loss of 58% was observed, with significantly increased prevalence across all construction trades. Construction workers had significantly increased risk of hearing loss compared to reference populations, with increasing risk by work duration. Noise exposure, solvent exposure, hypertension, and smoking were significant risk factors in multivariate models.

Conclusions

Results support a causal relationship between construction trades work and hearing loss. Prevention should focus on reducing exposure to noise, solvents, and cigarette smoke.

     

528名接触非稳态噪声听力损失调查及预测方法的探讨

本文报道了528名接触非稳态噪声的冷作工、锻工听力损失的调查,以接触噪声在70dB(A)以下的机关干部95名作对照。调查结果,作业场所噪声等效连续A声级强度在85～115 dB,语言听力损失率为23.0%,高频听力损失率为83.7%。高频听损和语言听损的发生率与噪声强度和工龄密切相关,与对照组比有极显著性差异(P<0.005)。应用调查结果,采用线性回归方程式y=14.395(ДΓ_(00)-0.735)%计算,其听力损失值与本次调查实测位及ISO公布有关听觉丧失危险性的资料十分接近。故认为,该方程式可作为预测非稳态噪声作业人员听损发生率的预测方法。此方法符合实际,简单易行,具有实用价值。     

噪声所致工人听力损失与高血压的关系

目的研究某钢铁企业工人噪声暴露与高血压的关系。方法选择2014年1~7月底参加职业体检单纯接触噪声工人2061例,按照高频听力损失严重程度分组,即在4000 Hz或者6000 Hz,低听力损失组平均听力损失值(HLVs)15 d B(A)660例,噪声40 h等效声级为(74.69±11.97)d B(A);中听力损失组,15 d B(A)≤HLVs30 d B(A)741例,噪声40 h等效声级为(84.38±11.57)d B(A);高听力损失组,HLVs≥30 d B(A)660例,噪声40 h等效声级为(88.03±14.08)d B(A)。比较三组高血压患病率的差异。结果工人4000 Hz和6000 Hz时,左、右和两耳平均的HLVs值与平均噪声暴露水平显著相关(P0.05)。高血压患病率中听力损失组(29.5%)和高听力损失组(36.1%)明显高于低听力损失组(23.8%)(P0.05)。多因素Logistic回归分析显示,在调整了年龄、心率(HR)、甘油三酯(TG)、噪声40 h等效声级、糖尿病、吸烟、饮酒、体育锻炼等影响因素后,中听力损失组和高听力损失组患高血压的风险较高,其OR值分别为2.14(1.21~3.79)、2.58(1.44~4.62)。结论钢铁企业工人高频噪声引起的听力损失与患高血压的风险有关。     

接触不同噪声强度的听力损失及预测方法的探讨

本文报道了429例持续接触85、90、105dB(A)稳态噪声的工人听力损失的调查结果,发现85dB(A),工龄8年以上、13年以上和18～22年三组听力损失发生率分别为5.82%、16.66%和30.00%;高损发生率分别为35.29%、45.83%、60.00%。听力损失预测方法分析研究表明,应用回归方程y=15..9(-1)%的听力损失计算值与本次调查实测值及ISO公布有关听觉丧失危险性的资料均十分接近;接触85dB(A)工龄10、15、20和25年的听损发生率计算值分别为12.72%、19.08%、23.85%和28.62%。因此,建议对我国目前85dB(A)的噪声卫生标准予以适当的修订。     

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名生产性噪声作业工人进行听力检查 ,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 ,听力损失随之增加 ,二者间有高度正相关性 (r =0 95 76) ,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听力损失影响的差异有显著性 (P <0 0 5或P <0 0 1)。 [结论 ]累积噪声暴露量在噪声研究及噪声防治中有重要应用价值。     

Hearing loss as a risk factor for agricultural injuries

BACKGROUND: Previous studies suggested that hearing impairment based on self-report might increase the risk of agricultural injuries. However, self-reported hearing measures may be subject to inaccuracy and subjective perception. We assessed the association of agricultural injuries with hearing loss and other hearing characteristics using measured hearing. METHODS: Study subjects were 150 farmers who participated in the Iowa Certified Safe Farm study. Injury information was collected by telephone interviews at 2-5 month intervals from September 1999 to October 2002. Hearing levels were measured annually using the pure tone audiometry from 1998 to 2002. Adjusted rate ratios of injuries were calculated using the multivariate Poisson regression model. RESULTS: Hearing loss in the better ear (RR = 1.62), hearing asymmetry (RR = 1.67), and fair/poor self-reported hearing (RR = 1.96) were significantly associated with the risk of agricultural injuries. It is notable that self-reported hearing might be a stronger predictor of injuries than pure tone audiometry (PTA). Exposure to noise elevated the risk of injuries in those farmers with hearing loss or hearing asymmetry. The occasional use of hearing protection was significantly associated with agricultural injuries. CONCLUSIONS: This study adds substantial evidence that hearing loss acts as a risk for agricultural injuries. Prevention of hearing loss and noise exposure may be important in reducing the burden of agricultural injuries.     

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.     

稳态噪声与非稳态噪声所致工人听力损害的对比研究

目的评价两种不同性质的噪声对工人听力损害的差异方法对35家企业的稳态噪声接触1年以上工人共1421人,非稳态噪声(除脉冲噪声之外)接触1年以上冲压工人共957人进行纯音听力测试,并对35家接触噪声企业进行职业卫生学调查。结果在1421名稳态噪声组检出观察对象131例,患病率为9.2%,职业性噪声聋98人,患病率为6.8%;在957名非稳态噪声组检出观察对象74例,患病率为7.7%,职业性噪声聋60人,患病率为6.3%。两组比较差异无统计学意义(P0.05)。两组高频和语频听力损失的患病率随累积噪声暴露量的增大而增大,呈剂量-反应关系。结论在累积噪声暴露量接触水平一致的情况下,稳态噪声与非稳态噪声(除脉冲噪声之外)对引起的听力损失差异无统计学意义。     

某纺织厂噪声作业工人听力损失调查

目的:通过对某纺织厂噪声强度监测和对作业人员的听力检测,掌握噪声强度及听力损失的发生情况,为采取积极有效的防护措施提供依据。方法:用HS6288系列噪声分析仪监测作业场所噪声强度,并进行频谱分析,计算累积噪声暴露量(CNE);对某纺织厂接触噪声作业的无耳疾患的931人进行听力检测;用EpiData建立数据库,SAS软件8.0统计包进行统计分析。结果:该厂噪声车间的连续等效A声级均超过了85db(A),主要为中高频噪声;噪声作业人员有高频听力损失264人,检出率为28.36%,语频听力损失9人,检出率为0.97%;高频和语频听力损失的发生率均随累积接触噪声剂量的增加而升高;听力损失发生率及程度与工龄密切相关;织一车间和织二车间噪声平均>100dB(A),高频听损率分别为43.68%和42.62%,在强噪声车间作业戴耳塞者高频听损检出率低于不戴耳塞者,但高频听力损失的检出率仍然明显高于其他车间;听力损失曲线以高频凹陷谷点为3kHz及4 kHz的“V”字型为主,占高频听力损失的73.0%。结论:该厂噪声污染较严重,对作业人员听力已经产生了明显影响,应采取积极的综合预防性措施来控制噪声对作业人员健康的影响。     

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。     

Audiometric notch as a sign of noise induced hearing loss

OBJECTIVES—To investigate the relation between different types of exposure to noise and a classic sign of noise induced hearing loss (NIHL), the audiometric notch.METHODS—The study sample had exposure to both continuous and impulse noise and was drawn from a population of electrical transmission workers. Audiograms, taken as part of a hearing conservation programme, were read by three clinicians experienced in the assessment of NIHL. Working independently and using their clinical judgment, they were asked to identify localised increases in the threshold of hearing (audiometric notches) which they would attribute to noise, had a suitable history of exposure been elicited. Prevalent cases of NIHL were identified by the presence of a notch in either ear. Risk factors for NIHL were assessed by a questionnaire which sought information about exposure to air blast circuit breaker noise; firearms; explosions, and continuous noise. The odds of exposure to these factors in those with and without hearing loss were calculated, and odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated by logistic regression.RESULTS—Of the 648 questionnaires sent out 357 were returned, a response rate of 55%. Of these, at least two out of the three assessors identified 175 (49%) people with a notch at any audiometric frequency. There was no association between these cases and the NIHL risk factors identified by the questionnaire, but a further frequency specific analysis showed a small proportion of people (15 (4%)) with notches at 4 kHz who had the expected associations with exposure to noise and a significant OR for firearms of 4.25 (95% CI 1.28 to 14.1). The much larger proportion of people with 6 kHz notches (110 (31%)) did not show these associations.CONCLUSIONS—To diagnose NIHL it is important to elicit a detailed and accurate history of exposure to noise: although the notch at 4 kHz is a well established clinical sign and may be valuable in confirming the diagnosis, the 6 kHz notch is variable and of limited importance.     

Occupational noise exposure and hearing loss: A study of knowledge,attitude and practice among Tanzanian iron and steel workers

Abstract

We assessed Knowledge Attitude and Practice (KAP) regarding occupational noise exposure, Noise-induced hearing loss, audiometry and use of hearing protection devices among iron and steel factory workers exposed to high noise level. A modified, validated, structured questionnaire was used to collect information from 253 male workers randomly selected from the four factories. The sum scores for each domain of KAP were computed. Scores above 75% were defined as good knowledge and positive attitude. For practice, scores of >50% were defined as good. Independent samples t-test and Chi-squared test were used to analyze association between KAP and continuous/categorical variables respectively. Majority of workers displayed poor knowledge and poor practice (94%), but 76% displayed a positive attitude. Most of the workers (86%) had never been provided with hearing protection devices. The mean scores for attitude and practice differed significantly between the four factories (one-way ANOVA, p?<?0.001). Implementation of hearing conservation program with provision of hearing protection devices are suggested.     

Hearing impairment among young Chinese in a rural area

To evaluate hearing levels in Chinese young people, audiometry was carried out at a rural village in Shandong Prefecture. The subjects were 282 healthy school children and students ranging in age from 7–17 y. All subjects were asked to complete a brief questionnaire on otological symptoms, personal histories and use of noisy playthings. Audiometric threshold testing was performed at the audiomeric frequencies of 0.5, 1, 2, 4 and 8 kHz. Cluster analysis was used to estimate the associations between questions in the questionnaire and hearing impairment. Fifty-six subjects (20% subjects) were excluded from the normal groups. Twenty-two ears of the excluded subjects showed 4 kHz-dip and 38 ears showed high frequency hearing loss. An increased prevalence of hearing impairment was found when compared with young Japanese (1% from the nationwide school health survey) and with young Chinese in Shandong Prefecture (0.5%). In the questionnaire, 4 questions on dizziness, head trauma, aminoglycoside administration, and suspicion of Meniere's syndrome, were included in the cluster of hearing impairment. The cause of this hearing impairment was proposed to be the potentiating effects of aminoglycoside antibiotics and exposure to noise.     

Is occupational noise exposure during pregnancy a risk factor of damage to the auditory system of the fetus?

In the Province of Quebec, the regulated daily noise exposure limit is 90 dBA-8h. This limit value also applies to pregnant women. Experimental studies suggest however, that this standard is not sufficiently stringent to protect the auditory system of the fetus, particularly in cases of low-frequency noise exposure. An exploratory study was undertaken to assess this possibility. A total of 131 children were examined. Their mothers had worked, while pregnant with that child, in noise conditions ranging from 65 to 95 dBA-8h. Results show a three-fold increase in the risk of having a high-frequency hearing loss in the children whose mothers were exposed to noise in the range between a LAeq,9 m of 85 to 95 dB, and a significant increase in the risk of hearing loss at a frequency of 4000 Hz when these exposures involved a strong component of low-frequency noise.