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.

Effect of environmental risk factors in occupational noise exposure on noise-induced hearing loss

Objective To observe the effect of environmental risk factors in occupational noise exposure on hearing loss and find out the susceptible population of noise induced heating loss(NIHL).Methods A case-control study was designed to study the effect of environmental risk factors on NIHL 2400 workers exposed to 75～120 dB noises from an air conditioning factory in southern China served as the subjects.202 workers were selected from 10% of population with the maximum hearing shift of the left ear to 3000 Hz noises as the NIHL susceptible group while 204 workers from 10%of population with the least heating shift as the NIHL tolerant group.A questionnaire was designed to carry out an investigation,and an occupational health survey was used to identify the occupational risk factors which might affect the hearing system.The univariate analysis and multivariate analysis were used to observe the effect of environmental risk factors on NIHL.Results The results of univariate analysis showed that smoking,alcohol drinking,organic solvent,heavy metal,heat,dust were significantly was associated with NIHL(P＜0.05).Multivariate analysis showed that only heat was associated with NIHL(P＜0.05),and OR value was 1.804(95%CI:1.101～2.958).Conclusion Exposure to heat may be a high risk factor of NIHL.