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。

Dose-response relationship for continuous noise induced high frequency hearing loss with two different noise measurements and assessments in textile workers

Objective Comparing dose-response relationship for continuous noise induced hearing loss with sound pressure level,L Aeq.8h and cumulative noise exposure.Methods Four groups of textile workers were designed as investigating subjects,three to five workers were selected to measure L Aeq.8h with dosimeter for each group in each shift workday.L Aeq.1 min were measured with sound level meter and lattice sampling method in same workshops.Questionnaire and hearing measurement were carried out in the 163 textile workers.Results The adjusted prevalence of high frequency noise induced hearing loss(HFNIHL)was 64.4%(105/163),and the adjusted prevalence of low frequency noise induced hearing loss was 2.5%(4/163).The prevalence of HFNIHL was increased in higher noise exposure groups,that means there was a typical dose-response relationship for noise induced HFNIHL in the continuous noise exposure population.Trend chi-square and logistic model analysis showed that cumulative noise exposure(CNE)and L Aeq.8h assessment model was better than other models by dose-response assessment.Conclusion CNE and L Aeq.8h assessment model is one of the best potential candidate models for assessing industrial continuous noise exposure,it needs more observation in different kinds of industrial noise exposure population to confirm the hypothesis.