Job A, Raynal M, Tricoire A, Signoret J, Rondet P
Centre de recherches du service de santé des armées Emile Pardé, 24, Avenue des maquis du Grésivaudan, BP 87, 38702 La Tronche cedex France.
Rev Epidemiol Sante Publique. 2000 Jun;48(3):227-37.
It is currently thought that young adults are at increasing risk of exposure to deleterious sources of noise. To test this possibility we have assessed hearing status of young French men aged between 18 and 24 years in 1997 and study risk factors of deafness in a cross-sectional epidemiological study at selection centres for aptitudes to National Service.
During the time of the study, 1208 subjects were examined. For each subject, data of an interview, an otoscopy and audiograms were collected. We compared hearing thresholds between subjects with different noise exposures and we determined risk factors of deafness in this population.
The prevalence of hearing loss was 9% at medium frequencies (0.5-2 kHz) and 15% at high frequencies (4-8 kHz).We found that 60% of the subjects were regularly exposed to at least one source of loud noise. Acoustic trauma (6%) mostly explained hearing losses. Repeated episodes of otitis media in childhood (17%) also emerged as an important risk factor apparently due to increased sensitivity to noise. In subjects with antecedent of otitis media, hearing impairments were significant in personal stereo users (>1 hour per day) (p<0.001), in those who went to discos and rock concerts (>2 times per month) (p=0.01) and in those who worked in noisy places (p=0.01). In contrast, in subjects without antecedent of otitis, we found no difference in hearing thresholds between noise exposed and non noise exposed subjects.
Loud sound exposure is a true risk factor of early deafness in subjects that had had repeated episodes of otitis media in childhood. This study stresses the need for both prevention policies and information of health professionals and practitioners.
目前认为，年轻人接触有害噪声源的风险在不断增加。为了验证这种可能性，我们于1997年评估了18至24岁法国年轻男性的听力状况，并在国民服役能力选拔中心进行了一项横断面流行病学研究，以研究耳聋的风险因素。
在研究期间，对1208名受试者进行了检查。为每位受试者收集了访谈、耳镜检查和听力图数据。我们比较了不同噪声暴露受试者之间的听力阈值，并确定了该人群中耳聋的风险因素。
中频（0.5 - 2 kHz）听力损失患病率为9%，高频（4 - 8 kHz）为15%。我们发现60%的受试者经常接触至少一种高强度噪声源。声学创伤（6%）是听力损失的主要原因。儿童期反复中耳炎发作（17%）也成为一个重要的风险因素，显然是由于对噪声的敏感性增加。在有中耳炎病史的受试者中，个人立体声音响使用者（每天>1小时）（p<0.001）、去迪斯科舞厅和摇滚音乐会的人（每月>2次）（p = 0.01）以及在嘈杂场所工作的人（p = 0.01）的听力损伤明显。相比之下，在没有中耳炎病史的受试者中，噪声暴露组和非噪声暴露组之间的听力阈值没有差异。
在儿童期有反复中耳炎发作史的受试者中，高强度声音暴露是早期耳聋的一个真正风险因素。本研究强调了预防政策以及对健康专业人员和从业者进行宣传的必要性。
