Palmer K T, Griffin M J, Syddall H E, Davis A, Pannett B, Coggon D
MRC Environmental Epidemiology Unit, Community Clinical Sciences, Southhampton General Hospital, University of Southampton, SO16 6YD, UK.
Occup Environ Med. 2002 Sep;59(9):634-9. doi: 10.1136/oem.59.9.634.
To determine the prevalence of self reported hearing difficulties and tinnitus in working aged people from the general population, and to estimate the risks from occupational exposure to noise and the number of attributable cases nationally.
A questionnaire was mailed to 22 194 adults of working age selected at random from the age-sex registers of 34 British general practices (21 201 subjects) and from the central pay records of the British armed services (993 subjects). Information was collected on years of employment in a noisy job; and whether the respondent wore a hearing aid, had difficulty in hearing conversation, or had experienced persistent tinnitus over the past year. Associations of hearing difficulty and tinnitus with noise exposure were examined by logistic regression, with adjustment for age, sex, smoking habits, and frequent complaints of headaches, tiredness, or stress. The findings were expressed as prevalence ratios (PRs) with associated 95% confidence intervals (CIs). Attributable numbers were calculated from the relevant PRs and an estimate of the prevalence of occupational exposure to noise nationally.
Some 2% of subjects reported severe hearing difficulties (wearing a hearing aid or having great difficulty in both ears in hearing conversation in a quiet room). In men, the prevalence of this outcome rose steeply with age, from below 1% in those aged 16-24 years to 8% in those aged 55-64. The pattern was similar in women, but severe hearing loss was only about half as prevalent in the oldest age band. Tinnitus was far more common in subjects with hearing difficulties. In both sexes, after adjustment for age, the risk of severe hearing difficulty and persistent tinnitus rose with years spent in a noisy job. In men older than 35 years with 10 or more years of exposure, the PR for severe hearing difficulty was 3.8 (95% CI 2.4 to 6.2) and that for persistent tinnitus 2.6 (95% CI 2.0 to 3.4) in comparison with those who had never had a noisy job. Nationally, some 153 000 men and 26 000 women aged 35-64 years were estimated to have severe hearing difficulties attributable to noise at work. For persistent tinnitus the corresponding numbers were 266 000 and 84 000.
Significant hearing difficulties and tinnitus are quite common in men from the older working age range. Both are strongly associated with years spent in a noisy occupation--a predominantly male exposure. The national burden of hearing difficulties attributable to noise at work is substantial.
确定普通人群中工作年龄人群自我报告的听力困难和耳鸣的患病率，并估计职业性噪声暴露的风险以及全国范围内可归因病例数。
向从34个英国全科诊所的年龄 - 性别登记册（21201名受试者）和英国武装部队的中央薪资记录（993名受试者）中随机抽取的22194名工作年龄成年人邮寄问卷。收集有关在嘈杂工作中的就业年限的信息；以及受访者是否佩戴助听器、在听力对话方面是否有困难，或者在过去一年中是否经历过持续性耳鸣。通过逻辑回归分析听力困难和耳鸣与噪声暴露之间的关联，并对年龄、性别、吸烟习惯以及经常出现的头痛、疲劳或压力投诉进行调整。研究结果以患病率比（PRs）及相关的95%置信区间（CIs）表示。可归因病例数根据相关的PRs和全国职业性噪声暴露患病率的估计值计算得出。
约2%的受试者报告有严重听力困难（佩戴助听器或在安静房间中双耳听力对话有很大困难）。在男性中，这一结果的患病率随年龄急剧上升，从16 - 24岁年龄段的低于1%升至55 - 64岁年龄段的8%。女性的情况类似，但在最年长年龄组中严重听力损失的患病率仅约为男性的一半。耳鸣在有听力困难的受试者中更为常见。在男女两性中，调整年龄后，严重听力困难和持续性耳鸣的风险随在嘈杂工作中度过的年限增加而上升。在35岁及以上且有10年或更长时间噪声暴露的男性中，与从未从事过嘈杂工作的人相比，严重听力困难的PR为3.8（95%CI 2.4至6.2），持续性耳鸣的PR为2.6（95%CI 2.0至3.4）。在全国范围内，估计约有153000名35 - 64岁的男性和26000名女性因工作中的噪声而有严重听力困难。对于持续性耳鸣，相应的人数分别为266000和84000。
在年龄较大的工作年龄男性中，明显的听力困难和耳鸣相当常见。两者都与在嘈杂职业中度过的年限密切相关——这主要是男性面临的暴露。工作中噪声导致的听力困难的全国负担相当大。
