Hong OiSaeng
Health Promotion & Risk Reduction Program, School of Nursing, University of Michigan, Ann Arbor, MI 48109-0482, USA.
Int Arch Occup Environ Health. 2005 Aug;78(7):565-74. doi: 10.1007/s00420-005-0623-9. Epub 2005 Jul 14.
Occupational noise exposure and noise-induced hearing loss (NIHL) among construction workers has long been recognized as a problem in the United States, yet little is known about the prevalence of NIHL among American construction workers. The purpose of this study was to determine the prevalence and characteristics of hearing loss among operating engineers (OEs) who operate heavy construction machinery.
As a part of hearing protection intervention, an audiometric test was conducted for both ears at frequencies 0.5 through 8 kHz in the soundproof booth. Prior to the audiometric test, a paper-pencil pre-hearing test questionnaire was administered and an otoscopic examination was completed. Prevalence of hearing loss was determined based on hearing threshold levels (HTLs) in the worst ear with a low fence of 25 dB.
A total of 623 workers were included in the analysis and they were predominantly middle-aged Caucasian males (mean age = 43 years, Caucasian = 90%, male = 92%). Over 60% of OEs showed hearing loss in the noise-sensitive higher frequencies of 4 and 6 kHz. The rate of hearing loss was particularly higher among workers who reported longer years of working in the construction industry. Workers showed significantly poorer hearing in the left ear, and a typical characteristic of NIHL, a V-notch at 4 or 6 kHz, was not shown in this population. Thirty-eight percent reported ringing/buzzing in the ear and 62% indicated having problems in understanding what people say in loud noise. Average reported use of hearing protection devices (HPDs) was 48% of the time they were required to be used. Significant inverse relationship was found between higher frequency (4-6 kHz) hearing loss and use of HPDs (r =-0.134, p < 0.001). Workers using HPDs more had significantly better hearing than those who did not.
The study demonstrated a significant NIHL problem and low use of HPDs in OEs. An effective hearing conservation program, including a periodic audiometric testing and hearing protection intervention, for this study population should be in place.
在美国，建筑工人的职业噪声暴露和噪声性听力损失（NIHL）长期以来一直被视为一个问题，但对于美国建筑工人中NIHL的患病率却知之甚少。本研究的目的是确定操作重型建筑机械的操作工程师（OE）中听力损失的患病率和特征。
作为听力保护干预的一部分，在隔音室内对双耳进行了0.5至8千赫频率的听力测试。在听力测试之前，进行了纸笔式听力前测试问卷，并完成了耳镜检查。听力损失的患病率根据最差耳的听力阈值水平（HTL）确定，低限为25分贝。
共有623名工人纳入分析，他们主要是中年白人男性（平均年龄=43岁，白人=90%，男性=92%）。超过60%的操作工程师在4千赫和6千赫的噪声敏感高频出现听力损失。在建筑行业工作年限较长的工人中，听力损失率尤其更高。工人左耳听力明显较差，该人群未表现出噪声性听力损失的典型特征，即4千赫或6千赫处的V型切迹。38%的人报告有耳鸣/耳内嗡嗡声，62%的人表示在嘈杂环境中理解他人说话有困难。报告的听力保护装置（HPD）平均使用时间为要求使用时间的48%。发现高频（4至6千赫）听力损失与HPD使用之间存在显著的负相关（r=-0.134，p<0.001）。使用HPD较多的工人听力明显优于未使用的工人。
该研究表明操作工程师中存在严重的噪声性听力损失问题且HPD使用率较低。应为该研究人群制定有效的听力保护计划，包括定期听力测试和听力保护干预。
