Rabinowitz P M, Galusha D, Slade M D, Dixon-Ernst C, O'Neill A, Fiellin M, Cullen M R
Yale Occupational and Environmental Medicine Program, Yale University School of Medicine, 135 College Street, 3rd Floor, New Haven, CT 06510, USA.
Occup Environ Med. 2008 Apr;65(4):230-5. doi: 10.1136/oem.2006.031047. Epub 2007 Jun 13.
Organic solvent exposure has been shown to cause hearing loss in animals and humans. Less is known about the risk of hearing loss due to solvent exposures typically found in US industry. The authors performed a retrospective cohort study to examine the relationship between solvent exposure and hearing loss in US aluminium industry workers.
A cohort of 1319 workers aged 35 years or less at inception was followed for 5 years. Linkage of employment, industrial hygiene and audiometric surveillance records allowed for estimation of noise and solvent exposures and hearing loss rates over the study period. Study subjects were classified as "solvent exposed" or not, on the basis of industrial hygiene records linked with individual job histories. High frequency hearing loss was modelled as both a continuous and a dichotomous outcome.
Typical solvent exposures involved mixtures of xylene, toluene and/or methyl ethyl ketone (MEK). Recorded solvent exposure levels varied widely both within and between jobs. In a multivariate logistic model, risk factors for high frequency hearing loss included age (OR = 1.06, p = 0.004), hunting or shooting (OR = 1.35, p = 0.049), noisy hobbies (OR = 1.74, p = 0.01), baseline hearing level (OR = 1.04, p<0.001) and solvent exposure (OR = 1.87, p = 0.004). A multivariate linear regression analysis similarly found significant associations between high frequency hearing loss and age (p<0.001), hunting or shooting (p<0.001), noisy hobbies (p = 0.03), solvent exposure (p<0.001) and baseline hearing (p = 0.03).
These results suggest that occupational exposure to organic solvent mixtures is a risk factor for high frequency hearing loss, although the data do not allow conclusions about dose-response relationships. Industries with solvent-exposed workers should include such workers in hearing conservation programs.
已表明有机溶剂暴露会导致动物和人类听力损失。对于美国工业中常见的溶剂暴露导致听力损失的风险了解较少。作者进行了一项回顾性队列研究，以检查美国铝业工人溶剂暴露与听力损失之间的关系。
对初始时年龄在35岁及以下的1319名工人进行了为期5年的随访。通过就业、工业卫生和听力监测记录的关联，可估计研究期间的噪声和溶剂暴露以及听力损失率。根据与个人工作经历相关的工业卫生记录，将研究对象分为“溶剂暴露组”和“非溶剂暴露组”。高频听力损失被建模为连续变量和二分变量两种结果。
典型的溶剂暴露涉及二甲苯、甲苯和/或甲乙酮（MEK）的混合物。记录的溶剂暴露水平在不同工作之间和工作内部差异很大。在多变量逻辑模型中，高频听力损失的风险因素包括年龄（OR = 1.06，p = 0.004）、打猎或射击（OR = 1.35，p = 0.049）、喧闹的爱好（OR = 1.74，p = 0.01）、基线听力水平（OR = 1.04，p<0.001）和溶剂暴露（OR = 1.87，p = 0.004）。多变量线性回归分析同样发现高频听力损失与年龄（p<0.001）、打猎或射击（p<0.001）、喧闹的爱好（p = 0.03）、溶剂暴露（p<0.001）和基线听力（p = 0.03）之间存在显著关联。
这些结果表明，职业性接触有机溶剂混合物是高频听力损失的一个风险因素，尽管数据无法得出剂量反应关系的结论。有溶剂暴露工人的行业应将此类工人纳入听力保护计划。
