Picard Michel, Girard Serge André, Simard Marc, Larocque Richard, Leroux Tony, Turcotte Fernand
Université de Montréal, Ecole d'orthophonie et d'audiologie, C.P. 6128, succ. centre-ville, Montreal, QC, Canada H3C 3J7.
Accid Anal Prev. 2008 Sep;40(5):1644-52. doi: 10.1016/j.aap.2008.05.013. Epub 2008 Jul 3.
This retrospective study explores the association between occupational noise exposure at the time of hearing tests, permanent noise-induced hearing loss and work-related accident risk. Log-binomial analysis was used to first ascertain the association between study variables according to activity sector (North American Industry Classification System, NAICS) and accident context while controlling for age. Second part of the paper estimates the overall number of accidents attributable to occupational noise or the associated hearing loss (excess fraction). Study was carried on a sample of 52,982 male workers exposed to a minimum of 80 dBA on a daily basis and whose hearing was examined at least once between 1983 and 1996 by public health authorities of Quebec. These participants evidenced bilateral average hearing threshold levels at 3, 4 and 6 kHz ranging from normal (< or = 15 dB) to hearing loss in excess of 50 dB as a result of chronic occupational noise exposure (subjects otherwise otologically normal). The occupational accident count of these workers was derived from the individual histories registered with the Quebec workers' compensation board for the 1983-1998 period. Results show an association between accident risk and worker's hearing sensitivity. For example, a hearing loss of 20 dB corresponds to a rise of accident risk equal to 1.14 when controlling for age and occupational noise exposure at the time of hearing tests. NAICS economic activity sectors where association is the most noticeable are "Metal Transformation", "Metal Product Manufacturing" and "Transportation Equipment Manufacturing". "Passive accidents" (PR per decibel of hearing loss = 1.008; CI 95 (1.007; 1.010)) and "same-level falls" (1.007; CI 95 (1.003; 1.010)) are the two accidents categories most strongly associated with hearing loss. Overall, 12.2% of accidents considered in this study were attributable to a combination of noise exposure in the workplace (> or = 90 dBA) and noise-induced hearing loss.
这项回顾性研究探讨了听力测试时的职业噪声暴露、永久性噪声性听力损失与工作相关事故风险之间的关联。采用对数二项式分析首先根据活动部门（北美行业分类系统，NAICS）和事故背景确定研究变量之间的关联，同时控制年龄因素。论文的第二部分估计了可归因于职业噪声或相关听力损失的事故总数（超额比例）。该研究以52982名男性工人为样本，他们每天至少暴露于80分贝的噪声环境中，并且在1983年至1996年期间至少接受过一次魁北克公共卫生当局的听力检查。这些参与者由于长期职业噪声暴露（其他方面耳科正常），在3千赫、4千赫和6千赫处的双侧平均听力阈值水平从正常（≤15分贝）到超过50分贝的听力损失不等。这些工人的职业事故数量来自于1983 - 1998年期间在魁北克工人赔偿委员会登记的个人记录。结果显示事故风险与工人的听力敏感度之间存在关联。例如，在控制年龄和听力测试时的职业噪声暴露的情况下，20分贝的听力损失对应事故风险增加1.14。关联最为明显的NAICS经济活动部门是“金属加工”、“金属制品制造”和“运输设备制造”。“被动事故”（每分贝听力损失的PR = 1.008；95%置信区间（1.007；1.010））和“同水平跌倒”（1.007；95%置信区间（1.003；1.010））是与听力损失关联最紧密的两类事故。总体而言，本研究中12.2%的事故可归因于工作场所噪声暴露（≥90分贝）和噪声性听力损失的综合影响。
