Davies H W, Teschke K, Kennedy S M, Hodgson M R, Demers P A
School of Environmental Health, University of British Columbia, Vancouver, Canada.
Occup Environ Med. 2009 Jun;66(6):388-94. doi: 10.1136/oem.2008.040881. Epub 2008 Dec 5.
Chronic exposure to high levels of noise may be associated with increased risk of cardiovascular disease. We therefore undertook a quantitative retrospective exposure assessment using predictive statistical modelling to estimate historical exposures to noise among a cohort of 27,499 sawmill workers as part of an investigation of acute myocardial infarction mortality.
Noise exposure data were gathered from research, industry and regulatory sources. An exposure data matrix was defined and exposure level estimated for job title/mill/time period combinations utilising regression analysis to model determinants of noise exposure. Cumulative exposure and duration of exposure metrics were calculated for each subject. These were merged with work history data, and exposure-response associations were tested in subsequent epidemiological studies, reported elsewhere.
Over 14,000 noise measurements were obtained from British Columbia sawmills. A subset, comprising 1901 full-shift dosimetry measurements from cohort mills was used in producing a predictive model (R(2) = 0.51). The model was then used to estimate noise exposures for 3809 "cells" of an exposure data matrix representing 81 jobs at 14 mills over several decades. Various exposure metrics were then calculated for subjects; mean cumulative exposure was 101 dBA*year. Mean durations of employment in jobs with exposure above thresholds of 85, 90 and 95 dBA, were 9.9, 7.0 and 3.2 years, respectively.
The utility of predictive statistical modelling for occupational noise exposure was demonstrated. The model required input data that were relatively easily obtained, even retrospectively. Remaining issues include adequate handling of the use of hearing protectors that likely bias exposure estimation.
长期暴露于高强度噪声环境可能会增加患心血管疾病的风险。因此,作为对急性心肌梗死死亡率调查的一部分,我们采用预测统计模型进行了定量回顾性暴露评估,以估算27499名锯木厂工人的历史噪声暴露情况。
从研究、行业和监管来源收集噪声暴露数据。定义了一个暴露数据矩阵,并利用回归分析对噪声暴露的决定因素进行建模,以估算工作岗位/工厂/时间段组合的暴露水平。计算了每个受试者的累积暴露量和暴露持续时间指标。将这些指标与工作经历数据合并,并在后续的流行病学研究中测试暴露-反应关联,相关研究结果已在其他地方报道。
从不列颠哥伦比亚省的锯木厂获得了超过14000次噪声测量数据。其中一个子集,包括来自队列工厂的1901次全时剂量测定测量数据,被用于建立一个预测模型(R² = 0.51)。然后,该模型被用于估算一个暴露数据矩阵中3809个“单元”的噪声暴露情况,该矩阵代表了14家工厂在几十年中的81个工作岗位。随后计算了受试者的各种暴露指标;平均累积暴露量为101分贝年。在噪声暴露高于85、90和95分贝阈值的工作岗位上,平均就业持续时间分别为9.9年、7.0年和3.2年。
证明了预测统计模型在职业噪声暴露评估中的实用性。该模型所需的输入数据相对容易获得,即使是回顾性数据。遗留问题包括如何妥善处理可能会使暴露估计产生偏差的听力保护器的使用情况。