Department of Environmental and Occupational Medicine, University of Aberdeen, Aberdeen, UK.
Occup Med (Lond). 2010 Jan;60(1):36-42. doi: 10.1093/occmed/kqp152. Epub 2009 Nov 13.
The aims are to compare hearing loss between professional divers and offshore workers and to study whether hearing loss symptoms reflected physical disorder. A secondary objective was to study total threshold shift assessment as a method of detecting noise-induced hearing loss (NIHL).
Participants (151 divers and 120 offshore workers) completed a questionnaire for symptoms and screening audiometry. Audiograms were assessed for total threshold shift at 1, 2, 3, 4 and 6 kHz and the prevalence of referral (within population 5th centile) or warning levels (within population 20th centile) of hearing loss. Audiograms were assessed for an NIHL pattern at four levels by two occupational physicians.
Hearing loss symptoms were commoner in divers at all levels of hearing loss regardless of differences between groups on audiometry. Hearing loss in offshore workers was within the population age-adjusted norm. Thirteen per cent of divers were within the 5th percentile for threshold shift for the population norm in contrast to 4% of offshore workers and this was predominantly left sided (OR 3.16, 95% CI 1.13-8.93). This difference was lost after adjustment for history of regular exposure to explosion or gunfire. Divers were more likely to have a pattern of severe NIHL on the left (OR 4.61, 95% CI 1.39-15.39, P < 0.05). Approximately 50% of participants with severe NIHL did not have a referral level of hearing loss.
Divers suffer more NIHL than a control population. Current guidance on the assessment of total threshold shift for the detection of significant NIHL was inadequate in the sample studied.
比较专业潜水员和海上作业工人的听力损失情况，并研究听力损失症状是否反映了身体机能障碍。次要目的是研究总阈移评估作为检测噪声性听力损失（NIHL）的方法。
参与者（151 名潜水员和 120 名海上作业工人）完成了症状和筛查听力计问卷。对听力图在 1、2、3、4 和 6 kHz 的总阈移进行评估，并评估听力损失的转诊（人群第 5 百分位内）或警告（人群第 20 百分位内）水平的发生率。两名职业医生根据四个水平评估听力图的 NIHL 模式。
无论听力计检查结果两组之间是否存在差异，所有听力损失水平的潜水员听力损失症状都更为常见。海上作业工人的听力损失在人群年龄调整正常范围内。13%的潜水员的阈移处于人群正常值的第 5 百分位，而海上作业工人仅为 4%，且主要为左侧（OR 3.16，95%CI 1.13-8.93）。在调整了定期接触爆炸或枪声的病史后，这种差异消失了。潜水员更有可能出现左侧严重 NIHL 的模式（OR 4.61，95%CI 1.39-15.39，P<0.05）。大约 50%的严重 NIHL 患者没有达到听力损失的转诊水平。
与对照组相比，潜水员遭受更多的 NIHL。在研究样本中，目前关于总阈移评估以检测显著 NIHL 的指南是不充分的。
