Department of Otorhinolaryngology- Head and Neck Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
J Occup Environ Hyg. 2011 Oct;8(10):618-23. doi: 10.1080/15459624.2011.609013.
One of the major occupational hazards of working in military service is being subjected to intense impulse noise. We analyzed the clinical presentation of acoustic traumas, induced by mass rifle gunshot noise during military training, in unprotected patients. We evaluated 189 soldiers who had otologic symptoms after rifle shooting exercises without using any hearing protection. All soldiers had been training on the K2 rifle. We took medical histories; conducted physical examinations and hearing evaluations (pure-tone audiometry, speech audiometry, and impedence audiometry); and distributed the Newmann's Tinnitus Handicap Inventory (THI) survey. In addition, we evaluated a normal control group of 64 subjects of similar age who had never fired a rifle. In the patient group, the most common and irritating reported symptom was tinnitus (94.2%), and the average THI score in the patient group was 39.51 ± 14.87, which was significantly higher than the control group score (0.56 ± 3.94) (p < 0.001). Average outcomes of post-exposure air conduction thresholds were 21.33 ± 13.25 dB HL in the affected ears. These levels also were significantly higher than those of the control group (9.16 ± 4.07dB HL) (p < 0.001). Hearing loss was most prominent at high frequencies. An asymmetry of hearing loss related to head position during shooting was not observed. Acoustic trauma induced by gunshot noise can cause permanent tinnitus and hearing loss. Hearing protection (bilateral earplugs) and environmental reform are necessary.
在军队服役中，主要的职业危害之一是受到强烈的脉冲噪声。我们分析了在军事训练中，未使用任何听力保护装置的情况下，大规模步枪射击噪声引起的声创伤的临床表现。我们评估了 189 名在没有使用任何听力保护装置的情况下进行步枪射击训练后出现耳科症状的士兵。所有士兵都曾在 K2 步枪上接受过训练。我们记录了病史；进行了体格检查和听力评估（纯音测听、言语测听和阻抗测听）；并分发了 Newmann 耳鸣残疾量表（THI）调查问卷。此外，我们评估了一个由 64 名年龄相仿、从未打过步枪的正常对照组。在患者组中，最常见和最烦人的报告症状是耳鸣（94.2%），患者组的平均 THI 得分为 39.51 ± 14.87，明显高于对照组的得分（0.56 ± 3.94）（p < 0.001）。暴露后空气传导阈值的平均结果为受影响耳的 21.33 ± 13.25 dB HL。这些水平也明显高于对照组（9.16 ± 4.07dB HL）（p < 0.001）。听力损失最明显的是高频。在射击过程中与头部位置相关的听力损失不对称未被观察到。枪声引起的声创伤可导致永久性耳鸣和听力损失。有必要使用听力保护装置（双侧耳塞）和进行环境改革。
