* Cochrane Occupational Safety and Health Review Group, Finnish Institute of Occupational Health , Kuopio , Finland.
Int J Audiol. 2014 Mar;53 Suppl 2(0 2):S84-96. doi: 10.3109/14992027.2013.857436.
To assess the effectiveness of interventions for preventing occupational noise exposure or hearing loss compared to no intervention or alternative interventions.
We searched biomedical databases up to 25 January 2012 for randomized controlled trials (RCT), controlled before-after studies and interrupted time-series of hearing loss prevention among workers exposed to noise.
We included 19 studies with 82 794 participants evaluating effects of hearing loss prevention programs (HLPP). The overall quality of studies was low to very low, as rated using the GRADE approach.
One study of stricter legislation showed a favorable effect on noise levels. Three studies, of which two RCTs, did not find an effect of a HLPP. Four studies showed that better use of hearing protection devices in HLPPs decreased the risk of hearing loss. In four other studies, workers in a HLPP still had a 0.5 dB greater hearing loss at 4 kHz (95% CI - 0.5 to 1.7) than non-exposed workers. In two similar studies there was a substantial risk of hearing loss in spite of a HLPP.
Stricter enforcement of legislation and better implementation of HLPPs can reduce noise levels in workplaces. Better evaluations of technical interventions and long-term effects are needed.
评估干预措施在预防职业性噪声暴露或听力损失方面的效果，与无干预或替代干预措施相比。
我们检索了生物医学数据库，截至 2012 年 1 月 25 日，寻找针对噪声暴露工人的听力损失预防的随机对照试验（RCT）、对照前后研究和时间序列中断研究。
我们纳入了 19 项研究，共 82794 名参与者，评估了听力损失预防计划（HLPP）的效果。使用 GRADE 方法评价，研究的整体质量为低到极低。
一项关于更严格法规的研究显示对噪声水平有有利影响。三项研究，其中两项为 RCT，未发现 HLPP 的效果。四项研究表明，在 HLPP 中更好地使用听力保护装置可降低听力损失的风险。在另外四项研究中，HLPP 中的工人在 4 kHz 时仍有 0.5 dB 的听力损失增加（95%CI-0.5 至 1.7），高于未暴露的工人。在两项类似的研究中，尽管有 HLPP，但仍存在听力损失的高风险。
更严格地执行法规和更好地实施 HLPP 可以降低工作场所的噪声水平。需要更好地评估技术干预措施和长期效果。
