Saffree Jeffree Mohammad, Ismail Noorhassim, Awang Lukman Khamisah
Department of Community & Family Medicine, Faculty of Medicine & Health Science, University of Malaysia Sabah.
J Occup Health. 2016 Sep 30;58(5):434-443. doi: 10.1539/joh.16-0043-OA. Epub 2016 Aug 4.
Hearing impairment remains the main occupational health problem in the manufacturing industry, and its contributing factors have not been well controlled.
Unmatched case control and comparative studies were carried out among fertilizer factory workers in Sarawak with the aim of determining contributing factors for hearing impairment. Respondents consisted of 49 cases that were diagnosed from 2005 to 2008 with 98 controls from the same work places. Chi-square test and Mann-Whitney test were used in a univariate analysis to determine the association between hearing impairment and the contributing risks being studied.
The results of the univariate analysis showed that hearing impairment was significantly (p<0.05) associated with older age, lower education level, high smoking dose, high occupational daily noise dose, longer duration of service, infrequent used of hearing protection device (HPD), and low perception of sound on HPD usage. Multivariate logistic regression of hearing impairment after controlling for age found the following five variables: occupational daily noise dose ≥50% (OR 3.48, 95% CI 1.36-8.89), ≥15 years of services (OR 2.92, 95% CI 1.16-7.33), infrequent use of HPD (OR 2.79, 95% CI 1.15-6.77), low perception of sound on HPD (POR 2.77, 95% CI 1.09-6.97), and smoking more than 20 packs per year (OR 4.71, 95% CI 1.13-19.68).
In conclusion, high occupational noise exposure level, longer duration of service, low perception of sound on HPD, infrequent used of HPD, and smoking more than 20 packs per year were the contributing factors to hearing impairment, and appropriate intervention measures should be proposed and taken into considerations.
听力损伤仍然是制造业主要的职业健康问题,其影响因素尚未得到有效控制。
在砂拉越的化肥厂工人中开展了非匹配病例对照和比较研究,旨在确定听力损伤的影响因素。研究对象包括2005年至2008年确诊的49例病例以及来自相同工作场所的98名对照。单因素分析中使用卡方检验和曼-惠特尼检验来确定听力损伤与所研究的影响风险之间的关联。
单因素分析结果显示,听力损伤与年龄较大、教育水平较低、吸烟量大、职业每日噪声剂量高、服务年限长、很少使用听力保护装置(HPD)以及对HPD使用的声音感知低显著相关(p<0.05)。在控制年龄后对听力损伤进行多因素逻辑回归分析,发现以下五个变量:职业每日噪声剂量≥50%(比值比3.48,95%置信区间1.36 - 8.89)、服务年限≥15年(比值比2.92,95%置信区间1.16 - 7.33)、很少使用HPD(比值比2.79,95%置信区间1.15 - 6.77)、对HPD的声音感知低(比值比2.77,95%置信区间1.09 - 6.97)以及每年吸烟超过20包(比值比4.71,95%置信区间1.13 - 19.68)。
总之,高职业噪声暴露水平、较长的服务年限、对HPD的声音感知低、很少使用HPD以及每年吸烟超过20包是听力损伤的影响因素,应提出并考虑适当的干预措施。