Yu S F, Chen G S, Jiao J, Gu G Z, Zhang H L, Wang X M, Zhou W H, Wu H, Li Y H, Zheng Y X
Office of Henan Provincial Institute of Occupational Health, Zhengzhou 450052, China.
Office of WuGang Institute of Occupational Health, Pingdingshan 467000, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2017 Jan 6;51(1):13-19. doi: 10.3760/cma.j.issn.0253-9624.2017.01.005.
To analyze the incidence rate of occupational noise-induced hearing loss in noise-exposed workers in an iron and steel plant from 2006 to 2015. Using a cohort study method, workers exposed to occupational noise from Jan 1, 2006 to Dec 12, 2015 were followed up and the pure tone hearing test was conducted. In total, 6 297 subjects completed two or more physical checks and the pure tone hearing test and were included in the analysis. The noise exposure level at the workplace and the equivalent continuous A-weighted sound pressure level for workers was monitored and the cumulative noise exposure dose was evaluated. The subjects were divided into low, middle and high exposure groups according to the noise exposure level, and the equivalent continuous A-weighted sound pressure level for 8 hours for each group was 80.6-85.0, 85.1-90.0 and 90.1-103.4 dB (A), respectively. While the and 95% were derived from unconditional logistic regression models. In logistic regression analysis, confounding factors such as age, gender, smoking habit, drinking habit, high temperature exposure and chemical hazards exposure level were controlled. During the follow-up period, 392 cases of occupational noise-induced hearing loss were diagnosed among the 6 297 subjects, with an incidence rate of 6.23%; 318 cases of high-frequency hearing loss were diagnosed, with an incidence rate of 5.05%; and 74 cases of occupational noise-induced deafness were diagnosed, with an incidence rate of 1.18% . The incidence rates of hearing loss among the high, medium and low exposure groups were 9.22% (158/1 737), 6.49% (204/3 142) and 2.08% (30/1 442), respectively; the rates of high-frequency hearing loss were 7.41% (127/1 737), 5.25% (165/3 142) and 1.80% (26/1 442), respectively; and the rates of occupational noise-induced deafness were 1.81% (31/1 737), 1.24% (39/3 142) and 0.28% (4/1 442), respectively. For the groups corresponding to cumulative noise exposure doses of ≤84.99, 85.00- 87.99, 88.00- 90.99, 91.00- 93.99, 94.00- 96.99, 97.00- 100.99, 101.00- 102.99 and ≥103.00 dB (A) · year, the incidence rates of hearing loss were 0 (0/185), 1.22% (2/164), 2.52% (17/674), 3.83% (35/913), 5.80% (106/1 827), 6.02% (67/1 113), 9.20% (95/1 003) and 18.04% (70/388), respectively. Compared with the low exposure group, the of hearing loss, high-frequency hearing loss and occupational noise-induced deafness for the high exposure group were 4.78 (95% 3.22- 7.11), 4.36 (95% 2.84- 6.69) and 6.63 (95% 2.33- 18.82), respectively; and for the medium exposure group were 3.27 (95% 2.22-4.82), 3.02 (95% 1.99-4.59) and 4.52 (95% 1.61-12.67), respectively. The incidence rate of hearing loss for workers exposed to noise in an iron and steel plant was related to the cumulative noise exposure dose, gender, age, educational level, smoking habits, drinking habits and exposure to high temperature.
分析某钢铁厂2006年至2015年噪声暴露工人职业性噪声聋的发病率。采用队列研究方法，对2006年1月1日至2015年12月12日接触职业噪声的工人进行随访，并进行纯音听力测试。共有6297名受试者完成了两次或更多次体检和纯音听力测试，并纳入分析。监测工作场所的噪声暴露水平和工人的等效连续A声级，评估累积噪声暴露剂量。根据噪声暴露水平将受试者分为低、中、高暴露组，每组8小时等效连续A声级分别为80.6 - 85.0、85.1 - 90.0和90.1 - 103.4 dB(A)。采用无条件logistic回归模型计算发病率及95%置信区间。在logistic回归分析中，控制了年龄、性别、吸烟习惯、饮酒习惯、高温暴露和化学危害暴露水平等混杂因素。随访期间，6297名受试者中诊断出职业性噪声聋392例，发病率为6.23%；诊断出高频听力损失318例，发病率为5.05%；诊断出职业性噪声聋74例，发病率为1.18%。高、中、低暴露组听力损失发病率分别为9.22%（158/1737）、6.49%（204/3142）和2.08%（30/1442）；高频听力损失发病率分别为7.41%（127/1737）、5.25%（165/3142）和1.80%（26/1442）；职业性噪声聋发病率分别为1.81%（31/1737）、1.24%（39/3142）和0.28%（4/1442）。累积噪声暴露剂量≤84.99、85.00 - 87.99、88.00 - 90.99、91.00 - 93.99、94.00 - 96.99、97.00 - 100.99、101.00 - 102.99和≥103.00 dB(A)·年对应的组，听力损失发病率分别为0（0/185）、1.22%（2/164）、2.52%（17/674）、3.83%（35/913）、5.80%（106/1827）、6.02%（67/1113）、9.20%（95/1003）和18.04%（70/388）。与低暴露组相比，高暴露组听力损失、高频听力损失和职业性噪声聋的发病率比值比分别为4.78（95%置信区间3.22 - 7.11）、4.36（95%置信区间2.84 - 6.69）和6.63（95%置信区间2.33 - 18.82）；中暴露组分别为3.27（95%置信区间2.22 - 4.82）、3.02（95%置信区间1.99 - 4.59）和4.52（95%置信区间1.61 - 12.67）。钢铁厂噪声暴露工人的听力损失发病率与累积噪声暴露剂量、性别、年龄、文化程度、吸烟习惯、饮酒习惯和高温暴露有关。
