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一家公司中接触噪声的男性工人患糖尿病对其4年听力阈值变化的影响:一项纵向研究。

The effect of diabetes on 4-year changes of hearing thresholds in male workers exposed to noise in a single company: a longitudinal study.

作者信息

Kim Dae Yun, Kim A Ram, Sung Joo Hyun, Lee Choong Ryeol, Lee Jiho

机构信息

Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

Department of Occupational and Environmental Medicine, Institute of Health Sciences, Gyeongsang National University Changwon Hospital, Gyeongsang National University College of Medicine, Jinju, Korea.

出版信息

Ann Occup Environ Med. 2019 Jun 28;31:e11. doi: 10.35371/aoem.2019.31.e11. eCollection 2019.

Abstract

BACKGROUND

Recently, several studies have assessed the association between diabetes and hearing impairment. However, the effect of diabetes on hearing impairment is not well known in diabetic patients exposed to noise, a typical cause of hearing impairment. The aim of this study is to longitudinally analyze the effect of diabetes on hearing impairment in workers exposed to similar noise levels from 2013 to 2017 who had experienced little change in their working conditions.

METHODS

The study subjects included 2,087 male workers exposed to noise in a single company and who underwent health examinations at the same hospital in Ulsan city in 2013 and 2017. Hearing impairment was defined that a pure-tone average of pure-tone audiometry (PTA) thresholds at 1,000, 2,000, 3,000, and 4,000 Hz was 25 dB and over in both ears. Statistical analyses were conducted using χ tests, ANOVA, and Cox proportional hazard models. We analyzed covariates that might affect hearing impairment, including age; working period; levels of total cholesterol, triglyceride, and serum creatinine; smoking and alcohol history; and noise level.

RESULTS

The average PTA thresholds and their average changes between 2013 and 2017 were significant in the diabetes mellitus (DM) group than those in the normal and impaired fasting glucose group. Among the subjects with the same status of fasting glucose group in 2013 and 2017, the adjusted hazard ratios for incident hearing impairment among those in the DM group compared to normal group were 3.35 (95% confidence interval [CI], 1.54-7.29) in the left ear and 5.66 (95% CI, 2.01-15.98) in the right ear.

CONCLUSIONS

This study suggested that the risk of hearing impairment in the DM group was significantly higher than that in the normal group in both ears, even when exposed to similar noise levels.

摘要

背景

最近,多项研究评估了糖尿病与听力障碍之间的关联。然而,在暴露于噪声(听力障碍的典型病因)的糖尿病患者中,糖尿病对听力障碍的影响尚不明确。本研究的目的是纵向分析2013年至2017年期间工作条件变化不大、暴露于相似噪声水平的工人中,糖尿病对听力障碍的影响。

方法

研究对象包括2087名在同一家公司暴露于噪声的男性工人,他们于2013年和2017年在蔚山市同一家医院接受了健康检查。听力障碍的定义为双耳在1000、2000、3000和4000赫兹的纯音听力计(PTA)阈值的纯音平均阈值为25分贝及以上。使用χ检验、方差分析和Cox比例风险模型进行统计分析。我们分析了可能影响听力障碍的协变量,包括年龄;工作年限;总胆固醇、甘油三酯和血清肌酐水平;吸烟和饮酒史;以及噪声水平。

结果

糖尿病(DM)组2013年至2017年的平均PTA阈值及其平均变化比正常和空腹血糖受损组更为显著。在2013年和2017年空腹血糖组状态相同的受试者中,DM组发生听力障碍的调整后风险比与正常组相比,左耳为3.35(95%置信区间[CI],1.54 - 7.29),右耳为5.66(95%CI,2.01 - 15.98)。

结论

本研究表明,即使暴露于相似噪声水平,DM组双耳听力障碍的风险也显著高于正常组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/35b1/6751739/f265be2fdfe2/aoem-31-e11-g001.jpg

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