Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.
Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.
Am J Ind Med. 2020 Jun;63(6):535-542. doi: 10.1002/ajim.23105. Epub 2020 Mar 18.
A large population study with adequate data on confounders is required to determine whether asymmetric hearing loss (AHL) is associated with occupational noise exposure.
We performed a cross-sectional population study in Norway (the Health Investigation in Nord-Trøndelag: HUNT) with 24 183 participants, using pure-tone audiometry and questionnaires. AHL was defined as a difference in hearing threshold between the right and left ears of greater than or equal to 15 dB for the pure-tone average of 0.5 to 2 or 3 to 6 kHz.
The mean age of the participants was 53 years (range, 19-99); 53% were women. The prevalence of AHL in this general Norwegian population was 6% for the 0.5 to 2 kHz range and 15% for 3 to 6 kHz. In unadjusted regression models, subjects reporting prolonged occupational noise exposure to high-level noise sources (N = 1652) had a higher risk of AHL at 3 to 6 kHz than those reporting no prior exposure (odds ratio [OR], 1.98; 95% confidence interval [CI], 1.75-2.25). After adjustment for age and sex, OR was 1.08; (95% CI, 0.95-1.24). After additional adjustment for head trauma, ear infections, blasting or shooting (all associated with AHL), smoking, and diabetes, OR was 1.00 (95% CI, 0.87-1.16). No association between occupational noise and right-ear hearing threshold advantage (left-right ear difference) was observed after adjustment for confounders.
Our study suggests that AHL is relatively common in the general population, especially at the high-frequency range in men and elderly subjects. Our study showed no relation between occupational noise exposure and AHL after confounder adjustment.
需要进行一项有足够混杂因素数据的大规模人群研究，以确定非对称听力损失（AHL）是否与职业性噪声暴露有关。
我们在挪威进行了一项横断面人群研究（健康调查在诺德特罗尔兰：HUNT），共有 24183 名参与者，使用纯音测听和问卷调查。AHL 的定义为右耳和左耳的纯音平均听力阈值之差大于或等于 15dB，0.5 至 2 或 3 至 6kHz。
参与者的平均年龄为 53 岁（范围 19-99 岁）；53%为女性。在这个普通的挪威人群中，0.5 至 2kHz 频段 AHL 的患病率为 6%，3 至 6kHz 频段为 15%。在未调整的回归模型中，报告有长期职业性噪声暴露于高强度噪声源（N=1652）的受试者在 3 至 6kHz 频段发生 AHL 的风险高于未报告有先前暴露的受试者（比值比[OR]，1.98；95%置信区间[CI]，1.75-2.25）。在调整年龄和性别后，OR 为 1.08；（95%CI，0.95-1.24）。在进一步调整头部外伤、耳部感染、爆炸或射击（均与 AHL 相关）、吸烟和糖尿病后，OR 为 1.00（95%CI，0.87-1.16）。在调整混杂因素后，未观察到职业性噪声与右耳听力优势（左右耳差异）之间存在关联。
我们的研究表明，AHL 在普通人群中相对常见，尤其是在男性和老年人群的高频范围内。我们的研究表明，在调整混杂因素后，职业性噪声暴露与 AHL 之间没有关系。
