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职业性噪声暴露与非对称性听力损失:来自挪威 HUNT 人群研究的结果。

Occupational noise exposure and asymmetric hearing loss: Results from the HUNT population study in Norway.

机构信息

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.

出版信息

Am J Ind Med. 2020 Jun;63(6):535-542. doi: 10.1002/ajim.23105. Epub 2020 Mar 18.

Abstract

BACKGROUND

A large population study with adequate data on confounders is required to determine whether asymmetric hearing loss (AHL) is associated with occupational noise exposure.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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