[Combined effect of noise and hand-transmitted vibration on noise-induced hearing loss in the automobile manufacturing industry].

To investigate the combined effect of noise and hand-transmitted vibration on noise-induced hearing loss (NIHL) in the automobile manufacturing industry. From September 2018 to January 2019, cluster sampling was used to select 998 workers in an automobile factory as study subjects, among whom 352 workers exposed to noise alone were enrolled as noise group, 342 workers exposed to noise and hand-transmitted vibration were enrolled as combined effect group, and 304 workers without exposure to occupational hazardous factors were enrolled as control group. A questionnaire survey and pure tone audiometry were performed for all study subjects. An analysis of variance was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups; a ordinal polytomous logistic regression analysis was used to investigate the influencing factors for NIHL (with 0.05 as the inclusion criteria and 0.10 as the exclusion criteria for independent variables) . There was a significant difference in L(Aeq, 8 h) between groups (<0.05) ; the noise group and the combined effect group had a significantly higher L(Aeq, 8 h) than the control group (<0.05) , while there was no significant difference in L(Aeq, 8 h) between the noise group and the combined effect group (>0.05) . The control group had a significantly lower detection rate of hearing loss than the noise group and the combined effect group (<0.0125) , and the combined effect group had a significantly higher detection rate of hearing loss than the noise group (<0.0125) . The ordinal polytomous logistic regression analysis showed that after adjustment for confounding factors such as age, working years, sex, smoking, and drinking, both noise exposure and exposure to both noise and hand-transmitted vibration had an influence on workers' hearing (<0.05) , and the workers exposed to both noise and hand-transmitted vibration had a higher risk of hearing loss than those exposed to noise alone. There may be a combined effect of noise and hand-transmitted vibration in the automobile manufacturing industry, which can increase the risk of NIHL in workers.