Ullman Elon D, Smith Lauren M, McCullagh Marjorie C, Neitzel Richard L
Department of Environmental Health Sciences, University of Michigan, Ann Arbor, Michigan, USA.
Department of Systems, Populations and Leadership, University of Michigan, Ann Arbor, Michigan, USA.
Occup Environ Med. 2021 Jan 12. doi: 10.1136/oemed-2020-106838.
This study investigated risk factors for poor earplug fit, with a focus on the association between hearing loss and personal attenuation ratings (PARs).
Earplug fit was assessed by obtaining PARs using a real ear at attenuation threshold (REAT) system. Hearing loss was assessed using the unoccluded hearing thresholds measured during the REAT testing and the results of a speech-in-noise test. Potential predictors of PARs were modelled using both simple and multiple linear regression. Hearing loss was the primary predictor of interest.
Data were collected from 200 workers at ten above-ground mining sites in the Midwestern USA. Workers reported wearing their hearing protection on average 73.9% of the time in a high noise environment (mean 8-hour time-weighted average noise exposure 85.5 dBA, range 65-103 dBA). One-quarter (26.7%) of workers were found to have a hearing loss (hearing threshold ≥25 dB across 1-4 kHz), and 42% reported symptoms of tinnitus. Workers with a hearing loss had a significantly lower PAR than those without a hearing loss (β=-5.1, SE=1.7).
The results of the adjusted regression models suggest that workers with hearing loss achieved significantly lower PARs than those without hearing loss. This association between hearing loss and hearing protection devices (HPD) fit brings into focus the potential benefit of fit checks to be included in hearing conservation programmes. Workers found to have hearing loss should be prioritised for fit testing, as their hearing impairment may be associated with poor HPD fit.
本研究调查了耳塞佩戴不佳的风险因素,重点关注听力损失与个人衰减评级(PAR)之间的关联。
使用真耳在衰减阈值(REAT)系统获取PAR来评估耳塞佩戴情况。使用REAT测试期间测量的未佩戴耳塞时的听力阈值以及噪声环境下言语测试结果来评估听力损失。使用简单线性回归和多元线性回归对PAR的潜在预测因素进行建模。听力损失是主要关注的预测因素。
从美国中西部十个露天矿场的200名工人收集数据。工人们报告称,在高噪声环境中,他们平均73.9%的时间佩戴听力保护设备(平均8小时时间加权平均噪声暴露85.5分贝A,范围65 - 103分贝A)。发现四分之一(26.7%)的工人有听力损失(1 - 4千赫频率范围内听力阈值≥25分贝),42%报告有耳鸣症状。有听力损失的工人的PAR显著低于无听力损失的工人(β = -5.1,标准误 = 1.7)。
调整后的回归模型结果表明,有听力损失的工人的PAR显著低于无听力损失的工人。听力损失与听力保护设备(HPD)佩戴情况之间的这种关联凸显了在听力保护计划中纳入佩戴情况检查的潜在益处。被发现有听力损失的工人应优先进行佩戴测试,因为他们的听力障碍可能与HPD佩戴不佳有关。