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耳鸣、声音不耐受与心理健康:长期职业噪声暴露的作用。

Tinnitus, sound intolerance, and mental health: the role of long-term occupational noise exposure.

机构信息

Department of Neuroscience, Canadian Centre for Behavioural Neuroscience (CCBN), University of Lethbridge, Lethbridge, AB, T1K 3M4, Canada.

Audiology First, Lethbridge, AB, T1J 4B5, Canada.

出版信息

Eur Arch Otorhinolaryngol. 2022 Nov;279(11):5161-5170. doi: 10.1007/s00405-022-07362-2. Epub 2022 Mar 31.

Abstract

PURPOSE

Whereas chronic noise exposure (CNE) is a known risk factor for tinnitus, little is known about how a history of CNE impacts tinnitus characteristics and its comorbid symptoms.

METHODS

Seventy-five participants with chronic tinnitus (59m/16f, 22-78 years, 48 with sensory-neural hearing loss, and 27 with a normal audiogram) including 43 individuals with (Tin-CNE group) and 32 without (Tin group) a history of long-term occupational noise exposure were studied. Tinnitus characteristics were rated by a visual analog scale, and tinnitus comorbid symptoms were scored using self-assessment questionnaires.

RESULTS

The Tin-CNE group showed reduced uncomfortable loudness level (ULL), sound tolerance, and quality of life (QoL), and increased tinnitus loudness, tinnitus handicap, anxiety, depression, insomnia severity, and tinnitus annoyance scores compared to the Tin group. Higher tinnitus loudness and a lower anxiety score were observed in participants with hearing loss relative to those without. Using a stepwise regression model also showed that tinnitus-related characteristics, hyperacusis, and tinnitus comorbid symptoms enhance one another.

CONCLUSIONS

The findings were in support of accumulative evidence indicating the adverse auditory and non-auditory effects of CNE, including exacerbated sound intolerance and tinnitus-related psychiatric symptoms. The results also showed that tinnitus alone can affect mental health regardless of hearing loss.

摘要

目的

慢性噪声暴露(CNE)是耳鸣的已知危险因素,但对于 CNE 史如何影响耳鸣特征及其共病症状知之甚少。

方法

75 名慢性耳鸣患者(59 名男性/16 名女性,22-78 岁,48 名伴有感音神经性听力损失,27 名听力正常),包括 43 名有(Tin-CNE 组)和 32 名无(Tin 组)长期职业噪声暴露史的个体。通过视觉模拟量表评估耳鸣特征,使用自我评估问卷对耳鸣共病症状进行评分。

结果

与 Tin 组相比,Tin-CNE 组的不适响度级(ULL)、耐音量和生活质量(QoL)降低,耳鸣响度、耳鸣残疾、焦虑、抑郁、失眠严重程度和耳鸣烦恼评分增加。与无听力损失者相比,听力损失者的耳鸣响度更高,焦虑评分更低。逐步回归模型也表明,耳鸣相关特征、听觉过敏和耳鸣共病症状相互增强。

结论

这些发现支持了累积证据表明 CNE 的听觉和非听觉不良影响,包括不耐音量增加和耳鸣相关精神症状恶化。结果还表明,无论是否存在听力损失,耳鸣本身都会影响心理健康。

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