He Jie, Smith Lauren M, Shkembi Abas, Neitzel Richard L
Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Abor, MI, 48109, USA.
Department of Environmental Health Sciences, School of Public Health, University of Michigan, Ann Abor, MI, 48109, USA.
Int J Hyg Environ Health. 2025 Jan;263:114468. doi: 10.1016/j.ijheh.2024.114468. Epub 2024 Sep 26.
This study assessed the relationship between occupational noise exposure and the incidence of workplace fatal injury (FI) and nonfatal injury (NFI) in the United States from 2006 to 2020. It also examined whether distinct occupational and industrial clusters based on noise exposure characteristics demonstrated varying risks for FI and NFI.
An ecological study design was utilized, employing data from the U.S. Bureau of Labor Statistics for FI and NFI and demographic data, the U.S. Census Bureau for occupation/industry classification code lists, and the U.S./Canada Occupational Noise Job Exposure Matrix for noise measurements. We examined four noise metrics as predictors of FI and NFI rates: mean Time-Weighted Average (TWA), maximum TWA, standard deviation of TWA, and percentage of work shifts exceeding 85 or 90 dBA for 619 occupation-years and 591 industry-years. K-means clustering was used to identify clusters of noise exposure characteristics. Mixed-effects negative binomial regression examined the relationship between the noise characteristics and FI/NFI rates separately for occupation and industry.
Among occupations, we found significant associations between increased FI rates and higher mean TWA (IRR: 1.06, 95% CI: 1.01-1.12) and maximum TWA (IRR: 1.10, 95% CI: 1.07-1.14), as well as TWA exceedance (IRR: 1.04, 95% CI: 1.01-1.07). Increased rates of NFI were found to be significantly associated with maximum TWA (IRR: 1.06, 95% CI: 1.04-1.09) and TWA exceedance (IRR: 1.03, 95% CI: 1.01-1.05). In addition, occupations with both higher exposure variability (IRR with FI rate: 1.49, 95% CI: 1.23-1.80; IRR with NFI rate: 1.40, 95% CI: 1.14-1.73) and higher level of sustained exposure (IRR with FI rate: 1.27, 95% CI: 1.12-1.44; IRR with NFI rate: 1.21, 95% CI: 1.05-1.39) were associated with higher rates of FI and NFI compared to occupations with low noise exposure. Among industries, significant associations between increased NFI rates and higher mean TWA (IRR: 1.05, 95% CI: 1.02-1.08) and maximum TWA (IRR: 1.06, 95% CI: 1.04-1.08) were observed. Unlike the occupation-specific analysis, industries with higher exposure variability and higher sustained exposures did not display significantly higher FI/NFI rates compared to industries with low exposure.
The results suggest that occupational noise exposure may be an independent risk factor for workplace FIs/NFIs, particularly for workplaces with highly variable noise exposures. The study highlights the importance of comprehensive occupational noise assessments.
本研究评估了2006年至2020年美国职业噪声暴露与工作场所致命伤害（FI）和非致命伤害（NFI）发生率之间的关系。它还研究了基于噪声暴露特征的不同职业和产业集群是否表现出不同的FI和NFI风险。
采用生态研究设计，利用美国劳工统计局的FI和NFI数据以及人口统计数据、美国人口普查局的职业/产业分类代码列表，以及美国/加拿大职业噪声工作暴露矩阵进行噪声测量。我们将四个噪声指标作为FI和NFI发生率的预测因子：平均时间加权平均值（TWA）、最大TWA、TWA的标准差，以及619个职业年和591个产业年中超过85或90分贝的工作班次百分比。使用混合效应负二项回归分别研究职业和产业中噪声特征与FI/NFI发生率之间的关系。
在职业方面，我们发现FI发生率增加与较高的平均TWA（发病率比值比：1.06，95%置信区间：1.01 - 1.12）和最大TWA（发病率比值比：1.10，95%置信区间：1.07 - 1.14）以及TWA超标（发病率比值比：1.04，95%置信区间：1.01 - 1.07）之间存在显著关联。发现NFI发生率增加与最大TWA（发病率比值比：1.06，95%置信区间：1.04 - 1.09）和TWA超标（发病率比值比：1.03，95%置信区间：1.01 - 1.05）显著相关。此外，与低噪声暴露职业相比，具有较高暴露变异性（FI发生率的发病率比值比：1.49，95%置信区间：1.23 - 1.80；NFI发生率的发病率比值比：1.40，95%置信区间：1.14 - 1.73）和较高持续暴露水平（FI发生率的发病率比值比：1.27，95%置信区间：1.12 - 1.44；NFI发生率的发病率比值比：1.21，95%置信区间：1.05 - 1.39）的职业与较高的FI和NFI发生率相关。在产业方面，观察到NFI发生率增加与较高的平均TWA（发病率比值比：1.05，95%置信区间：1.02 - 1.08）和最大TWA（发病率比值比：1.06，95%置信区间：1.04 - 1.08）之间存在显著关联。与特定职业分析不同，与低暴露产业相比，具有较高暴露变异性和较高持续暴露的产业并未显示出显著更高的FI/NFI发生率。
结果表明，职业噪声暴露可能是工作场所FI/NFI的独立风险因素，特别是对于噪声暴露高度可变的工作场所。该研究强调了全面职业噪声评估的重要性。
