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噪声性听力损失的职业流行病学特征及噪声与粉尘联合暴露对工人听力的影响:一项回顾性研究。

Occupational epidemiological characteristics of noise-induced hearing loss and the impact of combined exposure to noise and dust on workers' hearing-a retrospective study.

机构信息

The Third People's Hospital of Hefei, Hefei Third Clinical College of Anhui Medical University, Hefei, Anhui, China.

School of Public Health, Anhui Medical University, Hefei, Anhui, China.

出版信息

Front Public Health. 2024 Oct 30;12:1488065. doi: 10.3389/fpubh.2024.1488065. eCollection 2024.

Abstract

INTRODUCTION

The aim of the study was to investigate the occupational epidemiological characteristics of hearing loss among noise-exposed workers through a cross-sectional study and to explore the impact of combined noise and dust exposure on workers' hearing loss through a longitudinal study.

RESULTS

This cross-sectional study revealed that the risk of speech-frequency hearing loss increases with age (OR = 1.096, 95%CI = 1.081-1.111). Independent factors influencing high-frequency hearing loss include sex, age, hazardous factors, industry category, and enterprise size. Scientific research and technical services (OR = 1.607, 95%CI = 1.111-2.324), wholesale and retail (OR = 2.144, 95%CI = 1.479-3.107), manufacturing (OR = 1.907, 95%CI = 1.429-2.545), and other industries (OR = 1.583, 95%CI = 1.002-2.502) are risk factors for high-frequency hearing loss, whereas being female (OR = 0.297, 95%CI = 0.236-0.373) is a protective factor against high-frequency hearing loss. Independent factors influencing occupational noise-induced hearing loss include sex, working age, hazardous factors, industry category, smoking, and drinking, with the risk of occupational noise-induced hearing loss increasing with working age (OR = 1.045, 95%CI = 1.031-1.058). Noise and dust work (OR = 1.271, 95%CI = 1.011-1.597), other work (OR = 0.619, 95%CI = 0.479-0.800), manufacturing (OR = 2.085, 95%CI = 1.336-3.254), other industries (OR = 2.063, 95%CI = 1.060-4.012), occasional smokers (OR = 0.863, 95%CI = 0.652-1.142), regular smokers (OR = 1.216, 95% CI = 0.987-1.497), and excessive drinkers (OR = 2.171, 95%CI = 1.476-3.193) are risk factors for occupational noise-induced hearing loss, whereas being female (OR = 0.496, 95%CI = 0.347-0.709) is a protective factor against occupational noise-induced hearing loss. The longitudinal study revealed differences in pure-tone hearing threshold test results at 500 Hz, 1,000 Hz, 3,000 Hz, 4,000 Hz, and 6,000 Hz in both ears before and after enrollment among noise-exposed workers ( < 0.05). Combined noise and dust exposure (OR = 4.660, 95%CI = 1.584-13.711), 1st year (OR = 1.540, 95%CI = 1.128-2.103), 2nd year (OR = 1.994, 95%CI = 1.409-2.821), and 3rd year (OR = 1.628, 95%CI = 1.170-2.264) were risk factors for high-frequency hearing loss.

DISCUSSION

Combined noise and dust exposure is a risk factor for occupational noise-induced hearing loss. Additionally, occupational noise-induced hearing loss is influenced by gender, working age, enterprise industry category, smoking, and drinking. Employers should enhance occupational health management and improve workers' occupational health literacy, with a particular focus on older male workers of long working age, and those with unhealthy habits. Combined exposure to noise and dust may have a synergistic effect on causing high-frequency hearing loss, and comprehensive protective measures should be implemented for workers exposed to both.

摘要

简介

本研究旨在通过横断面研究调查噪声暴露工人听力损失的职业流行病学特征,并通过纵向研究探讨噪声和粉尘联合暴露对工人听力损失的影响。

结果

该横断面研究表明,言语频率听力损失的风险随年龄增长而增加(OR=1.096,95%CI=1.081-1.111)。影响高频听力损失的独立因素包括性别、年龄、危险因素、行业类别和企业规模。科学研究和技术服务业(OR=1.607,95%CI=1.111-2.324)、批发和零售业(OR=2.144,95%CI=1.479-3.107)、制造业(OR=1.907,95%CI=1.429-2.545)和其他行业(OR=1.583,95%CI=1.002-2.502)是高频听力损失的危险因素,而女性(OR=0.297,95%CI=0.236-0.373)是高频听力损失的保护因素。影响职业性噪声聋的独立因素包括性别、工龄、危险因素、行业类别、吸烟和饮酒,职业性噪声聋的风险随工龄增加而增加(OR=1.045,95%CI=1.031-1.058)。噪声和粉尘作业(OR=1.271,95%CI=1.011-1.597)、其他作业(OR=0.619,95%CI=0.479-0.800)、制造业(OR=2.085,95%CI=1.336-3.254)、其他行业(OR=2.063,95%CI=1.060-4.012)、偶尔吸烟者(OR=0.863,95%CI=0.652-1.142)、经常吸烟者(OR=1.216,95%CI=0.987-1.497)和过量饮酒者(OR=2.171,95%CI=1.476-3.193)是职业性噪声聋的危险因素,而女性(OR=0.496,95%CI=0.347-0.709)是职业性噪声聋的保护因素。纵向研究表明,噪声暴露工人在入组前后双耳 500 Hz、1000 Hz、3000 Hz、4000 Hz 和 6000 Hz 的纯音听阈测试结果存在差异( < 0.05)。噪声和粉尘联合暴露(OR=4.660,95%CI=1.584-13.711)、第 1 年(OR=1.540,95%CI=1.128-2.103)、第 2 年(OR=1.994,95%CI=1.409-2.821)和第 3 年(OR=1.628,95%CI=1.170-2.264)是高频听力损失的危险因素。

讨论

噪声和粉尘联合暴露是职业性噪声聋的危险因素。此外,职业性噪声聋还受到性别、工龄、企业行业类别、吸烟和饮酒的影响。雇主应加强职业健康管理,提高工人的职业健康素养,特别关注工龄长、年龄较大的男性工人和有不良习惯的工人。噪声和粉尘的联合暴露可能对引起高频听力损失有协同作用,应对同时接触这两种因素的工人采取综合防护措施。

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