Shu Linyan, Fan Zhixing, Tang Jia, Xu Guoyong, Guo Jianyu, Long Taihua, Wu Junle, Xiao Minghui, Hu Shijie, Xiao Bin
Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, China; Guangdong Medical University, Dongguan, Guangdong, China.
Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong, China; Guangdong Pharmaceutical University, Guangzhou, Guangdong, China.
Sci Total Environ. 2025 Feb 10;964:178507. doi: 10.1016/j.scitotenv.2025.178507. Epub 2025 Jan 28.
Noise is a threat to human auditory system, hearing protection devices (HPDs) are widely used to prevent noise-induced hearing loss (NIHL). However, the role of wearing HPDs on NIHL and the complex relationship between them are still unclear. This study aims to explore such relationship and identify the associated influencing pathways. Providing the important targets for hearing health interventions.
We tested audiometry and Personal Attenuation Ratings (PARs) in 862 participants, recording HPDs usage and fitting actions. Furthermore, an intervention, the comfort survey and the insertion depth measuring of foam earplugs were conducted with 455 participants. Using structural equation models to assess the association among these variables.
There were 18.1 % of participants who wore HPDs had NIHL in our study, and their baseline PARs were lower (p < 0.001). Then we found proper fitting actions and continuous use of HPDs led to higher PARs, with "roll" and "pull" being crucial for foam earplugs. In addition, baseline PARs (OR = 0.783; 95 % Cl: 0.644, 0.953) and HPDs wearing frequency (OR = 0.131; 95 % Cl: 0.079, 0.218) were the protective factors of NIHL. Moreover, both proper fitting actions (β = 0.237; 95 % Cl, 0.070, 0.404) and continuous wearing foam earplugs (β = 0.018; 95 % Cl: 0.010, 0.025) could moderate NIHL through baseline PARs, and they also had indirect effect on NIHL. HPDs wearing comfort and insertion depth could mediate the link between wearing HPDs and baseline PARs. The mediation effect of insertion depth on baseline PARs accounted for 35.5 %.
Our study found that people who wore HPDs improperly in noisy environments had a risk of suffering from NIHL. Highlighting the important role of proper fitting actions and continuously wearing HPDs in improving PARs and preventing NIHL, especially roll and pull actions for foam earplugs. Proposing that the insertion depth might be an auxiliary indicator to help screen workers that need to be focused on for identification and intervention.
噪声对人类听觉系统构成威胁，听力保护装置（HPD）被广泛用于预防噪声性听力损失（NIHL）。然而，佩戴HPD对NIHL的作用以及它们之间的复杂关系仍不清楚。本研究旨在探讨这种关系并确定相关的影响途径，为听力健康干预提供重要靶点。
我们对862名参与者进行了听力测定和个人衰减评级（PAR）测试，记录HPD的使用情况和佩戴操作。此外，对455名参与者进行了一项干预、舒适度调查以及泡沫耳塞插入深度测量。使用结构方程模型评估这些变量之间的关联。
在我们的研究中，佩戴HPD的参与者中有18.1%患有NIHL，他们的基线PAR较低（p < 0.001）。然后我们发现正确的佩戴操作和持续使用HPD会导致更高的PAR，对于泡沫耳塞来说，“卷”和“拉”的动作至关重要。此外，基线PAR（OR = 0.783；95% Cl：0.644，0.953）和HPD佩戴频率（OR = 0.131；95% Cl：？0.079，0.218）是NIHL的保护因素。而且，正确的佩戴操作（β = 0.237；95% Cl，0.070，0.404）和持续佩戴泡沫耳塞（β = 0.018；95% Cl：0.010，0.025）都可以通过基线PAR来减轻NIHL，并且它们对NIHL也有间接影响。HPD的佩戴舒适度和插入深度可以介导佩戴HPD与基线PAR之间的联系。插入深度对基线PAR的中介效应占35.5%。
我们的研究发现，在嘈杂环境中佩戴HPD不当的人有患NIHL的风险。强调了正确的佩戴操作和持续佩戴HPD在提高PAR和预防NIHL方面的重要作用，特别是对于泡沫耳塞的“卷”和“拉”动作。提出插入深度可能是一个辅助指标，有助于筛选需要重点关注以进行识别和干预的工人。 （注：原文中“95% Cl：？0.079”这里的问号可能是录入错误，推测应该是“95% Cl：0.079” ）
