Xu Guoyong, Tang Jia, Guo Jianyu, Fan Zhixing, Shu Linyan, Yang Hairu, Xiao Bin
Institute of Physical Factors and Occupational Health, Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong Province, China.
School of Public Health, Southern Medical University, Guangzhou, Guangdong Province, China.
J Occup Environ Hyg. 2025 Apr;22(4):311-321. doi: 10.1080/15459624.2024.2444438. Epub 2025 Jan 28.
The noise exposure levels of workers wearing hearing protective devices (HPDs) depend on ambient noise and the protective effect of hearing protectors. This cross-sectional study aimed to adjust for cumulative noise exposure (CNE) based on the effective protection of hearing protection devices and explore the dose-response relationship between noise-induced hearing loss (NIHL) and adjusted cumulative noise exposure. A questionnaire was used to acquire the basic characteristics and occupational information of noise-exposed workers. Individual noise dosimetry, individual fitting tests, and pure-tone audiometric tests were performed to assess workers' noise exposure levels, HPDs' sound attenuation, and hearing status. A total of 714 workers participated in this study. Four hundred seventy-three participants wore foam earplugs and 241 wore pre-molded earplugs. The median Personal Attenuation Rating (PAR) was 13.0 dB. The median PAR' (the PAR after combining the earplugs usage time) was 8.0 dB. Thirty-one percent of the workers wore earplugs properly during noise exposure and they tended to possess a greater PAR. The median L was 94.1 dB (A) and the median unadjusted cumulative noise exposure was 102.3 dB (A)· year. The PAR'-adjusted CNE (CNE) was 91.3 dB (A)·year. A total of 161 workers (22.5%) with hearing loss were identified. There was an obvious trend between the prevalence of NIHL and CNE (χ = 31.9, < 0.01). The Wald values of the CNE and CNE logistic regression models were 4.0 and 14.1, respectively. Furthermore, the curve slope of the CNE was steeper than that of the unadjusted CNE. The CNE can represent the noise exposure level among workers wearing hearing protectors more accurately and has an apparent dose-response relationship with the prevalence of NIHL. For workers utilizing hearing protection devices, wearing them properly and consistently in the workplace is recommended. Assessing noise exposure based on the protective effects of hearing protectors is also essential. Additional studies are needed to quantify the impact of behaviors associated with the improper use of hearing protection.
佩戴听力保护装置（HPD）的工人的噪声暴露水平取决于环境噪声和听力保护器的保护效果。这项横断面研究旨在根据听力保护装置的有效保护来调整累积噪声暴露（CNE），并探讨噪声性听力损失（NIHL）与调整后的累积噪声暴露之间的剂量反应关系。通过问卷调查获取噪声暴露工人的基本特征和职业信息。进行个体噪声剂量测定、个体适配测试和纯音听力测试，以评估工人的噪声暴露水平、HPD的声衰减和听力状况。共有714名工人参与了本研究。473名参与者佩戴泡沫耳塞，241名佩戴预成型耳塞。个人衰减评级（PAR）中位数为13.0dB。PAR'（结合耳塞使用时间后的PAR）中位数为8.0dB。31%的工人在噪声暴露期间正确佩戴耳塞，且他们往往具有更高的PAR。L中位数为94.1dB（A），未调整的累积噪声暴露中位数为102.3dB（A）·年。PAR'调整后的CNE为91.3dB（A）·年。共识别出161名听力损失工人（22.5%）。NIHL患病率与CNE之间存在明显趋势（χ = 31.9，<0.01）。CNE和CNE逻辑回归模型的Wald值分别为4.0和14.1。此外，CNE的曲线斜率比未调整的CNE更陡。CNE可以更准确地代表佩戴听力保护器的工人的噪声暴露水平，并且与NIHL患病率具有明显的剂量反应关系。对于使用听力保护装置的工人，建议在工作场所正确且持续佩戴。基于听力保护器的保护效果评估噪声暴露也很重要。需要进一步研究来量化与听力保护不当使用相关行为的影响。
