Prince M M, Stayner L T, Smith R J, Gilbert S J
Education and Information Division, National Institute for Occupational Safety and Health, Cincinnati, Ohio 45226, USA.
J Acoust Soc Am. 1997 Feb;101(2):950-63. doi: 10.1121/1.418053.
This paper describes a new analysis of data from the 1968-72 National Institute for Occupational Safety & Health (NIOSH) Occupational Noise and Hearing Survey (ONHS). The population consisted of 1172 (792 noise-exposed and 380 "controls") predominately white male workers from a cross section of industries within the United States. The analysis focused on how risk estimates vary according to various model assumptions, including shape of the dose-response curve and the amount of noise exposure among low-noise exposed workers (or controls). Logistic regression models were used to describe the risk of hearing handicap in relation to age, occupational noise exposure, and duration exposed. Excess risk estimates were generated for several definitions of hearing handicap. Hearing handicap is usually denoted as an average hearing threshold level (HTL) of greater than 25 dB for both ears at selected frequencies. The frequencies included in the biaural averages were (1) the articulation-weighted average over 1-4 kHz, (2) the unweighted average over 0.5, 1, and 2 kHz, and (3) the unweighted average over 1, 2, and 3 kHz. The results show that excess risk estimates for time-weighted average sound levels below 85 dB were sensitive to statistical model form and assumptions regarding the sound level to which the "control" group was exposed. The choice of frequencies used in the hearing handicap definition affected the magnitude of excess risk estimates, which depended on age and duration of exposure. Although data were limited below 85 dB, an age-stratified analysis provided evidence of excess risks at levels ranging from 80 to 84 dB, 85-89 dB, and 90-102 dB. Due to uncertainty in quantifying risks below 85 dB, new data collection efforts should focus on better characterization of dose-response and longitudinal hearing surveys that include workers exposed to 8-hour time-weighted noise levels below 85 dB. Results are compared to excess risk estimates generated using methods given by ANSI S3.44-1996.
本文描述了对1968 - 1972年美国国家职业安全与健康研究所（NIOSH）职业噪声与听力调查（ONHS）数据的一项新分析。研究对象包括1172名（792名噪声暴露者和380名“对照组”）主要为白人男性的工人，他们来自美国各行各业。该分析聚焦于风险估计如何根据各种模型假设而变化，这些假设包括剂量 - 反应曲线的形状以及低噪声暴露工人（或对照组）中的噪声暴露量。使用逻辑回归模型来描述听力障碍风险与年龄、职业噪声暴露及暴露时长之间的关系。针对几种听力障碍定义生成了超额风险估计值。听力障碍通常被定义为在选定频率下双耳平均听力阈值水平（HTL）大于25 dB。双耳平均值中所包含的频率为：（1）1 - 4 kHz的清晰度加权平均值；（2）0.5、1和2 kHz的未加权平均值；（3）1、2和3 kHz的未加权平均值。结果表明，对于低于85 dB的时间加权平均声级，超额风险估计值对统计模型形式以及关于“对照组”所暴露声级的假设较为敏感。听力障碍定义中所使用的频率选择会影响超额风险估计值的大小，这取决于年龄和暴露时长。尽管低于85 dB的数据有限，但按年龄分层的分析提供了证据，表明在80 - 84 dB、85 - 89 dB和90 - 102 dB水平存在超额风险。由于在量化低于85 dB的风险时存在不确定性，新的数据收集工作应侧重于更好地描述剂量 - 反应关系以及进行纵向听力调查，其中包括暴露于8小时时间加权噪声水平低于85 dB的工人。将结果与使用ANSI S3.44 - 1996所给出方法生成的超额风险估计值进行了比较。
