中国制造业非稳态噪声性听力损失的meta分析  

Noise-induced hearing loss associated with non-Gaussian noise in manufacturing industry of China:A systematic review and meta-analysis

作　　者：施志豪 辛佳芮 周洁娜 周莉芳[3] 高向景[3] 张美辨 SHI Zhihao;XIN Jiarui;ZHOU Jiena;ZHOU Lifang;GAO Xiangjing;ZHANG Meibian(School of Medicine,Ningbo University,Ningbo,Zhejiang 315211,China;School of Medicine,Hangzhou Normal University,Hangzhou,Zhejiang 310051,China;Occupational Health and Radiation Protection Institute,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,Zhejiang 310051,China;National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China)

机构地区：[1]宁波大学医学院,浙江宁波315211 [2]杭州师范大学医学部,浙江杭州310051 [3]浙江省疾病预防控制中心职业健康与辐射防护所,浙江杭州310051 [4]中国疾病预防控制中心职业卫生与中毒控制所,北京100050

出　　处：《环境与职业医学》2022年第4期382-390,共9页Journal of Environmental and Occupational Medicine

基　　金：浙江省重点研发项目(2015C03039);2018年度浙江省151人才工程培养项目(无编号);2016年度浙江省卫生创新人才培养项目(无编号);职业健康标准前期研究项目(20210102);浙江省医药卫生基金(2019KY057);浙江省医药卫生基金(2021KY120)

摘　　要：[背景]非稳态噪声已成为工业中最常见的噪声类型,然而对非稳态噪声暴露及其相关的噪声性听力损失(NIHL)流行病学特征仍了解不足,相关综述极少。[目的]总结中国制造业非稳态噪声相关的听力损失流行病学特征,为职业噪声性听力损失的早期防控提供依据。[方法]检索有关中国制造业中非稳态噪声性听力损失的中英文文献;根据各研究中的听力损失患病率数据,统计合计患病率;对带有稳态噪声对照组的研究作meta分析,计算合并OR值以比较非稳态噪声与稳态噪声对听力损失的影响差异,并通过绘制漏斗图、作Egger回归进行发表偏倚评价,依次剔除文献作敏感性分析。[结果]共纳入37篇横断面研究,共涉及25055名接触非稳态噪声的中国制造业工人,其中男性占92.5%,年龄为(32.7±9.6)岁,接触噪声工龄为(6.8±4.9)年,噪声暴露水平为(87.0±4.2)d B(A),累积噪声暴露量(CNE)为(95.9±8.0)d B(A)·年。非稳态噪声接触工人的高频和语频听力损失患病率分别为29.0%和14.2%。19篇带有稳态噪声对照组的横断面研究的meta分析显示,非稳态噪声组与稳态噪声对照组相比,年龄、工龄、等效A声级(L_(Aeq))和CNE差异没有统计学意义,而对高频听力损失影响的合并OR值为1.87(95%CI:1.46~2.41),有统计学意义;漏斗图对称性较好,Egger回归结果显示t=-0.11,P=0.910(>0.05),表明本次meta分析不存在发表偏倚;敏感性分析显示结果变化不大,表明结果较稳健。[结论]中国制造业中噪声作业工人以男性青壮年为主,长期接触高水平有害的非稳态噪声,听力损失患病率高,相对于接触稳态噪声的工人,会遭受更严重的听力损失。[Background]Non-Gaussian noise has become the dominant noise type in industry.However,the epidemiological characteristics of non-Gaussian noise exposure and associated noiseinduced hearing loss(NIHL)are still unclear.[Objective]To summarize the epidemiological characteristics of NIHL associated with nonGaussian noise in manufacturing industry in China and provide a basis for the early prevention and control of occupational hearing loss.[Methods]Chinese and English literature on hearing loss associated with non-Gaussian noise in China were retrieved.The overall prevalence was calculated based on the prevalence dataprovided by each included study.A meta-analysis of studies with Gaussian noise as a control group was also performed and the overall weighted odds ratio(OR)was calculated to compare the effects of non-Gaussian noise and Gaussian noise on hearing loss.Publication bias was evaluated by funnel plot and Egger regression,and a sensitivity analysis was performed by eliminating references in turn.[Results]A total of 37 cross-sectional studies involving 25055 Chinese manufacturing workers exposed to non-Gaussian noise were included,92.5%of whom were male.These workers aged(32.7±9.6)years were exposed to non-Gaussian noise at(87.0±4.2)d B(A)for(6.8±4.9)years.The mean cumulative noise exposure(CNE)was(95.9±8.0)d B(A)·year.The prevalence rate of high-frequency NIHL(HFNIHL)and speech-frequency NIHL(SFNIHL)were 29.0%and 14.2%,respectively.The results of the meta-analysis treating 19 crosssectional studies with Gaussian noise as a control group showed that there were no significant differences in age,exposure duration,and equivalent continuous A-weighted sound pressure level(L_(Aeq)),and CNE between the non-Gaussian noise group and the Gaussian noise group.The overall weighted OR of HFNIHL was 1.87(95%CI:1.46-2.41),which was statistically significant.The funnel plot showed good symmetry and the result of Egger regression was t=-0.11,P=0.910(>0.05),suggesting a low risk of publication bias in this meta-analysis.Th

关 键 词：非稳态噪声 听力损失 制造业工人 职业暴露 META分析 

分 类 号：R131[医药卫生—劳动卫生]