应用峰度调整噪声累积暴露量新指标评估家具制造工人的职业性听力损失  

Applying kurtosis-adjusted cumulative noise exposure to assess occupational hearing loss among furniture manufacturing workers

作　　者：辛佳芮 施志豪 钱佩谊 陈莹琦 高向景[3] 周莉芳[3] 杨磊[1] 张美辨 XIN Jiarui;SHI Zhihao;QIAN Peiyi;CHEN Yingqi;GAO Xiangjing;ZHOU Lifang;YANG Lei;ZHANG Meibian(School of Public Health,Hangzhou Normal University,Hangzhou,Zhejiang 310016,China;School of Medicine,Ningbo University,Ningbo,Zhejiang 315000,China;Institute of Occupational Health and Radiation Protection,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)

机构地区：[1]杭州师范大学公共卫生学院,浙江杭州310016 [2]宁波大学医学院,浙江宁波315000 [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367-373,共7页Journal of Environmental and Occupational Medicine

基　　金：浙江省重点研发项目(2015 C03039);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(2019 KY057);浙江省医药卫生基金(2021 KY120);浙江省一般科研项目(Y202147694)

摘　　要：[背景]职业噪声性听力损失(NIHL)是世界上最普遍的职业病之一。随着工业的发展,工作场所的噪声源变得越来越复杂。[目的]应用峰度调整累积噪声暴露量(CNE)来评估家具制造工人非稳态噪声暴露所致的听力损失,为我国噪声测量方法和职业接触限值修订提供依据。[方法]通过横断面调查,选择694名制造业工人为研究对象,包括542名非稳态噪声暴露的家具制造工人以及152名稳态噪声暴露的纺织企业和造纸企业工人,其中非稳态噪声组分为枪钉工和木工,稳态噪声组分为织造工、纺纱工和造纸工。收集每个研究对象的高频(3、4、6 k Hz)听力损失(HFNIHL)情况和噪声暴露数据。噪声能量指标包括8 h等效A声级(L_(Aeq,8h))、CNE,噪声时域结构测量指标为峰度。峰度调整CNE作为一个噪声能量和时域结构的联合指标。[结果]研究对象的年龄为(35.64±10.35)岁,工龄为(6.71±6.44)年,男性比例为75.50%。L_(Aeq,8h)为(89.43±6.01)d B(A),81.42%的研究对象暴露于85 d B(A)以上的噪声水平,CNE为(95.85±7.32)d B(A)·年,峰度为99.34±139.19,HFNIHL患病率达35.59%。非稳态噪声组平均峰度高于稳态噪声组平均峰度(125.33±147.17 vs.5.86±1.94,t=-21.04,P<0.05)。二元logistic回归分析结果显示:校正年龄、工龄、L_(Aeq,8h)后,峰度是工人HFNIHL的影响因素(OR=1.49,P<0.05)。多元线性回归分析结果显示:年龄、工龄、L_(Aeq,8h)和峰度对较差耳在高频3、4、6 k Hz的噪声性永久听阈位移的影响有统计学意义(均P<0.05)。卡方趋势分析结果显示,在CNE≥90 d B(A)·年时,HFNIHL患病率随峰度的增高而上升(P<0.05)。非稳态噪声组平均HFNIHL患病率高于稳态噪声组(31.7%vs.22.0%,P<0.05)。应用峰度调整后,非稳态噪声组的CNE和HFNIHL患病率的线性方程与稳态噪声组的方程几乎重合,两组之间的HFNIHL患病率平均差值从9.7%减少到1.4%(P<0.05)。[结论]噪声峰度是评估NIHL的重要参�[Background]Occupational noise-induced hearing loss(NIHL)is one of the most prevalent occupational diseases in the world.With the development of industry,noise sources in the workplace have become increasingly complex.[Objective]To apply kurtosis-adjusted cumulative noise exposure(CNE)to assess the occupational hearing loss among furniture manufacturing workers,and to provide a basis for revising noise measurement methods and occupational exposure limits in China.[Methods]A cross-sectional survey was conducted to select 694 manufacturing workers,including 542 furniture manufacturing workers exposed to non-Gaussian noise,and 152 textile manufacturing workers and paper manufacturing workers exposed to Gaussian noise.The job titles involving non-Gaussian noise were gunning and nailing,and woodworking,while those involving Gaussian noise were weaving,spinning,and pulping.High frequency noise-induced hearing loss(HFNIHL)and noise exposure data were collected for each study subject.Noise energy metrics included eight-hour equivalent continuous A-weighted sound pressure level(L_(Aeq,8h))and CNE.Kurtosis was a noise temporal structure metric.Kurtosis-adjusted CNE was a combined indicator of noise energy and temporal structure.[Results]The age of the study subjects was(35.64±10.35)years,the exposure duration was(6.71±6.44)years,and the proportion of males was 75.50%.The L_(Aeq,8h)was(89.43±6.01)d B(A).About 81.42%of the study subjects were exposed to noise levels above 85 d B(A),the CNE was(95.85±7.32)d B(A)·year,with a kurtosis of 99.34±139.19,and the prevalence rate of HFNIHL was 35.59%.The mean kurtosis of the non-Gaussian noise group was higher than that of the Gaussian noise group(125.33±147.17 vs.5.86±1.94,t=-21.04,P<0.05).The results of binary logistic regression analysis showed that kurtosis was an influential factor of workers’HFNIHL after correcting for age,exposure duration,and L_(Aeq,8h)(OR=1.49,P<0.05).The results of multiple linear regression analysis showed that the effects of age,exposure duratio

关 键 词：峰度 累积噪声暴露量 非稳态噪声 职业性听力损失 家具制造业 

分 类 号：R135[医药卫生—劳动卫生]