机场地勤人员噪声暴露与高血压患病率的剂量-反应关系  

Dose-response relationship between noise and hypertension in airport ground crew

作　　者：祝文杰[1] 吕旌乔[1] 王建新[2] 黄云兰[3] 艾丽萍[3] 赵一鸣[1] 

机构地区：[1]北京大学第三医院,北京100083 [2]北京市疾病预防控制中心,北京100020 [3]北京飞机维修工程有限公司,北京100621

出　　处：《中国工业医学杂志》2006年第6期333-337,共5页Chinese Journal of Industrial Medicine

摘　　要：目的探讨机场地勤人员噪声暴露与高血压患病率之间的关系。方法以某机场长期接触噪声的463名地勤人员为研究对象，将其工作内容和工作性质相似的分为一组，每组抽取3—5人用噪声个体计量仪测量等效A声级（LAcq），按等能最原理将LAcq和噪声作业工龄合并计算累积噪声暴露量（CNE）。高血压判定按WHO／ISH（1999）标准：收缩压≥140mm Hg（18．6kPa）和／或舒张压≥90mmHg（12．0kPa）者为高血压，已确诊高血压并服降压药者均按高血压统计。结果机场地勤人员8h等效声级LAcq.8h为（89．3±4．0）dB（A），97％地勤人员的LAcq.8h高于85dB（A）.体检发现高血压患者91人，高血压患病率19．7％。单因素分析表明工龄、年龄、体重指数（BMI）以及父母高血压史均与高血压患病率呈正相关关系（P〈0．05），CNE与高血压患病率之间存在典型的剂量-反应关系（P〈0．01）。多元Logistic回归显示．年龄（OR=1．062）、BMI（0R=1．280）、父母高血压史（OR=1．945）是高血压患病的独立危险因素，CNE的OR值为1．040（P=0．197）。结论CNE与高血压患病率之间存在典型的剂量-反应关系，调整混杂因素影响后CNE每增加1dB（A）地勤人员高血压发病的危险增加约4％，但差异尚无统计学意义。Objective To explore the dose-response relationship between noise and hypertension in airport ground crew. Method A total of 463 ground crew at airport were selected as study subjects, they were further divided into two groups according to their noise expesure levels. 3-5 persons each group were selected for collecting personal noise exposure data-equivalent continuous A-weighted sound pressure noise level （LAcq） by dosimeter during a working day. According to equal-energy rule, Lapland noise exposure duration were incorporated for the calculation of cumulative noise exposure （CNE）. The definition of hypertension was followed WHO/ISH standard （1999） ： systolic blood pressure≥ 140 mm Hg （ 18.6 kPa） and/or diastolic blood pressure ≥90 mm Hg （ 12.0 kPa）. The diagnosed hypertension patients, including those taken anti-hypertension drugs, were all defined as hypertension cases. Result The noise exposodby ground erewat airport were non-steady noise, the LAcq.8hwas （89.3±4.0） dB （A） [79.0±98.8 dB （A）], nearly 97% of ground crew their exposure level beyond 85 dB （A）. There were 91 hypertension patients found in the investigation with a prevalence of 19.7%. The statistics analysis revealed that there were significant correlation between the hypertension prevalence and noise exposure duration, age, BMI, parents＇ hypertension history （ P 〈 0.05）. logistic regression model further showed that age, parents＇ hypertension history, BMI are independent risk factors of hypertension, while odds ratio （OR） of CNE was i.040 （P = 0.197）. Conclusion It is suggested that after adjusting the effect of confounding factors, there seens some dose-response relationship between CNE and hypertension： there would be 4% increase of hypertension risk with 1 dB （A） increase of noise exposure, but without significance, the confirmation on the relationship needs more cases investigation in future.

关 键 词：非稳态噪声 高血压 剂量-反应关系 个体计量仪 累积噪声暴露量 

分 类 号：TB53[理学—物理] R544.1[理学—声学]