饮酒与职业噪声暴露对听力损失的联合作用  

Combined effects of alcohol drinking and occupational exposure to noise on hearing loss

作　　者：李旭东[1] 刘移民[1] 李永胜[1] 郭晓[1] 肖吕武[2] 肖启华[2] 何国权[2] 吴琳[2] 

机构地区：[1]中山大学公共卫生学院,广东广州510080 [2]广州市职业病防治院

出　　处：《华南预防医学》2008年第3期1-5,共5页South China Journal of Preventive Medicine

基　　金：广东省自然科学基金项目(7018635);广州市医药卫生科技重点项目(2006-ZDi-06)

摘　　要：目的 探讨饮酒与听力损失的关系以及饮酒和职业性噪声对听力损失的联合作用。方法 利用回顾性队列研究，选择广州市某大型空调生产企业连续性噪声作业人员244名男性饮酒者为饮酒组，在相同的噪声暴露环境中选择140名男性不饮酒者为对照组，两组间除饮酒外，其他均均衡可比。按照《作业场所噪声测量规范》（WS／T69—1996）要求对噪声暴露作业场所进行测点选择和噪声强度测量[dB（A）]，并计算累积噪声暴露量（CNE）。按GB7583—87要求，对工人进行左、右耳500～6000Hz内6个频率的纯音气导听阈测试，并问卷调查其一般情况、个人生活史、职业史、噪声暴露史、家族性耳聋史以及耳毒性药物使用史等。利用t检验、有序多分类logistic回归分析、卡方检验分析噪声和饮酒对听力的影响以及两者的联合作用。结果 同一噪声暴露环境下，在4000Hz频段，饮酒组左、右耳听阈位移分别为（29．9±12．9）dB和（30．0±13．5）dB；6000Hz听阈位移为（26．9±11．8）dB和（27．3±15．3）dB，均高于对照组（P〈0．05）。饮酒组听力损失的发生率为21．7％，对照组为10．7％，两组比较差异有统计学意义（P〈0．01），年饮酒量达32L及以上听力损失发生的相对危险度是不饮酒的2．632倍（P〈0．05）。累积噪声量达80dB（A）及以上时，饮酒和职业噪声听力损失的RR值分别为3．353和4．643，饮酒与职业噪声联合作用的RR值（9．662）大于两个变量独立作用之和。结论 大量饮酒可导致听力损失发生率增高，在高强度噪声暴露情况下，饮酒和职业噪声暴露对听力损失存在协同作用。Objective To observe effects of alcohol drinking on hearing loss and combined effects with occupational noise exposure. Methods A retrospective cohort study was design to select 244 male drinkers as drinking group and 140 male non - drinkers as control group in the similar exposure environment in a large scale air conditioner factory. After adjusted group factors to keep comparability, noise level of selected points in work area was measured according to the directive rules for noise measurement in the work environment（ WS/T 69 -1996）, and then calculated the cumulative noise exposure（CNE）. Hearing loss was assessed by a qualified audiologist using the pure tone air audiometry according to the GB7583 - 87. A questionnaire was finished at the same time to obtain basic information of individual characteristics, employment, noise exposure history, family deaf history and drug toxicity history. T test, logistic regression analysis and chi square test were applied to analyze effects of alcohol drinking on hearing loss and combined effects with occupational noise exposure. Results In the same noise exposure environment, the audibility threshold shift of left and right ear in drinking group were （ 29.9 ± 12.9 ） dB and （ 30.0 ± 13.5 ） dB respectively at 4000Hz level, （26.9 ± 11.8） dB and （ 27.3 ± 15.3 ） dB at 6 000Hz level, and was significantly higher than control group（P 〈 0.05）. The occurrence of hearing loss was 21.7 % in alcohol drinking group, and 10.7% in control group, with significant difference between two groups（P 〈 0.01 ）. The relative risk of hearing loss in drinkers who drank 32L and above per year was 2. 632 compared to non - drinkers （P 〈 0.05 ）. When CNE was 80 dB （A） and above, the RR of drinking and noise exposure reached 3. 353 and 4.643 respectively, and 9. 662 while combined alcohol drinking and occupational noise exposure, which exceeded sum of two separate exposures. Conclusion Heavy alcohol drink increased hearing loss occurrence, and there existe

关 键 词：饮酒 噪声 职业性 听力 

分 类 号：R764[医药卫生—耳鼻咽喉科]