职业性噪声暴露对新入职工人听力及心血管系统的影响  

Impacts on hearing and cardiovascular system in new workers exposed to occupational noise

作　　者：施安琪[1] 蒋丽[1] 沙磊[1] SHI An-qi;JIANG Li;SHA Lei(Outpatient Department, Nantong Center for Disease Control and Prevention, Nantong Jiangsu , 226007, Chin)

机构地区：[1]南通市疾病预防控制中心门诊部,江苏南通226007

出　　处：《职业与健康》2018年第11期1453-1456,共4页Occupation and Health

摘　　要：目的探讨职业性噪声暴露对新入职工人的听力、血压及心电图的影响。方法采用横断面研究方法,以2011—2014年南通市参加职业健康检查并合格的764名新入职工人为调查对象,跟踪分析该职业人群入职前和入职后2年内,先后3次职业健康检查的结果,对听力损伤、血压及心电图情况进行对比分析。结果 (1)职业性噪声暴露工人1年后双耳高频平均听阈损失[>25 dB(A)]的检出率为3.40%,筛查检出4名职业禁忌证,其中1名为噪声敏感者[上岗前职业健康体检纯音听力检查各频率听力损失均≤25 dB(A),但噪声作业1年之内,高频段3 000Hz、4 000 Hz和6 000 Hz中任一耳,任一频率听阈≥65 dB(A)];职业性噪声暴露2年后双耳高频平均听阈损失[>25 dB(A)]的检出率为4.87%,筛查检出1名职业禁忌证工人,1名疑似职业病工人。职业性噪声暴露工人入职后1年和2年的听力损失检出率均较入职前明显升高,其差异均有统计学意义(P<0.05)。(2)职业性噪声暴露工人入职前后收缩压、舒张压以及高血压现患率在全体人群及性别分层中的变化均无统计学意义(P>0.05)。(3)职业性噪声暴露工人入职2年后心电图检查较入职前,窦性心律失常(窦性心动过速、窦性心动过缓、窦性心律不齐)和其他异常心电图(束支传导阻滞、ST-T段改变等)检出率显著上升,其中女性工人心电图变化差异具有统计学意义(P<0.05)。结论职业性噪声暴露对新入职工人的听力损失和心血管系统有一定影响。[Objective]To discuss the effects of occupational noise exposure on the hearing,blood pressure,and electrocardiogram of new workers. [Methods] A cross-sectional study was conducted. A total of 764 new workers with normal results of pre-employment examination in Nantong City from 2011 to 2014 were admitted to the study. Changes in noise induced hearing loss（NIHL）,blood pressure,and electrocardiogram were analyzed using the data of pre-employment health examination,first-year health examination,and second-year health examination during the two years. [Results]（1） The detection rate of average binaural high frequency hearing loss [〉25 dB（A）] was 3.40% for the workers with one year of occupational noise exposure. Four workers were diagnosed as occupational contraindications,and one of them was diagnosed as noise-sensitivity [workers with normal hearing in preemployment examination and hearing threshold of any ear at any high frequency（3 000 Hz,4 000 Hz and 6 000 Hz） ≥65 dB（A）after one-year noise exposure]. The detection rate of average binaural high frequency hearing loss [〉25 dB（A）] was 4.87% for the workers with two years of occupational noise exposure. One worker was diagnosed as occupational contraindications and one was diagnosed as suspected occupational disease. The detection rates of hearing loss for the workers with both one-year and two-year occupational noise exposure were significantly higher than that in pre-employment examination（P〈0.05）.（2） There were no significant differences in the systolic blood pressure,diastolic blood pressure and the prevalence of hypertension among all the workers and gender stratification before and after occupational noise exposure（P〉0.05）.（3）The detection rates of sinus arrhythmia（sinus tachycardia,sinus bradycardia,sinus arrhythmia） and other abnormal ECG（bundle branch block and ST-T segment change）for the workers with two-year occupational noise exposure were significantly higher than that in pre-employment examinat

关 键 词：职业性噪声暴露 听力损伤 血压 心电图 新入职工人 

分 类 号：R135.8[医药卫生—劳动卫生]