造船企业噪声所致作业工人高频听力损失回顾性队列研究  

A retrospective cohort study on high-frequency hearing loss of workers occupationally exposed to noise in shipbuilding enterprise

作　　者：王文朋[1,2] 黄云彪 李钢[1] 沈惠平 WANG Wenpeng;HUANG Yunbiao;LI Gang;SHENHuiping(Pudong New Area Center for Disease Control and Prevention,Shanghai 200136,China;Pudong Institute of Preventive Medicine,Fudan University,Shanghai 200136,China)

机构地区：[1]上海市浦东新区疾病预防控制中心,上海200136 [2]上海市复旦大学浦东预防医学研究院,上海200136

出　　处：《职业卫生与应急救援》2023年第2期127-132,共6页Occupational Health and Emergency Rescue

基　　金：上海市浦东新区卫生系统优秀青年医学人才培养计划项目(PWRq2020-42);浦东新区卫生系统医药学科建设资助(PWYgts 2021-04)。

摘　　要：目的探讨造船业不同职业性噪声暴露水平对作业工人高频听力损失的影响。方法采用回顾性队列研究方法,对上海市浦东新区某造船企业进行现场职业卫生调查,收集噪声暴露工人2016—2020年听力检测资料,根据噪声暴露水平,将工人分为高暴露组[≥90.0 dB(A)]、中暴露组[85.0~90.0 dB(A)]和低暴露组[<85.0 dB(A)],采用Cox比例风险回归模型分析高频听力损失的影响因素。结果2016年有1240名研究对象进入队列,随访期间进入队列人员105名,失访85名,截至2020年12月31日,有1260名完成1次及以上健康检查和听力测试。共检出高频听力损失154例,检出率为12.22%。Cox比例风险回归模型结果显示:与低暴露组比较,中、高暴露组发生高频听力损失的风险增加(P<0.01),其RR(95%CI)值分别为4.594(2.874~7.345)和5.355(3.277~8.749);与暴露时间<5年组相比,暴露时间为15~24年、≥25年组发生高频听力损失的风险增加(P<0.01),其RR(95%CI)值分别为3.883(1.397~10.794)、4.317(1.542~12.085);与不接触其他有害物质组比较,接触多种职业病危害因素组发生高频听力损失的风险增加(P<0.01),其RR(95%CI)值为2.057(1.627~3.030)。结论造船企业噪声暴露工人高频听力损失发生率较高。企业应积极寻求有效干预措施,减少工人噪声暴露水平和暴露时间,保护工人听力健康。Objective To observe the effect of different occupational noise exposure levels on high-frequency hearing loss in shipbuilding workers.Methods A retrospective cohort study was carried out in a shipbuilding enterprise in Pudong,Shanghai,by which the hearing test data of noise-exposed workers from 2016 to 2020 were collected.The workers were divided into three groups according to their exposure level,namely the high exposure group[≥90.0 dB(A)],the moderate exposure group[85.0-90.0 dB(A)],and the low exposure group[<85.0 dB(A)].A Cox proportional hazards regression model was used to analyze the influencing factors for high-frequency hearing loss.Results Totally 1240 workers were included in the cohort in 2016,while 105 workers were added and 85 were lost during the follow-up period until December 31,2020;1260 noise-exposed workers completed one or more health examinations and hearing tests,and 154 subjects had high-frequency hearing loss with an incidence rate of 12.22%.The results of the Cox proportional hazards regression model showed that the risk of high-frequency hearing loss among workers in the middle and high exposure groups was higher than that in the low exposure group(P<0.01),with RR(95%CI)values of 4.594(2.874-7.345)and 5.355(3.277-8.749),respectively.Compared with workers exposed for less than 5 years,those exposed for 15-24 years,longer than or equal to 25 years,had an increased risk of high-frequency hearing loss(P<0.01),with RR(95%CI)values of 3.883(1.397-10.794)and 4.317(1.542-12.085),respectively.Compared with non-exposed workers,the workers with exposure to multiple occupational hazards increased the risk of high-frequency hearing loss(P<0.01),with a RR(95%CI)of 2.057(1.627-3.030).Conclusions The incidence of high-frequency hearing loss was high among workers exposed to noise in shipbuilding enterprises.Enterprises should actively seek effective intervention measures to reduce noise exposure intensity and exposure time to protect workers’hearing health.

关 键 词：造船业 噪声 高频听力损失 回顾性队列研究 COX回归 

分 类 号：R135[医药卫生—劳动卫生]