峰度调整等效声级对非稳态噪声致听力损失评估的有效性研究  

Study on the effectiveness of kurtosis-adjusted equivalent sound levels in assessing hearing loss associated with non-steady noise

作　　者：李金哲 曾安可 辛佳芮 邹华[2] 孙新[1] 张美辨 LI Jinzhe;ZENG Anke;XIN Jiarui;ZOU Hua;SUN Xin;ZHANG Meibian(National Institute of Occupational Health and Poison Control,Chinese Center for Disease Control and Prevention,Beijing 100050,China;不详)

机构地区：[1]中国疾病预防控制中心职业卫生与中毒控制所,北京100050 [2]浙江省疾病预防控制中心

出　　处：《工业卫生与职业病》2024年第2期103-108,共6页Industrial Health and Occupational Diseases

基　　金：美国国立卫生研究院(NIH)资助项目(1R01DC015990-01);“十四五”国家重点研发项目(2022YFC2503200,2022YFC2503203)。

摘　　要：目的 本研究旨在分析峰度调整L_(Aeq)(L_(Aeq)-K)在评估非稳态噪声相关的职业性听力损失的有效性。方法 对中国东部某省制造业工厂2015—2020年1 034名制造业工人噪声暴露数据以及听力损失情况进行横断面调查。利用多因素回归分析高频噪声性听力损失(High frequency noise-induced hearing loss,HFNIHL)的影响因素。利用峰度调整前后的ISO 1999 NIPTS(Noise-Induced Permanent Threshold Shift)预测值低估的改善情况,和两条logistics曲线[非稳态噪声峰度调整累积噪声暴露量(CNE-K)与高频听力损失患病率(HFNIHL%)之间以及稳态噪声CNE与HFNIHL%之间]的重叠程度来评估L_(Aeq)-K的有效性。结果多元回归及广义线性混合模型显示峰度是影响工人NIPTS的因素之一(t=3.700,P<0.05;t=2.368,P<0.05)。采用L_(Aeq)-K能显著改善ISO 1999 NIPTS预测值的低估,且改善效果与峰度呈正相关。非稳态噪声CNE-K与HFNIHL%的logistic曲线与稳态噪声CNE与HFNIHL%的logistic曲线几乎重叠,两组的HFNIHL%平均差值从3.2%减小到0.2%(t=4.300,P<0.05)。结论 噪声峰度是职业性NIHL的主要危险因素,在评估复杂噪声相关的NIHL风险时,峰度调整的L_(Aeq,8h)-K比单独的L_(Aeq,8h)更有效。Objective This study aimed to analyze the effectiveness of kurtosis-adjusted L_(Aeq)(L_(Aeq)-K)in assessingoccupational hearing loss associated with non-steady noise.Methods A cross-sectional survey was conducted on1,034 Chinese manufacturing workers from 2015 to 2020.General demographic characteristics,noise exposure data,andhearing loss information were collected and analyzed.Multiple regression was used to determine the factors influencingHigh-frequency noise-induced hearing loss(HFNIHL).The effectiveness of L_(Aeq)-K was assessed by an improvement inthe underestimation of ISO 1999 NIPTS(Noise-induced permanent threshold shift)predictions before and after kurtosisadjustment,as well as the degree of overlap between two logistic curves(non-steady noise CNE(Cumulative noiseexposure)vs.HFNIHL%and steady noise CNE-K(Kurtosis-adjusted CNE)vs.HFNIHL%).Results Multipleregression and generalized linear mixed models revealed that kurtosis was one of the factors affecting workers'NIPTS(t=3.700,P<0.05;t=2.368,P<0.05).Using L_(Aeq)-K significantly improved the underestimation of ISO 1999NIPTS predictions,with a positive correlation with kurtosis.The logistic curve between CNE-K and HFNIHL%fornon-steady noise almost overlapped with the logistic curve between CNE and HFNIHL%for steady noise,with a decrease inaverage HFNIHL%from 3.2%to 0.2%between the two groups(t=4.300,P<0.05).Conclusion Kurtosis is aprimary risk factor for occupational noise-induced hearing loss(NIHL).When assessing the NIHL risk related to complexnoise,kurtosis-adjusted L_(Aeq,8h)(L_(Aeq,8h)-K)is more effective than L_(Aeq,8h) alone.

关 键 词：非稳态噪声 峰度 等效A声级 职业性听力损失 工作场所 

分 类 号：R135[医药卫生—劳动卫生]