不同性别职业噪声暴露人群听力损失程度与高血压的关联分析  

Analysis of relationship between hearing loss degree and hypertension in differentgenders of occupational noise-exposed populations

作　　者：许蕊 罗渝 邓华欣[2] 胡彬 邱景富[1] XU Rui;LUO Yu;DENG Huaxin;HU Bin;QIU Jingfu(College of Public Health,Chongqing Medical University,Chongqing 400042,China;Chongqing Center for Disease Control and Prevention,Chongqing 400042,China;Chongqing Municipal Health Commission,Chongqing 401100,China)

机构地区：[1]重庆医科大学公共卫生学院,重庆400042 [2]重庆市疾病预防控制中心,重庆400042 [3]重庆市卫生健康委员会,重庆401100

出　　处：《重庆医学》2024年第8期1237-1243,共7页Chongqing medicine

基　　金：重庆市卫生健康委员会医学科研项目(2023WSJK087)。

摘　　要：目的探讨重庆地区职业噪声暴露对高血压患病的影响,为噪声暴露人群的高血压防治提供参考。方法运用重庆市重点职业病监测和职业病危害因素场所监测数据库,整群抽样选取重庆成年男性和女性在岗职业噪声暴露人群样本,收集体检资料,以双耳高频平均听阈值评估听力损失程度。随访3年(2017-2019年)和5年(2017-2021年),分别比较男性和女性不同听力损失程度调查对象的年龄、噪声作业工龄、BMI及血压;并采用Cox比例风险回归模型分析听力损失程度与高血压的关系。结果随访3年,调查对象高血压患病率为6.47%(308/4761),男性为6.92%(289/4178),女性为3.26%(19/583);正常听力、低听力损失、高听力损失检出率分别为46.42%、42.62%、10.96%。随访5年,调查对象高血压患病率为12.44%(431/3464),男性为12.92%(399/3088),女性为8.51%(32/376);正常听力、低听力损失、高听力损失检出率分别为64.20%、25.87%、9.93%。随访3、5年,无论男性还是女性,不同听力损失程度调查对象收缩压无明显差异(P>0.05),舒张压有明显差异(P<0.05)。校正混杂因素后,男性噪声暴露低听力损失(双耳高频平均听阈值25~40 dB)调查对象高血压的5年风险明显升高(HR=1.25,95%CI:1.05~1.48,P<0.01),女性噪声暴露高听力损失(双耳高频平均听阈值>40 dB)调查对象高血压的5年风险明显升高(HR=1.26,95%CI:1.10~1.44,P<0.01)。结论职业噪声暴露人群中,低听力损失男性患高血压风险增加,高听力损失女性患高血压风险增加。Objective To explore the effects of occupational noise exposure on hypertension in Chongqing area,and to provide reference for the prevention and treatment of hypertension in noise-exposed populations.Methods Using the Chongqing key occupational disease surveillance and occupational disease hazard factor site monitoring database,the samples of adult male and female occupational noise-exposed populations in Chongqing were selected by the cluster sampling,the physical examination data were collected,and the degree of hearing loss was evaluated by the binaural high-frequency mean hearing thresholds.The follow-up lasted for 3 years(2017-2019)and 5 years(2017-2021).The age,noise operation working age,BMI and blood pressure were respectively compared among the male and female respondents with different degrees of hearing loss;the Cox proportional risk regression model was adopted to analyze the relationship between degree of hearing loss and hypertension.Results After 3-year follow-up,the prevalence rate of hypertension in the respondents was 6.47%(308/4761),6.92%(289/4178)in males and 3.26%(19/583)in females;the detection rates of normal hearing,mild hearing loss and high degree of hearing loss were 46.42%,42.62%and 10.96%respectively.After 5-year follow-up,the prevalence rate of hypertension among the respondents was 12.44%(431/3464),12.92%(399/3088)in males,and 8.51%(32/376)in females;the detection rates of normal hearing,mild hearing loss,and high degree of hearing loss were 64.20%,25.87%and 9.93%respectively.After 3-year,5-year follow-up,there was no significant difference in the systolic blood pressure among respondents with different degrees of hearing loss in males and females(P>0.05),but the diastolic blood pressure had significant difference(P<0.05).After adjusting the confounding factors,the 5-year risk of hypertension in male respondents with noise-induced mild hearing loss(binaural high-frequency mean hearing threshold 25-40 dB)was significantly increased(HR=1.25,95%CI:1.05-1.48,P<0.01).The 5-year risk of

关 键 词：噪声 职业性 听阈 听力损失 随访 性别 高血压 

分 类 号：R135[医药卫生—劳动卫生]