机械制造工人职业性噪声接触与动脉硬化的关联性研究  

Study on the relationship between occupational noise exposure and arteriosclerosis in mechanical manufacturing workers

作　　者：陈兆敏 黄雪赞 陶月情 张淏喆 李文祯 王冬明 CHEN Zhaomin;HUANG Xuezan;TAO Yueqing;ZHANG Haozhe;LI Wenzhen;WANG Dongming(School of Public Health,Tongji Medical College,Huazhong University of Science and Technology,Key Laboratory of Environment and Health,Ministry of Education,Wuhan,Hubei 430030,China;不详)

机构地区：[1]华中科技大学同济医学院公共卫生学院,教育部环境与健康重点实验室,湖北武汉430030 [2]香港中文大学赛马会公共卫生及基层医疗学院,中国香港999077

出　　处：《中国职业医学》2024年第2期150-155,共6页China Occupational Medicine

基　　金：国家重点研发计划(2022YFC2503203);湖北省卫生健康委员会科研项目(WJ2023M002)。

摘　　要：目的探讨机械制造工人职业性噪声与动脉硬化之间的关联。方法采用判断抽样方法,选择某机械制造企业453名员工为研究对象。测量其工作场所噪声接触水平,结合工种-噪声暴露矩阵和职业病危害接触史评估其累积噪声暴露量(CNE)。对研究对象进行纯音听力测试,测量其肱-踝脉搏波传导速度(baPWV)。结果研究对象CNE为(91±11)dB(A)·年,baPWV中位数为1278.0 cm/s。广义线性回归模型分析结果显示,CNE每增加1 dB(A)·年,总人群baPWV增加0.20%[95%置信区间(CI)为0.10%~0.30%,P<0.01],男性增加0.17%(95%CI为0.06%~0.28%,P<0.01),女性增加0.28%(95%CI为0.07%~0.49%,P<0.01)。采用听力损失作为高强度噪声接触结局指标,结果显示,双耳听力损失人群baPWV增加7.04%(95%CI为2.42%~11.87%,P<0.01),双耳和任一耳高频听阈提高人群baPWV分别增加9.84%和6.53%(95%CI分别为3.07%~17.07%和2.13%~11.11%,P值均<0.01),而语频听阈提高与动脉硬化间无统计学意义(P>0.05)。结论职业性噪声接触可能会增加动脉硬化的风险。Objective To explore the relationship between the occupational noise exposure and arteriosclerosis in mechanical manufacturing workers.Methods A total of 453 employees of a machinery manufacturing enterprise were selected as the study subjects using the judgment sampling method.The noise exposure levels in their workplaces were measured,and their cumulative noise exposure(CNE)was assessed based on the type of job-noise exposure matrix and occupational hazard exposure history.Pure-tone audiometry was performed on the research subjects,and their brachial-ankle pulse wave velocity(baPWV)was measured.Results The CNE was(91±11)dB(A)per year and the median baPWV was 1278.0 cm/s in the research subjects.The results of the generalized linear regression model analysis showed that for every one dB(A)per year increase in CNE,the baPWV of the general population increased by 0.20%[95%confidence interval(CI)0.10%-0.30%,P<0.01],with an increase of 0.17%in males(95%CI 0.06%-0.28%,P<0.01)and 0.28%in females(95%CI 0.07%-0.49%,P<0.01).Using the hearing loss as an outcome indicator for high intensity noise exposure,the results showed that baPWV increased by 7.04%(95%CI 2.42%-11.87%,P<0.01)in individuals with bilateral hearing loss,and by 9.84%and 6.53%(95%CI 3.07%-17.07%and 2.13%-11.11%,all P<0.01)in individuals with elevated high-frequency hearing thresholds in both ears and in either ear,respectively.There was no significant association in elevated speech-frequency hearing thresholds and arteriosclerosis(P>0.05).Conclusion Occupational noise exposure may increase the risk of arteriosclerosis.

关 键 词：职业性噪声 动脉硬化 肱-踝脉搏波传导速度 听力损失 关联性 

分 类 号：R135.99[医药卫生—劳动卫生]