职业性和非职业性噪声接触导致高频听力损失的交互作用  

Interaction of occupational and non-occupational noise exposure leads to high frequency hearing loss

作　　者：白卢皙 肖颖[1] 段丹萍 张晋蔚 宋慧东[2,3] 王致 BAI Luxi;XIAO Ying;DUAN Danping;ZHANG Jinwei;SONG Huidong;WANG Zhi(School of Medicine,Macao University of Science and Technology,Macao 999078,China;不详)

机构地区：[1]澳门科技大学医学院,中国澳门999078 [2]广州市第十二人民医院职业环境与健康重点实验室,广东广州510620 [3]广州市职业病防治院,广东广州510620

出　　处：《中国职业医学》2024年第2期163-167,共5页China Occupational Medicine

基　　金：广东省医学科学技术研究基金(B2023347);广州市科技计划项目2024年度市校(院)企联合资助项目(2024A03J0505);广州市市校(院)企联合资助专题(广州市职业环境与健康重点实验室)(2023A03J0502);广州市科学技术局重点研发计划项目(202206010061)

摘　　要：目的探讨职业性和非职业性噪声接触的交互作用对噪声作业工人高频听力损失(HFHL)发生风险的影响。方法采用回顾性队列研究方法,以某汽车生产企业2016—2018年上岗的602名听力正常男性噪声作业工人为研究对象。对其进行纯音听阈测试和问卷调查;采用Kaplan-Meier生存分析法和多因素Cox比例风险回归模型分析职业性与非职业性噪声接触对HFHL发生风险的交互作用。结果研究对象于2020年的HFHL发生率为34.1%,无发生语频听力损失者。Kaplan-Meier生存分析结果显示,职业性噪声接触强度超标、自评居住环境嘈杂、职业性噪声接触强度超标且自评居住环境嘈杂人群发生HFHL的风险均增加(P值均<0.01)。Cox比例风险回归模型分析结果显示,职业性噪声接触强度超标+自评居住环境嘈杂的联合作用[相对危险度(RR)=2.40,P<0.01]分别高于职业性噪声接触强度超标的单独作用(RR=2.09,P<0.01)和自评居住环境嘈杂的单独作用(RR=2.39,P<0.01),职业性噪声接触强度超标与自评居住环境嘈杂之间存在拮抗作用(交互作用指数<1.00)。结论职业性与非职业性噪声接触均可增加噪声作业工人发生HFHL的风险,且两者存在交互作用。Objective To explore the impact of the interaction between occupational and non-occupational noise exposure on the risk of high-frequency hearing loss(HFHL)in noise-exposed workers.Methods A total of 602 male workers with normal hearing,engaged in an automobile manufacturing company between 2016 and 2018,were selected as the study subjects using the retrospective cohort study method.Pure-tone audiometry and questionnaire surveys were conducted on the workers.The Kaplan-Meier survival analysis and multivariate Cox proportional hazards regression model were used to analyze the interaction between occupational and non-occupational noise exposure and the risk of HFHL in these workers.Results The prevalence of HFHL of the workers was 34.1%in 2020,without any cases of speech frequency hearing loss.Kaplan-Meier survival analysis result showed that the risk of HFHL increased in workers with excessive national occupational noise exposure intensity,self-reported noisy living environments,and both excessive national occupational noise exposure intensity and self-reported noisy living environments(all P<0.01).The results of the Cox proportional hazards model showed that the combined effect of excessive national occupational noise exposure intensity and self-reported noisy living environments[relative risk(RR)=2.40,P<0.01]was higher than the individual effects of excessive national occupational noise exposure intensity(RR=2.09,P<0.01)and selfreported noisy living environments(RR=2.39,P<0.01).There was an antagonistic effect between excessive national occupational noise exposure intensity and self-reported noisy living environments(interaction index<1.00).Conclusion Both occupational and non-occupational noise exposure can increase the risk of HFHL in noise-exposed workers,and there is an interaction between them.

关 键 词：职业接触 非职业性 噪声 听力损失 交互作用 工人 

分 类 号：R135.8[医药卫生—劳动卫生]