Do ambient noise exposure levels predict hearing loss in a modern industrial cohort?
Do ambient noise exposure levels predict hearing loss in a modern industrial cohort?
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DOI：
10.1136/oem.2005.025924
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发表时间：
2007-01-01
影响因子：
4.9
通讯作者：
Cullen, M. R.
中科院分区：
文献类型：
--
作者：
Rabinowitz, P. M.;Galusha, D.;Cullen, M. R.
背景：大部分关于职业性噪声暴露与听力损失之间的暴露-反应关系的已知信息来自于在广泛实施工作场所听力保护计划之前进行的横断面研究。目前人们对环境噪声暴露测量与听力损失风险之间的关系知之甚少。目的：研究现代工业劳动力高频听力损失率与测量噪声暴露水平之间的关系。方法：对某铝制造企业6217名职工进行十年听力损失调查。工业卫生和人力资源记录允许重建个人噪声暴露。听力损失率与基于年龄和噪音暴露的ANSI 3.44预测进行了比较。使用多变量回归评估听力损失、噪声暴露和协变量风险因素之间的关联。结果：在高噪音环境下工作的工人比在低噪音环境下工作的同事更容易出现高频听力损失。这种趋势在白人男性和非猎人的分层分析中也可以看到。在较高的噪声暴露水平下，听力损失的程度小于ANSI 3.44公式预测的程度。没有迹象表明健康工作者效应可以解释这些发现。大多数10分贝标准阈值移位（STS）发生在计算的环境噪声暴露小于或等于85 dBA的工人身上。结论：在这个现代工业队列中，听力保护措施似乎可以降低听力损失率，特别是在较高的环境噪声水平下。这可能与听力保护的不同使用有关。可预防的职业性听力损失负担最大的是平均噪音暴露在85 dBA或更低的工人。为了进一步降低职业性听力损失的发生率，听力保护计划可能需要针对噪声暴露接近85 dBA的工人采取创新方法。
Background: Much of what is known about the exposure-response relationship between occupational noise exposures and hearing loss comes from cross-sectional studies conducted before the widespread implementation of workplace hearing conservation programmes. Little is known about the current relationship of ambient noise exposure measurements to hearing loss risk.Aim: To examine the relationship between rates of high frequency hearing loss and measured levels of noise exposure in a modern industrial workforce.Methods: Ten-year hearing loss rates were determined for 6217 employees of an aluminium manufacturing company. Industrial hygiene and human resources records allowed for reconstruction of individual noise exposures. Hearing loss rates were compared to ANSI 3.44 predictions based on age and noise exposure. Associations between hearing loss, noise exposure, and covariate risk factors were assessed using multivariate regression.Results: Workers in higher ambient noise jobs tended to experience less high frequency hearing loss than co-workers exposed at lower noise levels. This trend was also seen in stratified analyses of white males and nonhunters. At higher noise exposure levels, the magnitude of hearing loss was less than predicted by ANSI 3.44 formulae. There was no indication that a healthy worker effect could explain these findings. The majority of 10 dB standard threshold shifts (STS) occurred in workers whose calculated ambient noise exposures were less than or equal to 85 dBA.Conclusions: In this modern industrial cohort, hearing conservation efforts appear to be reducing hearing loss rates, especially at higher ambient noise levels. This could be related to differential use of hearing protection. The greatest burden of preventable occupational hearing loss was found in workers whose noise exposure averaged 85 dBA or less. To further reduce rates of occupational hearing loss, hearing conservation programmes may require innovative approaches targeting workers with noise exposures close to 85 dBA.