10-Year prospective study of noise exposure and hearing damage among construction workers
10-Year prospective study of noise exposure and hearing damage among construction workers
复制标题
DOI：
10.1136/oemed-2011-100578
复制
发表时间：
2012-09-01
影响因子：
4.9
通讯作者：
Kujawa, Sharon
中科院分区：
文献类型：
--
作者：
Seixas, Noah S.;Neitzel, Rick;Kujawa, Sharon
目的探讨间歇性和峰值性噪声暴露对听力损伤的影响，并通过标准纯音听阈和耳声发射进行评估。316例患者至少接受了2次（平均4.6次）检查，并被纳入本分析。年度检查包括纯音听阈水平（HTLs）和畸变产物耳声发射（DPOAE）振幅。基于任务的职业噪声暴露水平和娱乐暴露进行了估计。线性混合模型拟合HTLs和DPOAEs在3，4和6 kHz的时间，自基线以来的平均噪声水平，自基线，同时控制在基线和其他危险因素的听力水平。线性混合模型表明，在3、4或6 kHz下，暴露量增加10 dB，预计10年内HTL显著升高约2-3 dB。DPOAE模型（使用L1=40）预测约1分贝的发射振幅下降超过10年的10分贝增加exposure.Conclusions研究提供了证据，噪音引起的损害在平均暴露水平在85分贝左右的水平。在考虑基线听力损失后，HTL的预测变化略高于标准听力损失模型的预测。观察到高峰分量噪声增强效应的证据有限，DPOAE虽然受到类似影响，但在检测噪声对耳朵和听力的影响方面，与标准听阈评估相比没有优势。
Objectives To characterise the effects of noise exposure, including intermittent and peaky exposure, on hearing damage as assessed by standard pure-tone thresholds and otoacoustic emissions, a longitudinal study was conducted on newly hired construction apprentices and controls over a 10-year period.Methods Among the 456 subjects recruited at baseline, 316 had at least two (mean 4.6) examinations and were included in this analysis. Annual examinations included hearing threshold levels (HTLs) for air conducted pure tones and distortion product otoacoustic emission (DPOAE) amplitudes. Task-based occupational noise exposure levels and recreational exposures were estimated. Linear mixed models were fit for HTLs and DPOAEs at 3, 4 and 6 kHz in relation to time since baseline and average noise level since baseline, while controlling for hearing level at baseline and other risk factors.Results Estimated L-EQ noise exposures were 87 +/- 3.6 dBA among the construction workers. Linear mixed modelling demonstrated significant exposure-related elevations in HTL of about 2-3 dB over a projected 10-year period at 3, 4 or 6 kHz for a 10 dB increase in exposure. The DPOAE models (using L1=40) predicted about 1 dB decrease in emission amplitude over 10 years for a 10 dB increase in exposure.Conclusions The study provides evidence of noise-induced damage at an average exposure level around the 85 dBA level. The predicted change in HTLs was somewhat higher than would be predicted by standard hearing loss models, after accounting for hearing loss at baseline. Limited evidence for an enhanced effect of high peak component noise was observed, and DPOAEs, although similarly affected, showed no advantage over standard hearing threshold evaluation in detecting effects of noise on the ear and hearing.