The dose-response relationship between in-ear occupational noise exposure and hearing loss.
The dose-response relationship between in-ear occupational noise exposure and hearing loss.
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DOI：
10.1136/oemed-2011-100455
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发表时间：
2013-10
影响因子：
4.9
通讯作者：
Neitzel RL
中科院分区：
文献类型：
--
作者：
Rabinowitz PM;Galusha D;Dixon-Ernst C;Clougherty JE;Neitzel RL
目前对职业性噪声和听力损失之间剂量-反应关系的理解是基于广泛使用听力保护之前的横断面研究，以及关于低于85dBA的噪声暴露的有限数据。我们报告了一组独特的产业工人的听力损失经历，他们每天都在监测听力保护装置内的噪音。在一家工业设施中，表现出加速听力损失的工人被登记参加一个强制性计划，以监测听力保护范围内的日常噪音暴露。我们使用混合效应模型将这些噪声测量(时间加权LAVG)与六年期间高频听力损失的间隔率进行比较，并对潜在的混杂因素进行了调整。研究开始时，工人的高频听力水平平均超过40分贝听力阈值水平(HTL)。大多数噪声暴露在85dBA以下(平均LAVG 76dBA，四分位数范围74~80dBA)。我们发现LAvg与高频听力损失无统计学关系(p=0.53)。使用每月最大噪声暴露的指标并不能改善模型拟合。耳部噪声暴露在85dBA以下与工人高频听力损失的风险没有相关性，这些工人过去有大量噪声暴露，听力损失在基线水平。因此，有效地将噪声控制在85dBA以下可能会显著降低这些人的职业性听力损失风险。听力正常、既往噪声暴露较少的个体，噪声与听力损失的剂量反应关系有待进一步研究。
Current understanding of the dose-response relationship between occupational noise and hearing loss is based on cross-sectional studies prior to the widespread use hearing protection and with limited data regarding noise exposures below 85dBA. We report on the hearing loss experience of a unique cohort of industrial workers with daily monitoring of noise inside of hearing protection devices. At an industrial facility, workers exhibiting accelerated hearing loss were enrolled in a mandatory program to monitor daily noise exposures inside of hearing protection. We compared these noise measurements (as time-weighted LAVG) to interval rates of high frequency hearing loss over a six year period using a mixed effects model, adjusting for potential confounders. Workers’ high frequency hearing levels at study inception averaged more than 40 dB hearing threshold level (HTL). Most noise exposures were less than 85dBA (mean LAVG 76 dBA, interquartile range 74 to 80 dBA). We found no statistical relationship between LAvg and high frequency hearing loss (p = 0.53). Using a metric for monthly maximum noise exposure did not improve model fit. At-ear noise exposures below 85dBA did not show an association with risk of high frequency hearing loss among workers with substantial past noise exposure and hearing loss at baseline. Therefore, effective noise control to below 85dBA may lead to significant reduction in occupational hearing loss risk in such individuals. Further research is needed on the dose response relationship of noise and hearing loss in individuals with normal hearing and little prior noise exposure.
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影响因子：
4.9
作者：
Rabinowitz PM;Galusha D;Kirsche SR;Cullen MR;Slade MD;Dixon-Ernst C
通讯作者：
Dixon-Ernst C
影响因子：
2.4
作者：
KRYTER, KD
通讯作者：
KRYTER, KD
影响因子：
--
作者：
Neitzel, Richard;Daniell, William;Seixas, Noah
通讯作者：
Seixas, Noah
影响因子：
2.4
作者：
Prince, MM;Stayner, LT;Gilbert, SJ
通讯作者：
Gilbert, SJ
影响因子：
--
作者：
Seixas, N;Neitzel, R;Goldman, B
通讯作者：
Goldman, B