Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers
Combined effect of smoking and occupational exposure to noise on hearing loss in steel factory workers
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DOI：
10.1136/oem.60.1.56
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发表时间：
2003-01-01
影响因子：
4.9
通讯作者：
Shimizu, T
中科院分区：
文献类型：
--
作者：
Mizoue, T;Miyamoto, T;Shimizu, T
背景资料：关于吸烟对听力的不良影响的证据已经积累，但目前尚不清楚是否吸烟修改暴露于噪声和hearing loss.Aims之间的关联：检查这些变量对hearing.Methods的协同效应：所使用的数据来自定期健康检查4624钢铁公司工人在日本，包括听力测试和吸烟习惯的信息。根据公司记录确定职业性噪声暴露。Logistic回归分析用于研究吸烟与听力损失之间的剂量反应关系。采用Cochran-Mantel-Haenszel方法计算各吸烟和噪声暴露因素组合的听力损失患病率比（PRR），以不接触职业性噪声的非吸烟者为参照。吸烟和噪声暴露之间的相互作用进行了评估，使用一个协同指数，等于1时，联合效应是additer.Results：吸烟与增加的几率有高频听力损失的剂量反应方式。暴露于职业噪声的吸烟者高频听力损失的PRR为2.56（95% CI 2.12至3.07），而未暴露于噪声的吸烟者的PRR为1.57（95% CI 1.31至1.89），暴露于噪声的非吸烟者的PRR为1.77（95% CI 1.36至2.30）。增效指数为1.16。吸烟与低频听力损失无相关性。结论：吸烟可能是高频听力损失的一个危险因素，其与职业噪声暴露对听力的联合作用是加性的。
Background: Evidence has accumulated concerning the adverse effects of smoking on hearing acuity, but it is not clear whether smoking modifies the association between exposure to noise and hearing loss.Aims: To examine the synergistic effect of these variables on hearing.Methods: Data used were derived from periodic health examinations for 4624 steel company workers in Japan and included audiometry testing and information on smoking habits. Occupational exposure to noise was determined based on company records. Logistic regression was used to examine the dose-response association between smoking and hearing loss. The Cochran-Mantel-Haenszel method was used to calculate the prevalence rate ratio (PRR) of hearing loss for each combination of smoking and noise exposure factors, taking non-smokers not exposed to occupational noise as a reference. The interaction between smoking and noise exposure was assessed using a synergistic index, which equals 1 when the joint effect is additive.Results: Smoking was associated with increased odds of having high frequency hearing loss in a dose-response manner. The PRR for high frequency hearing loss among smokers exposed to occupational noise was 2.56 (95% CI 2.12 to 3.07), while the PRR for smokers not exposed to noise was 1.57 (95% CI 1.31 to 1.89) and the PRR for non-smokers exposed to noise was 1.77 (95% CI 1.36 to 2.30). The synergistic index was 1.16. Smoking was not associated with low frequency hearing loss.Conclusions: Smoking may be a risk factor for high frequency hearing loss, and its combined effect on hearing with exposure to occupational noise is additive.