耐火陶瓷纤维作业工人早期听力损失情况及影响因素

Early hearing loss and its influencing factors in refractory ceramic fibers workers

关键词: 耐火陶瓷纤维(RCFs)  职业性噪声  早期听力损失

Keywords: refractory ceramic fibers(RCFs)  occupational noise  early hearing loss

摘 要: 目的 探讨接触噪声作业工人早期听力损失情况及可能的影响因素,为早期发现听力损失和制定相关防治措施提供依据和指导。方法 选择某大型耐火陶瓷纤维(RCFs)企业进行现场职业卫生学调查,对 9 个生产加工车间 31 个主要作业岗位的噪声接触水平进行测定,239 名接触噪声的一线作业工人作为研究对象,进行问卷调查并收集经校正的纯音听力检查结果。出现以下情况中≥1 项判定为早期噪声性听力损失:(1)单耳或双耳于 4000 Hz 和/或 6000 Hz频率听阈≥40 dB; (2)单耳或双耳高频平均听阈与语频平均听阈之差≥10 dB。 采用 χ² 检验和多因素 logistic 回归模型分析 RCFs 作业工人早期听力损伤的影响因素。 结果 31 个岗位中有 23 个岗位的噪声声级≥80 dB(A), 14 个岗位的噪声声级≥85 dB(A); 239 名 RCFs 作业工人中 34 人发生早期听力损失,检出率 14.2%;男性、体质量指数(BMI)≥24 kg/m2、工龄≥10 年、接触噪声声级≥80 dB(A)的工人早期听力损失检出率较高(均 P<0.05)。 Logistic 回归分析显示,工龄≥10 年是 RCFs 作业工人发生早期听力损失的危险因素(OR=3.12,95%CI:1.36~7.16, P=0.007)。结论 RCFs 作业场所存在较严重的噪声危害, 应在加强防尘措施的同时, 重视噪声危害治理和听力防护。 本研究选取的早期听力损失筛查指标具有较好的应用价值, 有助于开展早期听力损失的评价。

Abstract: Objective To explore the situation of early noise-induced hearing loss in refractory ceramic fibers (RCF)-exposed workers, and its potential influencing factors, thereby, to provide a basis and guidance for the early detection of hearing loss and the development of prevention and control measures. Methods A cross-sectional occupational hygiene investigation was conducted at a large RCFs enterprise, the noise exposure level was measured at 31 key workstations across 9 RCFs production and processing workshops, a total of 239 frontline workers exposed to noise were selected as study subjects, who underwent questionnaire survey and pure-tone audiometric test, early noise-induced hearing loss might be diagnosed if any of following criteria was met: (1)unilateral or bilateral hearing threshold at 4 000 Hz and/or 6 000 Hz was ≥40 dB; (2) the difference between high-frequency average hearing threshold and speech-frequency average hearing threshold was ≥10 dB in one or both ears. Then, using Chi-square test and multi-factor logistic regression models to analyze the influencing factors of early hearing loss in RCFs-exposed workers. Results The results showed that out of 31 job positions, 23 positions had the noise level ≥80 dB(A), and 14 positions ≥ 85 dB(A); out of 239 workers, 34 showed early hearing loss, detection rate reached 14.2%. Male workers with BMI≥24 kg/m2, work experience ≥10 years, noise exposure levels≥80 dB(A) all had a higher detection rate of early hearing loss (P<0.05); and the logistic regression analysis showed that the work experience of ≥10 years was a risk factor of early hearing loss in RCFs workers (OR=3.12,95%CI:1.36—7.16, P=0.007). Conclusion The results suggested that there was serious noise hazards in RCFs production and processing workplaces, it was necessary to strengthen noise control measures in the workplace, attention should be paid to noise hazard control and hearing protection; additionally, the early hearing loss screening indicators selected in this study showed good application value, and should be helpful for the evaluation of early hearing loss.