隧道射钉枪作业致职业性爆震聋 1 例

One case of occupational explosive deafness caused by nail gun operation in a tunnel

关键词: 射钉枪  封闭空间  职业性爆震聋

Keywords: nail gun  enclosed space  occupational explosive deafness

摘 要: 报道 1 例隧道施工人员因射钉枪空包弹暴露导致右耳极重度听力损失的病例资料。患者暴露于 173.4 dB 冲击波噪声后出现右耳持续性耳鸣及感音神经性聋,经 2 个月动态观察排除其他致聋因素,年龄、性别修正后右耳平均听阈达 81 dB, 依据《职业性爆震聋的诊断》(GBZ/T 238—2011)确诊为职业性极重度爆震聋(右)。本例提示封闭空间可显著增强射钉枪冲击波致伤效应,建议修订行业标准时将隧道等受限空间噪声暴露纳入特殊风险评估范畴。

Abstract: A case of profound hearing loss in the right ear of a tunnel construction worker caused by exposure to blank bullets from a nail gun was reported. The patient developed persistent tinnitus and sensorineural deafness in the right ear after exposure to shock wave noise of 173.4 dB. After two months of dynamic observation to rule out other deafness factors, the average hearing threshold of the right ear after age and sex correction reached 81 dB. According to the Diagnosis of Occupational Explosive Deafness (GBZ/T 238—2011), the patient was diagnosed with occupational severe explosive deafness (right). This case suggests that confined space can significantly enhance the shock wave injury effect of nail gun, and it is suggested that noise exposure in confined space, such as tunnel should be included in the scope of special risk assessment when revising the industry standard.