职业性噪声环境从业人员耳鸣状况调查

摘要

目的 分析职业性噪声暴露人群的耳鸣发生率与噪声暴露时间、年龄、性别、听力损失等因素的关系.方法 选择1 985例某造船厂中符合纳入标准的噪声暴露环境下工作1～30年的20～60岁工人为研究对象,其中男1 831例,女154例,平均年龄为36.3±8.25岁;平均噪声暴露工龄9.1±6.5年,分别进行问卷调查及0.25～8kHz纯音听阈(PTA)检查,根据耳鸣自评严重程度将受试者分为轻度耳鸣、中度耳鸣、重度耳鸣及无耳鸣组,分析耳鸣与噪声暴露时间、年龄、性别、听力损失等因素的关系.结果 1 985例中耳鸣发生率为20.55％(408/1 985),其中轻度耳鸣367例(89.95％),中度耳鸣39例(9.56％),重度耳鸣2例(0.49％);轻度耳鸣和中度耳鸣的发生率均随噪声暴露时间的延长呈阶梯式上升;在＜55岁人群中轻度耳鸣发生率随年龄的增长持续升高,＞55岁年龄段人群中度耳鸣发生率较高;男性耳鸣发生率(389/1 831,21.25％)较女性(19/154,12.34％)高;各耳鸣组4和/或6kHz纯音气导听阈较无耳鸣组升高(P＜0.01).结论 本组职业性噪声暴露者噪声暴露时间越长、年龄越大、男性发生耳鸣的概率更高;职业性噪声暴露主要引起轻度耳鸣,可伴4和/或6 kHz纯音气导听阈升高.%Objective To investigate the correlation between incidence rate of tinnitus and noise exposure time,age,hearing condition in noise exposure workers.Methods A total of 1 985 noise exposure workers (age between 20～60 years old;working length between 1 ～30 years) in a large dockyard were randomly selected as the subject of this study with 1 831 male workers and 154 female workers in average 36.3±8.25 years old.The average noise exposure time was 9.1±6.50 years and pure tone threshold of final candidates in sound-proofed environment was evaluated (at 0.25～8 kHz).The subjects were divided into four groups according to the subjective tinnitus level:mild tinnitus,moderate tinnitus,severe tinnitus and no tinnitus to analysis the correlation among incidence rate of tinnitus and noise exposure time,age,hearing condition,etc.Results Among all 1 985 subjects enrolled the occurrence rate of tinnitus was 20.55％ (408/1 985),with 367 acquired mild tinnitus(89.95％),39 acquired moderate tinnitus (9.56％) and 2 for severe tinnitus (0.49％).Mild tinnitus and moderate tinnitus showed a multi-step raising according to noise exposure time.Mild tinnitus increased continually with age while moderate tinnitus showed an accumulation in age group over 55 years old.Female was less likely to be annoyed by tinnitus than male.Conclusion Tinnitus can be early warning of auditory damage by noise exposure;older male group with longer noise exposure time is more vulnerable to tinnitus.Tinnitus acquired in noise environment is more likely to be mild.