联合接触噪声及甲苯与职业性听力损伤关系的Meta分析

摘要

Objective:To assess the occupational hearing loss effects of workers between noise plus toluene group and one factor only group by Meta-analysis .Methods:Original English and Chinese articles on association between combined exposure of noise and toluene and occupational hearing loss (Jan.1990 to Dec.2013) were retrieved by such databases as Chinese CNKI , Wanfang , Medline and Pubmed .A random effect model was used to calculate pooled OR and their corresponding 95% CI.Potential sources of heterogeneity among studies were explored and publication bias was evaluated .Results: A total of 8 ( 2 in Chinese and 6 in English ) observational studies were identified.The prevalence rate of high frequency hearing loss in combined exposure group was higher than that in noise-only group and in toluene-only group, with pooled OR=1.98(95% CI:1.20-3.25) and 2.48(95% CI:1 .09-5 .65 ) ,respectively .The significant heterogeneity was found in subgroup analysis and publication bias was not significant among recruited studies .Conclusion:The results suggest that toluene exposure in noisy working places can exacerbate high frequency hearing loss in workers .%目的：用Meta分析方法探讨同时接触噪声及甲苯两种因素与单种因素暴露相比对劳动者职业性听力损伤的影响。方法：利用中国学术期刊全文数据库、万方全文数据库、Medline及Pubmed数据库检索国内外公开发表的从1990年1月至2013年12月的所有关于联合接触噪声及甲苯与职业性听力损伤关系的中英文文献；利用随机效应模型计算纳入文献的合并OR值及其95％CI 值；进行亚组分析探究异质性来源并分析出版偏倚。结果：纳入分析的文献共8篇（中文2篇，英文6篇）。经Meta分析，与单纯噪声暴露及单纯甲苯暴露相比，同时接触噪声和甲苯的高频听力损伤发生率分别增加1．98倍（95％CI：1．20～3．25）及2．48倍（95％CI：1．09～5．65）。亚组分析显示研究有显著异质性，但无明显发表偏倚。结论：同时接触甲苯会加重噪声作业场所劳动者高频听力损伤的发生率。