施志豪, 辛佳芮, 周洁娜, 周莉芳, 高向景, 张美辨. 中国制造业非稳态噪声性听力损失的meta分析[J]. 环境与职业医学, 2022, 39(4): 382-390. DOI: 10.11836/JEOM21264
引用本文: 施志豪, 辛佳芮, 周洁娜, 周莉芳, 高向景, 张美辨. 中国制造业非稳态噪声性听力损失的meta分析[J]. 环境与职业医学, 2022, 39(4): 382-390. DOI: 10.11836/JEOM21264
SHI Zhihao, XIN Jiarui, ZHOU Jiena, ZHOU Lifang, GAO Xiangjing, ZHANG Meibian. Noise-induced hearing loss associated with non-Gaussian noise in manufacturing industry of China: A systematic review and meta-analysis[J]. Journal of Environmental and Occupational Medicine, 2022, 39(4): 382-390. DOI: 10.11836/JEOM21264
Citation: SHI Zhihao, XIN Jiarui, ZHOU Jiena, ZHOU Lifang, GAO Xiangjing, ZHANG Meibian. Noise-induced hearing loss associated with non-Gaussian noise in manufacturing industry of China: A systematic review and meta-analysis[J]. Journal of Environmental and Occupational Medicine, 2022, 39(4): 382-390. DOI: 10.11836/JEOM21264

中国制造业非稳态噪声性听力损失的meta分析

Noise-induced hearing loss associated with non-Gaussian noise in manufacturing industry of China: A systematic review and meta-analysis

  • 摘要: 背景 非稳态噪声已成为工业中最常见的噪声类型,然而对非稳态噪声暴露及其相关的噪声性听力损失(NIHL)流行病学特征仍了解不足,相关综述极少。

    目的 总结中国制造业非稳态噪声相关的听力损失流行病学特征,为职业噪声性听力损失的早期防控提供依据。

    方法 检索有关中国制造业中非稳态噪声性听力损失的中英文文献;根据各研究中的听力损失患病率数据,统计合计患病率;对带有稳态噪声对照组的研究作meta分析,计算合并OR值以比较非稳态噪声与稳态噪声对听力损失的影响差异,并通过绘制漏斗图、作Egger回归进行发表偏倚评价,依次剔除文献作敏感性分析。

    结果 共纳入37篇横断面研究,共涉及25 055名接触非稳态噪声的中国制造业工人,其中男性占92.5%,年龄为(32.7±9.6)岁,接触噪声工龄为(6.8±4.9)年,噪声暴露水平为(87.0±4.2) dB(A),累积噪声暴露量(CNE)为(95.9±8.0) dB(A)·年。非稳态噪声接触工人的高频和语频听力损失患病率分别为29.0%和14.2%。19篇带有稳态噪声对照组的横断面研究的meta分析显示,非稳态噪声组与稳态噪声对照组相比,年龄、工龄、等效A声级(LAeq)和CNE差异没有统计学意义,而对高频听力损失影响的合并OR值为1.87(95%CI:1.46~2.41),有统计学意义;漏斗图对称性较好,Egger回归结果显示t=−0.11,P=0.910(>0.05),表明本次meta分析不存在发表偏倚;敏感性分析显示结果变化不大,表明结果较稳健。

    结论 中国制造业中噪声作业工人以男性青壮年为主,长期接触高水平有害的非稳态噪声,听力损失患病率高,相对于接触稳态噪声的工人,会遭受更严重的听力损失。

     

    Abstract: Background Non-Gaussian noise has become the dominant noise type in industry. However, the epidemiological characteristics of non-Gaussian noise exposure and associated noise-induced hearing loss (NIHL) are still unclear.

    Objective To summarize the epidemiological characteristics of NIHL associated with non-Gaussian noise in manufacturing industry in China and provide a basis for the early prevention and control of occupational hearing loss.

    Methods Chinese and English literature on hearing loss associated with non-Gaussian noise in China were retrieved. The overall prevalence was calculated based on the prevalence data provided by each included study. A meta-analysis of studies with Gaussian noise as a control group was also performed and the overall weighted odds ratio (OR) was calculated to compare the effects of non-Gaussian noise and Gaussian noise on hearing loss. Publication bias was evaluated by funnel plot and Egger regression, and a sensitivity analysis was performed by eliminating references in turn.

    Results A total of 37 cross-sectional studies involving 25 055 Chinese manufacturing workers exposed to non-Gaussian noise were included, 92.5% of whom were male. These workers aged (32.7±9.6) years were exposed to non-Gaussian noise at (87.0±4.2) dB(A) for (6.8±4.9) years. The mean cumulative noise exposure (CNE) was (95.9±8.0) dB(A)·year. The prevalence rate of high-frequency NIHL (HFNIHL) and speech-frequency NIHL (SFNIHL) were 29.0% and 14.2%, respectively. The results of the meta-analysis treating 19 cross-sectional studies with Gaussian noise as a control group showed that there were no significant differences in age, exposure duration, and equivalent continuous A-weighted sound pressure level (LAeq), and CNE between the non-Gaussian noise group and the Gaussian noise group. The overall weighted OR of HFNIHL was 1.87 (95%CI: 1.46−2.41), which was statistically significant. The funnel plot showed good symmetry and the result of Egger regression wast=−0.11,P=0.910 (>0.05), suggesting a low risk of publication bias in this meta-analysis. The sensitivity analysis showed no significant changes of results after eliminating references in turn, indicating that the results were robust.

    Conclusion Chinese manufacturing workers, mainly young adult males, are exposed to non-Gaussian noise at high levels for a long time and have a high prevalence of NIHL. Compared to workers exposed to Gaussian noise, those exposed to non-Gaussian noise suffer from more serious hearing loss.

     

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