职业性噪声暴露对新入职青年工人听力及心血管系统的影响
Impacts on Hearing and Cardiovascular System in New and Young Workers Exposed to Occupational Noise
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摘要:
目的 调查职业性噪声暴露对新入职青年工人的听力、血压及心电图的影响,探讨青年工人初次职业噪声暴露的职业健康风险。 方法 以南京市职业健康体检机构2011年至2013年进行职业健康体格检查合格的367名新入职青年职工为研究对象,跟踪分析该职业人群入职前和入职后2年内,先后3次职业健康体检的噪声性听力损失(noiseinduced hearing loss,NIHL)、血压和心电图变化。 结果 青年工人噪声作业1年双耳高频平均听阈损失 >25 dB(A)的检出率为4.63%,噪声暴露2年内双耳高频听力损失检出为3.77%;入职1年后听力筛查检出3名噪声敏感工人高频段任一频率,任一耳 ≥ 65 dB(A)。工人入职1年收缩压出现显著性上升,且男性工人连续两年收缩压呈上升趋势;女性工人噪声作业1年高血压现患率上升。男性工人入职1年后心电图检查发现,心律不齐和其他异常心电图(束支传导阻滞、ST-T段改变等)检出率显著上升。 结论 职业性噪声暴露可能对新入职青年工人的听力损失和心血管系统有一定影响。噪声暴露第1年,青工听力损失检出率较高,可能与易感人群有关。 Abstract:Objective To evaluate the effects of occupational noise exposure on the hearing, blood pressure, and electrocardiogram of new recruitments among young workers. Methods A total of 367 new and young workers with normal hearing in pre-employment examination were admitted to the study who were identified from occupational health examination institutes in Nanjing from 2011 to 2013. Changes in noise induced hearing loss (NIHL), blood pressure, and electrocardiogram were analyzed using the health examination data on pre-, first-year, and second-year employment. Results The detection rate of average binaural high frequency hearing loss>25 dB (A) was 4.63% for the young workers with one year of occupational noise exposure and 3.77% for those with two years of exposure. Three workers were diagnosed as noise-sensitivityhearing threshold of any ear at any high frequency ≥ 65 dB(A) after one-year noise exposure. Systolic blood pressure was significant increased after oneyear noise exposure, and consecutively rose in two years in the male workers. The prevalence of hypertension in the female workers was increased after one-year noise exposure. The males workers' abnormal electrocardiogram rates including cardiac arrhythmias and other abnormalities (such as bundle branch block and ST-T change) had a significant increase after one-year noise exposure. Conclusion Hearing loss and cardiovascular disorders might be induced by exposure to occupational noise of new recruitment among young workers. The comparatively high incidence of NIHL in the first-year health examination might be associated with susceptibility.
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