某汽车制造企业噪声作业工人高频听力损失的影响因素分析
Factors affecting high-frequency hearing loss among noise-exposed workers in an automobile manufacturing company
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摘要:
背景 汽车制造业噪声危害影响因素复杂多样，且相互关联，对劳动者健康危害较大。
目的 探索应用广义估计方程（GEE）对汽车制造企业噪声作业工人高频听力损失的影响因素进行分析，指导企业科学地开展职工听力保护。
方法 收集某汽车制造企业2018—2022年连续5年的职业卫生检测和职业健康监护数据资料，选取其中连续5年均进行了纯音听力测试的806名噪声作业工人作为研究对象，并收集其性别、体检年份、噪声强度、血压、白细胞数、红细胞数、血小板计数、血红蛋白浓度、谷丙转氨酶和谷草转氨酶水平、吸烟、饮酒等资料信息。将性别、噪声强度、血压、白细胞数、红细胞数、血红蛋白浓度、血小板计数、谷丙转氨酶水平、谷草转氨酶水平、吸烟、饮酒等因素设定为自变量，高频听力损失设定为应变量，采用SPSS 20.0统计软件构建GEE，分析高频听力损失的影响因素。
结果 本研究选取的该汽车制造企业806名研究对象中，男性698人（86.6%）、女性108人（13.4%），2018—2022年各年度的高频听力损失检出率分别为66.4%（535/806）、69.8%（563/806）、70.0%（564/806）、68.9%（555/806）、68.2%（550/806）。单因素分析结果显示，该汽车制造企业不同性别以及是否白细胞计数降低、红细胞计数降低、血小板数降低、吸烟、饮酒等不同特征人群高频听力损失检出率差异具有统计学意义（
P <0.05）。GEE分析结果显示，调整研究对象混杂因素影响，排除相互影响效应后，研究对象男性发生高频听力损失的风险高于女性（P =0.001），OR（95%CI）为1.907（1.286~2.829）；噪声强度超标时发生听力损失的风险较高（P =0.043），OR（95%CI）为1.289（1.009~1.648）；吸烟者发生听力损失的风险较高（P =0.004），OR（95%CI）为1.507（1.137~1.999）。结论 该汽车制造企业噪声作业工人高频听力损失的主要影响因素为性别、噪声强度和吸烟，控制吸烟和降低噪声暴露强度可以减少该企业职工高频听力损失的发生。
Abstract:Background The influencing factors of noise hazards in the automotive manufacturing industry are complex, diverse, and mutually correlated, resulting in significant health impacts on workers.
Objective To explore the application of generalized estimating equations (GEE) to analyze the factors affecting high-frequency hearing loss among noise-exposed workers in an automotive manufacturing company, guiding enterprises to scientifically carry out employee hearing protection programs.
Methods The data of occupational health field evaluation and occupational health surveillance of an automobile manufacturing company for five consecutive years from 2018 to 2022 were collected, and 806 noise-exposed workers with pure tone hearing test results for all five consecutive years were selected as study participants. The retrieved indicators were gender, physical examination year, noise intensity, blood pressure, white blood cell counts, red blood cell counts, platelet counts, concentrations of hemoglobin, alanine transaminase, aspartate aminotransferase, smoking, drinking, etc. Gender, noise intensity, blood pressure, white blood cell counts, red blood cell counts, concentrations of hemoglobin, platelet counts, glutamate aminotransferase, glutamate aminotransferase, smoking, and drinking were set as independent variables, and occurrence of high-frequency hearing loss was set as a dependent variable, and GEE were constructed by using the statistical software of SPSS 20.0 to analyze the influencing factors of high-frequency hearing loss.
Results Of the 806 workers, 698 were male (86.6%) and 108 were female (13.4%). The detection rates of high-frequency hearing loss in each year from 2018 to 2022 were 66.4% (535/806), 69.8% (563/806), 70.0% (564/806), 68.9% (555/806), and 68.2% (550/806), respectively. The detection rate of high-frequency hearing loss in the company was varied significantly by gender, lowered white blood cell counts, lowered red blood cell counts, lowered platelet counts, smoking, and drinking (
P <0.05). The results of GEE analysis showed that after adjusting for selected confounding factors and excluding interaction effects, the risk of high-frequency hearing loss was higher in men than in women (P =0.001; OR=1.907, 95%CI: 1.286, 2.829); it was higher in workplace with disqualified noise intensity than in those without (P =0.043; OR=1.289, 95%CI: 1.009, 1.648); it was also higher in smokers than in non-smokers (P =0.004; OR=1.507, 95%CI: 1.137, 1.999).Conclusion Gender, noise intensity, and smoking are the main influencing factors of high-frequency hearing loss in noise-exposed workers in this automobile manufacturing company. Controlling smoking and reducing noise exposure intensity may reduce the occurrence of high-frequency hearing loss in workers.
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