背景:高频听力损失(HFHL)是全球普遍存在的职业发病率,有许多相关的危险因素,其中一些是可以修改的。在全面的听力保护计划的背景下,最初的步骤包括早期筛查和识别具有这些可改变的风险因素的工人,旨在降低听力损失的患病率。我们的目标是估计HFHL的患病率并确定其在矿山工人中的预测因子。
方法:我们对古吉拉特邦10个露天矿的226名矿工进行了横断面研究,印度西部,2020年11月。我们收集了社会人口数据,上瘾,职业历史和合并症,随着人体测量,血压,和血糖测量。使用便携式诊断听力计进行听力评估以评估HFHL,定义为在高频(3000、4000、6000和8000Hz)下超过25分贝(dB)的听力阈值。在调整混杂变量后,使用具有二项式家族的广义线性模型(GLM)来确定显着预测HFHL的预测因子。
结果:在我们的研究环境中,HFHL的患病率为35%(95%CI:29-42%)。办公室工作人员的患病率为19%,而其他工作类别的患病率更高,为42%,导致23%的显着患病率差异和2.2的患病率。GLM分析显示,变量,例如工作期间的噪声暴露[调整后的患病率(aPR)2.3(95%CI:1.2-4.7,p=0.018)]和噪声暴露持续时间[aPR1.1(95%CI:1.0-1.1,p=0.042)],是HFHL的重要预测因子。
结论:在我们的研究环境中,煤矿工人表现出很高的HFHL患病率,暴露于工作场所的噪音和持续时间是可修改的预测因子。由于HFHL进展缓慢,通常未被个人发现,我们建议使用测听法进行定期测试,以在矿山工人中识别它,如果可能,将他们从采矿活动转移到办公室。此外,我们主张尽可能实施全面的听力保护计划。
BACKGROUND: High-frequency hearing loss (HFHL) stands as a prevalent occupational morbidity globally, with numerous associated risk factors, some of which are modifiable. In the context of a comprehensive hearing conservation program, the initial steps involve early screening and identification of workers with these modifiable risk factors, aiming to reduce the prevalence of hearing loss. Our objective was to estimate the prevalence of HFHL and determine its predictors among mine workers.
METHODS: We conducted a cross-sectional study among 226 mine workers in ten open-cast mines in Gujarat state, the western part of India, in November 2020. We collected data on socio-demography, addiction, occupation history and comorbidities, along with anthropometric, blood pressure, and blood sugar measurements. Audiometric evaluations using a portable diagnostic audiometer were employed to assess HFHL, defined as a hearing threshold exceeding 25 decibels (dB) at high frequencies (3000, 4000, 6000, and 8000 Hz). A generalized linear model (GLM) with a binomial family was performed to determine the predictors significantly predicting HFHL after adjusting for confounding variables.
RESULTS: The prevalence of HFHL was 35% (95% CI: 29-42%) in our study setting. Office workers demonstrated a prevalence of 19%, whereas other job categories displayed a higher prevalence of 42%, resulting in a significant prevalence difference of 23% and a prevalence ratio of 2.2. The GLM analysis revealed that variables, such as noise exposure during work [adjusted prevalence ratio (aPR) 2.3 (95% CI: 1.2-4.7, p = 0.018)] and noise exposure duration [aPR 1.1 (95% CI: 1.0-1.1, p = 0.042)], were significant predictors of HFHL.
CONCLUSIONS: In our study setting, mine workers exhibited a high prevalence of HFHL, with exposure to workplace noise and duration being modifiable predictors. Because HFHL advances slowly and is generally undetected by the individual, we recommend periodic testing using audiometry to identify it among mine workers and, if possible, shifting them from mining activities to office. Furthermore, we advocate for the implementation of a comprehensive hearing conservation program to the extent possible.