目的:分析制造工人中噪声引起的永久阈值偏移(NIPTS)低估的影响因素,为修订噪声暴露标准提供基线数据。
方法:对来自10个行业的35家企业的2702名接触噪声的工人进行了横断面研究。个人噪声暴露水平(LAeq,8h)和噪声峰度水平由噪声剂量计确定。对每个受试者进行问卷调查和听力损失测试。预测的NIPTS是使用ISO1999:2013模型为每个参与者计算的,对实际测量的NIPTS进行年龄和性别校正。调查了影响NIPTS低估的因素。
结果:使用ISO1999:2013模型在每个测试频率(0.5、1、2、3、4或6kHz)下的预测NIPTS和在2、3、4和6kHz下的平均NIPTS(NIPTS2346)显着低于其相应的测量NIPTS,分别(P<0.001)。ISO模型显著低估了NIPTS234612.36dBHL。多元线性回归分析表明,噪声暴露水平,暴露持续时间,年龄,峰度可能影响NIPTS2346的低估程度。具有(惩罚)样条分量的广义加性模型(GAM)显示了关键因素(年龄、暴露持续时间,噪声级,和峰度)和被低估的NIPTS2346。被低估的NIPTS2346随着暴露持续时间的增加(特别是超过十年)而减少。随着年龄的增长,被低估的NIPTS2346没有明显的趋势。被低估的NIPTS2346随着噪声水平的增加而降低[特别是>90dB(A)]。在调整噪声暴露水平和暴露持续时间并最终表现出线性回归关系后,低估的NIPTS2346随噪声峰度的增加而增加。
结论:ISO1999预测模型大大低估了制造工人中噪声引起的听力损失。在少于十年的噪声暴露条件下,低估程度变得更加显著,小于90dB(A),和更高的峰度水平。在使用ISO预测模型时,有必要应用峰度来调整听力损失的低估,并考虑噪声能量指标的应用条件。
To analyze factors influencing the
underestimation of noise-induced permanent threshold shift (NIPTS) among manufacturing workers, providing baseline data for revising noise exposure standard.
A cross-sectional study was designed with 2702 noise-exposed workers from 35 enterprises from 10 industries. Personal noise exposure level(LAeq,8h) and noise kurtosis level were determined by a noise dosimeter. Questionnaires and hearing loss tests were performed for each subject. The predicted NIPTS was calculated using the ISO 1999:2013 model for each participant, and the actual measured NIPTS was corrected for age and sex. The factors influencing the
underestimation of NIPTS were investigated.
The predicted NIPTS at each test frequency (0.5, 1, 2, 3, 4, or 6kHz) and mean NIPTS at 2, 3, 4, and 6kHz (NIPTS2346) using the ISO 1999:2013 model were significantly lower than their corresponding measured NIPTS, respectively (P < 0.001). The ISO model significantly underestimated the NIPTS2346 by 12.36 dB HL. The multiple linear regression analysis showed that noise exposure level, exposure duration, age, and kurtosis could affect the degree of
underestimation of NIPTS2346. The generalized additive model (GAM) with (penalized) spline components showed nonlinear relationships between critical factors (age, exposure duration, noise level, and kurtosis) and the underestimated NIPTS2346.The underestimated NIPTS2346 decreased with an increase in exposure duration (especially over ten years). There was no apparent trend in the underestimated NIPTS2346 with age. The underestimated NIPTS2346 decreased with the increased noise level [especially > 90 dB(A)]. The underestimated NIPTS2346 increased with an increase in noise kurtosis after adjusting for the noise exposure level and exposure duration and ultimately exhibiting a linear regression relationship.
The ISO 1999 predicting model significantly underestimated the noise-induced hearing loss among manufacturing workers. The degree of
underestimation became more significant at the noise exposure condition of fewer than ten years, less than 90 dB(A), and higher kurtosis levels. It is necessary to apply kurtosis to adjust the
underestimation of hearing loss and consider the applying condition of noise energy metrics when using the ISO predicting model.