目的 本研究旨在分析峰度调整LAeq(LAeq-K)在评估非稳态噪声相关的职业性听力损失的有效性.方法 对中国东部某省制造业工厂2015-2020年1 034名制造业工人噪声暴露数据以及听力损失情况进行横断面调查.利用多因素回归分析高频噪声性听力损失(High frequency noise-induced hearing loss,HFNIHL)的影响因素.利用峰度调整前后的 ISO 1999 NIPTS(Noise-Induced Permanent Threshold Shift)预测值低估的改善情况,和两条logistics曲线[非稳态噪声峰度调整累积噪声暴露量(CNE-K)与高频听力损失患病率(HFNIHL％)之间以及稳态噪声CNE与HFNIHL％之间]的重叠程度来评估LAeq-K的有效性.结果 多元回归及广义线性混合模型显示峰度是影响工人NIPTS的因素之一(t-3.700,P＜0.05;t=2.368,P＜0.05).采用LAeq-K能显著改善ISO 1999 NIPTS预测值的低估,且改善效果与峰度呈正相关.非稳态噪声CNE-K与HFNIHL％的logistic曲线与稳态噪声CNE与HFNIHL％的logistic曲线几乎重叠,两组的HFNIHL％平均差值从3.2％减小到0.2％(t=4.300,P＜0.05).结论 噪声峰度是职业性NIHL的主要危险因素,在评估复杂噪声相关的NIHL风险时,峰度调整的LAeq,8h-K比单独的LAeq,8h更有效.
Study on the effectiveness of kurtosis-adjusted equivalent sound levels in assessing hearing loss associated with non-steady noise
Objective This study aimed to analyze the effectiveness of kurtosis-adjusted LAeq(LAeq-K)in assessing occupational hearing loss associated with non-steady noise.Methods A cross-sectional survey was conducted on 1,034 Chinese manufacturing workers from 2015 to 2020.General demographic characteristics,noise exposure data,and hearing loss information were collected and analyzed.Multiple regression was used to determine the factors influencing High-frequency noise-induced hearing loss(HFNIHL).The effectiveness of LAeq-Kwas assessed by an improvement in the underestimation of ISO 1999 NIPTS(Noise-induced permanent threshold shift)predictions before and after kurtosis adjustment,as well as the degree of overlap between two logistic curves(non-steady noise CNE(Cumulative noise exposure)vs.HFNIHL％and steady noise CNE-K(Kurtosis-adjusted CNE)vs.HFNIHL％).Results Multiple regression and generalized linear mixed models revealed that kurtosis was one of the factors affecting workers'NIPTS(t=3.700,P＜0.05;t=2.368,P＜0.05).Using LAeq-K significantly improved the underestimation of ISO 1999 NIPTS predictions,with a positive correlation with kurtosis.The logistic curve between CNE-K and HFNIHL％for non-steady noise almost overlapped with the logistic curve between CNE and HFNIHL％for steady noise,with a decrease in average HFNIHL％from 3.2％to 0.2％between the two groups(t=4.300,P＜0.05).Conclusion Kurtosis is a primary risk factor for occupational noise-induced hearing loss(NIHL).When assessing the NIHL risk related to complex noise,kurtosis-adjusted LAeq,8h(LAeq,8h-K)is more effective than LAeq,8h alone.
Non-Steady noiseKurtosisEquiva-lent A sound levelOccupational hearing lossWorkplace
NETL
NSTL
万方数据
