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[目的]研究采用个体听力防护措施的噪声作业人群的高频听阈动态变化,探讨其相关规律,为临床实践和相关标准的制定提供职业流行病学依据。[方法]选择上海地区5家噪声超标[≥85dB(A)]并执行听力保护计划的企业,收集其中355人、698耳的连续3年4次纯音听力测试结果进行统计分析。[结果]全体研究对象3年4次语频听阈值均≤25dB(HL),未见明显变化,高频听阈值随着工作时间的增加而增高,不同工龄组3年间高频平均听阈值亦呈逐年上升趋势。根据初次纯音听阈测试结果,高频听力正常、轻度高频受损和观察对象的高频听阈平均值均逐年上升,其中听力正常者高频听阈值的增高最为显著,3年后的测试值与初次测试值的差异为(4.14±3.98)dB(HL)。[结论]全体研究对象3年4次高频听阈值每年增高<2dB(HL),在噪声作业环境中采用的个体听力防护措施,可使作业人员的听力变化控制在较小范围内;提示噪声作业在岗期间的健康监护周期可延长至2年或2年以上。
[Objective] To study the dynamic changes of high-frequency hearing threshold of noise-exposed workers using individual hearing protection measures and to explore the relevant rules, and to provide occupational epidemiological evidence for the development of clinical practice and related standards. [Methods] Five enterprises in Shanghai area with noise exceeding [≥85dB (A)] and carrying out hearing protection plan were selected to collect 355 patients and 698 ears of pure tone audiometry test for 3 years and 4 times in a row for statistical analysis. [Results] The hearing thresholds of all subjects were ≤ 25 dB (HL) for 3 years and no significant changes were observed. The threshold of high-frequency hearing was increased with the increase of working hours. The average hearing threshold of high-frequency It is increasing year by year. According to the first pure tone audiometry test results, high-frequency hearing was normal, mild high-frequency damage and the average high-frequency listening threshold were observed year by year increased, of which hearing normal high-frequency threshold of hearing the most significant increase in test values after 3 years The difference from the initial test value was (4.14 ± 3.98) dB (HL). [Conclusion] The hearing thresholds of all the subjects were increased by 2 dB (HL) every year for 4 times in 3 years. The individual hearing protection measures adopted in the noisy working environment can control the audiological changes of operators to a small extent. The noise The period of health monitoring during homework can be extended to two years or more.