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目的探讨甲苯与噪声联合接触对听力损失的影响。方法选择珠海市两家企业中同时接触甲苯和噪声人员78例为混合接触组,单纯接触噪声人员75例为噪声接触组,不接触职业病危害因素的办公室和后勤人员90例为对照组,进行现场甲苯浓度和噪声强度检测,对三组研究对象进行纯音测听检查,并对结果进行统计学分析。结果接触组各作业点甲苯浓度、噪声强度均超过国家职业接触限值。混合接触组与噪声接触组在高频段(3.0 k Hz、4.0 k Hz、6.0 k Hz)听阈值差异有统计学意义(P均<0.05)。混合接触组与对照组比较,各频段听力差异均有统计学意义(P均<0.05)。混合接触组、噪声接触组的语频听力异常检出率(25.6%、22.7%)均高于对照组(2.2%),差异均有统计学意义(P<0.05/3);混合接触组的高频听力异常检出率(51.3%)均大于噪声组(24.0%)和对照组(7.8%),差异有统计学意义(P<0.05/3)。工龄≥5年者,混合接触组与噪声接触组听力损害发生率差异有统计学意义(P<0.05)。结论甲苯与噪声联合接触对听力损害有协同作用,应充分考虑联合接触因素的职业安全防护。
Objective To investigate the effect of joint exposure of toluene and noise on hearing loss. Methods Eighty-eight workers with simultaneous exposure to toluene and noise in two enterprises in Zhuhai City were selected as the mixed exposure group. There were 75 noise-exposed workers in the noise exposure group and 90 workers in the office and back-off workers who did not touch the occupational hazards as the control group Toluene concentration and noise intensity testing, pure tone audiometry examination of three groups of subjects, and the results were statistically analyzed. Results Toluene concentration and noise intensity of each working point in the contact group exceeded the national occupational exposure limit. The thresholds of hearing threshold in high frequency band (3.0 k Hz, 4.0 k Hz, 6.0 k Hz) were significantly different between mixed exposure group and noise exposure group (all P <0.05). Compared with the control group, the mixed hearing group had significant difference in hearing between different frequency bands (all P <0.05). The frequency of audible abnormalities (25.6%, 22.7%) in mixed exposure group and noise exposure group were significantly higher than those in control group (2.2%) (P <0.05 / 3) The detection rate of high frequency hearing abnormalities (51.3%) was higher than that of noise group (24.0%) and control group (7.8%), the difference was statistically significant (P <0.05 / 3). There was significant difference in the incidence of hearing loss between mixed exposure group and noise exposure group (P <0.05). Conclusion The combined exposure of toluene and noise has a synergistic effect on hearing impairment. Occupational safety should be fully considered in combination with exposure factors.