Prevalence and influencing factors of hearing status for workers with different subjective perception of hearing in Wuhan City from 2017 to 2019
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摘要:
目的 探讨2017―2019年武汉市不同听力主观感觉人群的听力现状及影响因素。 方法 2017年1月―2019年12月，在武汉市职业病防治院对前来体检的部分汽车制造业工人进行问卷调查和纯音气导听阈测试。在排除信息缺失的个体后，最终纳入15 594人进行分析与研究，采用Logistic回归分析模型分析不同听力主观感觉人群听力的影响因素。 结果 在15 594名汽车制造业男性工人中，听力主观感觉好、一般和差的占比分别为45.86%(7 152/15 594)、51.75%(8 070/15 594)和2.39%(372/15 594)。语频和高频检测结果显示，在听力主观感觉好的人群中，其听力损失的占比分别为3.45%和18.47%。在听力主观感觉好的人群中，年龄≥40岁(OR=4.53, 95% CI: 3.34~6.14, P < 0.001)和服兵役或射击行为(OR=1.55, 95% CI: 1.01~2.41, P < 0.001)是高频双耳听力损失的危险因素。在听力主观感觉一般和差的人群中，年龄≥40岁、职业性噪声暴露、暂时性耳鸣、听力突然改变和目前吸烟是高频双耳听力损失的危险因素(均有P < 0.05)。 结论 听力主观感觉好的部分人仍然存在听力损失，不同听力主观感觉人群听力的影响因素不同。 Abstract:Objective To investigate the hearing status and influencing factors of hearing among people with different subjective perception of hearing in Wuhan City from 2017 to 2019. Methods A cross-sectional survey was conducted to select some automobile manufacturing workers who underwent physical examination in Wuhan Prevention and Treatment Center for Occupational Disease from Jan 2017 to Dec 2019 as the research subjects. Questionnaire survey and pure tone threshold test were conducted. After excluding individuals with missing information, a total of 15 594 individuals were finally included for analysis and research. Logistic regression analysis was used to explore the influencing factors of hearing status for workers with different subjective perception of hearing. Results Among the 15 594 male workers in automobile manufacturing industry, the proportion of subjective feeling of hearing for good, general and poor was 45.86% (7 152/15 594), 51.75% (8 070/15 594) and 2.39% (372/15 594), respectively. In terms of speech frequency, the proportion of hearing loss of the workers with good subjective hearing was 3.45%. In terms of high frequency, the proportion of hearing loss of workers with good subjective hearing was 18.47%. Age≥40 (OR=4.53, 95% CI=3.34-6.14, P < 0.001) and military service or shooting behavior (OR=1.55, 95% CI=1.01-2.41, P < 0.001) were risk factors for high-frequency bilateral hearing loss among people with good subjective perception of hearing. Age ≥40, occupational noise exposure, temporary tinnitus, sudden change of hearing and current smoking were risk factors for high frequency bilateral hearing loss among people with general and poor subjective perception of hearing. Conclusion Some people with good subjective perception of hearing still have hearing loss, and risk factors of hearing loss among people with different subjective perception of hearing are different. -
Key words:
- Subjective perception of hearing /
- Hearing loss /
- Influence factor
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表 1 2017―2019年武汉市不同听力主观感觉人群纯音听阈结果分析[n (%)]
Table 1. Analysis of pure tone hearing threshold results of people with different subjective hearing perceptions from 2017 to 2019 in Wuhan City [n (%)]
变量 听力主观感觉好 听力主观感觉一般 听力主观感觉差 听力正常 听力损失 听力正常 听力损失 听力正常 听力损失 单耳 双耳 单耳 双耳 单耳 双耳 语频 人数 6 905(96.55) 183(2.56) 64(0.89) 7 503(92.97) 399(4.95) 168(2.08) 254(68.28) 72(19.35) 46(12.37) 年龄[岁, (x±s)] 27.23±6.32 31.51±8.68 33.17±9.99 27.87±7.34 32.97±9.89 34.14±10.80 33.91±9.39 41.84±10.20 43.48±9.19 < 40 6 531(97.06) 151(2.24) 47(0.70) 6 867(94.44) 290(3.99) 114(1.57) 189(81.82) 28(12.12) 14(6.06) ≥40 374(88.42) 32(7.56) 17(4.02) 636(79.60) 109(13.64) 54(6.76) 65(46.10) 44(31.20) 32(22.70) 职业性噪声暴露 1 532(97.08) 36(2.28) 10(0.64) 2 041(91.45) 134(6.00) 57(2.55) 94(61.04) 33(21.43) 27(17.53) 服兵役或射击行为 265(93.97) 9(3.19) 8(2.84) 291(90.94) 23(7.19) 6(1.87) 22(64.71) 9(26.47) 3(8.82) 听力损失家族史 16(80.00) 3(15.00) 1(5.00) 55(85.94) 7(10.94) 2(3.12) 5(41.67) 2(16.67) 5(41.66) 糖尿病史 13(86.67) 2(13.33) 0(0.00) 31(86.11) 2(5.56) 3(8.33) 3(50.00) 3(50.00) 0(0.00) 暂时性听力下降 2 305(96.53) 56(2.35) 27(1.12) 3 803(92.60) 206(5.02) 98(2.38) 195(66.78) 59(20.21) 38(13.01) 暂时性耳鸣 1 035(97.00) 26(2.44) 6(0.56) 1 865(92.93) 100(4.98) 42(2.09) 135(65.85) 38(18.54) 32(15.61) 听力突然改变 50(96.15) 2(3.85) 0(0.00) 188(85.07) 22(9.95) 11(4.98) 39(62.90) 13(20.97) 10(16.13) 目前吸烟 3 326(96.21) 91(2.63) 40(1.16) 3 665(92.71) 195(4.93) 93(2.36) 142(71.36) 33(16.58) 24(12.06) 睡眠差 1 205(96.86) 31(2.49) 8(0.65) 2 182(93.25) 115(4.91) 43(1.84) 141(70.85) 35(17.59) 23(11.56) 工作时听力保护 5 156(96.54) 136(2.55) 49(0.91) 5 494(93.36) 280(4.76) 111(1.88) 182(70.27) 47(18.15) 30(11.58) 工作外听力保护 1 422(96.41) 38(2.58) 15(1.01) 1 279(91.82) 85(6.10) 29(2.08) 41(67.22) 10(16.39) 10(16.39) 高频 人数 5 831(81.53) 933(13.05) 388(5.42) 5 650(70.01) 1 643(20.36) 777(9.63) 119(31.99) 186(50.00) 67(18.01) 年龄[岁, (x±s)] 26.72±5.87 29.84±7.80 31.60±8.62 26.77±6.48 31.39±8.98 32.41±9.28 31.02±9.06 39.42±10.07 38.85±9.13 < 40 5 596(83.16) 809(12.02) 324(4.82) 5 360(73.72) 1 322(18.18) 589(8.10) 100(43.29) 93(40.26) 38(16.45) ≥40 235(55.56) 124(29.31) 64(15.13) 290(36.30) 321(40.18) 188(23.52) 19(13.48) 93(65.96) 29(20.56) 职业性噪声暴露 1 253(79.40) 227(14.39) 98(6.21) 1 461(65.46) 520(23.30) 251(11.24) 46(29.87) 84(54.55) 24(15.58) 服兵役或射击行为 207(73.40) 49(17.38) 26(9.22) 197(61.56) 92(28.75) 31(9.69) 7(20.59) 14(41.18) 13(38.23) 听力损失家族史 15(75.00) 4(20.00) 1(5.00) 36(56.25) 23(35.94) 5(7.81) 2(16.67) 10(83.33) 0(0.00) 糖尿病史 12(80.00) 3(20.00) 0(0.00) 19(52.78) 14(38.89) 3(8.33) 3(50.00) 2(33.33) 1(16.67) 暂时性听力下降 1 916(80.23) 322(13.48) 150(6.29) 2 781(67.71) 892(21.72) 434(10.57) 84(28.77) 157(53.77) 51(17.46) 暂时性耳鸣 851(79.76) 148(13.87) 68(6.37) 1 320(65.77) 450(22.42) 137(11.81) 58(28.29) 105(51.22) 42(20.49) 听力突然改变 44(84.62) 5(9.62) 3(5.76) 139(62.90) 55(24.89) 27(12.21) 11(17.74) 38(61.29) 13(20.97) 目前吸烟 2 807(81.20) 459(13.28) 191(5.52) 2 698(68.25) 832(21.05) 423(10.70) 61(30.65) 97(48.74) 41(20.61) 睡眠差 1 027(82.56) 156(12.54) 61(4.90) 1 625(69.44) 477(20.38) 238(10.18) 62(31.16) 99(49.74) 38(19.10) 工作时听力保护 4 381(82.03) 673(12.60) 287(5.37) 4 176(70.96) 1 178(20.02) 531(9.02) 85(32.82) 126(48.65) 48(18.53) 工作外听力保护 1 207(81.83) 187(12.68) 81(5.49) 971(69.71) 304(21.82) 118(8.47) 19(31.15) 30(49.18) 12(19.67) 
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表 2 2017―2019年武汉市不同听力主观感觉人群听力损失影响因素分析[OR(95% CI)]
Table 2. Analysis of influencing factors of hearing loss among people with different subjective perception of hearing from 2017 to 2019 in Wuhan City [OR(95% CI)]
变量 听力主观感觉好 听力主观感觉一般和差 双耳听力损失 单耳听力损失 双耳听力损失 单耳听力损失 语频 年龄(岁) ≥40 5.72(3.20~10.24) a 3.73(2.50~5.59) a 6.22(4.61~8.40) a 4.64(3.73~5.78) a < 40 1.00 1.00 1.00 1.00 职业性噪声暴露 是 0.55(0.27~1.09) 0.80(0.55~1.16) 1.34(1.02~1.83) a 1.23(1.00~1.50) 否 1.00 1.00 1.00 1.00 服兵役或射击行为 是 2.82(1.24~5.94) a 0.96(0.48~1.96) 0.52(0.26~1.05) 1.07(0.72~1.59) 否 1.00 1.00 1.00 1.00 听力损失家族史 是 7.26(0.86~61.21) 5.52(1.44~21.11) a 2.82(1.19~6.63) a 1.87(0.89~3.91) 否 1.00 1.00 1.00 1.00 糖尿病史 是 1.33(0.62~1.78) 3.10(0.62~15.59) 1.19(0.34~1.46) 0.95(0.36~2.54) 否 1.00 1.00 1.00 1.00 暂时性听力下降 是 1.57(0.93~2.63) 0.84(0.60~1.18) 1.34(0.99~1.83) 1.03(0.84~1.26) 否 1.00 1.00 1.00 1.00 暂时性耳鸣 是 0.52(0.22~1.25) 0.95(0.61~1.49) 1.00(0.73~1.38) 0.92(0.74~1.16) 否 1.00 1.00 1.00 1.00 听力突然改变 是 1.23(0.53~2.05) 1.51(0.34~6.70) 2.84(1.69~4.75) a 2.28(1.54~3.38) a 否 1.00 1.00 1.00 1.00 目前吸烟 是 1.73(1.04~2.88) 1.07(0.80~1.44) 1.12(0.85~1.48) 0.89(0.73~1.08) 否 1.00 1.00 1.00 1.00 睡眠差 是 0.65(0.30~1.40) 0.96(0.64~1.44) 0.78(0.57~1.06) 0.93(0.75~1.15) 否 1.00 1.00 1.00 1.00 工作时听力保护 是 1.16(0.64~2.10) 1.01(0.72~1.43) 0.82(0.61~1.11) 0.90(0.73~1.11) 否 1.00 1.00 1.00 1.00 工作外听力保护 是 1.21(0.67~2.19) 1.01(0.70~1.47) 1.12(0.77~1.61) 1.29(1.01~1.64) a 否 1.00 1.00 1.00 1.00 高频 年龄(岁) ≥40 4.53(3.34~6.14) a 3.52(2.79~4.45) a 5.71(4.68~6.97) a 4.73(4.02~5.58) a < 40 1.00 1.00 1.00 1.00 职业性噪声暴露 是 1.18(0.93~1.51) 1.14(0.97~1.35) 1.22(1.04~1.44) a 1.22(1.09~1.38) a 否 1.00 1.00 1.00 1.00 服兵役或射击行为 是 1.55(1.01~2.41) a 1.24(0.90~1.35) 0.93(0.65~1.34) 1.07(0.82~1.40) 否 1.00 1.00 1.00 1.00 听力损失家族史 是 0.94(0.12~7.52) 1.38(0.43~4.46) 0.60(0.22~1.62) 2.00(1.21~3.31) a 否 1.00 1.00 1.00 1.00 糖尿病史 是 0.61(0.26~1.58) 0.96(0.25~3.67) 0.42(0.13~1.30) 0.94(0.46~1.89) 否 1.00 1.00 1.00 1.00 暂时性听力下降 是 1.21(0.97~1.52) 1.03(0.89~1.21) 1.15(0.98~1.35) 1.19(1.06~1.34) a 否 1.00 1.00 1.00 1.00 暂时性耳鸣 是 1.18(0.88~1.58) 1.09(0.89~1.34) 1.29(1.08~1.53) a 1.12(0.98~1.28) 否 1.00 1.00 1.00 1.00 听力突然改变 是 1.17(0.36~1.82) 0.69(0.27~1.77) 1.55(1.06~2.28) a 1.58(1.19~2.10) a 否 1.00 1.00 1.00 1.00 目前吸烟 是 1.02(0.83~1.25) 1.03(0.89~1.18) 1.28(1.11~1.49) a 1.07(0.96~1.19) 否 1.00 1.00 1.00 1.00 睡眠差 是 0.76(0.56~1.01) 0.89(0.73~1.08) 0.98(0.83~1.15) 0.93(0.83~1.06) 否 1.00 1.00 1.00 1.00 工作时听力保护 是 0.96(0.75~1.22) 0.86(0.74~1.01) 0.84(0.71~0.99) 0.94(0.83~1.06) 否 1.00 1.00 1.00 1.00 工作外听力保护 是 1.01(0.78~1.30) 0.98(0.82~1.17) 0.91(0.74~1.12) 1.12(0.97~1.29) 否 1.00 1.00 1.00 1.00 注：a P < 0.05。
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