高向景, 任鸿, 袁伟明, 全长健, 谢红卫, 栾俞清, 张美辨. 峰度调整噪声等效A声级对评估非稳态噪声导致职业性听力损失的作用[J]. 环境与职业医学, 2022, 39(4): 374-381. DOI: 10.11836/JEOM21298
引用本文: 高向景, 任鸿, 袁伟明, 全长健, 谢红卫, 栾俞清, 张美辨. 峰度调整噪声等效A声级对评估非稳态噪声导致职业性听力损失的作用[J]. 环境与职业医学, 2022, 39(4): 374-381. DOI: 10.11836/JEOM21298
GAO Xiangjing, REN Hong, YUAN Weiming, QUAN Changjian, XIE Hongwei, LUAN Yuqing, ZHANG Meibian. Applying kurtosis-adjusted equivalent continuous A-weighted sound pressure level to evaluate risk of occupational hearing loss associated with non-steady state noise[J]. Journal of Environmental and Occupational Medicine, 2022, 39(4): 374-381. DOI: 10.11836/JEOM21298
Citation: GAO Xiangjing, REN Hong, YUAN Weiming, QUAN Changjian, XIE Hongwei, LUAN Yuqing, ZHANG Meibian. Applying kurtosis-adjusted equivalent continuous A-weighted sound pressure level to evaluate risk of occupational hearing loss associated with non-steady state noise[J]. Journal of Environmental and Occupational Medicine, 2022, 39(4): 374-381. DOI: 10.11836/JEOM21298

峰度调整噪声等效A声级对评估非稳态噪声导致职业性听力损失的作用

Applying kurtosis-adjusted equivalent continuous A-weighted sound pressure level to evaluate risk of occupational hearing loss associated with non-steady state noise

  • 摘要: 背景 等效A声级不适用非稳态噪声的暴露风险评估,需用噪声时域结构进行修正,但修正方法及修正后指标的适用性有待探讨。

    目的 探讨峰度调整8 h等效A声级(LAeq,8 h)在评估噪声性听力损失(NIHL)中的作用,完善不同类型噪声导致职业性听力损失的评估方法。

    方法 选择噪声暴露水平在70~95 dB(A)范围内的6个典型行业2 466名噪声暴露工人作为研究对象。研究对象按照1 dB(A)为单位将流行病学数据进行分层,分别计算每1 dB(A)内工人的平均噪声峰度以及3、4、6 kHz频率下噪声导致的永久性听阈位移平均值(NIPTS346),然后依据已有的修正方法,通过多因素线性回归计算出峰度修正等效声级的调整系数λ,用λ修正LAeq,8 hL'Aeq,8 h)。将研究对象按照暴露噪声的平均峰度水平分为K1(≤10,稳态噪声组)、K2(>10~50,非稳态噪声组)和K3(>50,非稳态噪声组)三组。使用ISO 1999模型预测每个工人的NIPTS346。对实际测量的NIPTS346进行年龄和性别校正,NIPTS346预测值与实测值之间的差值为NIPTS346预测低估值。通过分析L'Aeq,8 h与HFNIHL的相关性以及NIPTS346的预测低估值,验证L'Aeq,8 h在评估NIHL中的适用性。

    结果 通过线性回归得到调整系数λ=5.43。多因素logistic回归分析显示,峰度调整后,L'Aeq,8 h与HFNIHL之间的相关性从6.6%提高到9.6%。LAeq,8 h和HFNIHL的剂量-反应关系显示,峰度调整后,非稳态噪声组的HFNIHL检出率明显降低,与L'Aeq,8 h的剂量-反应关系曲线接近于稳态噪声组,非稳态噪声组(K2和K3)曲线的R2分别从0.935 3和0.905 6升高到0.986 3和0.951 6。峰度调整前,ISO 1999模型对非稳态噪声组(K3)NIPTS346的预测低估值明显高于稳态噪声组(t=−3.23,P=0.001);峰度调整后,3个峰度组的NIPTS346低估程度与调整前比较均明显降低(K1t=6.78,P<0.001;K2t=14.31,P<0.001;K3t=11.06,P<0.001),3个峰度组的NIPTS346低估值曲线基本重叠,低估程度差异无统计学意义(K1 vs K2t=−0.22,P=0.830;K1 vs K3t=−1.40,P=0.205)。

    结论 峰度调整后的LAeq,8 h可更准确地评估非稳态噪声导致的职业性听力损失。

     

    Abstract: Background Equivalent continuous A-weighted sound pressure level is not appropriate for evaluating the risk of non-steady noise exposure, and need to be corrected by noise time-domain structure, but the correction method and its applicability need to be discussed.

    Objective To validate the application of the kurtosis-adjusted normalization of equivalent continuous A-weighted sound pressure level to a normal 8 h working day ( LAeq,8 h) in assessing noise-induced hearing loss (NIHL), and to improve the methods for assessing occupational hearing loss associated with different types of noise.

    Methods Audiometric and shift-long noise exposure data were acquired from a population(n=2 466) of screened workers exposed to noise between 70 dB(A) and 95 dB(A) from 6 industries in China. The cohort data were collapsed into 1 dB(A) bins, and the average kurtosis and noise-induced permanent threshold shifts at 3 kHz, 4 kHz, and 6 kHz (NIPTS346) within 1 dB(A) were calculated respectively. According to the existing correction method, the adjustment coefficient λ was calculated by multiple regression, and LAeq,8 h was corrected by λ (L'Aeq,8 h). The entire cohort was divided into K1 (≤10; steady noise), K2 (10~50; non-steady noise), and K3 (>50; non-steady noise) groups based on mean kurtosis levels. Predicted NIPTS346 was calculated using the ISO 1999 model for each participant and the actual measured NIPTS346 was corrected for age and gender. The underestimated NIPTS346 was the difference between the values of estimated NIPTS346 and the corresponding actual NIPTS346. To validate the applicability of LAeq,8 h in evaluating NIHL, the correlation between LAeq,8 h and HFNIHL, and the mean difference between real NIPTS346 and estimated NIPTS346 were analyzed.

    Results The adjustment coefficient λ was determined at 5.43. The results of multiple logistic regression analysis showed that the relationship between L'Aeq,8 h and HFNIHL increased from 6.6% to 9.6% after the kurtosis adjustment. The DRR of LAeq,8 h and HFNIHL showed that the percentage of HFNIHL decreased after the adjustment of kurtosis in the non-steady noise groups, and the regression lines of the non-steady noise groups approached that of the steady noise group. The R2 of the K2 group increased from 0.935 3 to 0.986 3, and the R2 of the K3 group increased from 0.905 6 to 0.951 6. Under the un-adjusted condition, the NIPTS346 underestimation for the K3 group was significantly higher than that for the steady noise group (t=−3.23, P=0.001). After the LAeq,8 h was adjusted by kurtosis, the NIPTS346 underestimation decreased significantly in the three kurtosis groups (K1: t=6.78, P<0.001; K2: t=14.31, P<0.001; K3: t=11.06, P<0.001). There was no significant difference in the degree of underestimation between the three kurtosis groups (K1 vs K2: t=−0.22, P=0.830; K1 vs K3: t=−1.40, P=0.205) as the curves of the three kurtosis groups were nearly overlapped.

    Conclusion The kurtosis-adjusted LAeq,8 h can effectively estimate the hearing loss associated with non-steady state noise.

     

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