本文選題：機(jī)車(chē)乘務(wù)員 + 噪聲�。� 參考：《中國(guó)疾病預(yù)防控制中心》2013年碩士論文

【摘要】：背景 鐵路運(yùn)輸是我國(guó)交通運(yùn)輸?shù)闹匾绞街?對(duì)國(guó)民經(jīng)濟(jì)、社會(huì)發(fā)展以及人民生活水平的提高起著重要作用。到2012年底,中國(guó)鐵路營(yíng)業(yè)里程達(dá)9.8萬(wàn)公里,居世界第二位；高鐵運(yùn)營(yíng)里程達(dá)9356公里,居世界第一位。而作為鐵路運(yùn)輸中運(yùn)載工具的鐵道機(jī)車(chē),是鐵路運(yùn)輸中的重要元素。隨著近年來(lái)經(jīng)濟(jì)和科學(xué)技術(shù)的發(fā)展,鐵路高速化、輕量化進(jìn)程不斷加速,鐵道機(jī)車(chē)的平穩(wěn)性和安全性引起了社會(huì)的高度重視。 隨著鐵路運(yùn)行速度的提高,機(jī)車(chē)產(chǎn)生的噪聲問(wèn)題也尤為嚴(yán)重。噪聲對(duì)人體的危害很大。噪聲對(duì)機(jī)體的損傷主要表現(xiàn)為聽(tīng)覺(jué)系統(tǒng)的損傷,這種損傷具有特異性。噪聲不但致聾,而且還可以對(duì)機(jī)體造成非特異性損傷,如引起頭暈、頭痛、耳鳴等癥狀。噪聲也會(huì)影響鐵路機(jī)車(chē)司乘人員的正常作業(yè),使人反應(yīng)遲鈍、工作效率降低,嚴(yán)重者甚至影響鐵路機(jī)車(chē)的運(yùn)輸安全。由于機(jī)車(chē)乘務(wù)員職業(yè)的特殊性,其晝夜不中斷工作和輪班工作制的要求,在一班次接觸噪聲的時(shí)間與其他企業(yè)噪聲作業(yè)工人接觸時(shí)間上有明顯不同。因此,對(duì)噪聲對(duì)機(jī)車(chē)乘務(wù)員影響因素進(jìn)行分析,探討噪聲對(duì)機(jī)車(chē)乘務(wù)員的聽(tīng)力損失,對(duì)進(jìn)一步研究有效的車(chē)內(nèi)噪聲控制措施具有重要意義。 目的 了解噪聲對(duì)機(jī)車(chē)乘務(wù)員聽(tīng)力的影響,探討機(jī)車(chē)乘務(wù)員噪聲性聽(tīng)力損失與噪聲接觸劑量之間的關(guān)系,分析工齡、年齡、文化、吸煙、飲酒等因素對(duì)噪聲性聽(tīng)力損失的影響,為防控職業(yè)性噪聲性聽(tīng)力損失提出建議,對(duì)進(jìn)一步研究有效的車(chē)內(nèi)噪聲控制措施、保護(hù)機(jī)車(chē)乘務(wù)員身體健康、保證運(yùn)輸生產(chǎn)安全提供依據(jù)。 方法 2012年我們對(duì)1027名男性機(jī)車(chē)乘務(wù)員進(jìn)行體檢,并對(duì)工人的年齡、文化、職業(yè)史、吸煙、飲酒等情況進(jìn)行了詳細(xì)的調(diào)查。調(diào)查問(wèn)卷由專(zhuān)職的職業(yè)病科醫(yī)師進(jìn)行詳細(xì)的詢(xún)問(wèn)、檢查和登記錄入,由專(zhuān)業(yè)人員進(jìn)行雙錄入核對(duì)。本次調(diào)查使用電測(cè)聽(tīng)測(cè)定噪聲作業(yè)工人聽(tīng)力,聲級(jí)計(jì)測(cè)定作業(yè)環(huán)境噪聲強(qiáng)度。采用x2驗(yàn)檢、t檢驗(yàn)、Logistic回歸等方法,分析噪聲性聽(tīng)力損失與噪聲接觸劑量之間的關(guān)系,分析工齡、文化、年齡、吸煙、飲酒等因素對(duì)噪聲性聽(tīng)力損失的影響。 結(jié)果 1.本次共測(cè)定8種車(chē)型74輛鐵道機(jī)車(chē)的司機(jī)室噪聲強(qiáng)度,結(jié)果顯示：噪聲均值為74.3dB(A),標(biāo)準(zhǔn)差為5.3,最小值為65.8dB(A),最大值為88.5dB(A),超標(biāo)數(shù)為15輛,超標(biāo)率為20.3%。 2.通過(guò)對(duì)兩組工人的純音測(cè)聽(tīng)檢查發(fā)現(xiàn),1027名暴露人群的聽(tīng)力損失發(fā)生率為22.1%,高于550名對(duì)照組人群的聽(tīng)力損失發(fā)生率(8.5%),差異有顯著性(P0.05)。 3.隨著工齡、年齡、累積噪聲暴露量(CNE)的增長(zhǎng),機(jī)車(chē)乘務(wù)員觀察對(duì)象和噪聲聾發(fā)生率也在逐漸增加,差異具有統(tǒng)計(jì)學(xué)意義(P0.001)；同時(shí)經(jīng)趨勢(shì)卡方檢驗(yàn)發(fā)現(xiàn)隨著工齡、年齡、CNE的增長(zhǎng),工人聽(tīng)力損失發(fā)生率有逐漸增加的趨勢(shì),這種趨勢(shì)具有統(tǒng)計(jì)學(xué)意義(P0.001)。 4.分別以聽(tīng)力測(cè)定結(jié)果中觀察對(duì)象和噪聲聾作為應(yīng)變量,CNE、年齡、文化、吸煙、飲酒作為自變量,并將其納入回歸模型進(jìn)行多因素logistic回歸分析,結(jié)果顯示：CNE、年齡均有統(tǒng)計(jì)學(xué)意義(P0.05),其余變量無(wú)統(tǒng)計(jì)學(xué)意義,這說(shuō)明CNE和年齡是聽(tīng)力損失的危險(xiǎn)因素。 5.工齡與觀察對(duì)象和噪聲聾的單因素Logistic回歸分析結(jié)果顯示：工齡均有統(tǒng)計(jì)學(xué)意義(P0.05),這說(shuō)明工齡是觀察對(duì)象和噪聲聾的危險(xiǎn)因素。 6.噪聲聾發(fā)生率和CNE關(guān)系的模型公式為：Y=0.758*[(X-75)/5]A2-0.9874*[(X-75)/5](R2=0.9972)。由此計(jì)算出當(dāng)5%個(gè)體發(fā)生噪聲聾時(shí),此時(shí)的CNE為89.50dB(A)年。按機(jī)車(chē)乘務(wù)員平均每天工作8小時(shí),根據(jù)現(xiàn)場(chǎng)噪聲強(qiáng)度測(cè)定結(jié)果,依據(jù)CNE公式,計(jì)算當(dāng)5%個(gè)體發(fā)生噪聲聾時(shí)的暴露年限值T。 ①按機(jī)車(chē)司機(jī)室噪聲強(qiáng)度均值74.3dB(A)計(jì)算,T=33年。 ②按機(jī)車(chē)司機(jī)室噪聲強(qiáng)度最小值65.8dB(A)計(jì)算,T=234年。 ③按機(jī)車(chē)司機(jī)室噪聲強(qiáng)度最大值88.5dB(A)計(jì)算,T=1.3年。 結(jié)論 噪聲是機(jī)車(chē)乘務(wù)員的主要職業(yè)危害之一。機(jī)車(chē)乘務(wù)員作為聽(tīng)力損失的高危險(xiǎn)職業(yè)之一,長(zhǎng)期在噪聲環(huán)境下作業(yè),若無(wú)適當(dāng)?shù)谋Ｗo(hù)措施,必將引起暫時(shí)性的或永久性的聽(tīng)力損失甚至耳聾。本次通過(guò)對(duì)機(jī)車(chē)乘務(wù)員聽(tīng)力情況的調(diào)查,機(jī)車(chē)乘務(wù)員聽(tīng)力損失率與工齡、年齡、CNE存在正相關(guān)關(guān)系,隨著工齡的延長(zhǎng)、年齡的增長(zhǎng)、CNE的增加,聽(tīng)力損失程度隨之加重。 本次調(diào)查資料建立的CNE與噪聲聾發(fā)生率的預(yù)測(cè)值,即累積噪聲暴露閾值89.50dB(A)年,暴露臨界閾值為33年。對(duì)工齡達(dá)20年、年齡達(dá)40歲的機(jī)車(chē)乘務(wù)員應(yīng)密切關(guān)注聽(tīng)力變化,如發(fā)現(xiàn)觀察對(duì)象者應(yīng)定期體檢,動(dòng)態(tài)觀察；發(fā)現(xiàn)語(yǔ)頻聽(tīng)力損失者,應(yīng)及時(shí)調(diào)離。 司機(jī)室內(nèi)噪聲如控制不當(dāng),不但影響機(jī)車(chē)乘務(wù)員聽(tīng)力,還可影響其工作情緒和勞動(dòng)能力,從而危及鐵路客運(yùn)安全。通過(guò)采取多種綜合措施控制噪聲強(qiáng)度,加強(qiáng)聽(tīng)力保護(hù)教育,定期進(jìn)行職業(yè)性健康體檢,增強(qiáng)工人自我保護(hù)意識(shí),減少煙酒嗜好等不良習(xí)慣,減少工人在噪聲強(qiáng)度超標(biāo)作業(yè)場(chǎng)所接觸噪聲的時(shí)間,減少接觸噪聲的總工齡,并注意做好健康監(jiān)護(hù)工作,逐步完善職業(yè)衛(wèi)生的防控工作,切實(shí)保護(hù)勞動(dòng)者的健康利益。
[Abstract]:Background

Railway transportation is one of the important modes of transportation in our country . It plays an important role in the improvement of national economy , social development and people ' s living standards . By the end of 2012 , China ' s railway operating mileage reached 9.80 million km , ranking second in the world ;
High - speed rail operation mileage is 9356 km , ranking first in the world . As the railway locomotive in railway transportation , railway locomotive is an important element in railway transportation . With the development of economy and science and technology in recent years , the process of railway high - speed and light quantization has accelerated , and the stability and safety of railway locomotive have caused great importance to society .

With the increase of the running speed of the railway , the problem of noise caused by the locomotive is particularly serious . The noise is very harmful to the human body . The noise is mainly caused by the damage of the auditory system . The noise is not only deaf but also can cause non - specific injury to the organism , such as dizziness , headache , tinnitus and other symptoms .

Purpose

To understand the effect of noise on the hearing loss of locomotive drivers , to explore the relationship between noise - induced hearing loss and noise exposure dose of locomotive drivers , to analyze the effects of factors such as age , age , culture , smoking and alcohol consumption on the noise - induced hearing loss , and to make suggestions for the prevention and control of occupational noise - induced hearing loss , and to further study the effective measures of noise control in vehicles , protect the health of locomotive operators and guarantee the safety of transportation production .

method

In 2012 , we conducted a detailed investigation on the situation of workers ' age , culture , occupation history , smoking , alcohol consumption and so on .

Results

1 . The noise intensity of the cab of 74 railway locomotives in 8 models is determined . The results show that the noise mean value is 74.3 dB ( A ) , the standard deviation is 5.3 , the minimum value is 65.8 dB ( A ) , the maximum value is 88.5dB ( A ) , the standard limit is 15 vehicles , the superstandard rate is 20.3 % .

2 . The incidence of hearing loss was 22.1 % , higher than that of 550 control group ( 8.5 % ) , and the difference was significant ( P0.05 ) .

3 . With the increase of age , age and cumulative noise exposure ( CNE ) , the incidence of observation target and noise deafness increased gradually , with statistical significance ( P0.001 ) .
At the same time , it was found that the incidence of hearing loss increased gradually with age , age and CNE , and the trend was statistically significant ( P 0.001 ) .

4 . The results showed that CNE , age , culture , smoking and alcohol consumption were used as independent variables . The results showed that CNE and age had statistical significance ( P0.05 ) . The results showed that CNE and age were the risk factors of hearing loss .

5 . The logistic regression analysis of single factor logistic regression analysis showed that the working age was significant ( P0.05 ) , which indicated that the working age was a risk factor for observing the object and hearing loss .

6 . The model formula of the relationship between the incidence of deafness and CNE was : Y = 0.758 * X ( X - 75 ) / 5 - A2 - 0.998 74 * X ( X - 75 ) / 5 - fold ( R2 = 0.9972 ) . As a result , the CNE was 89.50dB ( A ) years when the 5 % individual had a noise deafness . Based on the results of the field noise intensity measurement , the exposure - age limit value T of 5 % of the individual hearing loss was calculated according to the CNE formula .

( 1 ) The average noise intensity of locomotive cab is 74.3 dB ( A ) , T = 33 years .

( 2 ) Calculate the minimum noise intensity of locomotive cab by 65.8 dB ( A ) , and T = 234 years .

( 3 ) The maximum noise intensity of locomotive cab shall be calculated as 88.5dB ( A ) , and T = 1.3 years .

Conclusion

Noise is one of the major occupational hazards of locomotive drivers . As one of the high risk occupations of hearing loss , locomotive drivers operate under noise environment for a long time . If there is no proper protection measures , the hearing loss rate of locomotive drivers will cause temporary or permanent hearing loss or even deafness . Through investigation of the hearing condition of locomotive drivers , the hearing loss rate of locomotive drivers is positively correlated with age , age and CNE . As the age increases , age increases , CNE increases , and the degree of hearing loss increases .

According to the investigation data , the predicted value of CNE and the incidence of noise deafness , that is , the cumulative noise exposure threshold 89.50dB ( A ) , the threshold of exposure is 33 years . For 20 years of age , the locomotive attendant with age of 40 years should pay close attention to the hearing change , if it is found that the observation object should undergo regular physical examination and dynamic observation ;
Those who find the frequency hearing loss should be removed in time .

By taking various comprehensive measures to control the noise intensity , strengthen the hearing protection education , regularly carry out occupational health examination , strengthen the workers ' self - protection consciousness , reduce the total working age of contact noise , pay attention to the health monitoring work , gradually perfect the prevention and control work of occupational health , and effectively protect the health benefits of the workers .

【學(xué)位授予單位】：中國(guó)疾病預(yù)防控制中心
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R128.1

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