【摘要】：目的：調(diào)查分析噪聲和高溫對職業(yè)人群永久性聽力損傷的聯(lián)合效應。 方法：選取某鋼鐵廠接觸噪聲和高溫的工人作為研究對象，采用兩因素析因設計的統(tǒng)計學思想進行研究。職工接觸噪聲水平分為三個層次：小于85dB組、85至91dB組和大于等于91dB組，高溫水平也分為三個層次：低溫組、中溫組和高溫組，共計9個組。根據(jù)噪聲和高溫暴露實際情況把職工分入相應的組，每組納入研究對象30人，共計270人。然后調(diào)取納入分析的270人的2008至2011年聽力檢測數(shù)據(jù)進行統(tǒng)計分析。 結(jié)果：1、對語頻聽閾的影響：累計效應達到三年時高溫沒有表現(xiàn)出協(xié)同增強噪聲對語頻聽閾的效應。同時，累計效應達到一年時各高溫組間和各噪聲組間也沒有出現(xiàn)明顯語頻聽閾的差異。累計效應達到達到兩年時，各噪聲組間出現(xiàn)明顯語頻聽閾的差異，累計效應達到三年時，各高溫組間和各噪聲組間均出現(xiàn)明顯語頻聽閾的差異。2、對高頻聽閾的影響：累計效應達兩年時高溫就表現(xiàn)出協(xié)同增強噪聲對高頻聽閾的效應。同時，，累計效應達到一年時各噪聲組間出現(xiàn)明顯高頻聽閾的差異。累計效應達到兩年和三年時，各高溫組間和各噪聲組間均出現(xiàn)明顯高頻聽閾的差異。3、對年聽閾損失率的影響：高溫沒有表現(xiàn)出協(xié)同增強噪聲對年語頻聽閾損失率的效應，但是高溫表現(xiàn)出協(xié)同增強噪聲對年高頻聽閾損失率的效應。同時，各高溫組間和各噪聲組間均出現(xiàn)明顯年語頻聽閾損失率和年高頻聽閾損失率的差異。 結(jié)論：接觸高溫水平達到一定的級別和一定的年限，高溫會在一定程度上對聽力產(chǎn)生不良影響。相對語頻聽閾，高頻聽閾對溫度更敏感。相對高溫，噪聲對聽力的影響更大，特別是對高頻聽閾的影響。高溫表現(xiàn)出協(xié)同增強噪聲對高頻聽閾的效應，但是沒有表現(xiàn)出協(xié)同增強噪聲對語頻聽閾的效應。高溫單獨對聽力一般不會產(chǎn)生明顯的影響，高溫對聽力的影響建立在一定程度噪聲暴露的基礎之上。
[Abstract]:Objective: to investigate the combined effects of noise and hyperthermia on permanent hearing loss in occupational population. Methods: the workers exposed to noise and high temperature in a steel plant were selected as the research objects, and the two factor factorial design was used to study the statistics. The exposure noise level of workers was divided into three levels: less than 85dB group, to 91dB group and > 91dB group, and high temperature level was divided into three levels: hypothermia group, moderate temperature group and hyperthermia group, a total of 9 groups. According to the actual situation of noise and high temperature exposure, the workers were divided into the corresponding groups, each group included 30 people, a total of 270 people. Then the 2008-2011 hearing test data of 270 people who were included in the analysis were collected for statistical analysis. Results: the cumulative effect of three years of hyperthermia did not show the effect of synergistic enhancement of noise on the threshold of speech frequency. At the same time, there is no significant difference in the speech frequency hearing threshold between the groups and the noise groups when the accumulative effect reaches one year. When the cumulative effect reaches two years, there is a significant difference in the hearing threshold between the noise groups, and when the cumulative effect reaches three years, There was significant difference in the hearing threshold between the two groups. 2. The effect of the accumulative effect on the high frequency hearing threshold: when the accumulative effect reached two years, the synergetic enhancement effect of the noise on the high frequency hearing threshold was shown. At the same time, the accumulative effect reached one year, and there was obvious difference of high frequency hearing threshold among the noise groups. When the accumulative effect reached two years and three years, there was significant difference of high frequency hearing threshold between each high temperature group and each noise group, and the effect on the annual hearing threshold loss rate: the high temperature did not show the effect of synergistic enhancement noise on the loss rate of annual speech frequency threshold. But the high temperature shows the effect of synergistic enhancement noise on the loss rate of annual high frequency hearing threshold. At the same time, there were obvious differences in the loss rate of annual speech frequency threshold and annual high frequency hearing threshold loss between each high temperature group and each noise group. Conclusion: exposure to high temperature to a certain level and a certain number of years, hyperthermia will have a certain degree of adverse effects on hearing. The high frequency hearing threshold is more sensitive to temperature than the speech frequency hearing threshold. Relative to high temperature, noise has more influence on hearing, especially on high frequency hearing threshold. High temperature shows the effect of synergistic enhancement noise on the high frequency hearing threshold, but it does not show the effect of synergetic enhancement noise on the speech frequency hearing threshold. The effect of high temperature on hearing is based on a certain degree of noise exposure.
【學位授予單位】：重慶醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R131

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