輪班及身材與噪音作業聽力損失之相關性

中國醫藥大學機構典藏 China Medical University Repository, Taiwan > 公共衛生學院 > 環境醫學研究所(已停用) > 博碩士論文 > Item 310903500/638

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题名:	輪班及身材與噪音作業聽力損失之相關性
作者:	周鈺芳;Yu-Fang Chou
贡献者:	中國醫藥大學：環境醫學研究所碩士班
关键词:	聽力損失;輪班制度;防音防護具;身高;身體質量指數(BMI);Noise-induced hearing loss;shift work;PPE;Body size
日期:	2007-12-26
上传时间:	2009-08-11 16:56:29 (UTC+8)
摘要:	工廠噪音引起的勞工聽力損失的健康問題一直備受關注，它不僅影響勞工睡眠品質、妨礙交談與工作效率低落，亦會引起失眠、頭痛、心血管疾病、頭暈與免疫力下降等併發症。因此，各國政府致力於訂定聽力防護政策來改善噪音危害達到保護勞工之目的。其中減少造成聽力損失的危害因子是勞工聽力保護重要的課題之一。本研究之目的在了解勞工暴露在噪音環境下可能導致聽力損失的相關因子，包括聽力防護具、輪班等方式對其聽力的影響。本研究利用橫斷方式選取某工廠218名噪音作業男性勞工，調查其生活習慣、職業暴露史、個人基本資料、聽力檢查資料及防護具配戴習慣等資料。勞工聽力檢查係以純音分別測試0.5、1、2、3、4、6及8kHz，並依我國勞委會安全衛生研究所（IOSH）勞工聽力檢查之要求規範實施，主要內容分二大部分；第一部分是將研究對象身高分成三組、BMI分為二組，以了解勞工聽力損失與生長發育（身高、BMI）的相關性。第二部分則探討輪班作業者（對照組）及非輪班（暴露組）和噪音作業區配戴防護具（對照組）及非噪音區位配戴防護具（暴露組）對勞工聽力損失之影響。研究結果顯示無論聽力損失LHH、HFH在身高較矮（<165公分）的一組及BMI異常組（BMI>30或<20）其聽力損失平均值均較其他組為高，且身高較矮組（<165公分）較身高大於175公分組其HFH聽力損失勝算比（OR）是1.76倍，BMI異常組在HFH聽力損失的勝算比（OR）為2.14倍，有顯著性的增高。另外，非輪班者（正常班）在左、右耳HFH聽力損失的勝算比（OR）分別為1.38及2.83倍。在勞工防護具配戴方面，有配戴聽力防護具組其聽力平均損失無論是LFH、HFH及4 kHz皆較噪音值低於85dB且無需配戴聽力防護具組為低，兩組亦有顯著上之差異。因此，聽力防護具對於預防勞工聽力損失仍有保護作用，值得注意的是低於政府訂定的噪音作業（85dB）作業的勞工仍應隨時配戴聽力防護具，且配合不同輪班制度，以減少勞工持續每天暴露在高噪音環境的聽力保護效果。 The occupational noise-induced hearing loss (NIHL) resulted in the different effects of health such as; quality of sleep, hinder conversation, low work efficiency, insomnia, headache, cardiovascular disease, dizzy and immunological abnormality. Therefore, most of the country governments have focused on establishing a policy of hearing protection to decrease the risk factor of NIHL. The objective of this study is to investigate the effect of hearing loss due to the types of shift work and wear PPE（personal protection equipment）as well as to evaluate the effects of body size toward NIHL. A cross-sectional study was performed in a semiconductor factory. Information regarding to demographic, medical history of hearing problems, use of ototoxic drugs, hobbies, and smoking habit in non-occupational and wearing PPE wearing were obtained using a self-administered questionnaire in 218 male workers. A standardized audiometric test was performed by a qualified audiologist to measure pure-tone hearing thresholds at 0.5, 1, 2, 3z, 4z, and 6 kHz in both ears. Body size of participants was classified into three groups in the height and into two groups in the BMI. Two types of shifts work were normal shift (comparison group) and alternating shift (exposed group). Subjects of personal protective equipment (PPE) worn in the high noise exposure (>85 dB) was compared to subjects of no appropriate PPE (<85 dB). The result shows the percentage of hearing loss in LFH and HFH was higher in the groups with shorter height (<165cm) and BMI abnormality (BMI>30 or BMI<20). 1.74 of the odds ratio (OR) with short height and 2.14 of OR with BMI abnormality had the risk for the development of sensorineural hearing loss. Based on multivariate analysis adjusted for covariates, subjects with no shift rotation indicates had higher risk of 1.38 and 2.83 in the both ears at hearing loss in HFH. The subjects no appropriate PPE wearing were significantly higher hearing loss than the subject of having PPE wearing ( p < 0.05). In conclusion, it is necessary to promote the hearing conservation program to reduce the hearing loss of the exposure to high noise. Use of PPE and appropriate rotation are suitable and effective strategies to decrease the incidence of NIHL.
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