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Background Noise is the most common occupational hazard in the automobile manufacturing industry with the most workers exposed. Automobile manufacturing industry is a high-risk industry for noise-induced hearing loss. Objective To understand the epidemiological characteristics of noise-induced hearing loss among workers in automobile manufacturing industry and explore related influencing factors. Methods A questionnaire survey, individual noise recording, and pure tone audiometry were conducted among workers (n=656) exposed to noise from five automobile manufacturing enterprises. The data on age, sex, exposure duration, noise intensity, kurtosis, and hearing loss were obtained. The positive rates of high-frequency noise-induced hearing loss (HFNIHL) and speech-frequency noise-induced hearing loss (SFNIHL) were calculated, and each factor was compared between workers with and without HFNIHL. Chi-square test and analysis of trend were conducted among different groups of age, sex, exposure duration, A-weighted equivalent continuous sound pressure level normalized to a nominal 8-hour working day (LAeq,8h), and kurtosis. Logistic regression analysis was conducted to analyze the factors influencing the positive rates of HFNIHL and SFNIHL. Results The exposure rates of non-Gaussian noise was 73.6%. The positive rates of HFNIHL and SFNIHL were 32.6% (214 workers) and 6.7% (44 workers), respectively. The HFNIHL workers showed older age, higher proportion of male, longer exposure duration, higher noise intensity (LAeq,8 h), and increased kurtosis than those without HFNIHL (P<0.05). The positive rates of HFNIHL increased with the increase of age, exposure duration, LAeq,8 h, and kurtosis (\begin{document}$ {\chi
ABSTRACT
Background Non-Gaussian noise has become the dominant noise type in industry. However, the epidemiological characteristics of non-Gaussian noise exposure and associated noise-induced hearing loss (NIHL) are still unclear. Objective To summarize the epidemiological characteristics of NIHL associated with non-Gaussian noise in manufacturing industry in China and provide a basis for the early prevention and control of occupational hearing loss. Methods Chinese and English literature on hearing loss associated with non-Gaussian noise in China were retrieved. The overall prevalence was calculated based on the prevalence data provided by each included study. A meta-analysis of studies with Gaussian noise as a control group was also performed and the overall weighted odds ratio (OR) was calculated to compare the effects of non-Gaussian noise and Gaussian noise on hearing loss. Publication bias was evaluated by funnel plot and Egger regression, and a sensitivity analysis was performed by eliminating references in turn. Results A total of 37 cross-sectional studies involving 25 055 Chinese manufacturing workers exposed to non-Gaussian noise were included, 92.5% of whom were male. These workers aged (32.7±9.6) years were exposed to non-Gaussian noise at (87.0±4.2) dB(A) for (6.8±4.9) years. The mean cumulative noise exposure (CNE) was (95.9±8.0) dB(A)·year. The prevalence rate of high-frequency NIHL (HFNIHL) and speech-frequency NIHL (SFNIHL) were 29.0% and 14.2%, respectively. The results of the meta-analysis treating 19 cross-sectional studies with Gaussian noise as a control group showed that there were no significant differences in age, exposure duration, and equivalent continuous A-weighted sound pressure level (LAeq), and CNE between the non-Gaussian noise group and the Gaussian noise group. The overall weighted OR of HFNIHL was 1.87 (95%CI: 1.46−2.41), which was statistically significant. The funnel plot showed good symmetry and the result of Egger regression was t=−0.11, P=0.910 (>0.05), suggesting a low risk of publication bias in this meta-analysis. The sensitivity analysis showed no significant changes of results after eliminating references in turn, indicating that the results were robust. Conclusion Chinese manufacturing workers, mainly young adult males, are exposed to non-Gaussian noise at high levels for a long time and have a high prevalence of NIHL. Compared to workers exposed to Gaussian noise, those exposed to non-Gaussian noise suffer from more serious hearing loss.
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Background Occupational noise-induced hearing loss (NIHL) is one of the most prevalent occupational diseases in the world. With the development of industry, noise sources in the workplace have become increasingly complex. Objective To apply kurtosis-adjusted cumulative noise exposure (CNE) to assess the occupational hearing loss among furniture manufacturing workers, and to provide a basis for revising noise measurement methods and occupational exposure limits in China. Methods A cross-sectional survey was conducted to select 694 manufacturing workers, including 542 furniture manufacturing workers exposed to non-Gaussian noise, and 152 textile manufacturing workers and paper manufacturing workers exposed to Gaussian noise. The job titles involving non-Gaussian noise were gunning and nailing, and woodworking, while those involving Gaussian noise were weaving, spinning, and pulping. High frequency noise-induced hearing loss (HFNIHL) and noise exposure data were collected for each study subject. Noise energy metrics included eight-hour equivalent continuous A-weighted sound pressure level (LAeq,8 h) and CNE. Kurtosis was a noise temporal structure metric. Kurtosis-adjusted CNE was a combined indicator of noise energy and temporal structure. Results The age of the study subjects was (35.64±10.35) years, the exposure duration was (6.71±6.44) years, and the proportion of males was 75.50%. The LAeq,8 h was (89.43±6.01) dB(A). About 81.42% of the study subjects were exposed to noise levels above 85 dB(A), the CNE was (95.85±7.32) dB(A)·year, with a kurtosis of 99.34 ± 139.19, and the prevalence rate of HFNIHL was 35.59%. The mean kurtosis of the non-Gaussian noise group was higher than that of the Gaussian noise group (125.33±147.17 vs. 5.86±1.94, t=−21.04, P<0.05). The results of binary logistic regression analysis showed that kurtosis was an influential factor of workers' HFNIHL after correcting for age, exposure duration, and LAeq,8 h (OR=1.49, P<0.05). The results of multiple linear regression analysis showed that the effects of age, exposure duration, LAeq,8 h, and kurtosis on noise-induced permanent threshold shift at frequencies of 3, 4, and 6 kHz of the poor hearing ear were statistically significant (all P<0.05). The results of chi-square trend analysis showed that when CNE ≥ 90 dB(A)·year, the HFNIHL prevalence rate elevated with increasing kurtosis (P<0.05). The mean HFNIHL prevalence rate was higher in the non-Gaussian noise group than in the Gaussian noise group (31.7% vs. 22.0%, P<0.05). After applying kurtosis-adjusted CNE, the linear equation between CNE and HFNIHL prevalence rate for the non-Gaussian noise group almost overlapped with that for the Gaussian noise group, and the mean difference in HFNIHL prevalence rate between the two groups decreased from 9.7% to 1.4% (P<0.05). Conclusion Noise kurtosis is an effective metric for NIHL evaluation. Kurtosis-adjusted CNE can effectively evaluate occupational hearing loss due to non-Gaussian noise exposure in furniture manufacturing workers, and is expected to be a new indicator of non-Gaussian noise measurement and assessment.
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The existing measuring methods of noise exposure on the basis of equal energy hypothesis are applicable to Gaussian noise while not fully applicable to non-Gaussian noise. Studies have shown that temporal structure (kurtosis) combined with noise energy has the potential to quantify non-Gaussian noise exposure effectively. However, there is no unified measuring method adopting this joint metric. In this paper, the measuring method of non-Gaussian noise exposure based on kurtosis adjustment was introduced, detailing measurement indicators, adjustment schemes, applicable objects, instrument requirements, and measurement steps. Adjusting the exposure duration of cumulative noise exposure (CNE) by kurtosis or adjusting the equivalent continuous A-weighted sound pressure level (LAeq) by an adjustment coefficient based on animal or population studies can more accurately quantify workers' exposure to non-Gaussian noise and improve the underestimation of hearing loss caused by non-Gaussian noise. A large number of population studies are warranted in the future to verify the effectiveness of these two adjustment schemes.
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Objective:To investigate the optimal keV value of a novel dual-layer spectral detector CT virtual monoenergetic images (VMI) for displaying esophageal cancer lesions and to evaluate its diagnostic efficacy for preoperative T staging of esophageal cancer.Methods:The data of 50 patients with esophageal carcinoma in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School from October 2019 to August 2020 were retrospectively analyzed. There were 42 males and 8 females, aged 49-78(65±7) years. All patients underwent novel dual-layer spectral detector CT chest enhanced scan before treatment, the conventional CT images and 40-200 keV VMI were reconstructed. One-way ANOVA and Kruskal-Wallis H rank sum test were used to compare the signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) among conventional CT images and 40-200 keV VMI.The 5-grade grading method were applied for subjective evaluation, and the Friedman test was used to compare the differences in the subjective evaluation of image quality in each group.Spearman test was used to analyze the correlation of images at different energy levels with SNR and CNR. Fisher exact test was used to compare the accuracy of conventional CT and optimal keV value images for preoperative diagnosis of T staging of esophageal cancer. Results:There were significant differences in SNR and CNR among conventional CT images and 40-200 keV VMI images ( P<0.001), and the SNR and CNR of 40 keV images were superior to those of conventional CT images and 70-200 keV VMI images ( P<0.05). The energy level of 40-200 keV VMI was negatively correlated with SNR and CNR (SNR: r=-1.000, P<0.001; CNR: r =-1.000, P<0.001). The overall difference in subjective image quality scores among conventional CT images and 40-200 keV VMI was statistically significant (χ 2=498.37, P<0.001), of which the subjective image quality of 40-60 keV VMI was superior to that of conventional CT images ( P<0.05). The accuracy of preoperative diagnosis of T-stage of esophageal cancer was 62.9% (22/35) for both 40 keV VMI and conventional CT images. Conclusion:The novel dual-layer spectral detector CT of 40 keV VMI has the best display of esophageal cancer, and the accuracy of preoperative diagnosis of T staging is similar to that of conventional CT.