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Objective To investigate the epidemiological characteristics of occupational noise induced deafness (ONID) in Nantong area and analyze the risk factors. Methods A total of 421 workers in hydropower industry who underwent physical examination in the outpatient clinic of Nantong Center for Disease Control and Prevention from January 2017 to December 2021 were selected as the research subjects.168 workers without ONID were divided into control group, and 253 workers diagnosed with ONID were divided into ONID group. The expression levels of serum cortisol, interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in the two groups were compared and analyzed. Results There were more males than females in both groups (P<0.05). With the increase of working age, the detection rate of ONID also increased significantly (P<0.05). The hearing thresholds of left and right ears in workers of different workplaces in the ONID group were higher than those in the control group (P<0.05), and the hearing thresholds of workers in water wheel room and water machine operation duty room were higher (P<0.05). The expression levels of cortisol, IL-6 and TNF-α in the serum of ONID patients were significantly higher than those in the control group. Multivariate analysis showed that workplace, serum cortisol, IL-6 and TNF-α were the main influencing factors for ONID. Conclusion Workplace, serum cortisol, IL-6 and TNF-α are all risk factors for ONID. Appropriate measures should be taken to strengthen the prevention and treatment of noise-induced hearing loss according to the influencing factors.
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Objective To evaluate the risk of occupational noise-induced hearing loss in workers in a metal tool manufacturing enterprise, and to carry out risk classification and risk management. Methods A total of 91 male noise-exposed workers from a metal tool manufacturing enterprise in Hebei Province were selected as the research subjects using the convenience sampling method. The work site survey on occupational health and the measurement on individual noise exposure level were carried out. The ISO 1999：2013 (E) Acoustics-Estimation of Noise-Induced Hearing Loss was used to predict the risk of high frequency hearing loss (HFHL) and occupational noise-induced deafness (ONID). The risk classification and risk management were conducted using the WS/T 754-2016 Guideline for Risk Management of Occupational Noise Hazard (hereinafter referred to as WS/T 754-2016). Results The individual noise exposure intensity of workers in the six work sites of the enterprise, including blade workers, sheet punching workers, roller forging workers (hoe), hole punching workers, roller forging workers(shovels), and carpenters, exceeded the national occupational exposure limit, with the maximum volume of 91.2-104.1 dB(A). Among these workers, the positions of blade workers, sheet punching workers, and roller forging workers (hoe) were identified as critical control points for noise hazards in the enterprise. The detection rates of HFHL and ONID were 24.2% and 8.8%, respectively. The risk prediction results showed that, based on the actual noise exposure time and age of the study subjects, the risk of HFHL and ONID ranged from 1.7%-48.8% and 0.0%-29.5%, respectively. The risks of HFHL caused solely by occupational noise exposure when working up to 50.0, 55.0, and 60.0 years of age were 11.4% to 64.7%, 16.4% to 65.1%, and 17.2% to 59.4%, respectively. The risks of ONID caused solely by occupational noise exposure were 0.0% to 45.5%, 4.2% to 51.7%, and 5.9% to 57.4%, respectively. Except for the blade workers, the predicted median of potential noise-induced permanent threshold shifts (NIPTS) in the other five positions were lower than the actual values of NIPTS, with the difference ranging from 3.0-28.3 dB, and 73.3% of them underestimated by 10.0 dB or more. Conclusion The outcome of noise exposure on the hearing of workers in this enterprise are severe. Risk management should be conducted according to the WS/T 755-2016.
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@#Objective - （ ） To analyze the epidemiological characteristics of occupational noise induced deafness ONID （ ） diagnosed by Guangdong Province Hospital of Occupational Disease Prevention and Control GDHOD from 2016 to 2020 and - Methods the reasons non ONID diagnosis. The data of ONID patients diagnosed in GDHOD from 2016 to 2020 were collected “ from the Occupational Disease Report Card in the Occupational Disease and Occupational Health Information Monitoring ” “ ” - System subsystem of the China Disease Prevention and Control Information System . The data of non ONID subjects were ， collected from the occupational disease diagnosis archives in the same hospital and the relevant data were analyzed Results ， ， （ ） retrospectively. Of the 1 432 subjects 824 subjects were diagnosed as ONID patients mainly of mild ONID 86.0% . （M） ， M Male patients accounted for 88.0%. The median of diagnosis age was 45.0 years old and of length of employment of ， ， ， diagnosis was 8.3 years. ONID patients were mainly found in Zhongshan Dongguan Zhuhai Jiangmen and Guangzhou City in ， ， （ ） the Pearl River Delta accounting for 67.6%. The cases distributed in 519 enterprises mainly on manufacturing 90.2% . ， - ， ； Among the 139 enterprises each enterprise had 2 11 patients worked within five years accounting for 53.9% 91.1% of the -， - - - ONID patients were distributed in large medium and small enterprises. ONID patients mainly worked in non public enterprises that accounted for 91.3%. There were 606 subjects could not be diagnosed as ONID. The main reasons for not being （ ）， diagnosed were that the weighted value of better ear hearing threshold was less than 26 dB 34.8% the working history of （ ）， occupational noise exposure was less than three years 31.5% the weighted value of better ear hearing threshold was less thanConclusion 26 dB and the average hearing threshold of binaural high frequency was less than 40 dB 16.2% . The ONID ， ， -， - patients have the characteristics of group aggregation. The Pearl River Delta manufacturing industry large medium and - - ： small non public enterprises are the key points of ONID prevention. The main reasons for not being diagnosed as ONID were ， the working history of occupational noise exposure was less than three years the weighted value of better ear hearing threshold ， - was less than 26 dB and the average high frequency hearing threshold of both ears was less than 40 dB.
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OBJECTIVE: To investigate the status and association of anxiety, depression, tinnitus and sleep quality in patients with occupational noise-induced deafness(ONID). METHODS: A total of 302 ONID patients were selected as research subjects using judgment sampling method. Their status of anxiety, depression, tinnitus and sleep quality were investigated using questionnaires of Self-Rating Anxiety Scale, Self-Rating Depression Scale, Tinnitus Handicap Inventory and Pittsburgh Sleep Quality Index. RESULTS: Among the study subjects, there were 123 cases with no anxiety or depression, 46 cases with simple anxiety or depression, and 133 cases with combined anxiety and depression, accounting for 40.7%, 15.3% and 44.0%, respectively. The incidence of tinnitus and sleep disorder were 77.8%(235/302) and 48.0%(145/302), respectively. The total scores of tinnitus and sleep quality in simple anxiety or depression group were higher than those with no anxiety or depression(all P<0.01). The total scores of tinnitus and sleep quality in combined anxiety and depression group were higher than that with no anxiety and depression, and simple anxiety or depression group(all P<0.01). Among the research subjects, the incidence of tinnitus and sleep disorder from high to low were combined anxiety and depression group, simple anxiety or depression group, and no anxiety and depression group(tinnitus: 85.7% vs 76.1% vs 69.9%, sleep disturbance: 82.0% vs 37.0% vs 15.5%, all P<0.01). The standard scores of anxiety and depression in ONID patients were positively correlated with the total scores of tinnitus and sleep quality(correlation coefficients were 0.63, 0.72, 0.63, 0.69, all P<0.01). CONCLUSION: ONID patients can be accompanied by varying degrees of anxiety and depression. The existence of anxiety and depression may lead to increased tinnitus and decreased sleep quality in ONID patients.
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OBJECTIVE: To explore the status and its influencing factors of anxiety symptoms in patients with occupational noise-induced deafness(ONID). METHODS: A total of 220 ONID patients were selected as the ONID group,and 200 healthy participants without noise exposure were selected as the control group by judge sampling method.The two groups were investigated by the Self-Rating Anxiety Scale, Self-Rating Depression Scale and Pittsburgh Sleep Quality Index. The Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus, and pure-tone audiometry was used to assess the degree of tinnitus and hearing impairment in the ONID group. RESULTS: The incidence of anxiety, depression, and sleep disorder were higher in the ONID group than that in the control group(52.7% vs 9.0%, 55.0% vs 15.0%, 52.3% vs 7.0%, P<0.05). In ONID with anxiety subgroup, the duration of disease was longer(1.0 vs 2.0 years, P<0.01), incidences of tinnitus, depression and sleep disorder were higher than those in ONID without anxiety subgroup(92.3% vs 100.0%, 18.3% vs 87.9%, 19.2% vs 81.9%, P<0.01). The result of multivariate logistic regression analysis showed that the longer the duration of disease and the more severe of the tinnitus, the higher the risk of anxiety symptoms in patients with ONID [the odds ratio(OR) and its 95% confidence interval(CI) were 1.35(1.10-1.65) and 2.94(1.56-5.54) respectively, P<0.01]. The risk of anxiety in patients with sleep disorders was higher than those without sleep disorders [OR(95%CI) was 12.78(5.90-27.64), P<0.01]. CONCLUSION: The ONID patients are more likely to have anxiety. The duration of disease, severity of tinnitus and sleep disorders are the risk factors causing anxiety in ONID patients.
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OBJECTIVE: To explore the effect of electroacupuncture treatment on the levels of cortisol and immune factors in patients with occupational noise-induced deafness(ONID) combined with depressive symptoms. METHODS: A total of 78 ONID patients combined with depressive symptoms were randomly divided into control group(40 cases) and electroacupuncture group(38 cases) by a random number table method. The control group received routine therapy, while the electroacupuncture group was treated with routine therapy plus electroacupuncture on alternate days, 3 times a week for 4 consecutive weeks. The levels of salivary cortisol, as well as the serum levels of cortisol, tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) and C-reactive protein(CRP) of the two groups were observed and compared before and after treatment. RESULTS: Before treatment, the levels of saliva cortisol in the morning and night, and the serum levels of cortisol, IL-6, TNF-α and CRP in the two groups were compared, and the differences were not statistically significant(P>0.05). After treatment, the serum cortisol level of patients in electroacupuncture group reduced than that before treatment in the same group(P<0.05). However, there was no significant difference in the levels of salivary cortisol in the morning and night, and serum cortisol before and after treatment both in control group and electroacupuncture group(P>0.05). After treatment, the serum levels of IL-6 and TNF-α decreased in electroacupuncture group as compared with those before treatment and those after treatment in control group(P<0.01). CONCLUSION: Electroacupuncture treatment could reduce the levels of TNF-α and IL-6 in serum of ONID patients combined with depressive symptoms. The regulation of electroacupuncture on the inflammatory cytokines may be one of the mechanisms in treating ONID combined with depressive symptoms.
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OBJECTIVE: To analyze the current status and influencing factors of hearing loss in the suspected occupational noise-induced deafness(ONID) among welders in Nantong City. METHODS: A total of 3 265 noise-exposed welders who underwent the occupational health examination in Nantong City in 2017 were collected as the study subjects by judgment sampling method. The data of occupational medical examination of these welders was collected. The incidence and influencing factors of suspected ONID were analyzed. RESULTS: A total of 159 cases of suspected ONID were detected and the detection rate was 4.87%. The suspected ONID was mainly mild noise-induced deafness, accounting for 82.39%(131/159). The abnormal rates of 4 000 Hz hearing threshold in the left and right ears of suspected ONID cases were higher than that of 3 000 Hz in the corresponding ears(100.00% vs 93.08%, 98.11% vs 92.45%, P<0.05). The multivariate logistic regression analysis showed that age and length of service during noise exposure were risk factors for suspected ONID(P<0.05). The risks of suspected ONID among welders in general equipment manufacturing industry, metal products industry, other industries, electrical machinery and equipment manufacturing industry, and manufacturing of equipment of railways, ships, aerospace and other transportations were lower than that in computer, communication and other electronic equipment manufacturing industry. The odds ratio(OR) and 95% confidence interval(95%CI) were 0.341(0.155-0.752), 0.264(0.112-0.620), 0.149(0.038-0.582), 0.110(0.035-0.341), 0.418(0.179-0.972), respectively. The risk of suspected ONID among welders in state-owned enterprises was lower than that in private enterprises(OR=0.254, 95%CI 0.116-0.559,P<0.01). CONCLUSION: The age, service length of noise exposure, type of enterprise industry and economy of enterprise are all influencing factors of suspected ONID in electric welding workers in Nantong City.
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OBJECTIVE: To observe the effect of integrated Chinese and Western medicine for the treatment of occupational noise-induced deafness( ONID). METHODS: A total of 80 ONID patients were selected and randomly divided into control group and treatment group by judgment sampling method,with 40 cases in each group. The control group received routine western medicine treatment using mecobalamin tablets,vitamin B complex,nerve growth factor and hyperbaric oxygen. The treatment group received routine western medicine as the control group,plus acupuncture,moxibustion and auricular point pressing. The patients in both groups were treated continuously for 30 days. The questionnaire of conscious,the selfconscious symptoms such as tinnitus,headache,dizziness and insomnia were recorded in these two groups before and after treatment. Pure tone audiometry was performed on the patients at the same time. RESULTS: After treatment,the binaural high frequency threshold average( BHFTA) and threshold of weighted value of the left and right ears in the treatment group were better than that in the same group before treatment( P < 0. 05). The difference of the BHFTA and threshold of weighted value of the right ear in the treatment group before and after treatment was higher than that in the control group( P < 0. 05). After treatment,the symptoms of tinnitus,headache,dizziness and insomnia in the two groups were better than those in the same group before treatment. The total improvement rate of tinnitus and dizziness symptoms in the treatment group was higher than that in the control group( P < 0. 05). CONCLUSION: The treatment with integrated traditional Chinese and Western medicine for ONID can improve the hearing level of patients,effectively alleviate the accompanying self-conscious symptoms,and is suitable for promotion in clinical use.
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OBJECTIVE: To explore the 2014 edition of the diagnostic criteria of occupational noise-induced deafness on the assessment of hearing loss in occupational health examination. METHODS: A total of 835 noise-exposed workers were selected as study subjects by cluster sampling method. The hearing threshold results were compared through two different editions of criteria: GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness( GBZ 49-2007) and GBZ 49-2014 Diagnosis of Occupational Boise-induced Deafness( GBZ 49-2014). RESULTS: The binaural high frequency threshold average calculated by GBZ 49-2007 was lower than that of GBZ 49-2014 [( 46. 8 ± 8. 1) vs( 49. 2 ± 8. 0) d B,P < 0. 01].The speech frequency threshold average of the good ear calculated by GBZ 49-2007 was lower than the monaural threshold of weighted value of the good ear of GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 22. 0 ± 3. 3),P < 0. 01]. The speech frequency threshold average of the good ear and the monaural threshold of weighted value of the good ear calculated after age and sex correction using GBZ 49-2007 were lower than that calculated by using GBZ 49-2014 [( 18. 8 ± 3. 6) vs( 19. 4 ± 3. 6),( 21. 5 ±3. 4) vs( 22.0 ±3.3),P <0.05]. The detection rate of suspected occupational noise-induced deafness GBZ 49-2014 was higher than that of GBZ 49-2007( 6. 35% vs 2. 87%,P < 0. 01). CONCLUSION: In occupational health examination,the diagnostic criteria of GBZ 49-2014 can diagnose patients as suspected occupational noise-induced deafness easier than that of GBZ 49-2007.
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OBJECTIVE: To investigate the levels of cortisol and inflammatory factors and their influencing factors in patients with occupational noise-induced hearing loss(ONID). METHODS: A total of 106 ONID patients were selected as the ONID group, and 50 healthy participants without noise exposure were selected as the control group by judge sampling method. The levels of salivary cortisol in the two groups were detected by enzyme-linked immunosorbent assay.The serum levels of cortisol, tumor necrosis factor alpha(TNF-α), interleukin-6(IL-6) and C-reactive protein(CRP) in the peripheral blood were detected by electrochemiluminescence assay. Tinnitus Handicap Inventory was used to evaluate the disability levels of tinnitus in ONID patients. RESULTS: The level of salivary cortisol in the morning and in the nighttime, and cortisol, TNF-α, IL-6 in the serum were higher in the ONID group compared with that in the control group(P<0.05). There was no significant difference in the serum level of CRP between these two groups(P>0.05). Spearman correlation analysis results showed that the level of cortisol in the saliva and in the serum was not correlated with TNF-α and IL-6(P>0.05). Analysis of multiple linear regression showed that the levels of serum cortisol and salivary cortisol in the morning in the ONID patients were positively correlated with noise exposure level(P<0.05). The level of TNF-α in the serum was positively correlated with tinnitus score(P<0.05). CONCLUSION: Hyperactivity of hypothalamus-pituitary-adrenal axis and inflammation activation may exist in patients with ONID. The cortisol can be used as a biomarker for the effect of noise-stress.
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OBJECTIVE: To explore the application effect of clinical nursing pathway( CNP) in nursing care on patients with occupational noise-induced deafness( ONID) under medical observation.METHODS: The patients with ONID under medical observation in hospital were randomly selected and divided into CNP group( 50 cases) and control group( 50 cases) by random number table method.The control group was given routine nursing care,and the CNP group was given CNP care according to the nursing path table.Self-Rating Anxiety Scale,Self-rating Depression Scale and SF-36 Scale were used to observe the anxiety, depression and quality of life of these two groups.The time and expenses of hospitalization,and degree of nursing satisfaction were also observed.RESULTS: Before nursing care implementation,the scores of anxiety,depression and 8 dimension of quality of life did not show statistical significance between these two groups( P > 0.05).After nursing care implementation,the improvement of anxiety,depression and quality of life in the CNP group were significantly better than that of the control group( P < 0.01).The patients in the CNP group had shorter duration of hospitalization( P < 0.01),decreased hospitalization expenses( P < 0.05),and increased nursing satisfaction( P < 0.01) compared with the control group.CONCLUSION: CNP implementation can effectively reduce the anxiety and depression symptoms of patient with ONID under medical observation during the diagnostic process of occupational diseases.It can reduce the time and costs of hospitalization,improve their quality of life and satisfaction of nursing care.CNP can be widely used in clinical practice.
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OBJECTIVE: To analyze the influencing factors of suspected occupational noise-induced deafness( ONID) in noise-exposed workers. METHODS: A total of 38 770 noise-exposed workers engaged in occupational health examination were collected as the study subjects from 2012-2016 by judgment sampling method. The data of workers' occupational medical examination was collected,and the incidence and influencing factors of suspected ONID were analyzed. RESULTS: A total of 125 cases of suspected ONID were detected and the detection rate was 0. 32%. The result of multivariate Logistic regression showed that male workers exposed to noise had a higher risk of suspected ONID than female workers( P <0. 01). The odds ratio( OR) and 95% confidence interval( CI) were 1. 98( 1. 22-3. 19). The older the age and the longer service length of workers exposed to noise,the higher the risk of suspected ONID( P < 0. 01). The ORs and 95% CIs were 1. 79(1. 43-2. 25) and 1. 84( 1. 47-2. 30) respectively. The noise-exposed workers had a higher risk of suspected ONID in foreign-funded enterprises than domestic-funded enterprises( P < 0. 01). The noise-exposed workers had a higher risk of suspected ONID in metal manufacturing industries than in non-metal manufacturing industries( P < 0. 01). The ORs and 95% CIs were 1. 83(1. 19-2. 82) and 2. 02(1. 40-2. 94) respectively. CONCLUSION: The incidence of suspected ONID is affected by factors of gender,age,length of service,economy type of enterprises and industry type.
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OBJECTIVE: To analyze the impact of revised version of GBZ 49-2014 Diagnostic of Occupational Noise-induced Deafness on the diagnosis of occupational noise-induced deafness( ONID). METHODS: A total of 77 patients applied for ONID diagnosis and identification were selected as study subjects by judgment sampling method. The pure tone audiometry data were collected and diagnosed based on the criteria of GBZ 49-2014 and GBZ 49-2007 Diagnostic Criteria of Occupational Noise-induced Deafness. The changes of the diagnostic audiometry and the ONID diagnostic classification were compared. RESULTS: The monaural threshold of weighted value of the good ear calculated by GBZ 49-2014 was higher than the speech frequency threshold average of the good ear of GBZ 49-2007 [( 32. 4 ± 10. 3) vs( 29. 8 ± 10. 6) dB,P <0. 01]. The binaural high frequency threshold average calculated by GBZ 49-2014 was higher than that of GBZ 49-2007[( 50. 5 ± 13. 3) vs( 49. 1 ± 13. 6) dB,P < 0. 01]. The ONID diagnosis conclusions diagnosed by using GBZ 49-2014 and GBZ 49-2007 were consistent( Kappa value = 0. 92,P < 0. 01). There was statistical difference in the ONID diagnostic classifications diagnosed by using GBZ 49-2014 and GBZ 49-2007( P < 0. 05). Three ONID patients diagnosed as non ONID by GBZ 49-2007 were diagnosed as mild ONID by using GBZ 49-2014,and five cases diagnosed as mild ONID by GBZ 49-2007 were diagnosed as moderate ONID by using GBZ 49-2014. CONCLUSION: The diagnostic audiometry calculated based on GBZ 49-2014 is higher than that based on GBZ 49-2007. The number of ONID patients increased and the diagnostic classification became serious when the diagnosis was made based on GBZ 49-2014.