【摘要】 目的 基于职业人群的职业史、岗位噪声水平及暴露时间，探索职业相关的累积噪声暴露定量评估方法，为开展噪声所致慢性疾病风险的职业流行病学研究提供可行的暴露评估策略。方法 依据等能量原理，在岗位8 h工作日噪声等效声级[dB(A)]的基础上，以工作持续时间（累积天数）为权数，将较长时间内的噪声暴露按能量累积，提出职业相关的累积噪声剂量（Dnoise）估算指标，并采用线性回归模型分析和比较不同类型噪声暴露评估指标（定性指标、定量指标和剂量指标）与高频听力损失的关系，以验证剂量指标的准确性。结果 Dnoise指标相比于定性指标（岗位是否接噪）和定量指标（岗位噪声强度），对高频听力损失有更好的解释度（R2=0.221）。从回归系数来看，在调整人口学特征后的回归模型中，仅有Dnoise指标在模型4中达到了统计学检验水准（t=2.28, P<0.05），充分论证了Dnoise指标的合理性。结论 Dnoise指标具有理论合理性及现实可行性，可用于职业流行病学相关研究，特别是长期高噪声暴露与慢性疾病风险的相关研究，可根据职业史回溯和噪声检测结果对研究对象职业相关的累积噪声暴露进行个体化的评估。更多还原

【Abstract】 Objective To explore the quantitative assessment method of occupation-related cumulative noise exposure based on the occupational history, occupational noise level, and exposure time of occupational population, to provide a feasible ex-posure assessment strategy for occupational epidemiological study on the risk of chronic diseases caused by noise. Methods According to the equal energy principle, on the basis of the noise equivalent sound level(dB(A)) of the 8-hour working day,taking the working duration(cumulative days) as the weight, the noise exposure for a long time was accumulated according to energy, and the occupation-related cumulative noise dose(Dnoise) estimation index was put forward. The linear regression model was used to analyze and compare the relationship between different types of noise exposure assessment indexes(qualitative index, quantitative index, and dose index) and high frequency hearing loss in order to verify the accuracy of dose in-dex. Results Compared with the qualitative index(whether the post was exposed to noise or not) and the quantitative index(noise intensity), the Dnoiseindex had a better degree of explanation for high-frequency hearing loss(R2=0.221). From the point of view of regression coefficient, in the regression model after adjusting demographic characteristics, only Dnoiseindex reached the level of statistical test in model 4(t=2.28, P<0.05), which fully demonstrated the rationality of Dnoiseindex. Conclusion The Dnoiseindex has theoretical rationality and practical feasibility and can be used in the study of occupational epidemiology,especially in the study of long-term high noise exposure and chronic disease risk. The cumulative noise exposure of the subjects can be individually evaluated according to the results of retrospective occupational history and noise detection.更多还原