【摘要】 目的 评估某金属工具制造企业作业工人职业性噪声接触所致听力损失的风险，并进行风险分级与风险管理。方法 采用方便抽样法，选择河北某金属工具制造企业91名男性噪声作业工人为研究对象，开展现场职业卫生学调查和个体接触噪声强度测量。根据ISO 1999:2013 (E) Acoustics-Estimation of Noise-Induced Hearing Loss预测作业工人发生高频听力损失（HFHL）和职业性噪声聋（ONID）的风险，依据WS/T 754—2016《噪声职业病危害风险管理指南》（以下简称“WS/T 754—2016”）进行风险分级和风险管理。结果 该企业的开刃工、冲片工、辊锻工-锄头、冲孔工、辊锻工-锹和木工等6个岗位作业工人个体接触噪声强度均超过国家职业接触限值，最大值为91.2～104.1 dB(A)；其中，开刃工、冲片工和辊锻工-锄头岗位为该企业的噪声危害关键控制点。研究对象的HFHL检出率为24.2%,ONID检出率为8.8%。风险预测结果显示，基于研究对象实际的噪声接触时间和年龄，预测其发生HFHL、ONID的风险分别为1.7%～48.8%和0.0%～29.5%；其工作到50.0、55.0和60.0岁时单纯由职业性噪声接触引起HFHL的风险分别为11.4%～64.7%、16.4%～65.1%和17.2%～59.4%，引起ONID的风险分别为0.0%～45.5%、4.2%～51.7%和5.9%～57.4%。除开刃工岗位外，其余5个岗位的潜在噪声引起的永久性听阈位移（NIPTS）中值预测值均低于NIPTS实际值，差值为3.0～28.3 dB；其中，低估10.0 dB以上的占73.3%。结论 该企业噪声对作业工人听力的危害后果较为严重，需根据WS/T 754—2016进行风险管理。更多还原

【Abstract】 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.更多还原